Psychometric properties of the Brief-COPE for the evaluation of coping strategies in the Chilean population

The Psychometric Properties of the Brief COPE Among Young Adults

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.

Internalized stigma: Social support, coping, psychological distress, and mental well-being among older adults in Ghana

BACKGROUND

Older adults have been found to internalize stigma from society and this has been linked to several variables including social support, coping, psychological distress, and mental well-being. However, there is a dearth of research on how these variables interact with each other to impact the life of older adults.

AIMS

This study employed path analysis to explore social support and coping as boundary conditions and underlying mechanisms in the link between internalized stigma, psychological distress, and mental well-being, among older adults in Ghana.

METHOD

Using a cross-sectional design, the study recruited 167 older adults who responded to standardized questionnaires including The Internalized Stigma of Mental Illness scale, Multidimensional Perceived Social Support Scale, The Brief Coping Inventory, Kessler Distress Scale, and the Warwick-Edinburgh Mental Well-being Scale, to determine levels of internalized stigma, social support, coping strategies, psychological distress, and mental well-being, respectively.

RESULTS

The findings revealed that at low levels of social support, there is a significant and positive correlation between internalized stigma and mental well-being (β = -.36, SE = 0.17, p < .001). Path analysis showed that the relationship between internalized stigma and mental well-being was fully mediated by problem-focused coping (β = .11, p = . 001, 95% CI [0.04, 0.21]), but not psychological distress. Problem-focused coping was also found to have a significant positive correlation with mental well-being but no significant correlation with psychological distress. Conversely, avoidant-focused coping was found to have a significant positive correlation with psychological distress and a significant negative correlation with mental well-being.

CONCLUSIONS

This study revealed the importance of social support and coping to attaining mental well-being among older adults. This study provides insights into the development of tailored interventions aimed at improving social support and problem-focused coping among older Ghanaian adults facing internalized stigma, and it also establishes a base for future research.

The mediating role of emotional intelligence on nursing students' coping strategies and anxiety during the COVID-19 pandemic

Anxiety among nursing students documented during the COVID-19 pandemic reflected their fear of contracting infections, adhering to the mandatory use of masks in public, engaging in the new experience of distance learning, having financial problems, and so on. The purpose of this study was to examine the mediating role of emotional intelligence (EI) on nursing students' coping strategies and anxiety during the pandemic. This cross-sectional correlational study was conducted in a university in Jordan. An online survey was used to obtain data from a sample of 282 nursing students who had returned to on-campus learning during the summer semester of 2019/2020. The survey held four parts: (a) questions about sociodemographics, (b) the General Anxiety Disorder-7 (GAD-7) scale, (c) the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), and (d) the Brief-Coping Behavior Questionnaire (Brief-COPE). The results showed that EI had a fully mediating role in the relationship between problem-focused coping strategies and anxiety, and it partially mediated the emotion-focused and avoidant/dysfunctional coping strategies and anxiety relationships. Nursing students who used the problem-focused coping strategies had high levels of EI, and with increasing levels of EI, anxiety levels decreased. Promoting the development of EI among nursing students would enable them to manage their emotions effectively and control their anxiety, particularly in new circumstances such as those that occurred during the COVID 19 pandemic.

A longitudinal analysis of factors associated with post traumatic growth after acquired brain injury

ABSTRACTPost-Traumatic Growth (PTG) is a form of positive psychological change that occurs for some individuals following traumatic experiences. High levels of PTG have been reported among survivors of acquired brain injury (ABI). Yet it remains unclear why some survivors of ABI develop PTG and others do not. The present study investigated early and late factors that are associated with long-term PTG in people with moderate to severe ABIs. Participants (n = 32, Mage = 50.59, SD = 12.28) completed self-report outcome measures at two time-points seven years apart (one-year and eight-years post-ABI). Outcome measures assessed emotional distress, coping, quality of life and ongoing symptoms of brain injury, as well as PTG at the later timepoint. Multiple regression analyses indicated that one-year post-ABI, fewer symptoms of depression, more symptoms of anxiety, and use of adaptive coping strategies accounted for a significant amount of variance in later PTG. At eight years post-ABI, fewer symptoms of depression, fewer ongoing symptoms of brain injury, better psychological quality of life and use of adaptive coping strategies explained a substantial amount of variance in PTG. For individuals with ABIs, PTG may be promoted by implementing long-term neuropsychological support which aims to facilitate use of adaptive coping strategies, supports psychological wellbeing and allows individuals to find meaning post-ABI.

Assessing oral health and the minimally important differences in oral health-related quality of life of non-diabetic and diabetic patients: a cross-sectional study

BACKGROUND

Non-diabetics and diabetics might have different oral health problems and impacts on their oral health-related quality of life (OHRQoL). Comparison of oral health status and coping strategies between these patients, and evaluation of factors associated with OHRQoL might facilitate better treatment planning for improved patient-centred outcome.

METHODS

One hundred and eleven non-diabetics and 107 diabetics attending a public hospital were clinically examined and evaluated for coping strategies (abbreviated coping orientation to problems experienced) and OHRQoL [short-form oral health impact profile (OHIP-14S)]. Factors associated with OHRQoL were analysed through correlation/partial correlation. Minimally important differences (MID) of OHIP-14S were calculated to confirm associations between attachment loss, caries, and tooth loss with OHRQoL.

RESULTS

Non-diabetics had worse periodontal status. Diabetics had more missing teeth. Non-diabetics and diabetics employed maladaptive coping to manage oral health problems. Overall, non-diabetics reported worse OHRQoL. Determination of MID showed that non-diabetics with high-severe attachment loss and <20 teeth experienced poorer OHRQoL. Diabetics with caries, high-severe attachment loss, and <25 teeth experienced poorer OHRQoL.

CONCLUSION

Different factors were associated with OHRQoL of non-diabetics and diabetics. Delivery of treatment aimed at maintaining teeth in a periodontally healthy and caries free state, and provision of more chewing units might help improve OHRQoL of diabetics. © 2024 Australian Dental Association.

Psychometric Properties of the Brief Coping Orientation to Problems Experienced Inventory Among Patients Pursuing Bariatric Surgery

The Brief COPE Inventory is a widely used scale that measures how a person copes with a specific situation. Despite its widespread use, the factor structure of this scale is somewhat unclear and has not been tested among patients pursuing bariatric surgery. We tested competing factor analytic models of the Brief COPE Inventory among patients pursuing bariatric surgery to identify the best fitting factor model for use in pre-surgical psychological evaluations. We also examined reliability and validity of the subscales from the best fitting model of coping. Participants included 1984 patients pursuing bariatric surgery (Mage = 42.58 years, SD = 10.89, 81.39% female). The best fitting model of the Brief COPE Inventory among patients pursuing bariatric surgery was a three-factor model including interpersonal, intrapersonal, and maladaptive coping strategies. These results were replicated in a subset of the original sample and demonstrated appropriate convergent and discriminant validity with several key outcomes. The Brief COPE Inventory can be conceptualized as a multidimensional scale assessing interpersonal coping, intrapersonal coping, and maladaptive coping among patients pursuing bariatric surgery. Future work should examine how these subscales are related to surgical outcomes among people receiving treatment for excess weight.

The mediating role of coping styles in the relationship between fear of COVID-19 and mental health problems: a cross-sectional study among nurses

Fear of being infected by coronavirus disease 2019 (COVID-19) could trigger mental health problems among nurses at the frontline. In such a situation, coping strategies are needed to deal with the imminent threat. The purpose of this study was to test the mediating effects of coping on relationships of fear of COVID-19 with anxiety, depression and post-traumatic syndrome among nurses who were in contact with COVID-19 patients. A cross-sectional and correlational research design was used to recruit a sample of 278 nurses who treated COVID-19 patients in four government referral hospitals in Indonesia. A bootstrap resampling procedure was used to test the significance of the total and specific indirect effects of coping on relationships of Fear of COVID-19 with anxiety, depression and post-traumatic syndrome. The nurses reported moderate levels of fear of COVID-19, considerable anxiety and depression, and a moderate level of coping. We found coping to be significantly negatively correlated with the reported levels of anxiety, depression and post-traumatic syndrome (p < 0.001). Coping mediated relationships of fear of COVID-19 on depression, anxiety and post-traumatic syndrome after controlling for relevant confounders for each dependent variable. This shows that enacting coping mechanisms is important to achieve an adaptive effect on nurses' mental health. Proper assessments and interventions should be tailored and implemented for nurses who have contact with COVID-19 patients to facilitate their use of coping strategies when needed in stressful situations.

