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Kline AC, Harlé KM, Panza KE, Nichter B, Lyons R, Pitts M, Haller M, Allard CB, Capone C, Norman SB. Changes in guilt cognitions mediate the effect of trauma-informed guilt reduction therapy on PTSD and depression outcomes. J Clin Psychol 2024; 80:1147-1160. [PMID: 38340354 DOI: 10.1002/jclp.23659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/08/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE Trauma-informed guilt reduction therapy (TrIGR), a six-session cognitive behavioral therapy targeting trauma-related guilt and distress, reduces guilt and symptoms of posttraumatic stress disorder (PTSD) and depression, yet little is known regarding how and why TrIGR may be effective. METHOD This study examined treatment-related changes in avoidant coping and trauma-related guilt cognitions as possible mediators of treatment effects on PTSD and depression outcomes at 3- and 6-month follow-up. Data were from a randomized controlled trial for treatment of trauma-related guilt comparing TrIGR and supportive care therapy among 145 post-9/11 US veterans (Mage = 39.2 [8.1], 93.8% male). RESULTS At pretreatment, most (86%) met PTSD criteria. Intent to treat analyses using parallel mediation models indicated changes in guilt cognitions, but not avoidant coping, mediated the effect of TrIGR on reducing PTSD severity at 3-month (a × b = -0.15, p < 0.01, 95% CI: [-0.24 to -0.06], p = 0.001) and 6-month (a × b = -0.17, 95% CI: [-0.26 to -0.07], p = 0.001) follow-up. Similarly, changes in guilt cognitions, but not avoidant coping, mediated the effect of TrIGR on reducing depression severity at 3-month (a × b = -0.10, 95% CI: [-0.18 to -0.02], p = 0.02) and 6-month (a × b = -0.11, 95% CI: [-0.20 to -0.03], p = 0.01) follow-up. CONCLUSIONS Compared to guilt cognitions, changes in avoidant coping were less integral to downstream PTSD and depression symptom reduction. Guilt cognition change may be a salient active ingredient of PTSD and depression treatment for those with trauma-related guilt and a key therapy element to which providers should be attuned.
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Affiliation(s)
- Alexander C Kline
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Katia M Harlé
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Kaitlyn E Panza
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | | | - Robert Lyons
- VA San Diego Healthcare System, San Diego, California, USA
| | - Michelle Pitts
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Moira Haller
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Carolyn B Allard
- VA San Diego Healthcare System, San Diego, California, USA
- California School of Professional Psychology, Alliant International University, San Diego, California, USA
| | - Christy Capone
- Providence VA Medical Center, Providence, Rhode Island, USA
- Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
| | - Sonya B Norman
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- VA Center of Excellence for Stress and Mental Health, San Diego, California, USA
- National Center for Posttraumatic Stress Disorder, White River Junction, Vermont, USA
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Gupta S, Fischer J, Roy S, Bhattacharyya A. Emotional regulation and suicidal ideation-Mediating roles of perceived social support and avoidant coping. Front Psychol 2024; 15:1377355. [PMID: 38629033 PMCID: PMC11018903 DOI: 10.3389/fpsyg.2024.1377355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/14/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction Recent research has uncovered a wide prevalence variation of suicidal ideation in university students ranging from 9.7% to 58.3%. India has witnessed a 4.5% increase in suicide rates in the year 2021. The interplay between cognitive reappraisal of a stressful situation, suppression of emotional expression, and coping strategies for suicidal ideation of Indian University students is yet to be explored. We aim to determine whether suicidal ideation would differ across different types of family units, and to predict the extent to which perceived social support and avoidant coping could mediate the relation between emotion regulation processes and suicidal ideation. Methods Two hundred randomly selected University students (Mean age = 19.9, SD = 1.43) participated. Kruskal-Wallis, Pearson's product-moment correlation, and GLM mediation model were computed. Results and discussion Lifetime suicidal ideation significantly differed between those who stay alone and those who live in a nuclear family (p < 0.01), and also those who stay in a joint family (p < 0.05). Cognitive reappraisal predicted a reduction in suicidal ideation mediated by perceived social support (B = -0.06, p < 0.05) and avoidant coping (B = -0.07, p < 0.05). Whereas, expressive suppression predicted induced levels of suicidal ideation through perceived social support (B = 0.05, p < 0.05), and avoidant coping (B = 0.06, p < 0.05) as mediators. Conclusion Though our sample size restricts the generalization, our findings implied the importance of regular psychological consultation regarding the efficacy of the said coping processes in dealing with suicidal ideation.
