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Solberg MA, Peters RM, Templin TN. The Psychometric Properties of the Brief COPE Among Young Adults. J Nurs Meas 2024; 32:206-215. [PMID: 37348894 DOI: 10.1891/jnm-2022-0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Background and Purpose: Although the Brief COPE is a widely used instrument to measure coping, its factor structure is understudied in young adults. The purpose of this article was to determine the psychometric properties of the dispositional version of the Brief COPE among young adults. Methods: Two hundred young adults completed the dispositional version of the Brief COPE. Measures of depression, anxiety, and stress tested predictive validity. Confirmatory factor analyses and exploratory structural equation modeling were conducted. Results: The final model achieved good fit (minimum discrepancy/degrees of freedom = 1.59; comparative fit index = .93; standardized root mean square residual = .07). Three second-order factors were identified: adaptive (α = .81), support (α = 78), and disengaged coping (α = 71). Adaptive and disengaged coping were differentially associated with mental health outcomes. Conclusions: The results are consistent with a growing body of evidence to support the construct validity of the Brief COPE.
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Kabunga A, Kigongo E, Okalo P, Udho S, Grace AA, Tumwesigye R, Akello AR, Musinguzi M, Acup W, Nabaziwa J, Shikanga EM, Namata H. Burnout and coping mechanisms among healthcare professionals in central Uganda. Front Psychiatry 2024; 15:1373743. [PMID: 38686129 PMCID: PMC11056560 DOI: 10.3389/fpsyt.2024.1373743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 03/26/2024] [Indexed: 05/02/2024] Open
Abstract
Background The escalating global prevalence of burnout among healthcare professionals poses a serious health concern. Recent studies focus on prevalence and predictors of burnout among healthcare providers, emphasizing the need for well-being interventions. This study investigates burnout and coping mechanisms among healthcare professionals in central Uganda, addressing the dearth of knowledge about coping strategies specific to the region. Methods An analytical facility cross-sectional study was conducted in five healthcare facilities in central Uganda between June to July 2023. Participants included physicians, nurses, and technicians actively engaged in direct patient care. Data were collected using socio-demographic surveys, the Professional Quality of Life (ProQOL-5), and the Brief-COPE tools. Results The study revealed a high prevalence of burnout, with 39.8% of participants experiencing significant levels. Active coping, positive reframing, and denial were negatively correlated with low burnout levels. Dysfunctional coping, specifically self-distraction and denial, showed positive correlations with average and high burnout levels. Emotion-focused coping mechanisms were not employed across burnout levels. Conclusions The results emphasize the demanding nature of healthcare roles in the region and highlight the need for comprehensive, context-specific interventions to address burnout globally. While some healthcare professionals utilized adaptive strategies such as seeking social support, engaging in self-care activities, and utilizing problem-solving skills, others resorted to maladaptive coping mechanisms such as substance use and avoidance behaviors. This dichotomy highlights the need for targeted interventions to promote adaptive coping strategies and mitigate the negative impact of maladaptive behaviors on individual well-being and patient care.
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Affiliation(s)
- Amir Kabunga
- Department of Psychiatry, Faculty of Medicine, Lira University, Lira, Uganda
| | - Eustes Kigongo
- Department of Environmental Health and Disease Control, Faculty of Public Health, Lira University, Lira, Uganda
| | - Ponsiano Okalo
- Department of Psychiatry, Faculty of Medicine, Lira University, Lira, Uganda
| | - Samson Udho
- Department of Midwifery, Faculty of Nursing and Midwifery, Lira University, Lira, Uganda
| | - Anna Auma Grace
- Department of Midwifery, Faculty of Nursing and Midwifery, Lira University, Lira, Uganda
| | - Raymond Tumwesigye
- Department of Midwifery, Faculty of Nursing and Midwifery, Lira University, Lira, Uganda
| | - Anne Ruth Akello
- Department of Environmental Health and Disease Control, Faculty of Public Health, Lira University, Lira, Uganda
| | - Marvin Musinguzi
- Department of Community Health, Faculty of Public Health, Lira University, Lira, Uganda
| | - Walter Acup
- Department of Community Health, Faculty of Public Health, Lira University, Lira, Uganda
| | - Jannat Nabaziwa
- Department of Community Health, Faculty of Public Health, Lira University, Lira, Uganda
| | | | - Haliama Namata
- Department of Mental Health, Makerere University, Kampala, Uganda
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Xu RH, Chen C. Moderating Effect of Coping Strategies on the Association Between the Infodemic-Driven Overuse of Health Care Services and Cyberchondria and Anxiety: Partial Least Squares Structural Equation Modeling Study. J Med Internet Res 2024; 26:e53417. [PMID: 38593427 DOI: 10.2196/53417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/14/2023] [Accepted: 03/22/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to a substantial increase in health information, which has, in turn, caused a significant rise in cyberchondria and anxiety among individuals who search for web-based medical information. To cope with this information overload and safeguard their mental well-being, individuals may adopt various strategies. However, the effectiveness of these strategies in mitigating the negative effects of information overload and promoting overall well-being remains uncertain. OBJECTIVE This study aimed to investigate the moderating effect of coping strategies on the relationship between the infodemic-driven misuse of health care and depression and cyberchondria. The findings could add a new dimension to our understanding of the psychological impacts of the infodemic, especially in the context of a global health crisis, and the moderating effect of different coping strategies on the relationship between the overuse of health care and cyberchondria and anxiety. METHODS The data used in this study were obtained from a cross-sectional web-based survey. A professional survey company was contracted to collect the data using its web-based panel. The survey was completed by Chinese individuals aged 18 years or older without cognitive problems. Model parameters of the relationships between infodemic-driven overuse of health care, cyberchondria, and anxiety were analyzed using bootstrapped partial least squares structural equation modeling. Additionally, the moderating effects of coping strategies on the aforementioned relationships were also examined. RESULTS A total of 986 respondents completed the web-based survey. The mean scores of the Generalized Anxiety Disorder-7 and Cyberchondria Severity Scale-12 were 8.4 (SD 3.8) and 39.7 (SD 7.5), respectively. The mean score of problem-focused coping was higher than those of emotion- and avoidant-focused coping. There was a significantly positive relationship between a high level of infodemic and increased overuse of health care (bootstrapped mean 0.21, SD 0.03; 95% CI 0.1581-0.271). The overuse of health care resulted in more severe cyberchondria (bootstrapped mean 0.107, SD 0.032) and higher anxiety levels (bootstrapped mean 0.282, SD 0.032) in all the models. Emotion (bootstrapped mean 0.02, SD 0.008 and 0.037, SD 0.015)- and avoidant (bootstrapped mean 0.026, SD 0.009 and 0.049, SD 0.016)-focused coping strategies significantly moderated the relationship between the overuse of health care and cyberchondria and that between the overuse of health care and anxiety, respectively. Regarding the problem-based model, the moderating effect was significant for the relationship between the overuse of health care and anxiety (bootstrapped mean 0.007, SD 0.011; 95% CI 0.005-0.027). CONCLUSIONS This study provides empirical evidence about the impact of coping strategies on the relationship between infodemic-related overuse of health care services and cyberchondria and anxiety. Future research can build on the findings of this study to further explore these relationships and develop and test interventions aimed at mitigating the negative impact of the infodemic on mental health.
