Association between habitual use of coping strategies and posttraumatic stress symptoms in a non-clinical sample of college students: A Bayesian approach

The prevalence of PTSD and coping strategies among Palestinian mental health professionals during political violence and wartime

Background

In times of war, mental health professionals are at an increased risk of developing psychological problems, including posttraumatic stress disorder (PTSD). The effects of conflicts or wars on mental health professionals in Palestine and their coping methods of dealing with these challenges remain unknown. This study aimed to assess the prevalence of PTSD symptoms and strategies for coping among mental health professionals in Palestine, in light of the ongoing Gaza war and political violence.

Methods

The study utilized a cross-sectional research design. Self-reported questionnaires, including the PCL-5 and Brief COPE scales, were used to gather data. The relationship between the research variables and PTSD symptoms was investigated using frequencies, percentages, bivariate analysis, Pearson correlation, and Pearson's chi-square test.

Results

A total of 514 participants were recruited, with an estimated prevalence of PTSD of 38.7%. Furthermore, the multivariate analysis revealed that having a prior history of trauma and feeling disabled or unable to deal with your patients during the current Gaza war and Israeli-Palestinian political violence increases the likelihood of developing PTSD symptoms. In addition, using venting, self-blame, and behavioral disengagement as coping strategies increases the likelihood of developing symptoms of PTSD. Moreover, using acceptance and substance use as coping strategies reduces the risk of developing PTSD symptoms.

Conclusion

The findings revealed a high prevalence of PTSD symptoms among mental health professionals during wartime and political violence. As a result, mental health professionals need immediate assistance in enhancing their mental wellbeing through supervision, psychotherapy, and comprehensive and continuous training.

Cerebral cortical thinning in brain regions involved in emotional regulation relates to persistent symptoms in subjects with posttraumatic stress disorder

A considerable proportion of individuals exposed to trauma experience chronic and persistent posttraumatic stress disorder (PTSD). However, the specific brain and clinical features that render trauma-exposed individuals more susceptible to enduring symptoms remain elusive. This study investigated 112 trauma-exposed participants who had been diagnosed with PTSD and 112 demographically-matched healthy controls. Trauma-exposed participants were classified into those with current PTSD (persistent PTSD, n = 78) and those without (remitted PTSD, n = 34). Cortical thickness analysis was performed to discern group-specific brain structural characteristics. Coping strategies and resilience levels, assessed as clinical attributes, were compared across the groups. The persistent PTSD group displayed cortical thinning in the superior frontal cortex (SFC), insula, superior temporal cortex, dorsolateral prefrontal cortex, superior parietal cortex, and precuneus, relative to the remitted PTSD and control groups. Cortical thinning in the SFC was associated with increased utilization of maladaptive coping strategies, while diminished thickness in the insula correlated with lower resilience levels among trauma-exposed individuals. These findings imply that cortical thinning in brain regions related to coping strategy and resilience plays a vital role in the persistence of PTSD symptoms.

Coping profiles and differences in well‐being during the COVID‐19 pandemic: A latent profile analysis

During the current COVID-19 pandemic, people need to cope with multiple stressors which may affect their well-being. This study aimed (1) to identify latent coping profiles in the German general population, and (2) to investigate differences between these profiles in well-being. In total, N = 2326 German participants were recruited as part of the European Society of Traumatic Stress Studies (ESTSS) ADJUST study from June to September 2020 using an online survey. Coping strategies were assessed using the Brief-COPE and the Pandemic Coping Scale; well-being was assessed using the WHO-5 Well-Being Index. Coping profiles were identified using latent profile analysis; differences between profiles were examined using the automatic BCH method and multiple group analyses. Five coping profiles were identified that included different types and numbers of coping strategies: (1) High functional coping (17.84%), (2) Moderate functional coping (40.63%), (3) High functional and religious coping (9.07%), (4) Low functional coping (22.06%), (5) Moderate functional and dysfunctional coping (10.40%). The identified profiles significantly differed in well-being (χ²  = 503.68, p <0.001). Coping profiles indicating high functional coping were associated with greater well-being compared to coping profiles indicating low (χ²  = 82.21, p <0.001) or primarily dysfunctional (χ²  = 354.33, p <0.001) coping. These results provide insight into how people differ in their coping strategies when dealing with stressors in an early phase of the COVID-19 pandemic. The study indicates higher levels of well-being in coping profiles with more frequent use of functional strategies. To promote well-being in the general population, it might be beneficial to train functional coping strategies in appropriate interventions that are associated with increased well-being.