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Affiliation(s)
- Soham Gupta
- Amity Institute of Psychology and Allied Sciences, Amity University Kolkata, Kolkata, West Bengal, India
| | - Jonathan Fischer
- Department of Biostatistics, University of Florida, Gainesville, FL, United States
| | - Sakhi Roy
- Amity School of Economics, Amity University Kolkata, Kolkata, India
| | - Atreyee Bhattacharyya
- Amity Institute of Psychology and Allied Sciences, Amity University Kolkata, Kolkata, West Bengal, India
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Günther V, Strukova M, Pecher J, Webelhorst C, Engelmann S, Kersting A, Hoffmann KT, Egloff B, Okon-Singer H, Lobsien D, Suslow T. Cognitive Avoidance Is Associated with Decreased Brain Responsiveness to Threat Distractors under High Perceptual Load. Brain Sci 2023; 13:brainsci13040618. [PMID: 37190583 DOI: 10.3390/brainsci13040618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 05/17/2023] Open
Abstract
Cognitive coping strategies to deal with anxiety-provoking events have an impact on mental and physical health. Dispositional vigilance is characterized by an increased analysis of the threatening environment, whereas cognitive avoidance comprises strategies to inhibit threat processing. To date, functional neuroimaging studies on the neural underpinnings of these coping styles are scarce and have revealed discrepant findings. In the present study, we examined automatic brain responsiveness as a function of coping styles using functional magnetic resonance imaging. We administered a perceptual load paradigm with contemptuous and fearful faces as distractor stimuli in a sample of N = 43 healthy participants. The Mainz Coping Inventory was used to assess cognitive avoidance and vigilance. An association of cognitive avoidance with reduced contempt and fear processing under high perceptual load was observed in a widespread network including the amygdala, thalamus, cingulate gyrus, insula, and frontal, parietal, temporal, and occipital areas. Our findings indicate that the dispositional tendency to divert one's attention away from distressing stimuli is a valuable predictor of diminished automatic neural responses to threat in several cortical and subcortical areas. A reduced processing in brain regions involved in emotion perception and attention might indicate a potential threat resilience associated with cognitive avoidance.
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Affiliation(s)
- Vivien Günther
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Mariia Strukova
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Jonas Pecher
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Carolin Webelhorst
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Simone Engelmann
- Department of Neuroradiology, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Karl-Titus Hoffmann
- Department of Neuroradiology, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Boris Egloff
- Department of Psychology, Johannes Gutenberg University of Mainz, 55122 Mainz, Germany
| | - Hadas Okon-Singer
- Department of Psychology, University of Haifa, Haifa 3100000, Israel
| | - Donald Lobsien
- Department of Neuroradiology, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Thomas Suslow
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany
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Abstract
This study aims to examine the association between family communication and psychological distress with coping as a potential mediator. The study also developed and validated the Family Communication Scale (FCS) in the context of COVID-19 pandemic. Participants (n = 658; 74.9% female) were general public ranged in age between 18 and 58 years (mean age = 26.38, SD = 10.01). The results showed that family communication directly influenced psychological distress and indirectly influenced through approach coping. However, avoidant coping was not directly associated with psychological distress, nor did it mediate the association between family communication and psychological distress. The findings suggest that people, who have better family communication, highly engage in approach coping which in turn leads to better psychological health in face of adversity. The findings have important empirical and theoretical implications.
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Affiliation(s)
- Ekmel Geçer
- Department of Psychology, Hamidiye
Faculty of Life Sciences, University of Health
Sciences, Istanbul, Turkey
| | - Murat Yıldırım
- Department of Psychology, Faculty
of Science and Letters, Ağrı İbrahim Çeçen
University, Ağrı, Turkey
- Department of Neuroscience,
Psychology and Behaviour, University of Leicester, Leicester, UK
- Murat Yıldırım, Department of Psychology,
Faculty of Science and Letters, Ağrı İbrahim Çeçen University, Erzurum Yolu 4 Km
04100, Merkez, Ağrı, Turkey.
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Al Beainy S, El Hassan K. Coping strategies and personal growth: The case of Palestinian refugees in Shatila camp, Lebanon. Front Psychol 2023; 14:1083998. [PMID: 36968712 PMCID: PMC10034374 DOI: 10.3389/fpsyg.2023.1083998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 01/31/2023] [Indexed: 03/29/2023] Open
Abstract
This study investigated the relationship between coping strategies used by adolescent refugees in the Palestinian refugees' Shatila camp in Lebanon and posttraumatic growth. Moreover, the study explored and predicted the impact of coping strategies utilized by adolescent Palestinians in Shatila camp, Lebanon on their personal growth and psychological well-being. Data were collected using two questionnaires and a checklist: (a) LEC-5 checklist as an assessment tool to make sure that all the participants have faced or experienced stressful events, (b) questionnaires including the Ways of Coping Questionnaire (WCQ) to find out the style of coping refugees used, and (c) Posttraumatic Growth Inventory (PTGI) to identify the factors of growth refugees developed as a result of using different coping strategies. Sixty adolescent refugees at one of the centers in the camp (31 females and 29 males) who benefited from counseling services participated in the study. Adolescent refugees' performance on the checklist and questionnaires revealed the prevalence of stressors among the refugees. The coping strategies mostly utilized were problem-focused coping strategies, as there was a correlation between its factors and some coping strategies, and there were coping strategies used that predict the development of growth among. Finally, as for the counseling and training programs and services, interventions and guidance services seem to better prepare refugees to handle and cope with the stress that they encounter to develop personal growth.