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Affiliation(s)
- Richard Huan Xu
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, China (Hong Kong)
| | - Caiyun Chen
- Nanjing Academy of Administration, Nanjing, China
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Simione L, Gnagnarella C. Humor Coping Reduces the Positive Relationship between Avoidance Coping Strategies and Perceived Stress: A Moderation Analysis. Behav Sci (Basel) 2023; 13:bs13020179. [PMID: 36829408 PMCID: PMC9952361 DOI: 10.3390/bs13020179] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
Humor is considered an adaptive coping strategy as it could reduce the burden of perceived stress and increase positive emotional states when dealing with stressful situations. Humor has been reported in several models as a rather independent strategy that can be correlated with both approach-based coping strategies and avoidance-based coping strategies. Humor can be defined as a hedonistic escapism strategy that would work better in the presence of unpredictable or uncontrollable stressors, such as the spread of the COVID-19 pandemic and its related confinement measures. Therefore, during such a stressful event, humor would have increased the positive effect of the approach coping style on mental health and reduced the negative effect of the avoidance coping style. Based on this hypothesis, we conducted a cross-sectional study with a moderation analysis in which we assessed the interaction of humor with both approach-based and avoidance-based coping styles on perceived stress in a large sample of Italian participants collected in April and May 2021. Despite some limitations related to sampling and study design, the results obtained partially support our hypothesis, as we observed that humor had a significant moderating effect on the relationship between avoidance coping and psychological distress, with a reduction of perceived stress while using such a coping style in the presence of a medium to high level of humor. On the other hand, we did not observe a significant moderating effect of humor on the relationship between the approach coping style and perceived stress. In general, our results support the beneficial effect of humor on mental health and highlight a special role for humor as a moderator of other coping strategies.
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Affiliation(s)
- Luca Simione
- Istituto di Scienze e Tecnologie della Cognizione, ISTC, CNR, 00185 Rome, Italy
- Correspondence:
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Rodrigues F, Figueiredo N, Rodrigues J, Ferreira R, Hernández-Mendo A, Monteiro D. A Comprehensive Review and Bifactor Modeling Analysis of the Brief COPE. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221108127. [PMID: 36305610 PMCID: PMC9619253 DOI: 10.1177/00469580221108127] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The Brief COPE is a measure of coping strategies that contains 14 factors. The purpose of this research was twofold: (a) examine the psychometric proprieties of the Brief Cope in previous studies; and (b) perform Confirmatory Factor Analyses (CFA) with second-order model and bifactor model specifications that could be used to assess the best model that represents the 14 coping strategies inherent to the instrument. In order to meet the first objective, a bibliographic review of published peer-reviewed studies between 1997 and 2021 was conducted. Results from the review identified 50 studies, of which 21 used exploratory factor analysis, 28 CFA and one study test-retest analysis. Seventeen studies used the entire correlated 14-factor structure. However, only 11 studies conducted a CFA. For the second objective, a sample of 472 working class individuals (female = 278) with a mean work experience of 19.06 years (SD = 11,92) were recruited. We tested several model specifications, convergent and discriminant validity analysis. We found the correlated 14-factor structure of the Brief COPE to have good psychometric properties. The second-order and bifactor model specifications displayed poor fit or did not converge, respectively. The measure showed good convergent and discriminant validity, and the subscales showed adequate internal consistency. We provide further validity and reliability of the correlated 14-factor structure, evidencing that this measure can assess coping mechanisms. Second-order model specifications need further testing and empirical evidence to support such hierarchical categorization.