Path analysis of the role of coping strategies between emotional intelligence and lifestyle habits during COVID-19 lockdown

The relationship between Emotional Intelligence (EI) and lifestyle choices during the COVID-19 pandemic is obscure and not very well understood. To clarify the mechanisms underlying this relationship, we proposed to test the hypothesis that different coping styles (avoidant and approach) have an indirect effect on the association between EI and many types of lifestyle habits. A cross-sectional study was conducted between December 2020 and January 2021. Our target sample consisted of Lebanese adults from the general population. In path analysis, approach coping mediated the association between EI and different lifestyle habits (rest, nutrition, general physical conditions), but not exercise. Furthermore, avoidant coping did mediate the association between EI and general physical conditions, but not between EI and other lifestyle choices (namely rest, exercise, and nutrition). To conclude, individuals with high EI, and that are users of approach coping strategies to deal with stressors, have increased rest time, healthy nutrition and general physical conditions. This cautiously implies that fostering approach coping may help improve the positive effects of EI on healthy lifestyles during crises such as this pandemic.

Cross-sectional study on the psychosocial factors, the severity of depression, and coping strategies among patients attempting suicide

Background

With around 10-20 million individuals attempting suicide each year, suicide attempts have been considered a significant public health issue. A significant fraction of it is caused by depression. Life events and other psychosocial stressors were frequently linked to both depression and suicidal behavior. Coping strategies are cognitive, emotional, and behavioral approaches used to lessen and cope with the negative impacts of stressful situations.

Aim

This study aimed to find the psychosocial factors, the severity of depression, and coping strategies among patients attempting suicide.

Materials and Methods

Study design: This study was a hospital-based descriptive cross-sectional study. A total of 120 consecutive cases were selected using Patient Health Questionnaire 2 (PHQ-2) scales and assessed for severity of depression and coping strategies using the Hamilton Depression Rating Scale (HAM-D) and Coping Orientation to Problem Experienced Inventory (Brief-COPE) scales, respectively. Pearson's Chi-square or Fisher's exact test and independent-samples t-test have been performed to see the association between categorical and continuous variables. The Pearson correlation coefficient has been used to see the relationship between two continuous variables.

Results

Most of the cases (33.3%) were found to be severely depressed. Among all the cases, the majority, that is, 90.8%, were using avoidant-type coping strategies and only 9.2% were using approach-type coping strategies. A significant positive correlation between the avoidant-type coping strategy and depression and a negative correlation between the approach-type coping strategy and depression was found.

Conclusion

Patients with depression attempting suicide were found to utilize avoidant-type coping strategies to cope with life stresses. Hence, it is crucial to place greater emphasis on assessing coping strategies and focus on teaching approach-oriented coping strategies as a means to prevent suicidal attempts.

Multi-year investigation of a relaxation course with a mindfulness meditation component on college students' stress, resilience, coping and mindfulness

Examine the effects of a relaxation course with a mindfulness meditation component in a two-group pre-test and post-test non-randomized study design.

Participants included 219 undergraduate students (experimental group: n = 103; control group: n = 116), 18-43 years old.

Completion of measures of stress, resilience, coping and mindfulness at the beginning and end of the intervention.

The independent sample t-test analysis revealed a statistically significant decrease in stress and maladaptive coping, and an increase in resilience in the experimental group compared to the control group.

Benefits were observed following the intervention by positively impacting factors associated with increased functioning in life. Classroom-based interventions could be considered beneficial for students.

Development and Content Validity of a Disability Self-Management Questionnaire for Hispanic Older Adults

OBJECTIVE

There is no Spanish-language instrument for assessing the self-management strategies used by older adults with physical function disabilities to manage the difficulties that can occur in daily living activities. This study aimed to design and test the content validity of a Spanish version of the newly developed Self-Management of Function in Daily Living Activities Questionnaire (SF-DLAQ).

METHODS

A methodological study, guided by the Person-Environment-Occupation-Performance (PEOP) model, was conducted to develop the SF-DLAQ. Stage 1 focused on designing the questionnaire, doing so using qualitative data obtained from 24 older adults and obtained from 10 existing scales that measure the self-management of chronic conditions. Stage 2 focused on expert judgement, which consisted of validating the questionnaire with 8 experts in aging using an item-level content validity index (I-CVI), a scale-level CVI (S-CVI), and the kappa statistic.

RESULTS

All the scores that were attained in stage 2 were favorable, with those of the I-CVI for clarity ranging from 0.09 to 1.0 and those of the I-CVI for relevancy, the S-CVI, and the kappa all being 1.0.

CONCLUSION

The scale and item validity for the SF-DLAQ, Spanish version, has been demonstrated but should be confirmed with further testing.

Psychological characteristics of young adults with temporomandibular disorders, somatization and combined conditions: A multidimensional evaluation

BACKGROUND

Temporomandibular disorders and somatization have shown interrelation in many studies. The physical and psychological factors which contributed to the occurrence and relation of both conditions are yet to be determined.

OBJECTIVES

The personality traits, coping styles and psychological distress of young adults with temporomandibular disorder (TMD) and somatic symptoms were characterized together with the determination of psychological risk factors for TMDs, somatization and combined conditions.

METHODS

Participants were recruited from university-attending young adults. TMD and somatic symptoms were appraised with the short-form Fonseca Anamnestic Index and Patient Health Questionnaire-15. Psychological variables were assessed with the Big Five Personality Inventory-10, Brief-COPE Inventory and Depression, Anxiety, and Stress Scales-21. Data were evaluated using chi-squared/non-parametric tests and logistic regression analyses (α = .05).

RESULTS

Among the 507 participants (mean age 22.2 ± 1.5 years), 46.4% reported no TMD/somatic symptoms (NS) while 7.5%, 34.5% and 11.6% had TMDs only (TS), somatization only (SS) and combined TMDs-somatization (CS), respectively. Significant differences in conscientiousness (NS > SS), agreeableness (NS, TS > CS; NS > SS), dysfunctional coping, general distress, depression, anxiety and stress (CS ≥ SS > NS) were discerned. Multivariate analyses indicated that the odds of TS were increased by anxiety (OR = 1.10; 95% CI = 1.01-1.21), while the odds of SS/CS were affected by anxiety (OR = 1.15; 95% CI = 1.06-1.25/OR = 1.34; 95% CI = 0.19-1.52) and problem-focused coping (OR = 0.71; 95% CI = 0.56-0.89/OR = 0.55; 95% CI = 0.39-0.78).

CONCLUSION

Though individuals with TMDs and somatization have dissimilar psychological profiles, anxiety constantly increased their likelihood. Problem-focused coping strategies may help alleviate psychosocial and physical stressors associated with TMDs and somatization.

Development and validation of heart failure-specific quality-of-life measurement tool in India

Objective

To develop and validate a sensitive tool for assessment of quality of life (QoL) in heart failure (HF) patients in Indian settings.

Methods

The authors conducted literature review, in depth interviews, clinical observations and designed the first draft of the QoL tool. The tool was validated using content and face validity by a panel of experts. For internal consistency reliability, the questionnaire was administered among 270 HF patients. Test-retest reliability was assessed in 20 HF patients. Principal component factor analysis with varimax rotation was employed to assess the dimensionality and to reduce the number of items. Cronbach's alpha, and Intra-class correlation coefficients (ICCs) were employed to investigate reliability of questionnaire. The responsiveness data were collected 6 months after the baseline data collection from 30 HF patients. IBM® SPSS® Statistics Version 21 was used for statistical analysis.

Results

The principal component factor analysis revealed mainly 5 domains. The final tool included 25 items. Cronbach's alpha (α) for the overall tool was 0.915. Intra-class correlation coefficients (ICCs) based on test-retest was 0.734. The final tool showed good responsiveness to changes with a mean ± SD of the change in response of 46 ± 12.4 and a standardized mean response of 3.7 within six-months.