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Rou C, Janković M, Bogaerts S. The Moderating Roles of Resilience and Coping Strategy on Well-Being of Victimized Forensic Workers. Int J Offender Ther Comp Criminol 2022:306624X221124834. [PMID: 36181288 DOI: 10.1177/0306624x221124834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Previous research on workplace victimization has often disregarded forensic psychiatric populations and not yet been extended to the coronavirus pandemic. The present study expected the isolation of the government-issued lockdown to increase aggressive behavior in forensic patients, ultimately decreasing the general well-being of victimized forensic workers. Possible buffering protective factors (resilience and active coping) and enhancing risk factors (avoidant coping and passive coping) were investigated with the intention of optimizing the general well-being of at-risk forensic workers. The valid sample (N = 311) consisted of Dutch and Belgian forensic workers (74.6% females) with at least 9 hours of weekly patient contact, and with a mean age of 37.99 (SD = 12.20). Participants reported the number of violent incidents in the past 2 months, as well as completed a questionnaire battery including measures of well-being, resilience, and coping strategies. A significant increase of victimization during the lockdown compared to after it was lifted was found, however, the study did not find evidence to support that this negatively influenced the worker's general well-being. Active coping was found to be a significant moderator and protective factor for the general well-being of victimized forensic workers. In contrast, resilience, avoidant and passive coping were not significant moderators in this association. The present study has valuable clinical implications that could lead to preparatory and preventative measures for forensic workers at risk of being victimized. Future research may investigate constructs such as life satisfaction and post-traumatic growth, as well as be broadened into prison populations.
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Affiliation(s)
| | - Marija Janković
- Tilburg University, The Netherlands
- Fivoor Science and Treatment Innovation (FARID), Rotterdam, The Netherlands
| | - Stefan Bogaerts
- Tilburg University, The Netherlands
- Fivoor Science and Treatment Innovation (FARID), Rotterdam, The Netherlands
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O’Gorman KM, Wilson MJ, Seidler ZE, English D, Zajac IT, Fisher KS, Rice SM. Male-Type Depression Mediates the Relationship between Avoidant Coping and Suicidal Ideation in Men. Int J Environ Res Public Health 2022; 19:10874. [PMID: 36078589 PMCID: PMC9517898 DOI: 10.3390/ijerph191710874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 06/15/2023]
Abstract
Despite known links between men's avoidant coping behaviours (e.g., distraction, denial, substance use) and suicide risk, little research has explored the mechanisms underpinning this relationship. This study sought to examine whether male-type depression symptoms (e.g., anger, aggression, emotion suppression), assessed by the Male Depression Risk Scale, mediate the association between avoidant coping and suicide/self-harm ideation in men. Data were drawn from an online survey of a community sample of 606 Australian men (M age = 50.11 years; SD = 15.00), conducted during the COVID-19 pandemic. Mediation analyses were applied to examine the effect of male-type depression on the association between avoidant coping and suicidal/self-harm ideation, controlling for age, resilience and the experience of two psychosocial stressors during the COVID-19 pandemic (financial stress and government restrictions). Avoidant coping was associated with suicidal/self-harm ideation, r = 0.45, p < 0.001. Results supported a mediating role of male-type depression symptoms in this relationship, R2= 0.29, PM = 0.36, p < 0.001, underscoring the importance of screening for male-type depression symptoms to better identify men at risk of suicidal/self-harm ideation. Results also suggest a need to support men to develop effective coping strategies, particularly in the context of common psychosocial stressors experienced during the COVID-19 pandemic and beyond.