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Affiliation(s)
- Filipe Rodrigues
- ESECS – Polytechnique of Leiria, Leiria, Portugal,Life Quality Research Centre, Rio Maior, Portugal
| | - Nuno Figueiredo
- ESECS – Polytechnique of Leiria, Leiria, Portugal,Nuno Figueiredo, Instituto Politécnico de Leiria Escola Superior de Educação e Ciências Sociais, Rua Dr. João Soares, Apartado 4045, Leiria 2411-901, Portugal.
| | - José Rodrigues
- Life Quality Research Centre, Rio Maior, Portugal,Sport Science School of Rio Maior – Polytechnique Institute of Santarém (ESDRM-IPSantarém), Rio Maior, Portugal
| | - Regina Ferreira
- Life Quality Research Centre, Rio Maior, Portugal,Health Science School – Polytechnique Institute of Santarém, Santarém, Portugal
| | | | - Diogo Monteiro
- ESECS – Polytechnique of Leiria, Leiria, Portugal,Life Quality Research Centre, Rio Maior, Portugal,Research Center in Sport, Health and Human Development, Vila Real, Portugal
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Costa C, Teodoro M, De Vita A, Giambò F, Mento C, Muscatello MRA, Alibrandi A, Italia S, Fenga C. Factors Affecting Perceived Work Environment, Wellbeing, and Coping Styles: A Comparison between Physicians and Nurses during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11104. [PMID: 36078818 PMCID: PMC9518450 DOI: 10.3390/ijerph191711104] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic is a current emergency worldwide. All the consequent changes in sanitary systems have negatively affected the work-life balance. In particular, healthcare workers suffered from anxiety, stress, and depression, mostly nurses compared to physicians. To handle this situation, the adoption of different coping strategies has played a strategic role in psychophysical wellbeing. Our main goal is to the assess the perception of work environment and wellbeing (EQ-5D questionnaire), as well as to analyze possible differences in coping styles between physicians and nurses (brief COPE questionnaire). The arising differences were compared between the two groups, and associations with variables were assessed through a bivariate correlation analysis. This cross-sectional study was conducted from November to December 2020 through an online survey. A total of 172 respondents (117 physicians and 55 nurses), of which 102 were women and 70 were men, accepted to join the study. Our results showed that physicians referred a higher perception of wellbeing, and nurses reported an increased perception of work activity and efficiency, along with an unchanged economic status. The most frequently adopted coping strategies were Active and Planning (self-sufficient coping). Physicians showed a greater tendency to use avoidant coping strategies. More-experienced nurses and physicians were less prone to adopt socially supported coping strategies, emphasizing the need for novel organizational measures at the social dimension that favored sharing and interaction between peers. Future research should aim to further investigate the relationship between the perception of work environment and coping strategies in order to identify risk factors to be prevented by promoting adequate measures at an organizational level.
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Affiliation(s)
- Chiara Costa
- Clinical and Experimental Medicine Department, University of Messina, 98125 Messina, Italy
| | - Michele Teodoro
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, 98125 Messina, Italy
| | - Annalisa De Vita
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, 98125 Messina, Italy
| | - Federica Giambò
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, 98125 Messina, Italy
| | - Carmela Mento
- Psychiatric Unit, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Clinical Psychology, University of Messina, 98125 Messina, Italy
| | - Maria Rosaria Anna Muscatello
- Psychiatric Unit, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy
| | - Angela Alibrandi
- Department of Economics, University of Messina, 98125 Messina, Italy
| | - Sebastiano Italia
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, 98125 Messina, Italy
| | - Concettina Fenga
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, 98125 Messina, Italy
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Coping and rumination as predictors of posttraumatic growth and depreciation. Chin J Traumatol 2022; 25:264-271. [PMID: 35304016 PMCID: PMC9458987 DOI: 10.1016/j.cjtee.2022.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 01/28/2022] [Accepted: 02/16/2022] [Indexed: 02/04/2023] Open
Abstract
PURPOSE The present study examined the joint impact of coping and rumination after trauma on posttraumatic growth (PTG) and posttraumatic depreciation (PTD) based on the PTG model. METHODS A cross-sectional study was conducted between October 2017 and May 2018. A sample of 253 individuals who had experienced a traumatic event in the last two years, was included. Participants completed an online self-reported survey, including demographic variables, trauma characteristics, the German Posttraumatic Growth and Depreciation Inventory - Expanded, the Brief COPE Inventory, and the Event Related Rumination Inventory. An analysis of correlation, a principal component analysis and hierarchical regression analyses were conducted. Statistical analyses were undertaken on SPSS (version 25.0; IBM, New York, USA). RESULTS After controlling for the effects of personal and trauma characteristics, self-sufficient coping and socially supported coping were found to favor the emergence of PTG. Event-related and recent deliberate rumination were positively related to PTG. Avoidant-focused coping and recent intrusive rumination were positively associated with PTD. Overall, the final models accounted for 46% and 58% of the variance in PTG and PTD. CONCLUSION Our findings confirm the PTG model and support the central role of deliberate rumination, self-sufficient coping and socially supported coping in the development of PTG. Our results indicate that a similar model of PTD with comparable influencing factors can be assumed: if the individual is stuck in ongoing intrusive rumination and uses more avoidance-focused coping, it might lead to more reports of PTD.
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Hill ML, Loflin M, Nichter B, Na PJ, Herzog S, Norman SB, Pietrzak RH. Cannabis use among U.S. military veterans with subthreshold or threshold posttraumatic stress disorder: Psychiatric comorbidities, functioning, and strategies for coping with posttraumatic stress symptoms. J Trauma Stress 2022; 35:1154-1166. [PMID: 35275431 DOI: 10.1002/jts.22823] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/27/2021] [Accepted: 01/19/2022] [Indexed: 11/07/2022]
Abstract
Cannabis use is common among individuals with posttraumatic stress disorder (PTSD) symptoms, but its impact on psychiatric symptoms and functioning in this population is unclear. To clarify the clinical and functional correlates of cannabis use in individuals with PTSD symptoms, we analyzed data from the 2019-2020 National Health and Resilience in Veterans Study, a nationally representative survey of U.S. military veterans. Participants with current subthreshold or full PTSD (N = 608) reported on their past-6-month cannabis use and current psychiatric symptoms, functioning, treatment utilization, and PTSD symptom management strategies. Veterans with subthreshold/full PTSD who used cannabis more than weekly were more likely to screen positive for co-occurring depression, anxiety, and suicidal ideation than those who did not use cannabis, ORs = 3.4-3.8, or used cannabis less than weekly, ORs = 2.7-3.7. Veterans who used cannabis more than weekly also scored lower in cognitive functioning than veterans with no use, d = 0.25, or infrequent use, d = 0.71, and were substantially more likely to endorse avoidance coping strategies, ORs = 8.2-12.2, including substance use, OR = 4.4, and behavioral disengagement, ORs = 2.7-9.1, to manage PTSD symptoms. Despite more psychiatric and functional problems, veterans with frequent cannabis use were not more likely to engage in mental health treatment, ORs = 0.87-0.99. The results suggest enhanced cannabis use screening, interventions targeting risky use, and strategies promoting treatment engagement may help ameliorate more severe clinical presentations associated with frequent cannabis use among veterans with subthreshold/full PTSD.