Conclusion

The HF specific QoL tool developed for Indian patients is a valid and reliable instrument and it can be applied in daily clinical practice, and research.

Short summary

We had developed and validated a quality-of-life tool for heart failure patients in India. This is the first ever attempt to develop a measure for heart failure patients in India. We had used a mixed methodology approach to identify all the domains in the tool. The newly developed tool is a valid, reliable, sensitive and responsive tool to measure quality of life in HF patients in India. This tool can be applied in daily clinical practice, research and health system for patients with HF in India.

Coping strategies and emotional responses adopted by health care workers during COVID-19 pandemic-braving the storm

Background and Aims

Health care workers (HCWs) are caught in the middle of the COVID-19 pandemic storm and are exposed to a large degree of physical and emotional stress. This study was planned to describe the stressors, stress levels, emotional responses, and coping strategies adopted by HCWs amidst this pandemic.

Material and Methods

This cross-sectional, web-based survey was conducted after ethics approval, using a structured performa incorporating standardized stress (PSS-10 C), emotional responses (PANAS-10), and coping strategy (Brief COPE) scales. The snowball sampling technique was used to conduct the study and collect data. Data were analyzed using SPSS 26 version (SPSS Inc., Chicago, IL, USA) statistical software. A P value of <0.05 was considered significant.

Results

Out of 402 participants (65% doctors and 35% nurses), 87% perceived moderate stress levels, and nearly half of the participants were interns, residents, and medical officers. Infection to self or family members (77.1%), survival of sick patients (75.6%), aggression by patients and relatives (70.3%), and long duty hours (67%) were some of the major stressors as reported by HCWs. The most common positive emotion felt was being alert (19.17 ± 5.57) and negative emotion perceived was being upset (15.6 ± 6.06). Many participants adopted emotion and problem-focused coping strategies such as planning and strategization (68%) and positive reframing (67.6%), whereas dysfunctional coping strategies such as venting and denial were adopted less commonly.

Conclusion

Moderate stress levels perceived by HCWs are a cause for concern. Emotional responses of HCWs to stress vary; however, appropriate coping strategies including emotional and problem-focused coping strategies are the need of the hour to tackle pandemic-related stress.

Exploring stressors and coping strategies among dental students during COVID-19 pandemic in British Columbia

OBJECTIVE

The COVID-19 pandemic has caused stress among undergraduate dental students; coping mechanisms might be employed to deal with such stress. A cross-sectional study was conducted to explore the coping strategies employed by dental students at the University of British Columbia (UBC) in response to their self-perceived stressors during the pandemic.

METHODS

An anonymous 35-item survey was distributed to all four cohorts of UBC undergraduate dental students enrolled in the 2021-2022 academic year, 229 students in total. The survey gathered sociodemographic information, self-perceived COVID-19-related stressor, and coping strategies via the Brief Cope Inventory. Adaptive and maladaptive coping were compared among the years of study, self-perceived stressors, sex, ethnicity, and living situations.

RESULTS

Of the 229 eligible students, 182 (79.5%) responded to the survey. Of the 171 students that reported a major self-perceived stressor, 99 (57.9%) of them were stressed about clinical skill deficit due to the pandemic; fear of contraction was reported by 27 (15.8%). Acceptance, self-distraction, and positive reframing were the most used coping strategies among all students. The one-way ANOVA test revealed a significant difference in the adaptive coping scores among the four student cohorts (p = 0.001). Living alone was found to be a significant predictor for maladaptive coping (p < 0.001).

CONCLUSION

The main cause of stress related to the COVID-19 pandemic for dental students at UBC is their clinical skills being negatively affected. Coping strategies including acceptance and self-distraction were identified. Continued mitigation efforts should be made to address students' mental health concerns and create a supportive learning environment.

Psychosocial issues among paediatric health-care workers posted in intensive care unit during COVID-19 pandemic: A questionnaire-based survey (Psy-Co-19 survey)

AIM

To understand the moral distress experienced by health-care workers (HCWs) in the COVID paediatric intensive care unit (PICU). We also aimed to assess the psychological well-being and the coping mechanisms used by HCWs.

METHODS

A prospective observational cross-sectional study was conducted from July to September 2021, involving all HCWs who worked in the COVID PICU. Moral distress using Moral Distress for Health-care Professionals (MMD-HPs) scale, psychological well-being using Trauma Screening Questionnaire (TSQ) and coping strategies adopted by HCWs using Brief-COPE (Coping Orientation to Problems Experienced) were measured.

RESULTS

One hundred and eighty-four HCW data were examined. The most common causes of moral distress among HCWs were compromised patient care caused by a lack of resources and caring for more patients than they could safely handle. Moral distress was the same regardless of the HCWs' job profile, marital status, number of children or age. The TSQ revealed psychological stress in 23.3% of HCWs with Post-traumatic Stress Disorder, significantly higher in HCWs under the age of 30 and without children. Few HCWs turned to substance use, self-blame or denial as coping mechanisms; instead, acceptance, self-distraction and emotional support were the most frequently used.

CONCLUSION

The most common reasons for moral and psychological distress perceived by participants were insufficient staff and organisational support. Younger HCWs and those without children experienced higher levels of psychological distress. HCWs' typical coping mechanisms are constructive, such as seeking help and support from others, reframing situations and meditation. Health-care administrators must develop a framework to assist HCWs in dealing with such serious issues.

Understanding the prevalence and manifestation of anxiety and other socio-emotional and behavioural difficulties in children with Developmental Language Disorder

BACKGROUND

It is well-documented that children with Developmental Language Disorder (DLD) have a higher likelihood of experiencing anxiety, as well as other socio-emotional and behavioural (SEB) difficulties. Despite this, there is little consensus as to how these difficulties manifest. This study aims to understand the prevalence of broader SEB difficulties and anxiety, informing intervention development by understanding the relationships between them.

METHODS

A mixed-methods, case-control study was conducted. First, an online survey was completed by 107 parents of either children with DLD ("DLD sample"; n = 57) or typically developing children ("typical sample"; n = 50), aged 6-12 years old. Binary SEB statements informed by previous qualitative work (e.g. "my child requires routine/sameness"; "my child has frequent tantrums") provided an insight into the prevalence of SEB difficulties in both DLD and typical samples. Validated measures of anxiety, emotion regulation, intolerance of uncertainty, insistence on sameness, family stress and coping mechanisms were also collected. Correlation and mediation analyses were run using these validated measures to understand the manifestation of anxiety in children with DLD in more detail. Qualitative interviews were then carried out with a select panel of survey respondents (n = 4).

RESULTS

The DLD sample scored significantly higher on all binary SEB statements than the typical sample: experiencing anxiety (80.7%, p < .05), requiring routine and sameness (75.4%, p < .001) and emotional dysregulation (75.4%; p < .001) were the most common difficulties reported for children with DLD. Using the validated scales, family stress and coping mechanisms were found to only correlate with the manifestation of anxiety in the typical group, not the DLD group. "Intolerance of uncertainty" and "insistence on sameness" were found to fully mediate the relationship between DLD diagnosis and symptoms of anxiety. Parent's interviews provided contextual support for the analysis, as well as highlighting sensory sensitivities as a focus for future research.

CONCLUSIONS

Parents of children with DLD appear to cope well with their children's complex SEB needs. Intervention focussing on intolerance of uncertainty may help the management of difficulties with anxiety. Behaviours such as insistence on sameness should be investigated further, as potential indicators for anxiety amongst children with DLD.

Coping strategies in patients with good outcome but chronic fatigue after aneurysmal subarachnoid hemorrhage

BACKGROUND

Fatigue is a highly prevalent and debilitating symptom among patients in the chronic phase of aneurysmal subarachnoid haemorrhage (aSAH) with no identified effective treatment. Cognitive therapy has been shown to have moderate effects on fatigue. Delineating the coping strategies used by patients with post-aSAH fatigue and relating them to fatigue severity and emotional symptoms could be a step towards developing a behavioural therapy for post-aSAH fatigue.