Psychological impact of the COVID-19 pandemic among adults in India: A longitudinal study

A longitudinal follow-up design was used to study the psychological distress and coping among 168 individuals immediately after the national lockdown and after 6 months of the pandemic. Psychological distress was measured using the Depression, Anxiety, and Stress Scale (DASS-21). The coping strategies used were measured by the Brief-COPE, and Intolerance of Uncertainty Scale (IUS-12) was employed to measure response to uncertainty. On follow-up, the prevalence rates for severe/very severe levels of depression, anxiety, and stress had increased substantially from time 1 to time 2. The stepwise multivariate regression analyses revealed that the change in the three DASS-21 scores over time was primarily predicted by intolerance of uncertainty as measured by the IUS-12 and dysfunctional style as assessed by the coping Brief-COPE. There is a need to implement public health policies that promote psychological resilience among high-risk groups.

Association between psychological distress and coping strategies among students engaged in online learning

Distant or online learning on digital platforms has become the norm in education worldwide, putting students under immense mental strain. The present study examined the association between psychological distress and coping strategies among students engaged in online learning. This study used a cross-sectional design. A structured questionnaire was sent to each of the 210 university students at two prestigious public and private universities in Bangladesh through email. Data was collected from March 26 to April 27, 2021. Severe psychological distress was found in 55.2 percent of the population. Younger age groups, public university students, students with no self-income, moderate aid from the university in providing resources from home, and students with existing mental health illnesses were significantly associated with psychological distress (p-value<0.05). Among all 14 items of Brief COPE, active coping, using emotional support, and self-blame significantly influenced the psychological distress instrument Kessler-10 (p-value<0.01). Given the perspective of this study, coping strategies alleviate stress and facilitate positive psychological outcomes. Students’ mental health is a prioritized issue that needs more attention. Because of its higher prevalence and adverse consequences, institution authorities should support each student by providing study materials, student loans, and scholarships. Routine screening will allow identifying students going through a difficult time who can get help from experts through counseling.

Coping Methods Used by College Undergraduate and Graduate Students while Experiencing Childhood Adversities and Traumas

Experiences in childhood, both positive and negative, are crucial to a child's progression. Childhood traumas and adversities are detrimental to children's development and can have long term consequences that manifest themselves in young adulthood. The purpose of this study is to inductively explore coping strategies used by young adults during their experience of childhood traumas and adversities. A sample of college students from a diverse northeastern university (N = 146) provided quantitative and qualitative survey responses. Students were asked, "What were the tools you used to cope with adversity and/or traumatic events?" Participants responded to the prompt based on their experiences from childhood. The researchers analyzed the qualitative data using a mixed-method, thematic approach to coding participant responses. Additional quantitative information is explored to explain emerging qualitative themes. Two salient themes of coping strategies emerged, providing support for Machado et al. (2020): (1) Emotion-Focused Coping and (2) Problem-Focus Coping. Minor themes built on the findings in the area of Emotion-Focused Coping, highlighting processes of (i) emotional regulation, (ii) emotional expression, and (iii) emotional avoidance. Excerpts from this study's participants suggest that individuals dealing with adversities and traumas find a variety of ways to cope. These coping strategies can be implemented into institutions' everyday practices to aid children during their time of vulnerability. The article provides recommendations for school administrators, leadership teams, and any professional specializing in school culture, curriculum, and social work.

The Impact of COVID-19 and Associated Interventions on Mental Health: A Cross-Sectional Study in a Sample of University Students

BACKGROUND

Mental health issues have continued to rise globally, including among university students. The COVID-19 pandemic has exacerbated the previously existing and concerning problem. Given that coping mechanisms have been proposed to mediate the relationship between stressors and mental health, the aim of our cross-sectional study was to investigate the mediation of coping mechanisms on the relationship between the impact of the COVID-19 pandemic and mental health.

METHODS

University students (≥18 years old; N = 676; 31% male, 69% female) were administered an anonymous survey addressing current demographics, COVID-19 pandemic-related demographics, personal experiences, sources of stress and perceived effect on mental health, politics, sources of news/information, and various pre-validated scales addressing mental health (DASS-21), the impact of the COVID-19 pandemic (IES-R) and coping strategies utilized (Brief COPE).