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Affiliation(s)
- Melanie L Hill
- Department of Psychiatry, University of California, San Diego, California, USA.,VA San Diego Healthcare System, San Diego, California, USA
| | - Mallory Loflin
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Brandon Nichter
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Peter J Na
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Sarah Herzog
- Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, New York, USA.,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York, USA
| | - Sonya B Norman
- Department of Psychiatry, University of California, San Diego, California, USA.,VA San Diego Healthcare System, San Diego, California, USA.,National Center for PTSD, White River Junction, Vermont, USA.,VA Center of Excellence for Stress and Mental Health, San Diego, California, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,National Center for PTSD, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
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Mercier CM, Abbott DM, Ternes MS. Coping Matters: An Examination of Coping among Black Americans During COVID-19. COUNSELING PSYCHOLOGIST 2022. [DOI: 10.1177/00110000211069598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Using a critical race theory framework and a convergent mixed-method design, this study examined the relationship between coping with stress and psychological distress among Black U.S. Americans ( N = 155) during the COVID-19 pandemic in the context of race-based stressors (e.g., anti-Black racism). Path analysis revealed mixed support for hypotheses; avoidant coping was positively related to all measured facets of psychological distress, whereas socially supported coping was associated with none. Self-sufficient coping was negatively associated with only depressive symptoms. Qualitative analysis revealed four salient themes: (a) Race and the COVID-19 Pandemic, (b) Complex Pandemic Related Changes to Life, (c) Emotional Responses to the Pandemic, and (d) Coping with the COVID Pandemic. These themes suggested the pandemic disrupted participants’ ability to engage in, or effectively use, typically adaptive coping strategies and distress was exacerbated by fears for the safety of other Black U.S. Americans. Implications for training, practice, research, and advocacy are discussed.
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Affiliation(s)
- Caitlin M. Mercier
- Department of Psychology and Behavioral Sciences, Louisiana Tech University, Ruston, LA, USA
| | - Dena M. Abbott
- Department of Educational Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Michael S. Ternes
- Department of Psychology and Behavioral Sciences, Louisiana Tech University, Ruston, LA, USA
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Tait J, Edmeade L, Delgadillo J. Are depressed patients' coping strategies associated with psychotherapy treatment outcomes? Psychol Psychother 2022; 95:98-112. [PMID: 34617396 DOI: 10.1111/papt.12368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 07/28/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND In theory, depression is thought to be associated with deficits in adaptive and excesses in maladaptive coping strategies. This study aimed to investigate associations between coping strategies and depression treatment outcomes. METHOD Participants (N = 126) completed measures of adaptive and maladaptive coping strategies before and after accessing evidence-based psychotherapies for depression. The primary outcome was self-reported depression severity measured with the Patient Health Questionnaire (PHQ-9). Hierarchical regression was used to investigate associations between coping strategies and post-treatment depression symptoms, controlling for therapeutic alliance and relevant demographics. RESULTS Lower pre-treatment engagement coping and higher rumination predicted higher post-treatment depression, but both of these effects became non-significant after controlling for baseline depression severity. Similarly, correlations between change in rumination and change in depression were no longer significant after controlling for baseline severity. CONCLUSIONS Deficits in adaptive (engagement) and excesses in maladaptive (rumination) coping strategies may simply be proxy indicators (epiphenomena) of depression severity. PRACTITIONER POINTS Lower pre-treatment engagement coping predicted higher post-treatment depression Higher pre-treatment rumination predicted higher post-treatment depression Change in rumination during treatment correlated with change in depression symptoms However, none of the above associations remained statistically significant after controlling for baseline depression severity.
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Affiliation(s)
- James Tait
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, UK
| | | | - Jaime Delgadillo
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, UK
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Fisher JE, Rice AJ, Zuleta RF, Cozza SJ. Bereavement during the COVID-19 Pandemic: Impact on Coping Strategies and Mental Health. Psychiatry 2022; 85:354-372. [PMID: 35404761 DOI: 10.1080/00332747.2022.2051141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The COVID-19 coronavirus has caused 5.4 million deaths worldwide, including over 800,000 deaths in the United States (as of December 2021). In addition to these staggering statistics, an even greater number of individuals have died from other causes during the COVID-19 pandemic. As a result, a large portion of the global population has faced bereavement during the COVID-19 pandemic and resulting quarantine. The often rapid and unexpected nature of COVID-19 deaths and the presence of pandemic-related stressors and living restrictions make it more difficult for individuals bereaved during the pandemic to implement effective strategies for coping with the loss compared to non-pandemic periods. Quarantine-related constraints (e.g., social distancing, availability of and access to resources) impede coping strategies that have been found to be adaptive after a loss, such as supportive (e.g., seeking emotional and instrumental support) and active (e.g., problem-focused and cognitive reframing) coping, and they augment avoidant strategies (e.g., substance use, denial, and isolation) that have been found to be maladaptive. Poorer mental health outcomes (including prolonged grief disorder; PGD) have been associated with less healthy coping. This article reviews research findings regarding bereavement during the COVID-19 pandemic, discusses the effects of pandemic-related stressors on bereavement coping strategies, and proposes how different types of coping during the pandemic may account for the poorer mental health outcomes described in recent reports. Interventions for promoting adaptive coping strategies and minimizing maladaptive coping strategies are also outlined.