METHODS

Ninety-six good outcome patients with chronic post-aSAH fatigue answered the questionnaires Brief COPE, (a questionnaire defining 14 coping strategies and three Coping Styles), the Fatigue Severity Scale (FSS), Mental Fatigue Scale (MFS), Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory (BAI). The Brief COPE scores were compared with fatigue severity and emotional symptoms of the patients.

RESULTS

The prevailing coping strategies were "Acceptance", "Emotional Support", "Active Coping" and "Planning". "Acceptance" was the sole coping strategy that was significantly inversely related to levels of fatigue. Patients with the highest scores for mental fatigue and those with clinically significant emotional symptoms applied significantly more maladaptive avoidant strategies. Females and the youngest patients applied more "Problem-Focused" strategies.

CONCLUSION

A therapeutic behavioural model aiming at furthering "Acceptance" and reducing passivity and "Avoidant" strategies may contribute to alleviate post-aSAH fatigue in good outcome patients. Given the chronic nature of post-aSAH fatigue, neurosurgeons may encourage patients to accept their new situation so that they can start a process of positive reframing instead of being trapped in a spiral of futile loss of energy and secondary increased emotional burden and frustration.

Supporting students with empathy: the association between empathy and coping strategies in pre-clinical medical students

How medical students cope with stress predicts their mental health and academic/clinical performances, making the promotion of functional copy strategies a relevant outcome for medical educators. Empathy has been reported to be connected with coping. This study wanted to explore the most used coping strategies and whether gender differences existed, and to investigate whether and to what extent empathy affected coping in a sample of pre-clinical medical students. In a cross-sectional study design, the Interpersonal Reactivity Index (IRI) and the Coping Orientations to the Problems Experienced - New Italian Version (COPE-NIV) were administered to 398 (53% females) Italian second-year medical students. T-tests and multiple regression analyses were used to explore gender differences and the association between IRI and COPE-NIV scores, respectively. Problem Orientation obtained the highest mean score, whereas Avoidance the lowest one. Females outscored males on Social Support (t = 4.95, p < .001) and Transcendent Orientation (t = 4.04, p < .001). After controlling for gender, Empathic Concern was positively associated with Social Support (β = 0.223, p = .001) and Transcendent Orientation (β = 0.234, p = .001). Perspective Taking was positively and negatively associated with Positive Attitude (β = 0.248, p < .001) and Transcendent Orientation (β = − 0.180, p = .008), respectively. Personal Distress was negatively related to Problem Orientation (β = − 0.250, p < .001). Educational and psychological counselling interventions targeting empathy should be implemented in the pre-clinical years to equip medical students to cope functionally with the emotional distress linked to medical school.

Brief Assessment of Adaptive and Maladaptive Coping Strategies During Pandemic

This study aimed to analyse the internal structure, internal consistency, and convergent and divergent validity for the Coping Strategies Scale. We found a two-factor solution (maladaptive coping; adaptative coping) with a second-order general factor (coping strategies) that demonstrated adequate factorial structure and internal consistency for a brief nine items instrument in a sample of 211 economically active Brazilians (M_age = 37.07; SD = 13.03). The adaptive strategies factor converged with quality of life and work. It also diverged from phobia, stress, and anxiety. Maladaptive coping strategies converged with phobia, stress, and anxiety and diverged from the quality of work and life. According to the results, we found that coping strategies are a vital personal resource to overcome daily adversity, including those from the current pandemic. The present instrument may impact worldwide, offering conditions to investigate and promote mental health positive outcomes by reinforcing coping assessment during pandemics.

Coping mechanisms used by pharmacists to deal with stress, what is helpful and what is harmful?

Background

Australian pharmacists encountered increased stressors during the COVID-19 pandemic. This has raised questions regarding the effectiveness of the coping mechanisms used to manage this high work-related stress. Identifying useful and harmful coping mechanisms is critical for providing advice regarding addressing pharmacists' future work-related stress.

Objectives

This study aimed to explore the impact of pharmacy work on stress experienced by Australian pharmacists and the coping mechanisms used during the COVID-19 pandemic. This study also aimed to evaluate the pharmacists' perceptions of the impact of these coping mechanisms on their stress.

Methods

A cross-sectional study was conducted. Practising pharmacists and interns were recruited to complete an online survey that included the Perceived Stress Scale (PSS), which was used to measure pharmacists' work-related stress, and the Brief-COPE scale, used to assess the coping mechanisms used during the COVID-19 pandemic. The key outcome measure was the PSS score. A multiple regression analysis was used to evaluate the relationship between coping mechanisms and stress levels in a sample of Australian pharmacists.

Results

A total of 173 pharmacists and interns were recruited. The mean PSS was 18.02 (SD = 6.7). Avoidant coping mechanisms such as social withdrawal (β = 0.31; p = 0.0001) were significantly positively associated with work-related stress. In contrast, exercise was significantly negatively associated with work-related stress (β = -0.21; p = 0.009). The most frequently reported perceived barrier to seeking help was feeling burnt out and underappreciated.

Conclusions

This study highlights the association of coping mechanisms used by pharmacists during the COVID-19 pandemic with work-related stress. The study results demonstrate the importance of physical activity and spending time with pets in reducing work-related stress levels. Avoiding harmful coping mechanisms such as social withdrawal and drinking alcohol is recommended. This study also highlights the need for interventional studies to reduce work-related stress levels among pharmacists by addressing useful coping mechanisms.

Posttraumatic growth in people affected by an occupational accident: A longitudinal multilevel model of change

This study analyzed a predictive model of posttraumatic growth (PTG) in a cohort of 244 workers affected by an occupational accident. A longitudinal design with three points in time (i.e., 1, 6, and 12 months after the accident) was used. PTG, posttraumatic stress symptoms (PTSS), subjective severity of the event, deliberate rumination, and seeking social support were evaluated. In addition, time since the accident, age, and gender were included as predictors in our model. Deliberate rumination and seeking social support significantly predicted PTG trajectory in a multilevel model. Practical conclusions from the results suggest that work accident victims should be encouraged to seek social support and to positively reframe their experience.

Mental health and wellbeing of further and higher education students returning to face-to-face learning after Covid-19 restrictions

AIM

This study aimed to examine the mental health and wellbeing of further and higher education students and the associating factors after returning to face-to-face (in-person) learning after Covid-19 restrictions.

METHODS

A cross-sectional study informed by student consultations was conducted using a survey design. Mental health and wellbeing were assessed using self-report items on the Depression, Anxiety and Stress Scale (DASS-21) and the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS). Descriptive statistics and stepwise multiple linear regression analyses were conducted on data collected between December 2021 and June 2022.

RESULTS

N = 1160 students participated; 69.6% between 16 and 25 years, 67.9% studying in the UK, 66.5% studying away from home, 60.2% identified as she/her, 59.8% studying at the undergraduate degree level, 42.5% belonging to non-White ethnic backgrounds, 29.6% identifying as having additional needs and 22.8% as sexual minority. Moderate anxiety (M = 13.67, SD = 9.92) and depression (M = 17.04, SD = 11.56) scores were mainly reported. Wellbeing scores (M = 20.31, SD = 3.93) were lower than the estimate for the pre-pandemic general population. Gender expression, sexuality, age, ethnicity, having additional needs, and level and location of study was associated with mental health or wellbeing. Individual coping styles, levels of self-efficacy and physical activity were also associated with mental health or wellbeing.

CONCLUSIONS

Many students returning to further and higher education after Covid-19 restrictions experienced reduced mental health and wellbeing, and some students were at greater risk. Providing student-centred interventions focusing on self-efficacy, coping styles and physical activity may help improve the mental health and wellbeing of students.

A cross-sectional study of coping strategies and resilience and its association with psychological symptoms of doctors working in a dedicated COVID-19 care center

Context

Health-care professionals who are involved in treating COVID patients use multiple coping strategies to overcome stress. Studies have shown that individuals having poor coping strategies and resilience are more prone toward psychological symptoms.

Aims

The study was conducted to assess the coping strategies and resilience and its association with psychological symptoms of frontline doctors working in a COVID care center.