RESULTS

Our results indicate a substantial proportion of our sample reporting scores in the severe and extremely severe DASS-21 categories, in addition to ~50% reporting a perceived deterioration in mental health relative to pre-COVID-19 pandemic. Moreover, a substantial proportion of students reported IES-R scores at levels where PTSD is of clinical concern. Alarmingly, a significant proportion of females (~15%) reported scores reflecting potential long-term PTSD-related implications. Females tended to be more severely impacted in all mental health measures. Mediation analysis indicated that while dysfunctional coping mediated the relationship between the impact of the event (COVID-19 pandemic) and all three mental health outcomes, overall, this was not the case with the positive coping strategies.

CONCLUSION

Our study appears to indicate a reduced buffering influence on negative mental health outcomes by the positive coping mechanisms investigated in relation to the COVID-19 pandemic and secondary interventions implemented. While the findings of this study pertain specifically to university students, they corroborate the existing extensive body of research (from physiological to behavioral, preclinical to clinical) pertaining to the response associated with major stressful events at every level of society. In this regard, the findings imply the necessity for health and other authorities, tasked with safeguarding public well-being, to avoid reactive interventions that do not appropriately balance the risks and benefits, potentially exacerbating pre-existing psychopathologies and compromising social order.

Association between distinct coping styles and heart rate variability changes to an acute psychosocial stress task

Modern life comprises a myriad of stressful situations, ranging from life-threatening ones to others not so deadly, all of which activate a physiologic stress response. Engaging in healthy ways to cope can prevent us from wearing out our physiological systems. Heart rate variability (HRV) is often used as an index of emotion regulation response. Hence, our goal is to investigate whether the habitual use of coping strategies is related to a distinct pattern of HRV changes when the individual is exposed to a moderate psychosocial stressor. In this study, 60 female participants performed a psychosocial stress task-oral speech preparation-while ECG signals were collected during the whole experimental procedure. Heart rate (HR), HRV parameters (SDNN, RMSSD, LF, HF) and coping strategies (Brief COPE) were registered. Participants were divided into two groups (low and high groups) as a function of their scores on the maladaptive and adaptive coping strategies of the Brief COPE. As expected, the task alone induced increases in heart rate and reductions in HRV parameters. Additionally, the analyses revealed a different pattern of HRV (SDNN, RMSSD, LF and HF) changes in response to the stressor, with participants using less maladaptive strategies being able to maintain the HRV at baseline levels when confronting the stressor, while those using more maladaptive strategies reducing HRV during the task. These results show a different pattern of HRV changes as a function of the coping style, suggesting a possible autonomic advantage, namely, the maintenance of HRV, in individuals who use maladaptive coping strategies less frequently.

Tonic Immobility is Associated with PTSD Symptoms in Traumatized Adolescents

Purpose

Growing evidence suggests that peritraumatic tonic immobility, an involuntary defensive response that involves extreme physical immobility and the perceived inability to escape, is a significant predictor of post-traumatic stress disorder (PTSD) symptomatology. However, this issue has not been specifically addressed in adolescents. Here, we investigated whether tonic immobility response experienced during the worst childhood or adolescent trauma is associated with PTSD symptom severity in a non-clinical student sample.

Methods

The sample was composed of students in 9th grade who were attending public and private schools. Symptoms of post-traumatic stress and tonic immobility were assessed using questionnaires. We performed bivariate and multivariate negative binomial regressions to examine whether tonic immobility was associated with PTSD symptomatology after controlling for confounders (peritraumatic dissociation, peritraumatic panic reactions, gender, age and time since trauma).

Results

We found an association between tonic immobility and PTSD symptom severity, even after controlling for confounders. Therefore, tonic immobility is associated with PTSD symptoms in trauma-exposed adolescents.

Conclusion

These findings highlight tonic immobility as a possible risk factor that could be used to provide direction for more targeted trauma interventions for individuals, particularly those at risk for developing PTSD. Therefore, it contributes to preventing and reducing the psychiatric burden in adolescence and later in life.