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12
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Palmisano AN, Norman SB, Panza KE, Petrakis IL, Pietrzak RH. PTSD symptom heterogeneity and alcohol-related outcomes in U.S. military veterans: Indirect associations with coping strategies. J Anxiety Disord 2022; 85:102496. [PMID: 34775167 DOI: 10.1016/j.janxdis.2021.102496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 10/22/2021] [Accepted: 11/01/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION This study investigated the role of coping strategies in mediating the relationship between the 7-factor model of posttraumatic stress disorder (PTSD) symptoms and alcohol misuse in veterans. METHODS Data were analyzed from 615 veterans from a nationally representative study of U.S. veterans who met criteria for probable full or subthreshold PTSD. Path analyses examined the role of self-sufficient, socially-supported, and avoidant coping strategies in mediating associations between PTSD symptom clusters and alcohol use disorder (AUD), alcohol consumption, and alcohol-related consequences. RESULTS Negative affect PTSD symptoms were associated with AUD through increased use of avoidant coping. Additionally, dysphoric arousal PTSD symptoms were associated with AUD; avoidant coping was associated with AUD and increased alcohol consumption; self-sufficient coping was associated with reduced AUD likelihood anhedonia symptoms with decreased use of self-sufficient coping; and negative affect with decreased use of socially-supported coping and increased use of avoidant coping. CONCLUSIONS Results underscore the importance of avoidant coping strategies as potential mediators of the relation between PTSD symptoms and AUD. Interventions designed to mitigate engagement in avoidant coping strategies, and to bolster engagement in self-sufficient and socially-supported strategies may help reduce alcohol misuse in veterans with full or subthreshold PTSD.
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Affiliation(s)
- Alexandra N Palmisano
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; US Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA.
| | - Sonya B Norman
- Department of Psychiatry, University of California, San Diego, CA, USA; VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA; US Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, White River Junction, VT, USA; VA San Diego Healthcare System, San Diego, CA
| | - Kaitlyn E Panza
- Department of Psychiatry, University of California, San Diego, CA, USA; VA San Diego Healthcare System, San Diego, CA
| | - Ismene L Petrakis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; US Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; US Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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13
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Help-Seeking as a Maladaptive Coping Style in the Pandemic Scenario: What Worked and What Did Not for Facing This New Stressor. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010319. [PMID: 35010578 PMCID: PMC8751196 DOI: 10.3390/ijerph19010319] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 01/02/2023]
Abstract
The spread of COVID-19 and its related confinement measures were important stressors for a large part of the global population, with massive effects on both physical and mental health. Assessing how individuals coped with such a stressor and which strategies were effective is one of the main challenges for psychological research. In this study, we aimed to investigate the coping strategies implied during the COVID-19 lockdown and their effectiveness. We recruited 374 Italian participants through convenience sampling during the first pandemic wave (April 2020). We administered to our participants an online battery of questionnaires including the Brief COPE, the use of alternative coping strategies proposed by the WHO to help people facing lockdown stress, and a range of psychological symptoms. An exploratory factor analysis conducted on the subscales of the Brief COPE revealed a three-factor structure. Following the previous literature, we named these factors engagement, disengagement, and help-seeking coping styles. In the pandemic scenario, the engagement and disengagement styles revealed the typical correlation patterns with psychological symptoms (i.e., the engagement was adaptive while the disengagement was maladaptive). Instead, contrary to previous literature, help-seeking was positively related to psychological symptoms, suggesting a mismatch between searching for help and finding it during the lockdown. This result supports the importance of evaluating the effectiveness of coping strategies in the pandemic scenario, to give more compelling and precise advice to the population.
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14
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Galica J, Liu Z, Kain D, Merchant S, Booth C, Koven R, Brundage M, Haase KR. Coping during COVID-19: a mixed methods study of older cancer survivors. Support Care Cancer 2021; 29:3389-3398. [PMID: 33404813 PMCID: PMC7786158 DOI: 10.1007/s00520-020-05929-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/02/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE Older cancer survivors are among the most vulnerable to the negative effects of COVID-19 and may need specific survivorship supports that are unavailable/restricted during the pandemic. The objective of this study was to explore how older adults (≥ 60 years) who were recently (≤ 12 months) discharged from the care of their cancer team were coping during the pandemic. METHODS We used a convergent mixed method design (QUAL+quan). Quantitative data were collected using the Brief-COPE questionnaire. Qualitative data were collected using telephone interviews to explore experiences and strategies for coping with cancer-related concerns. RESULTS The mean sample age (n = 30) was 72.1 years (SD 5.8, range 63-83) of whom 57% identified as female. Participants' Brief-COPE responses indicated that they commonly used acceptance (n = 29, 96.7%), self-distraction (n = 28, 93.3%), and taking action (n = 28, 93.3%) coping strategies. Through our descriptive thematic analysis, we identified three themes: (1) drawing on lived experiences, (2) redeploying coping strategies, and (3) complications of cancer survivorship in a pandemic. Participants' coping strategies were rooted in experiences with cancer, other illnesses, life, and work. Using these strategies during the pandemic was not new-they were redeployed and repurposed-although using them during the pandemic was sometimes complicated. These data were converged to maximize interpretation of the findings. CONCLUSIONS Study findings may inform the development or enhancement of cancer and non-cancer resources to support coping, particularly using remote delivery methods within and beyond the pandemic. Clinicians can engage a strengths-based approach to support older cancer survivors as they draw from their experiences, which contain a repository of potential coping skills.