Settings and Design

It was a cross-sectional study using convenient sampling conducted among 150 frontline doctors working in a COVID care center.

Materials and Methods

The study tools included were sociodemographic questionnaire, Depression, Anxiety, and Stress Scale 21, Brief-COPE Scale, and Connor-Davidson Resilience Scale which was sent using Google Forms to participants after obtaining informed consent.

Statistical Analysis Used

Statistical analysis was conducted using Chi-square test for categorical variables, t-test for continuous variables, and Mann-Whitney U test for ordinal data, Spearman correlation for correlations, and backward multiple linear regression to predict psychological symptoms.

Results

Doctors with severe stress had higher dysfunctional coping and lower resilience scores (P = 0.001). There was a positive correlation of stress, anxiety, and depression with problem-focused, emotional-focused, and dysfunctional coping, and there was a negative correlation between total resilience scores with stress and depression. Stress and anxiety were predicted by dysfunctional coping and resilience. Depression was predicted by dysfunctional coping (β = 1.25, P < 0.001), resilience (β = -0.08, P = 0.005), and duration of working hours per month (β = -0.008, P = 0.05).

Conclusions

There is an urgent need to look at therapeutic strategies and factors which enhance resilience and promote better coping in this population.

Psychometric Validation of the Brief-COPE Scale in a Sample of Individuals with Multiple Sclerosis: A Brief Report

People with multiple sclerosis (MS) must often cope with high levels of stress, especially during the ongoing COVID-19 pandemic. The Brief-COPE is commonly used to assess how individuals use different coping strategies to deal with stressful life situations, but its application with people who have MS has not been validated. The purpose of this study was to assess the measurement structure and psychometric properties of the Brief-COPE in a sample of community-dwelling adults with multiple sclerosis, using exploratory factor analysis. Results revealed a three-factor measurement structure: (a) flexible coping, (b) succumbing coping, and (c) substance use coping. Correlations among these three factors and external measures of related concepts provided evidence of the validity of these factors. The Brief-COPE can be incorporated in rehabilitation counseling, mental health, and health care settings to assess coping strategies, assisting people with MS with managing stressful life events during and after the pandemic. Rehabilitation and health researchers can use it to assess the effectiveness of psychosocial interventions aimed to improve coping abilities and mental health of people with MS.

Psychometric properties and cross-cultural adaptation of the Indonesian version of the Brief COPE in a sample of advanced cancer patients

The Brief COPE Inventory has been proven as acceptable psychometric properties to examine coping strategies among cancer patients. However, most psychometric testing studies have been carried out in Western countries, raising concerns about the properties' relevance and applicability in other cultural contexts. This study aimed to present psychometric properties of the Brief COPE in a sample of patients with advanced cancer in Indonesia. Specifically, we intended to examine the factorial structure and the measure's validity and reliability. This study included 440 patients from the original study who completed the Indonesian version of Brief COPE. We used exploratory factor analysis and confirmatory factor analysis to assess factor structure and evaluate the structural model fit, respectively. Reliability was demonstrated by internal consistency represented by Cronbach's alpha coefficient. The factor analysis identified a 21-items scale with 5-factors (avoidance, religion and acceptance, social support coping, problem solving and distraction). Confirmatory factor analysis demonstrated a good model fit. For the whole scale and its subscales Cronbach's alpha coefficients were acceptable signifying good reliability. Convergent, divergent validity and contrast group comparison were evidenced by significant correlations among subscales and the other instruments used. This study shows that the Indonesian version of Brief COPE is a reliable and valid instrument to measure coping in advanced cancer patients and is ready for use amongst this population in the Indonesian cultural context.

Impact of COVID-19 Related Maternal Stress on Fetal Brain Development: A Multimodal MRI Study

BACKGROUND

Disruptions in perinatal care and support due to the COVID-19 pandemic was an unprecedented but significant stressor among pregnant women. Various neurostructural differences have been re-ported among fetuses and infants born during the pandemic compared to pre-pandemic counterparts. The relationship between maternal stress due to pandemic related disruptions and fetal brain is yet unexamined.

METHODS

Pregnant participants with healthy pregnancies were prospectively recruited in 2020-2022 in the greater Los Angeles Area. Participants completed multiple self-report assessments for experiences of pandemic related disruptions, perceived stress, and coping behaviors and underwent fetal MRI. Maternal perceived stress exposures were correlated with quantitative multimodal MRI measures of fetal brain development using multivariate models.

RESULTS

Increased maternal perception of pandemic related stress positively correlated with normalized fetal brainstem volume (suggesting accelerated brainstem maturation). In contrast, increased maternal perception of pandemic related stress correlated with reduced global fetal brain temporal functional variance (suggesting reduced functional connectivity).

CONCLUSIONS

We report alterations in fetal brainstem structure and global functional fetal brain activity associated with increased maternal stress due to pandemic related disruptions, suggesting altered fetal programming. Long term follow-up studies are required to better understand the sequalae of these early multi-modal brain disruptions among infants born during the COVID-19 pandemic.

Working With a Psychopath: Is There Light at the End of the Tunnel?

Having a supervisor with psychopathic characteristics is related to being bullied, poorer job satisfaction, work/family life conflict, financial instability, and distress. To date, all research on corporate psychopathy victims considers how they are negatively impacted rather than potential positive outcomes. In response, this study examined how working with a psychopath impacts posttraumatic growth (PTG). Utilizing a mixed-methods approach, this study draws upon the experiences of 285 individuals who have worked with a colleague or supervisor with alleged psychopathic characteristics. Results indicated that approach coping and psychopathic characteristics predicted PTG. Qualitative analyses revealed that the majority of participants used various coping strategies (e.g., emotion-focused), received support (e.g., emotional), and underwent post-experiential growth or learning (e.g., positive personal growth); not all growth/learning was positive, however (e.g., less trusting). Results suggest that cultivating approach-focused coping strategies may enhance PTG following a traumatic event.

Toxic Relationships: The Experiences and Effects of Psychopathy in Romantic Relationships

Limited research exists on the impact of psychopathy within romantic relationships. We examined mental and physical health consequences reported by intimate partners of individuals with psychopathic traits. Additionally, we explored whether psychopathy severity and coping impacted the severity of posttraumatic stress disorder and depression symptoms. Four hundred fifty-seven former and current intimate partners of individuals with psychopathic traits were recruited from online support groups. Victims reported a variety of abusive experiences and various negative symptomatology involving emotional, biological, behavioral, cognitive, and interpersonal consequences. Psychopathy severity and maladaptive coping were significantly related to increased PTSD and depression, while adaptive coping was only related to decreased depression. Regression analyses revealed that experiencing many forms of victimization predicted increased PTSD and depression symptoms. Examining the specific consequences experienced by intimate partners of individuals with psychopathic traits can aid the development of individualized treatment interventions aimed at symptom mitigation, recovery, and prevention of future victimization.

A Comprehensive Review and Bifactor Modeling Analysis of the Brief COPE

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.

Impact of COVID-19 related maternal stress on fetal brain development: A Multimodal MRI study

Background

Disruptions in perinatal care and support due to the COVID-19 pandemic was an unprecedented but significant stressor among pregnant women. Various neurostructural differences have been re-ported among fetuses and infants born during the pandemic compared to pre-pandemic counterparts. The relationship between maternal stress due to pandemic related disruptions and fetal brain is yet unexamined.

Methods

Pregnant participants with healthy pregnancies were prospectively recruited in 2020-2022 in the greater Los Angeles Area. Participants completed multiple self-report assessments for experiences of pandemic related disruptions, perceived stress, and coping behaviors and underwent fetal MRI. Maternal perceived stress exposures were correlated with quantitative multimodal MRI measures of fetal brain development using ltivariate models.

Results

Fetal brain stem volume increased with increased maternal perception of pandemic related stress positively correlated with normalized fetal brainstem volume (suggesting accelerated brainstem maturation). In contrast, increased maternal perception of pandemic related stress correlated with reduced global fetal brain temporal functional variance (suggesting reduced functional connectivity).