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Affiliation(s)
- Kieran M. O’Gorman
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Michael J. Wilson
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Zac E. Seidler
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia
- Movember, Richmond, VIC 3121, Australia
| | - Derek English
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Ian T. Zajac
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Adelaide, SA 5000, Australia
- School of Psychology, University of Adelaide, Adelaide, SA 5000, Australia
| | - Krista S. Fisher
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Simon M. Rice
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia
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McKenna A, Hazell CM, Souray R, Cai W, Man LC, Brown L, Floyd C, Lyons N, Widuch K, James G, Keay D, Souray J, Afsharzadegan R, Raune D. Do carers of adolescents at first episode psychosis have distinctive psychological needs? A pilot exploration. Int J Soc Psychiatry 2022; 68:600-609. [PMID: 33554710 DOI: 10.1177/0020764021992828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Carers of patients experiencing first episode psychosis (FEP) are at an increased risk of mental and physical health problems themselves. However, little is known about how the psychological needs of carers may differ between those caring for an adolescent versus an adult who has FEP. AIMS This pilot study aimed to explore any differences in the psychological needs of carers caring for adolescents versus adults with FEP. METHODS We surveyed 254 carers of 198 FEP patients (34 carers of adolescents of 24 FEP adolescent patients). Carers completed self-report measures of anxiety, depression, burnout, subjective burden, coping, and key illness beliefs. The sample was divided according to whether the patient was under (adolescent) or over (adult) age 18, and analysed using mixed model logistic regressions. RESULTS Compared to the carers of adult patients, carers of adolescents were more than twice as likely (12% vs. 30%) to experience overall burnout syndrome (all three domains), and to develop it much quicker (19.4 vs. 10.1 months). They were also more likely to adopt behavioural disengagement avoidance as a form of coping. However, there was no difference between carers in terms of anxiety, depression, beliefs and subjective burden. For carers of adolescents, burnout was independently predicted by: a negative belief about the consequences of psychosis for the adolescent patient and an incoherent understanding of the patient's mental health. CONCLUSIONS If our findings can be replicated in a larger sample, then Rapid-Onset-Burnout-Syndrome (ROBS) is a particular problem in carers of adolescents at FEP, suggesting a need for routine screening and possible prophylactic intervention. Carers of adolescent's use of behavioural escape coping maybe also require early intervention. Theoretically, consideration could be given to the development of an adolescent sub-branch to the cognitive model of caregiving.
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Affiliation(s)
- Alice McKenna
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK.,Community Transformation Project, East London NHS Foundation Trust, London, UK
| | - Cassie M Hazell
- Department of Social Sciences, University of Westminster, London, UK
| | - Rowan Souray
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - Wenyi Cai
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - Lai Chu Man
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - Lucy Brown
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - Caroline Floyd
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - Natasha Lyons
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - Kaja Widuch
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - Gareth James
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - Debra Keay
- CAHMS Ash Tree, Central and North West London NHS Foundation Trust, London, UK
| | - Jonathan Souray
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - Roya Afsharzadegan
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - David Raune
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
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Nordin NM, Dahamat Azam N, Rosnon MR, Abu Talib M. Job stress and depression among Malaysian anti-drug professionals: The moderating role of job-related coping strategies. Front Psychiatry 2022; 13:1020947. [PMID: 36419977 PMCID: PMC9676435 DOI: 10.3389/fpsyt.2022.1020947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/04/2022] [Indexed: 11/09/2022] Open
Abstract
Depression can cause negative consequences to workers' health and social functioning, such as poor work productivity, mental disorders, and suicide. Existing studies have argued that job stress is closely related to depression in many professions. Yet, information on how coping strategies play a significant role in the relationships among Malaysian anti-drug professionals is still scarce. Thus, the aim of this study was to examine to what extent coping strategies moderate the relationship between job stress and depression among Malaysian anti-drug professionals. A total of 3,356 National Antidrug Agency (NADA) officers aged between 21 and 59 years completed online self-report measures of depression, job stress, and job-related control coping and avoidant coping behaviors. The results showed that job stress was strongly correlated with depression, and both coping strategies were found to significantly moderate the correlations. The correlations between stress and depression were stronger among participants who had higher levels of avoidant coping or those who had lower levels of control coping. To conclude, this study highlights the importance of considering job stress and coping behaviors to understand anti-drug professionals' mental health during this challenging COVID-19 pandemic.
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Affiliation(s)
| | - Naqi Dahamat Azam
- Department of Human Development and Family Studies, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang, Malaysia
| | - Mohd Roslan Rosnon
- Department of Social and Development Sciences, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang, Malaysia
| | - Mansor Abu Talib
- Faculty of Social Science and Liberal Arts, UCSI University, Kuala Lumpur, Malaysia
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Günther V, Jahn S, Webelhorst C, Bodenschatz CM, Bujanow A, Mucha S, Kersting A, Hoffmann KT, Egloff B, Lobsien D, Suslow T. Coping With Anxiety: Brain Structural Correlates of Vigilance and Cognitive Avoidance. Front Psychiatry 2022; 13:869367. [PMID: 35463500 PMCID: PMC9021612 DOI: 10.3389/fpsyt.2022.869367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/14/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Individuals differ in their dispositional coping behavior when they are confronted with anxiety-provoking situations. Cognitive avoidance is characterized by a withdrawal from threatening information, whereas vigilance denotes the intensive search for threat-related information. Functional neuroimaging studies indicate alterations in brain responsivity to emotional stimuli as a function of cognitive avoidant and vigilant coping, but findings are partially discrepant. Studies on structural correlates of coping styles are scarce. MATERIALS AND METHODS By using structural magnetic resonance imaging, the present study examined the relationship between brain gray matter volume and coping strategies in 114 healthy individuals. Individual differences in vigilance and cognitive avoidance were measured by the Mainz Coping Inventory. RESULTS Exploratory whole-brain analyses were conducted. Cognitive avoidant coping significantly predicted reduced gray matter volume in the bilateral thalamus, whereas vigilant coping was associated with volumetric increases in the bilateral thalamus. These relationships remained significant when controlling for a potential influence of age, sex, depressive symptoms, and trait anxiety. DISCUSSION Our findings indicate that dispositional strategies to deal with anxiety-provoking situations are related to volumetric alterations in the thalamus, a brain structure that has been implicated in the mediation of attentional processes and alertness, and the anticipation of harm. The dispositional tendency to monitor the environment for potential threats (i.e., vigilance), appears to be associated with volumetric increases in the thalamus, whereas the dispositional inclination to divert one's attention away from distressing stimuli (i.e., cognitive avoidance) seems to go along with reductions in thalamic gray matter density.