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Affiliation(s)
- Jacqueline Galica
- School of Nursing, Queen's University, Kingston, Canada.
- Division of Cancer Care & Epidemiology, Queen's Cancer Research Institute, Kingston, Canada.
| | - Ziwei Liu
- School of Nursing, Queen's University, Kingston, Canada
| | - Danielle Kain
- Division of Palliative Medicine, Departments of Medicine and Oncology, School of Medicine, Queen's University, Kingston, Canada
| | - Shaila Merchant
- Division of General Surgery and Surgical Oncology, Queen's University, Kingston, Canada
| | - Christopher Booth
- Division of Cancer Care & Epidemiology, Queen's Cancer Research Institute, Kingston, Canada
- Cancer Centre of Southeastern Ontario, Kingston, Canada
- Department of Oncology, School of Medicine, Queen's University, Kingston, Canada
| | - Rachel Koven
- Division of Cancer Care & Epidemiology, Queen's Cancer Research Institute, Kingston, Canada
| | - Michael Brundage
- Division of Cancer Care & Epidemiology, Queen's Cancer Research Institute, Kingston, Canada
- Cancer Centre of Southeastern Ontario, Kingston, Canada
- Department of Oncology, School of Medicine, Queen's University, Kingston, Canada
- Department of Public Health Sciences, School of Medicine, Queen's University, Kingston, Canada
| | - Kristen R Haase
- School of Nursing, Faculty of Applied Science, The University of British Columbia, Vancouver, Canada
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15
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Cheng C, Yang CY, Inder K, Chan SWC. Psychometric properties of Brief Coping Orientation to Problems Experienced in patients with multiple chronic conditions: A preliminary study. Int J Nurs Pract 2021; 28:e12955. [PMID: 34062623 DOI: 10.1111/ijn.12955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 03/25/2021] [Accepted: 04/22/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Multiple chronic conditions (MCCs) are highly prevalent in primary care. Coping is an important psychological factor that influences patients' ability to adapt physically and mentally to MCCs. Testing a reliable and valid psychometric inventory is necessary to identify coping strategies before developing coping-oriented interventions. PURPOSE The purpose of this study is to examine the psychometric properties of the Chinese version of the Brief Coping Orientation to Problems Experienced (Brief COPE-CN) inventory in patients with MCCs. METHOD This study adopted a cross-sectional design. A convenience sample of 290 Chinese patients with MCCs was recruited from a tertiary hospital in East China. The Brief COPE-CN, sociodemographic characteristics and clinical data were collected using a self-reported questionnaire from November 2017 to May 2018. Factor analysis and reliability analysis were performed. RESULTS The mean age of the participants was 58.5 years (range from 23 to 95 years), and approximately half of the participants were female (49.3%). Most participants had two chronic conditions (82.1%) and reported having had MCCs for more than 2 years. The explanatory factor analysis (EFA) identified five factors in the Brief COPE-CN that explained 58.4% of the total variance. The Cronbach's α coefficients ranged from .65 to .85 for the five subscales. CONCLUSIONS The psychometric properties of the Brief COPE-CN were acceptable for use with Chinese patients with MCCs. With further evaluation, this instrument may help health-care professionals understand patients' coping and develop coping-based interventions to promote coping in this population.
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Affiliation(s)
- Cheng Cheng
- School of Nursing, Shanghai Medical College, Fudan University, Shanghai, China
| | - Cong-Yan Yang
- Department of Nursing, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Kerry Inder
- School of Nursing and Midwifery, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Sally Wai-Chi Chan
- UON Singapore Department, The University of Newcastle Singapore, Singapore
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16
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Solberg MA, Gridley MK, Peters RM. The Factor Structure of the Brief Cope: A Systematic Review. West J Nurs Res 2021; 44:612-627. [PMID: 33942676 DOI: 10.1177/01939459211012044] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Brief COPE is a widely used measure of coping that contains 28 items on 14 factors. Researchers have shortened the inventory, but the factor structure remains debated. A systematic review of peer-reviewed studies published in English between 1997 and 2021 was conducted to determine if a more parsimonious number of factors could be identified. Cumulative Index for Nursing and Allied Health, PsycINFO, PsycARTICLES, Medline, PubMed, and Scopus databases were searched using keywords "Brief COPE" and "factor, valid*, or psychometric.*" Searching yielded 573 articles; cited references added 38; 85 articles met inclusion criteria. Principal components analysis and confirmatory factor analysis were major analytic strategies used (28% and 27%, respectively). Only eight studies analyzed the original 14-factor structure. Factors identified ranged from 2 to 15, with dichotomous factors most frequently identified (25%; n = 21). A smaller number of factors may be able to represent the Brief COPE. Research is needed to test a condensed instrument.