The Consequences of COVID-19 Toward Human Growth: The Role of Traumatic Event and Coping Strategies Among Indonesian Sample

COVID-19 has brought a massive psychological impact on individuals' life. The current study sets a significant purpose to test the model whether post-traumatic stress and coping strategies affect stress-related growth regarding the COVID-19 event. One hundred and ninety-nine participants have participated in an online survey in the period of lockdown. The proposed hypotheses model is further tested using PLS-SEM. The first model explains a significant moderate, 46% amount of variance for stress-related growth. With gender as moderator, the second model explains a significant 29% amount of variance for stress-related growth, which is also moderate. This study shows that active coping strategies and positive affirmation significantly influence individual stress-related growth. The trauma event (COVID-19) does not significantly affect growth. Women experience trauma compared to men, besides active coping with the COVID-19 situation is higher in men than women. Using the Bio-centric perspective, having a positive connection through acceptance and awareness of the situation, self-care, and affective interaction with others would develop growth regarding traumatic situations. Further, interventions about coping skills and positive affirmations are essential to give, especially to vulnerable groups such as women.

Posttraumatic stress symptoms among health care workers during the COVID-19 epidemic: The roles of negative coping and fatigue

Healthcare workers (HCWs) exposed to Coronavirus disease 2019 (COVID-19) are not immune to stressors. This study aimed to explore the prevalence of posttraumatic stress symptoms (PTSS) among HCWs during the COVID-19 epidemic and investigate the associations among negative coping, fatigue and PTSS. A total of 507 HCWs from Anhui province enrolled in the study and completed the cross-sectional survey including demographic data, Simplified Coping Style Questionnaire (SCSQ), 14-item Fatigue Scale (FS-14), and PTSD Checklist-civilian Version (PCL-C). Univariate linear regression, Pearson correlation and Mackinnon's four-step procedure were performed in the statistical analysis. Results indicated that the prevalence of PTSS among HCWs during the pandemic was 24%. Univariate linear regression showed HCWs aged 31-40 years exhibited significantly higher scores of PTSS than those aged 51-60 (β = 0.20, 95% CI: 0.59 to 9.41). Having at least one child was associated with a higher risk of developing PTSS (β = 0.01, 95% CI: 0.36 to 5.45). Negative coping and fatigue were positively correlated with all three PTSS (all P < 0.001), including re-experiencing, avoidance and hyper-arousal. Fatigue has mediated the association between negative coping and PTSS among HCWs during the pandemic (ab = 0.09, SE = 0.03, bootstrap 95% CI: 0.04 to 0.14). A considerable proportion of HCWs was traumatized during the COVID-19 outbreak. Hence, the institutions should screen out and pay close attention to HCWs who tend to use negative coping (e.g., withdrawal thinking, distraction and blaming others) and arrange work scientifically to avoid overfatigue and PTSS amid the public health crisis.

Commonly Reported Problems and Coping Strategies During the COVID-19 Crisis: A Survey of Graduate and Professional Students

BACKGROUND

The COVID-19 crisis has introduced a variety of stressors, while simultaneously decreasing the availability of strategies to cope with stress. In this context, it could be useful to understand issues that people find most concerning and ways in which they cope with stress. In this study, we explored these questions with a sample of graduate and professional students.

METHOD

Using open-ended assessments, we asked participants (n = 305) to identify their biggest challenge or concern ("top problem"), their most effective way of handling stress ("effective strategy"), and their most common way of handling stress ("common strategy"). We applied thematic analysis and evaluated whether participants' strategies corresponded with evidence-based practices (EBPs).

RESULTS

Participants frequently reported top problems relating to productivity (27% of sample), physical health (26%), and emotional health (14%). Distraction was the most frequently classified common strategy (43%), whereas behavioral activation was the most frequently identified effective strategy (50%). Participants who reported a common strategy classified as an EBP reported lower depressive and anxiety symptoms. In contrast, there was no evidence of an association between symptom levels and whether or not participants' effective strategy was an EBP. Participants who reported the same strategy as both their common and effective strategy (29%) reported lower depressive symptoms than those whose common and effective strategies were different.

CONCLUSION

Our findings highlight stressors that students are experiencing and ways they are coping during the COVID-19 crisis. We discuss how these findings can inform mental health promotion efforts and future research on coping with stressors.