Conclusions

We report alterations in fetal brainstem structure and global functional fetal brain activity associated with increased maternal stress due to pandemic related disruptions, suggesting altered fetal programming. Long term follow-up studies are required to better understand the sequalae of these early multi-modal brain disruptions among infants born during the COVID-19 pandemic.

Grief reaction, depression, anxiety, and coping of relatives after palliative patients' death in Thailand

INTRODUCTION

Grief is a normal psychological response in relatives after the loss of their loved ones, which has shown to be associated with psychological reactions like depression, anxiety, and significant stress that many relatives have to cope with. In Thailand, there are limited research studies on grief, especially in palliative settings. This study aims to examine grief reaction, depression, anxiety, and coping of relatives after palliative patients' death.

MATERIALS AND METHODS

A multi-method design was applied. The authors completed the demographic data questionnaire, and the participants finished other measures which included the Hospital Anxiety and Depression Scale (HADS), the Inventory of Complicated Grief (ICG), and the Brief-Coping Orientation to Problems Experienced (Brief-COPE). The qualitative data from the focus group interview was analyzed with thematic analysis.

RESULTS

From the quantitative study, the mean scores of HADS for anxiety and depression subscales were 5.05 and 6.34, respectively, which indicated no anxiety and depressive disorders. The mean score of ICG was 19.51 with highest score on acceptance coping subscale. In contrast, the lowest score was on dealing with the substance subscale. There were significant correlations between anxiety subscale from HADS and ICG (r = 0.73), depression subscale from HADS and ICG(r = 0.85), and anxiety and depression subscale from the HADS (r = 0.79). From the qualitative study, the factors associated with grief reaction could be thoroughly explained according to the perceived character of deceased, perceived character of relatives, relationship characteristics, disease, medical care, and support systems.

CONCLUSION

The correlations among grief reaction, depression, and anxiety of relatives after palliative patients' death were high. The grief reaction was associated with many factors, including communication from medical personnel. This finding emphasized the importance of assessing the reactions after loss and associated factors in the relatives after palliative patients' death. Also, evaluating the ways that the relatives use to cope with their loss, expressing empathy, and supporting the relatives to cope with loss in an adaptive way were recommended.

Psychological Distress in Patients with Coronary Artery Disease During the COVID-19 Pandemic and its Association with Coping Mechanisms

Background and Objectives

Coronary artery disease (CAD) has been associated with increased stress both etiologically and as a consequence. The current pandemic of COVID-19 infection has impacted the personal, social, and occupational spheres of people's lives and has negatively affected mental health. People with existing chronic medical illnesses may be more vulnerable to the stressful effects of the ongoing pandemic.This study was conducted on patients with CAD during the COVID-19 pandemic to estimate the prevalence of psychological distress, the factors associated with distress, and their coping mechanisms.

Materials and Methods

A cross-sectional study was conducted at a tertiary care teaching hospital in Kerala in the cardiology department. After informed consent was obtained from the patients with CAD, sociodemographic details were collected, Kessler Psychological Distress Scale (K-10 scale) was administered to assess psychological distress and the Brief COPE scale was administered to assess their coping mechanisms.

Results

Among 50 patients who participated, the prevalence of psychological distress was 50%. The factors associated with distress were female gender, semiskilled occupation, incomplete COVID-19 vaccination status, exposure of family to COVID-19, experiencing financial difficulties, and experiencing difficulty acquiring medications prescribed for CAD. Religion and acceptance were the most common coping strategies applied by the patients and acceptance was found to be a better coping strategy than religion.

Conclusion

There is a high prevalence of psychological distress among patients with CAD during the pandemic, owing to the emotional, financial, and familial instability faced during the pandemic.

Factors Affecting Perceived Work Environment, Wellbeing, and Coping Styles: A Comparison between Physicians and Nurses during the COVID-19 Pandemic

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.

Impact of the COVID-19 Pandemic on the Wellbeing of International Oncology and Hematology Fellows at the Princess Margaret Cancer Center (PMCC)

Background

The COVID-19 pandemic has led to significant disruptions across all levels of medical training. International fellows in subspecialty training programs are essential members of the frontline physician workforce, but may face additional and unique challenges as a result of being away from their home country. In this study, we aimed to understand the impact of the COVID-19 pandemic on the wellbeing of international fellows in the Hematology and/or Oncology fellowship program at the PMCC.

Methods

In collaboration with our staff psychiatrist, we conducted an online survey of hematology and/or oncology fellows at the PMCC from July 6 to August 10, 2020. The survey consisted of 60 questions divided into 4 sections: demographics, wellbeing assessment using the validated Short Warwick Edinburgh Mental Wellbeing Scale (SWEMWBS), fellowship specific questions (personal and professional) and coping strategies using the validated brief COPE scale.

Results

Overall 24/52 (46%) fellows completed the survey: 21/24 were international fellows with 48% from Asia, 3/24 were Canadian fellows but away from home; 54% were male; 48% were aged 31–35 years; 65% were married, 48% had children. Mean SWEMWBS score was 21, indicating lower overall wellbeing than the general population who had a score of 23.6. Compared to their pre-COVID status, many reported a decline in their wellbeing (63%), sense of guilt for not being with their family (45%) or helping their country (41%), stress in personal relationships (26%), fatigue (50%), sleep disorders (38%) and loss of interest in daily activities (38%). Personal events were altered by almost 80%; and 20% planned to extend their fellowship. According to the Brief-COPE scale, during the pandemic, most fellows used more adaptive coping mechanisms (mean score 39.2) as opposed to maladaptive ones (mean score 21.8).

Conclusions

The ongoing COVID-19 pandemic has negatively affected the overall wellbeing of international fellows. Understanding the specific challenges and coping mechanisms used by international fellows may help institutions develop better targeted strategies to promote wellbeing, professional development and ensure high-quality patient care during unprecedented times like the COVID pandemic.

The validation of the brief COPE in a belgian perinatal population

INTRODUCTION

The Brief Coping Orientation to Problems Experienced (Brief-COPE) measures individuals' coping strategies. There is limited evidence on the psychometric properties of this measure in a perinatal population. The aim of this study is to explore the psychometric properties of the Brief COPE in pregnant and postpartum women.

METHODS

The Dutch/Flemish version of the Brief-COPE was administrated in a sample of 754 antenatal (n = 432) and postpartum (n = 322) women living in Belgium. Exploratory factor analyses assessed the factor structure of the Brief-COPE and its convergent validity in an antenatal and postpartum sample. Cronbach's alpha was calculated for internal consistency reliability of the Brief-COPE items.

RESULTS

Exploratory factor analysis showed a five-factor antenatal model, presented by the subscales: (1) Active coping (α = 0.86), (2) Self-blame and Disengagement (α = 0.70), (3) Alcohol use (α = 0.96), (4) Humour (α = 0.79), and (5) Spirituality (α = 0.81). For the postpartum sample, a three-factor model emerged, presented by the subscales: (1) Active coping (α = 0.85), (2) Self-blame (α = 0.85) and (3) Spirituality (α = 0.74).

CONCLUSIONS

We observed differences and similarities in coping strategies between antenatal and postpartum women - information to be of merit for clinical practice and research. The Brief-COPE is a promising tool for the use of identifying women's coping strategies during pregnancy and the postpartum period, specifically for women in a similar cultural context as the women in this study, mainly in terms of antenatal alcohol use.

Mental health outcomes and experiences of family caregivers of children with disabilities during the COVID-19 pandemic in Bolivia

This study examined whether certain demographic characteristics, caregiver strain, and coping behaviors were associated with the mental health outcomes of family caregivers of children with disabilities in Bolivia during the COVID-19 pandemic. A mixed-methods convergent study design was used with virtual interviews to quantitatively assess caregivers' demographic characteristics, caregiver strain, coping behaviors, and mental health outcomes, as well as qualitatively assess how the pandemic affected their family. Approximately 32%-71% of caregivers experienced poor mental health outcomes (stress, anxiety, and depression), especially among those experiencing poor health, high caregiver strain, and those using maladaptive coping strategies. Qualitative responses revealed that they experienced several unique stressors during the pandemic that affected them and their children. These findings highlight the need for culturally tailored prevention and treatment interventions to help offset the adverse effects of the COVID-19 pandemic on the mental health outcomes of this at-risk population.