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17
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Marais-Opperman V, Rothmann S, van Eeden C. Stress, flourishing and intention to leave of teachers: Does coping type matter? SA JOURNAL OF INDUSTRIAL PSYCHOLOGY 2021. [DOI: 10.4102/sajip.v47i0.1834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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18
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Wang AWT, Chang CS, Hsu WY. The Double-Edged Sword of Reflective Pondering: The Role of State and Trait Reflective Pondering in Predicting Depressive Symptoms Among Women With Breast Cancer. Ann Behav Med 2021; 55:333-344. [PMID: 32814961 DOI: 10.1093/abm/kaaa060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND AND PURPOSE Prior research has debated whether reflective pondering is a more constructive form of rumination than brooding, which is generally considered maladaptive. This study sought to investigate whether reflective pondering predicts depressive symptoms and whether reflective pondering is adaptive under certain conditions. We predicted that the effectiveness of reflective pondering could depend on concurrent coping strategies and the trait-state distinction. METHOD Women with breast cancer (N = 309; M age = 47.5) were assessed at four waves over 2 years. A time-lagged design was applied, with rumination (i.e., brooding and reflective pondering) and coping (i.e., engagement and disengagement) measured from T1 to T3, predicting depressive symptoms assessed from T2 to T4. These variables were measured by the Ruminative Response Scale, the Brief COPE, and the Hospital Anxiety and Depression Scale. RESULTS Using hierarchical linear modeling, brooding, but not reflective pondering, predicted elevated depressive symptoms at both between- and within-person levels. The relationship between reflective pondering and depression was moderated by the coping strategies. Individual differences in reflective pondering predicted worse depressive symptoms, but higher use of engagement coping mitigated the detrimental effect. Within individuals, the co-occurrence of reflective pondering and disengagement coping predicted a subsequent decrease in depressive symptoms. CONCLUSIONS The emerging role of reflective pondering in the face of breast cancer-related stress appears to be a double-edged sword. Its impact on depression may depend on concurrent coping strategies and whether reflective pondering is assessed at state and trait levels.
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Affiliation(s)
| | - Cheng-Shyong Chang
- Division of Hematology-Oncology and Cancer Center, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Wen-Yau Hsu
- Department of Psychology, National Chengchi University, Taipei, Taiwan.,Research Center for Mind, Brain, and Learning, National Chengchi University, Taipei, Taiwan
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19
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Nunes C, Pérez-Padilla J, Martins C, Pechorro P, Ayala-Nunes L, Ferreira LI. The Brief COPE: Measurement Invariance and Psychometric Properties among Community and At-Risk Portuguese Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062806. [PMID: 33801958 PMCID: PMC7998814 DOI: 10.3390/ijerph18062806] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/01/2021] [Accepted: 03/07/2021] [Indexed: 12/11/2022]
Abstract
Parenting generally brings about high internal and external demands, which can be perceived as stressful when they exceed families’ resources. When faced with such stressors, parents need to deploy several adaptive strategies to successfully overcome these challenges. One of such strategies is coping, an important cognitive and behavioural skill. In this study, we intended to examine the psychometric properties of Carver’s (1997) Brief COPE (Coping Orientation to Problems Experienced), extending its cross-cultural validity among a Portuguese sample of community and at-risk parents. The sample comprised community (n = 153) and at-risk (n = 116) parents who completed the brief COPE, the Family Adaptability and Cohesion Scales and the Parenting Stress Index—Short Form. Confirmatory factor analysis, internal consistency, cross sample invariance, convergent and discriminant validity were analysed. Data from the confirmatory factor analysis revealed that the 14-factor model obtained the best fit. The results provided evidence that the Brief COPE is a psychometrically sound instrument that shows measurement invariance across samples and good reliability. Our findings demonstrated that the Portuguese version of brief COPE is a useful, time-efficient tool for both practitioners and researchers who need to assess coping strategies, a relevant construct in family context.
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Affiliation(s)
- Cristina Nunes
- Psychology Research Centre (CIP) & Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal;
- Correspondence: ; Tel.: +351-289-800-100
| | - Javier Pérez-Padilla
- Faculty of Humanities and Education Sciences, University of Jaen & Research Group (HUM604) Development of Lifestyles in the Life Cycle and Health Promotion of University of Huelva, Campus de las Lagunillas, 23071 Jaén, Spain;
| | - Cátia Martins
- Psychology Research Centre (CIP) & Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal;
| | - Pedro Pechorro
- School of Psychology, Universidade do Minho, 4710-057 Braga, Portugal;
| | - Lara Ayala-Nunes
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK;
| | - Laura I. Ferreira
- Department of Psychology and Educational Sciences, Campus de Gambelas, Universidade do Algarve, 8005-139 Faro, Portugal;
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20
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Coulthard H, Sharps M, Cunliffe L, van den Tol A. Eating in the lockdown during the Covid 19 pandemic; self-reported changes in eating behaviour, and associations with BMI, eating style, coping and health anxiety. Appetite 2021; 161:105082. [PMID: 33476651 PMCID: PMC7976455 DOI: 10.1016/j.appet.2020.105082] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/01/2020] [Accepted: 12/19/2020] [Indexed: 11/30/2022]
Abstract
The global coronavirus pandemic (Covid 19) resulted in national lockdowns where individuals were asked to isolate in their homes to stop the spread of the disease. Using a cross-sectional survey, the current paper aimed to examine self-reported changes in eating patterns and behaviour during the lockdown in the UK, and associations with BMI, demographic variables, eating styles, health anxiety, food insecurity and coping strategies. Participants (N = 620) were recruited online through social media advertising. The results showed that there were self-reported changes to food consumption during the lockdown across the sample. Increases in consumption of HED (high energy density) snack foods during the lockdown was associated with sex, pre-lockdown eating behaviour (emotional eating and uncontrolled eating), and Covid-specific health anxiety. Increases in positive eating practices such as eating more home prepared foods, and fruits and vegetables, were associated with adaptive coping strategies. Higher emotional eating (EE) during the lockdown was associated with a higher BMI, higher pre-lockdown EE and maladaptive coping strategies. Maladaptive coping strategies moderated the relationship between BMI and EE during the lockdown. In particular a higher BMI was associated with higher EE during the lockdown if an individual also had higher maladaptive coping strategies. These findings suggest that changes to eating behaviour may be part of a wider style of maladaptive or adaptive coping, particularly in those with a history of EE or uncontrolled eating. Preparing individuals to adopt more adaptive coping strategies during lockdown situations may be crucial to improving health during subsequent the lockdown events.