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Affiliation(s)
- Vivien Günther
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Salome Jahn
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Carolin Webelhorst
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Charlott Maria Bodenschatz
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Anna Bujanow
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Simone Mucha
- Department of Neuroradiology, University of Leipzig Medical Center, Leipzig, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Karl-Titus Hoffmann
- Department of Neuroradiology, University of Leipzig Medical Center, Leipzig, Germany
| | - Boris Egloff
- Department of Psychology, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Donald Lobsien
- Department of Neuroradiology, University of Leipzig Medical Center, Leipzig, Germany
| | - Thomas Suslow
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
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Nik Jaafar NR, Abd Hamid N, Hamdan NA, Rajandram RK, Mahadevan R, Mohamad Yunus MR, Zakaria H, Leong Bin Abdullah MFI. Posttraumatic Growth and Coping Strategies Among Patients With Head and Neck Cancer: Do Approach Coping and Avoidant Coping Predict Posttraumatic Growth Over Time? Front Psychol 2021; 12:716674. [PMID: 34764904 PMCID: PMC8576436 DOI: 10.3389/fpsyg.2021.716674] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Despite an enormous number of studies addressing the importance of posttraumatic growth (PTG) among cancer patients, the literature lacks data regarding how different coping strategies affect PTG among head and neck cancer (HNC) patients over time. This longitudinal study investigated the PTG trend and coping over 5-7months among a cohort of HNC patients within the first year after their diagnosis. It determined an association between coping strategies and PTG over time. The study's HNC respondents were administered a socio-demographic and clinical characteristics questionnaire during their baseline assessments. Additionally, the Malay versions of the "PTG Inventory-Short Form" (PTGI-SF) and the "Brief Coping Orientation to Problems Experienced Inventory" (Brief COPE) were administered during respondents' baseline assessments and follow-up assessments (5-7months after the baseline assessments). In total, 200 respondents reported an increasing PTG trend and approach coping (active coping, planning, positive reframing, acceptance, emotional support, and instrumental support) and a decreasing trend of avoidant coping (self-distraction and denial) over time. Two approach coping strategies (acceptance and planning) significantly increased PTG while denial was the only avoidant coping strategy that significantly lowered PTG, after controlling for socio-demographic and clinical characteristics, over time. Our study's findings identified the need to incorporate psychosocial interventions that enhance approach coping and reduce avoidant coping into HNC patients' treatment regimes.
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Affiliation(s)
| | - Norhaliza Abd Hamid
- Lifestyle Science Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia
| | - Nur Amirah Hamdan
- Lifestyle Science Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia
| | - Rama Krsna Rajandram
- Department of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia
| | - Raynuha Mahadevan
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia
| | - Mohd Razif Mohamad Yunus
- Department of Otorhinolaryngology, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia
| | - Hazli Zakaria
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia
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Tan X, An Y, Chen C. Avoidant coping as mediator of the relationship between rumination and mental health among family caregivers of Chinese breast cancer patients. Eur J Cancer Care (Engl) 2021; 31:e13523. [PMID: 34658090 DOI: 10.1111/ecc.13523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 06/07/2021] [Accepted: 09/24/2021] [Indexed: 12/09/2022]
Abstract
INTRODUCTION Family caregivers of cancer patients were often referred to the 'forgotten patients', yet little researches have been conducted on their mental health. Rumination might put family caregivers at risk for psychological distress during the caregiving, such as stress and anxiety. The aim of the present study was to explore the relationship between rumination, stress and anxiety among family caregivers of breast cancer patients in China and examine the mediating role of avoidant coping in this relationship. METHODS Face-to-face questionnaire interviews were conducted with a sample of 99 caregivers from the public oncology hospital. They were assessed with stress, anxiety, rumination and avoidant coping by Chinese Perceived Stress Scale, Zung's Self-Rating Anxiety Scale, Ruminative Responses Scale and Coping Strategy Indicator. Structural equation modelling was applied to assess the mediation analysis. RESULTS The reporting scores of participants indicated the incidence of anxiety was 17.2%. Rumination could directly predict stress (β = 0.58, p < 0.01) and anxiety (β = 0.46, p < 0.01) and also predict stress and anxiety via the mediator of avoidant coping (stress: β = 0.087, p < 0.01; anxiety: β = 0.109, p < 0.01). CONCLUSIONS The important role played by family caregivers in supporting breast cancer patients is well recognised. The findings suggested that rumination and avoidant coping may be two critical risk factors for family caregivers of breast cancer developing stress and anxiety. This study highlights the importance of preventing avoidant coping, which plays a critical role for developing interventions for this vulnerable group.