Coping, Resilience, and Perceived Stress in Individuals with Internet Gaming Disorder in Taiwan

Aim: Gaming escapism is an essential factor for developing internet gaming disorder (IGD). We evaluated coping strategies, resilience, stress, and depression in individuals with IGD. Methods: We included 69 participants with IGD and 138 controls (69 regular gamers and other non-gamers) in Taiwan. The self-reported coping strategies, coping stress with gaming, resilience, perceived stress, and depression were assessed. Results: Participants with IGD had higher dysfunctional coping, coping stress by gaming, perceived stress, and depression, as well as lower problem-focused coping and resilience. Regression analysis revealed that coping by gaming was associated with dysfunctional coping mechanisms, particularly venting and self-distraction. Compared with participants with adequate resilience, those with lower resilience had higher perceived stress, depression, and coping by gaming, and lower problem-focused and emotion-focused coping. Dysfunctional coping and coping by gaming were associated with perceived stress and depression in both IGD and control groups. Problem-focused coping was negatively associated with perceived stress and depression in controls. Conclusion: Individuals with IGD had higher perceived stress and depression, as they were more likely to cope with stress by dysfunctional coping and gaming and less likely to try problem-focused coping, particularly those with lower resilience. Interventions for IGD should promote problem-focused coping, such as active coping and planning strategies, particularly among those with lower resilience.

The Effect of COVID-19 Anxiety on General Health: the Role of COVID-19 Coping

The Coronavirus Disease 2019 (COVID-19) epidemic has unprecedently affected many aspects of people’s lives including their health. This study examined the mediating effect of COVID-19 coping strategies on the relationship between COVID-19 anxiety and general health. Participants (70% females) included 4624 adults (M_age = 30.29 ± 10.97 years) collected through an online survey using a convenience sampling approach. Exploratory and confirmatory factor analyses yielded a one-factor structure for the COVID-19 Anxiety Scale (CFI = .98, TLI = .96, SRMR = .02, RMSEA = .09), COVID-19 Coping Scale (CFI = .97, TLI = .97, SRMR = .03, RMSEA = .12), and General Health Scale (CFI = .99, TLI = .97, SRMR = .01, RMSEA = .04) which were developed for the purpose of this study and exhibited satisfactory reliability. Findings showed that COVID-19 anxiety was negatively related with COVID-19 coping and general health. COVID-19 coping had a positive relationship with general health. Hierarchical multiple regression analyses revealed that COVID-19 coping partially mediated the relationship between COVID-19 anxiety and general health. These findings shed more light on the mechanism underlying between COVID-19 anxiety and health. The findings are important for tailoring and implementing coping-based intervention strategies to reduce the impact of COVID-19 anxiety on general health.

Affective Temperament is Associated with Stress Coping Strategies and Work Stress Perception Among Polish Bank Employees

Background

Stress in the banking workplace is associated with psychological and health problems. Intensity of work-related stress experiences is associated with specificity of job stress factors personal features such as affective temperament. The aim of the study was to evaluate associations between affective temperament, coping stress strategies, and perceived job stress in bank employees.

Methods

Subjects were 209 bank workers aged 22–55 years (n = 101 managers and 108 non-managers). Affective temperament and stress coping strategies were evaluated using the Temperament Evaluation of Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) and Coping Inventory for Stressful Situations (CISS), respectively. Both questionnaires, TEMPS-A and CISS, show good internal consistency and are proper research methods in the bank employee group. Perceived job-related stress was rated for different sources of job stress common among bank workers.

Results

Depressive temperament was negatively associated with coping style focused on avoidance, and with job stress regarding “responsibility for decisions regarding other people” and “frequent trips.” Irritable temperament was positively correlated with coping style focused on task and job stress regarding “frequent trips.” Cyclothymic temperament was positively correlated with job stress regarding “direct work with money” and “organizational conditions of work.” Multidimensional linear regression showed that irritable and anxious temperaments were associated with coping style focused on task; depressive temperament was associated with coping style focused on avoidance; and cyclothymic temperament was associated with intensity of job stress. The results obtained indicate different levels of job-related stress associated with different sources in bank employees, working with managers and non-managers positions. Affective temperament was associated with stress coping strategies and intensity of perceived job stress. On the basis of affective temperament dimensions it is possible to predict stress coping styles and work-related stress perception in bank employees.

Conclusion

Affective temperament traits measured by TEMPS-A were associated with stress coping strategies and intensity of work stress perception in Polish bank employees.