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Affiliation(s)
- Helen Coulthard
- School of Applied Social Sciences, Faculty of Health & Life Sciences, De Montfort University, Leicester, LE1 9BH, United Kingdom.
| | - Maxine Sharps
- School of Applied Social Sciences, Faculty of Health & Life Sciences, De Montfort University, Leicester, LE1 9BH, United Kingdom
| | - Louise Cunliffe
- School of Applied Social Sciences, Faculty of Health & Life Sciences, De Montfort University, Leicester, LE1 9BH, United Kingdom
| | - Annemieke van den Tol
- School of Psychology, University of Lincoln, Brayford Wharf East, Lincoln, LN5 7AY, United Kingdom
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21
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Fisher JE, Zhou J, Zuleta RF, Fullerton CS, Ursano RJ, Cozza SJ. Coping Strategies and Considering the Possibility of Death in Those Bereaved by Sudden and Violent Deaths: Grief Severity, Depression, and Posttraumatic Growth. Front Psychiatry 2020; 11:749. [PMID: 32848927 PMCID: PMC7427580 DOI: 10.3389/fpsyt.2020.00749] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/16/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Bereavement by sudden and violent deaths can lead to increased grief severity, depression, and reduced posttraumatic growth compared to those bereaved by natural causes. These outcomes can be affected by coping strategies and whether a survivor had been "prepared" for the death. The present study examined the effect of coping and considering the possibility of death on grief severity, depression, and posttraumatic growth in those bereaved by sudden deaths. METHODS Participants bereaved by suicide, accident, or combat deaths completed an online survey about demographics (including the cause of death), coping, grief severity, depression, and posttraumatic growth. A factor analysis of the coping measure yielded factors representing three coping strategies: avoidant coping, supportive coping, and active coping. These three strategies, the causes of death and considering the possibility of death were used as predictors of either grief severity, depression, or posttraumatic growth in multivariate linear regression models. RESULTS Each coping strategy and cause of death was differentially associated with grief severity, depression, and posttraumatic growth. Specifically, supportive coping and active coping were each only associated with higher posttraumatic growth. In contrast, avoidant coping was associated with all outcomes (higher grief severity and depression and lower posttraumatic growth). In addition, accidents and suicides (compared to combat deaths) had independent effects on grief severity and posttraumatic growth. Considering the possibility of death interacted with avoidant coping and also with supportive coping to predict grief severity in combat-loss survivors. DISCUSSION Findings highlight the differential contributions of coping strategies and their complex relationships with cause of death in contributing to grief severity, depression, and posttraumatic growth. Avoidant coping contributed to negative outcomes and inhibited posttraumatic growth, suggesting its importance as a target for therapeutic intervention. Although supportive and active coping facilitated posttraumatic growth, they had less of a role in mitigating grief severity or depression in this study. Although considering the possibility of death appeared to mitigate negative outcomes among survivors of combat death, avoidance of that possibility is likely protective for the majority of family members whose loved ones return home safely.
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Affiliation(s)
- Joscelyn E Fisher
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, United States.,Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Jing Zhou
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, United States.,Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Rafael F Zuleta
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, United States.,Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Carol S Fullerton
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Robert J Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Stephen J Cozza
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
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22
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Li Y, Bressington D, Chien WT. Pilot evaluation of a coping-oriented supportive program for people with spinal cord injury during inpatient rehabilitation. Disabil Rehabil 2017; 41:182-190. [PMID: 28994618 DOI: 10.1080/09638288.2017.1386238] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To report the feasibility and preliminary effects of a psychosocial care program entitled "coping-oriented supportive program" (COSP) for people with spinal cord injury (SCI) during inpatient rehabilitation. METHODS This was a pilot test of the COSP using a convenience sample of 22 participants with SCI (11 participants per group) with pre- and post-test, comparison group design. The feasibility, acceptability, and preliminary effects of the COSP were examined. RESULTS Nine patients with SCI in the intervention group and 11 in the comparison group who completed five or more sessions of the intervention were included in the data analysis. The COSP was feasible with high levels of recruitment, retention and protocol adherence. Good acceptability was suggested by the participants' feedback on the intervention program. The intervention group had a statistically significant greater improvement in self-efficacy (z = -1.978, p = 0.048), life enjoyment and satisfaction (z = -2.801, p = 0.005), and satisfaction of social support (z = -2.298, p = 0.022) at post-test, when compared to the comparison group. Whereas, no significant improvement was found for coping. CONCLUSIONS Our findings support the feasibility and acceptability of the COSP, and suggest that this intervention is a promising psychosocial care program to enhance people's life satisfaction and well-being as well as the satisfaction of social support after SCI. Further testing of this program with a larger-sized and diverse sample of people with SCI is needed. Implications for Rehabilitation The Chinese culturally-sensitive psychosocial care program (coping-oriented supportive program) is feasible, and has the potential to enhance people's self-efficacy in coping with spinal cord injury, and improve their psychosocial well-being and life satisfaction. The conventional inpatient spinal cord injury rehabilitation services could be improved by providing this "first-line" psychosocial care program in line with the current medical rehabilitation service.
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Affiliation(s)
- Yan Li
- a School of Nursing, The Hong Kong Polytechnic University , Hung Hom , Kowloon , Hong Kong
| | - Daniel Bressington
- a School of Nursing, The Hong Kong Polytechnic University , Hung Hom , Kowloon , Hong Kong
| | - Wai-Tong Chien
- a School of Nursing, The Hong Kong Polytechnic University , Hung Hom , Kowloon , Hong Kong
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