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Affiliation(s)
- Xing Tan
- School of Psychology, Nanjing Normal University, Nanjing, China.,School of Psychology, South China Normal University, Guangzhou, China
| | - Yuanyuan An
- School of Psychology, Nanjing Normal University, Nanjing, China
| | - Chen Chen
- Department of Social and Behavioural Sciences, City University of Hongkong, Hongkong, China
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13
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Cohee A, Johns SA, Alwine JS, Talib T, Monahan PO, Stump TE, Cella D, Champion VL. The mediating role of avoidant coping in the relationships between physical, psychological, and social wellbeing and distress in breast cancer survivors. Psychooncology 2021; 30:1129-1136. [PMID: 33749062 PMCID: PMC8411351 DOI: 10.1002/pon.5663] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/08/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Many breast cancer survivors (BCSs) recover from the negative sequelae of cancer treatment. However, some report persistent and disruptive distress well into disease-free survivorship. More information is needed on the predictors of distress in this growing population of BCS, including the role of avoidant coping, or attempts to avoid thoughts, feelings, and reminders of cancer, in mediating the relationship between distress and psychological, physical, and social domains of well-being. METHODS In a large cross-sectional study, BCS (n = 1,127), who were 3 to 8 years post-diagnosis, completed a survey assessing demographic characteristics, medical history, distress (anxiety and depressive symptoms), avoidant coping, and physical (fatigue), psychological (fear of recurrence, attention, body image), and social (social support from a partner, social constraints from a partner) well-being. Multiple mediation analyses were conducted to determine if avoidant coping mediated the relationship between each distress variable (anxiety and depressive symptoms) and each well-being (fear of recurrence, attention, body image, fatigue, social support, and social constraints) variable. RESULTS In all six mediation models, avoidant coping significantly (p < 0.001) mediated the relationship between each well-being variable (fear of recurrence, attention, body image, fatigue, social support, and social constraints) and each distress indicator (depression and anxiety). Avoidant coping mediated 19%-54% of the effects of the contributing factors on the distress variables. CONCLUSIONS Avoidant coping may indicate risk for, or presence of, distress among BCS. Interventions to reduce distress may benefit from addressing avoidant coping styles.
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Affiliation(s)
- Andrea Cohee
- Indiana University School of Nursing, Indianapolis, IN
| | - Shelley A. Johns
- Indiana University School of Medicine, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
| | | | - Tasneem Talib
- Indiana University School of Nursing, Indianapolis, IN
| | - Patrick O. Monahan
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana University Fairbanks School of Public Health, Indianapolis, IN, USA
| | - Timothy E. Stump
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - David Cella
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Chen Y, Li X, Chen C, An Y, Shi J, Huang J, Zhao Y. Influence of Avoidant Coping on Posttraumatic Stress Symptoms and Job Burnout Among Firefighters: The Mediating Role of Perceived Social Support. Disaster Med Public Health Prep 2021;:1-6. [PMID: 34176544 DOI: 10.1017/dmp.2021.155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The study aims to explore the effects of avoidant coping on posttraumatic stress symptoms (PTSS) and job burnout among firefighters, and to examine the mediating role of perceived social support on the relationship between avoidant coping and PTSS and job burnout. METHOD Assessments including the posttraumatic stress disorder checklist for DSM-5 (PCL-5), Maslach Burnout Inventory-General Survey (MBI-GS), Coping Style Inventory (CSI), and Perceived Social Support Scale (PSSS) were conducted among 431 firefighters studying in a school specializing in training firemen in Nanjing, China. RESULT The results show that: (1) Avoidant coping was positively related to PTSS and job burnout among firefighters; and (2) avoidant coping was positively related to PTSS and job burnout through the mediating effect of perceived social support. CONCLUSION These findings not only provide guiding information for relevant departments to prevent mental health issues of firefighters in the future, but also enlighten the psychological intervention for firefighters, that is, to encourage firefighters to actively face and solve problems and adopt positive coping styles, as well as offer them more care and support whenever possible.