Psychiatric and Psychosocial Characteristics of a Cohort of Spanish Individuals Attending Genetic Counseling Due to Risk for Genetically Conditioned Dementia

Background:

Predictive genetic tests are presently effective over several medical conditions, increasing the demand among patients and healthy individuals. Considering the psychological burden suspected familial dementia may carry on individuals, assessing personality, coping strategies, and mental health could aid clinicians in findings the appropriate time for delivering genetic test results and predict compliance regarding genetic counseling and expectations towards the genetic condition depending on the outcome.

Objective:

To describe the psychiatric, psychological, and coping characteristics of a sample of Spanish individuals at risk of familial dementia before genetic test results were given.

Methods:

We included 54 first degree relatives of patients diagnosed with Alzheimer’s disease, lobar frontotemporal degeneration, or prion diseases. The NEO-FFI-R, COPE, and HADS tests evaluated personality, coping strategies, and psychological distress, respectively.

Results:

Anxiety and depression were below the cut-off point for mild severity. Conscientiousness and Agreeableness were the most preponderant personality factors, while Neuroticism was the least. Positive reinterpretation and Acceptance were the most frequent coping strategies, and Denial and Alcohol and drug use were the least used. Ongoing medical pathologies increased depression, while psychiatric disorders worsened psychological distress.

Conclusion:

Contrary to our expectations, PICOGEN candidates showed psychological distress and personality traits within normative ranges, and the use of problem-focused coping strategies prevailed over avoidance coping strategies. Nevertheless, clinicians should pay particular attention to individuals attending genetic counseling who are women, aged, and present an ongoing psychiatric disorder and psychiatric history at inclusion to ensure their mental health and adherence throughout the process.

The Pattern of Substance Use among People Who Use Drugs (PWUD) Receiving Treatment at University Malaya Medical Centre (UMMC) during the COVID-19 Pandemic and the Associated Factors

There was a change in the pattern of substance usage among people who use substances during the COVID-19 pandemic period. This study aims to determine the effects of the COVID-19 pandemic on the pattern of substance usage among people who use drugs (PWUD) receiving treatment at the University Malaya Medical Centre (UMMC) as well as levels of anxiety and depression together with coping mechanisms and the factors affecting the pattern of substance use during COVID-19 pandemic period. A cross-sectional study was applied. The questionnaire used was the Mini-European Web Survey on Drugs (EWSD): COVID-19, Hospital Anxiety and Depression Scale (HADS), and Brief COPE Scale. In total, 130 PWUD were recruited. Of the participants, 36.2% of PWUD had not used/stopped the usage of illicit drugs/alcohol, 26.2% increased their usage, 20% decreased, and 14.6% used the same amount of illicit substances/alcohol during the COVID-19 pandemic period/restrictions. In addition, 28.5% of PWUD had an increased intention to seek professional support for drug counseling/treatment during the COVID-19 pandemic period. The prevalence anxiety and depression symptoms in PWUD according to HADS was 33% and 41.5%, respectively, with depression (p = 0.05) and isolation status (adjusted OR = 2.63, p < 0.05) being associated with an increase in alcohol/illicit substance use during the COVID-19 pandemic. PWUD who had increased their intention to seek professional support had significantly higher odds (adjusted OR = 4.42, p < 0.01) of reducing their alcohol/illicit substance use during the COVID-19 pandemic period. There were increased odds of maintaining alcohol/illicit substance usage among PWUD who practiced dysfunctional coping (adjusted OR = 3.87, p < 0.025) during the COVID-19 pandemic period. In conclusion, depression, isolation status, dysfunctional coping, and intention to seek professional support affected the pattern of alcohol/illicit substance use during the COVID-19 pandemic period. Strategies, substance rehabilitation/counseling, and proper mental health screening and the associated risk factors must be emphasized to prevent a further epidemic of substance use during the pandemic.

Mental health impact of COVID-19 in frontline healthcare workers in a Belgian Tertiary care hospital: a prospective longitudinal study

OBJECTIVES

A prospective longitudinal single-centre study to assess the mental health impact of COVID-19 on nurses working in the frontline during the first wave of COVID-19 hospitalizations in Belgium, 2020.

PATIENTS AND METHODS

The study was performed between April 1^st and 30 June 2020. Nurses who were actively and daily involved in the care of COVID-19 patients on selected intensive care units (ICU) and non-ICU wards were included. Depression, somatization, anxiety and distress scores were calculated using the Four-Dimensional Symptom Questionnaire (4DSQ). The Impact of Event Scale-Revised (IES-R) and Brief-COPE questionnaires were used to assess respectively the psychological impact and coping strategies. Participants were asked to fill in the questionnaire at the start of inclusion, 4 weeks later and 8 weeks later.

RESULTS

In total, 39/42 included nurses participated in the study. 4DSQ results showed low rates of depression, anxiety and somatization with a declining trend over time. Distress scores however were high throughout the study period. A past history of stress symptoms was significantly associated with higher distress scores at the inclusion and one month follow-up. As major psychological impact, more participants experienced 'intrusion' compared to 'avoidance' specifically among nurses working on ICU. In 10% of participants, IES-R-scores were predictive for post-traumatic stress disorder.

CONCLUSION

Healthcare workers dealing with COVID-19 patients during the pandemic reported high and enduring distress scores and experienced a major impact on mental health, especially when employed at ICU. These results highlight the importance of psychological support and proper long-term follow-up to mitigate this impact.

The Emotions, Coping, and Psychological Well-Being in Time of COVID-19: Case of Master's Students

Background: Master’s students have been affected by COVID-19 and the changing study conditions due to the lockdown. The aim was to uncover changes in emotions, coping strategies, and psychological well-being during a pandemic. Methods: Ryff scale, multidimensional emotion questionnaire, and Brief COPE scale. Participants: sample of 118 master’s students after the first wave and 128 master’s students after the second wave. Results: After the second wave of COVID-19, the happy, enthusiastic, and inspired scores of the emotion construct components increased statistically significantly (p < 0.05), but the scores of the components sad, afraid, angry, ashamed, and anxious decreased significantly (p < 0.05). After the first wave, students commonly used planning, positive reframing, self-blame, humor, and acceptance coping strategies, which are classified as problem-focused and emotion-focused coping strategies. The psychological well-being of master’s students after the second wave was statistically (p < 0.05) better than that after the first wave in many indicators. Environment mastery skills did not change significantly. Significant associations were revealed between the same components of psychological well-being, emotion, and coping strategies. Conclusions: This study showed that the master’s students improved their adaptive abilities probably in the environment of long-term exposure to coronavirus disease, as most psychological well-being indicators improved significantly after the second wave.

A Path Model of the Relationship between Mood, Exercise Behavior, Coping, and Mental Health among Malaysians during the COVID-19 Pandemic

The purpose of this study was to examine the relationship between the mood, physical activity, coping, and mental health of Malaysians during the COVID-19 pandemic. A cross-sectional study was conducted via an online survey, with self-administered questionnaires. The respondents were recruited using snowball sampling techniques. The Brunel Mood Scale (BRUMS), the Exercise Regulations in Exercise-3 (BREQ-3), the Brief Coping Orientation of Problem Experienced (Brief COPE), and the Depression, Anxiety, and Stress Scale (DASS-21) were used. A path analysis was conducted on the data. A total of 842 people participated in the survey. The mean age of participants was 22 years (interquartile range = 6) and 24.0% were male. The final path model fitted the data well, with a comparative fit index of 0.998, a Tucker–Lewis index of 0.988, a standardized root mean square residual of 0.001, and a root mean square error of approximation of 0.072. In this study, there were significant path relationships between mood, exercise behavior, coping, and mental health. Additionally, it was demonstrated that the variables of mood, exercise behavior, and coping have both direct and indirect effects on mental health. The results also suggested that utilizing appropriate coping skills, exercise behavior, and positive mood can directly lower levels of depression, anxiety and stress, and that appropriate coping skills and positive mood can directly affect exercise behavior.