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15
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Younis M, Norsa'adah B, Othman A. Effectiveness of Psycho-Education Intervention Programme on Coping Strategies Among Jordanian Women Diagnosed with Breast Cancer: A Randomised Controlled Trial. Breast Cancer (Dove Med Press) 2021; 13:285-297. [PMID: 34007208 PMCID: PMC8123945 DOI: 10.2147/bctt.s299584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/19/2021] [Indexed: 11/23/2022]
Abstract
Objective This study aimed to assess the effectiveness of a psycho-education intervention programme in improving the coping strategies of Jordanian breast cancer patients. Methods A double-blinded randomised control trial involving 200 participants between the ages of 20 to 65 years old breast cancer patients was performed. Apart from those who refused participation, patients with chronic diseases and extreme baseline depression scores were also excluded. The control group received standard care twice a week from the social welfare services team facilitator compared to the intervention group that received additional psycho-education intervention programme (PEIP). The coping strategies were measured using the Brief-COPE inventory consisting of 28 items. It was administered on the second and 12th week of trial. The primary end point was compared between pre- and post-intervention. The effect of the intervention between groups, time, and covariates was measured using the generalised linear mixed model (GLMM) analysis. Results The mean (SD) of adaptive coping score among the intervention group increased from 5.63 (1.3) at baseline to 6.42 (1.3) at post-intervention. The mean avoidant coping score was 3.87 (1.1) at baseline but reduced to 3.69 (0.8) post-intervention. GLMM showed that women who received the intervention reported significantly higher usage of the adaptive coping strategies after attending the programme (B=0.921, p <0.001). Conclusion PEIP significantly improved knowledge of breast cancer patients. Thus, this programme may be considered as a part of the healthcare services in Jordan towards improving the adaptive coping strategies among breast cancer patients, which may point towards the potential for these services to increase adaptive coping strategies among patients in Jordan. Implications for Public Health PEIP may be considered as psychosocial intervention in public health and healthcare setting to address rising concerns on quality of care among breast cancer patients.
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Affiliation(s)
- Murad Younis
- Unit of Biostatistics & Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, 16150, Kelantan, Malaysia.,Assistant Medical Science Department, Community College, University of Tabuk, Tabuk, Kingdom of Saudi Arabia.,Radiation Oncology Department, Al-Bashir Hospital, 261 Amman, The Hashemite Kingdom of Jordan
| | - Bachok Norsa'adah
- Unit of Biostatistics & Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, 16150, Kelantan, Malaysia
| | - Azizah Othman
- Department of Pediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, 16150, Kota Bharu, Kelantan, Malaysia
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Chen L, Qu L. From Stressful Experiences to Depression in Chinese Migrant Children: The Roles of Stress Mindset and Coping. Front Psychol 2021; 12:601732. [PMID: 33889105 PMCID: PMC8056082 DOI: 10.3389/fpsyg.2021.601732] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 03/01/2021] [Indexed: 11/13/2022] Open
Abstract
Migrant children are at high risk for depression, though the exact mechanism is still unclear. This study investigated whether and how different stress mindsets (threat vs. challenge) and coping strategies (avoidant vs. approach) mediated the association between stressful experiences and depression in migrant children, and whether these relationships would be moderated by gender. One hundred and ninety-eight rural-to-urban migrant children (56.0% girls; Mage = 11.8 years) in Beijing, China, completed self-administered measures of stressful experiences, threat and challenge mindsets, coping strategies, and depression. Path analysis was conducted to examine the proposed mediation model. A dual-pathway model of stress coping was discovered: (1) a stress-threat-avoidance-depression pathway, in which threat mindset and avoidant coping mediated the association between stressful experiences and depression, and (2) a challenge-approach-enhancement pathway, in which approach coping mediated the association between challenge mindset and fewer depressive symptoms, without being influenced by stressful experiences. The dual-pathway mechanism did not vary by gender, and it can explain the greater vulnerability of girls to depression. Together, findings suggest that stressful events, threat mindset, and avoidant coping act as risk factors for depression, whereas challenge mindset and approach coping can function as protective factors to counteract the impacts of stressful experiences and promote psychological well-being among migrant children.
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Affiliation(s)
- Luxi Chen
- Centre for Family and Population Research, National University of Singapore, Singapore, Singapore
| | - Li Qu
- School of Social Sciences, Nanyang Technological University, Singapore, Singapore
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17
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Peñacoba Puente C, Suso-Ribera C, Blanco Rico S, Marín D, San Román Montero J, Catalá P. Is the Association between Postpartum Depression and Early Maternal-Infant Relationships Contextually Determined by Avoidant Coping in the Mother? Int J Environ Res Public Health 2021; 18:E562. [PMID: 33440857 PMCID: PMC7826648 DOI: 10.3390/ijerph18020562] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 12/31/2020] [Accepted: 01/07/2021] [Indexed: 01/04/2023]
Abstract
This study analyzes the moderating role of avoidant coping (in early pregnancy) in the relationship between postpartum depressive (PPD) symptoms and maternal perceptions about mother-baby relations and self-confidence. Participants were 116 low-risk obstetric mothers (mean age = 31.2 years, SD = 3.95, range 23-42) who received care and gave birth at a Spanish public hospital. Measurements were made at two points in time: at first trimester of pregnancy (maternal avoidance coping) and four months after childbirth (PPD and maternal perceptions). Avoidant coping was associated with the perception of the baby as irritable and unstable (p = 0.003), including irritability during lactation (p = 0.041). Interaction effects of avoidant coping and postpartum depression were observed on the perception of the baby as irritable (p = 0.031) and with easy temperament (p = 0.002). Regarding the mother's self-confidence, avoidant coping was related to a lack of security in caring for the baby (p < 0.001) and had a moderating effect between PPD and mother's self-confidence (i.e., lack of security in caring for the baby, p =0.027; general security, p = 0.007). Interaction effects showed that the use of avoidant coping in the mother exacerbated the impact of PPD on the early mother-infant relationship.