Assessing the effect of the COVID-19 pandemic, shift to online learning, and social media use on the mental health of college students in the Philippines: A mixed-method study protocol

INTRODUCTION

The COVID-19 pandemic declared by the WHO has affected many countries rendering everyday lives halted. In the Philippines, the lockdown quarantine protocols have shifted the traditional college classes to online. The abrupt transition to online classes may bring psychological effects to college students due to continuous isolation and lack of interaction with fellow students and teachers. Our study aims to assess Filipino college students' mental health status and to estimate the effect of the COVID-19 pandemic, the shift to online learning, and social media use on mental health. In addition, facilitators or stressors that modified the mental health status of the college students during the COVID-19 pandemic, quarantine, and subsequent shift to online learning will be investigated.

METHODS AND ANALYSIS

Mixed-method study design will be used, which will involve: (1) an online survey to 2,100 college students across the Philippines; and (2) randomly selected 20-40 key informant interviews (KIIs). Online self-administered questionnaire (SAQ) including Depression, Anxiety, and Stress Scale (DASS-21) and Brief-COPE will be used. Moreover, socio-demographic factors, social media usage, shift to online learning factors, family history of mental health and COVID-19, and other factors that could affect mental health will also be included in the SAQ. KIIs will explore factors affecting the student's mental health, behaviors, coping mechanism, current stressors, and other emotional reactions to these stressors. Associations between mental health outcomes and possible risk factors will be estimated using generalized linear models, while a thematic approach will be made for the findings from the KIIs. Results of the study will then be triangulated and summarized.

ETHICS AND DISSEMINATION

Our study has been approved by the University of the Philippines Manila Research Ethics Board (UPMREB 2021-099-01). The results will be actively disseminated through conference presentations, peer-reviewed journals, social media, print and broadcast media, and various stakeholder activities.

The Future Looks Good: Examining the Associations Between Coping, Psychological Distress, and Optimism

The recent pandemic and consequent lockdown had a substantial impact on mental health and optimism regarding the future. Previous research showed that levels of depression, anxiety, and stress had increased throughout the pandemic. Nonetheless, how individuals cope when faced with adversity may be associated with positive expectations regarding the future. A sample of 274 Portuguese workers (female = 54) with a mean age of 40.86 (SD = 0.70) and work experience of 19.68 years (SD = 12.07) met inclusion criteria and agreed to participate in the proposed study. They represented a variety of working classes (i.e., arts, engineering, marketers, transportation and logistic, clerks, personal trainers, managers, lawyers, accountants, directors, journalism, health care). We investigated the associations between depression, stress, anxiety, adaptive and maladaptive coping, and optimism while controlling for working experience, gender, and work type. We found that depression was related to lower levels of optimism. However, for participants scoring high on adaptive coping and anxiety, higher scores of optimism were reported. Gender, work type, and experience did not significantly influence the results. These results provide evidence through which positive mental health can be promoted after the pandemic.

Development and Validation of a Coping Strategies Scale for Use in Chinese Contexts

Individuals’ coping strategies have a profound effect on how well they respond to negative life events. Despite this, most coping strategies instruments that are available currently have been developed exclusively in Western contexts. In the present study, a Coping Strategies Scale (CSS) for use with Chinese participants was developed and validated based on responses from 734 Chinese university students (334 male, 399 female, 1 other). Results supported a seven-factor structure for the CSS, which included the dimensions of Withdrawal, Positive Adaptation, Problem-solving, Disengagement, Prosocial Focus, Seeking Emotional Support, and Self-regulation. The results supported the validity of the seven-factor CSS in terms of its content, associated response processes, internal structure, and relationships with other variables. Based on these results, the CSS provides a psychometrically sound instrument for assessing the coping strategies used by Chinese adults in confronting potentially adverse psychological events.

Coping Strategies Among Undergraduates: Spanish Adaptation and Validation of the Brief-COPE Inventory

Purpose

Different studies have highlighted the importance of coping strategies in stressful situations. The Coping Orientation to Problem Experienced (COPE) by Carver et al is one of the instruments that is frequently used for measuring this aspect. The aim of this study was to carry out the cross-cultural adaptation and validation of the Brief-COPE inventory to measure coping strategies in Spanish populations.

Methods

The linguistic and cultural adaptation of the Brief-COPE was carried out using the back-translation method and, after considering the results of the pilot test, the Spanish version of the instrument was configured, and subsequently administered to a convenient sample of 2135 undergraduates. A confirmatory factor analysis was carried out to examine construct validity of the Spanish adaptation of the brief-COPE; likewise, reliability was analyzed from two approaches, internal consistency and composite reliability. Concurrent validity was also tested.

Results

The results showed that the Spanish version of Brief-COPE has adequate reliability values, as well as satisfactory fit indexes for the proposed 14-factor first-order structural model. Likewise, external evidence of the validity of the inventory with the variables perceived stress, level of satisfaction with life, and academic performance is provided.

Conclusion

The results suggest that this instrument presents a satisfactory metric quality and, therefore, it could be useful to evaluate coping strategies, which would allow further research on its incidence and consequences on health and psychological functioning.

The COVID-19 Pandemic Impacted Maternal Mental Health Differently Depending on Pregnancy Status and Trimester of Gestation

Introduction: We aimed to measure the impact of the COVID-19 pandemic on maternal mental health, stratifying on pregnancy status, trimester of gestation, and pandemic period/wave. Methods: Pregnant persons and persons who delivered in Canada during the pandemic, >18 years, were recruited, and data were collected using a web-based strategy. The current analysis includes data on persons enrolled between 06/2020−08/2021. Maternal sociodemographic indicators, mental health measures (Edinburgh Perinatal Depression Scale (EPDS), Generalized Anxiety Disorders (GAD-7), stress) were self-reported. Maternal mental health in pregnant women (stratified by trimester, and pandemic period/wave at recruitment) was compared with the mental health of women who had delivered; determinants of severe depression were identified with multivariate logistic regression models. Results: 2574 persons were pregnant and 626 had already delivered at recruitment. Participants who had delivered had significantly higher mean depressive symptom scores compared to those pregnant at recruitment (9.1 (SD, 5.7) vs. 8.4 (SD, 5.3), p = 0.009). Maternal anxiety (aOR 1.51; 95%CI 1.44−1.59) and stress (aOR 1.35; 95%CI 1.24−1.48) were the most significant predictors of severe maternal depression (EDPS ˃ 13) in pregnancy. Conclusion: The COVID-19 pandemic had a significant impact on maternal depression during pregnancy and in the post-partum period. Given that gestational depression/anxiety/stress has been associated with preterm birth and childhood cognitive problems, it is essential to continue following women/children, and develop strategies to reduce COVID-19′s longer-term impact.

Coping strategies and chiropractic student perceived stress

OBJECTIVE

To investigate coping strategies adopted by chiropractic college students and how these strategies affect student-perceived stress levels.

METHODS

Four hundred seven (407) 1st-quarter students were recruited during 2014 and 2015. The validated Brief COPE inventory was used to assess coping strategies during the 1st week of classes. Perceived Chiropractic College Stress (PCCS) was assessed via a modification of Vitaliano Perceived Medical School Stress survey instrument. The modified coping instrument was administered during the 1st quarter (PCCS1) and 6 months later during the 3rd quarter (PCCS2).

RESULTS

Mean perceived stress levels were greater after 6 months. Although perceived stress increased more for females than for males over that period, it was not statistically significant. Male and female coping strategies differed only in the preferential use of emotional support by females. Students generally adopted active coping strategies (eg, active coping and planning) rather than avoidant strategies (eg, substance abuse). Regression analysis revealed a moderate positive relationship between avoidant-emotion coping and PCCS1 with a weaker positive correlation between problem-focused coping, sex, and PCCS1. Avoidant-emotion coping also demonstrated a moderate positive correlation with PCCS2. Neither sex nor the 3 coping strategies were predictors of PCCS change (PCCS2 - PCCS1).

CONCLUSION

This study is a starting point for exploring the relationship between perceived stress and coping behaviors in a chiropractic training institution. Students generally used healthy adaptive coping strategies with minimal sex differences. Avoidant-emotion coping appears to be a reliable predictor of PCCS, with sex being a poor predictor.