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Affiliation(s)
- Cecilia Peñacoba Puente
- Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s/n, 28922 Madrid, Spain; (C.P.P.); (S.B.R.); (J.S.R.M.)
| | - Carlos Suso-Ribera
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, 12071 Castellon, Spain;
| | - Sheila Blanco Rico
- Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s/n, 28922 Madrid, Spain; (C.P.P.); (S.B.R.); (J.S.R.M.)
| | - Dolores Marín
- Hospital Universitario de Fuenlabrada, 28944 Madrid, Spain;
| | - Jesús San Román Montero
- Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s/n, 28922 Madrid, Spain; (C.P.P.); (S.B.R.); (J.S.R.M.)
| | - Patricia Catalá
- Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s/n, 28922 Madrid, Spain; (C.P.P.); (S.B.R.); (J.S.R.M.)
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18
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Schackner JN, Weiss NH, Edwards KM, Sullivan TP. Social Reactions to IPV Disclosure and PTSD Symptom Severity: Assessing Avoidant Coping as a Mediator. J Interpers Violence 2021; 36:508-526. [PMID: 29294901 DOI: 10.1177/0886260517727493] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Women's experiences of negative social reactions to disclosure of intimate partner violence (IPV) victimization have been linked to greater posttraumatic stress disorder (PTSD) symptom severity. However, research has not identified factors that may explain this association. The goal of the current study was to extend research in this area by elucidating the potential mediating role of avoidant coping in the relations among negative and positive social reactions to IPV disclosure and PTSD symptom severity. Participants were 173 community women currently experiencing IPV who disclosed their victimization to another individual (M age = 36.31, 65.9% African American). Findings revealed that IPV-victimized women who experienced greater negative social reactions to IPV endorsed higher levels of avoidant coping and greater PTSD symptom severity. Moreover, avoidant coping was found to mediate the negative social reactions-PTSD symptom severity association. Results highlight the relevance of avoidant coping to the link between negative social reactions to IPV disclosure and PTSD symptom severity, and suggest that prevention and intervention efforts targeting avoidant coping may be useful in reducing PTSD symptom severity among IPV-exposed women who experience negative social reactions to IPV disclosure.
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Abstract
This systematic review examined the validity of generic coping-with-stress measures in the relationships between avoidance-type coping and psychosocial adaptation to chronic illness and disability. Major data bases were searched for studies on the association between avoidance-type coping and psychosocial adaptation to chronic illness and disability. Findings indicated that reliance upon avoidance-type coping is linked to reports of poorer psychosocial adaptation. The veracity of these findings must be treated cautiously owing to conceptual, structural, psychometric, and other issues. Users of generic coping measures should consider these concerns prior to empirically investigating the link between generic avoidance-type coping measures and psychosocial adaptation among people with chronic illness and disability.
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20
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Abstract
BACKGROUND The psychological complexity of refugee status for children is poorly understood. Alone or with family members, child refugees are exposed to multiple and potentially traumatic events, including conflict and human rights deprivation in their country of origin, perilous and life-threatening escape journeys, years of statelessness, and isolation and discrimination in their new host country. AIMS This phenomenological study explored the positive and negative interpretations of four adults as they sought to make sense of their experiences of refugee status as children. METHOD Interpretative Phenomenological Analysis (IPA) guided the development of semi-structured interview for data collection and analysis. RESULTS One superordinate theme, Violation and Hope, overarched three subordinate themes, Violent detachment, Refugee identity, and Resourcefulness and reciprocity. One divergent theme also emerged: Clashing identities. These themes provide unique insight into the interpreted experiences of escaping oppression and persecution in each participant's country of origin as children, and the ensuing bleak interval as refugees, belonging nowhere. They identify the risk of becoming pawns of opportunism without human rights protection. Once stateless, survival was not guaranteed, producing a stark merging of acceptance of mortality and determined resourcefulness as children. Avoidant coping became a positive tool for surviving ever present threat, and was crucial in defining a life philosophy that was future oriented as they entered adulthood. CONCLUSION These participants rejected a 'refugee victim' identity, emphasising a legacy of resourcefulness, hope, gratitude and reciprocity, domains of post-traumatic growth which are unreported aspects of refugee well-being that can provide future therapeutic and research direction.
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Affiliation(s)
- Lynne McCormack
- School of Psychology, Faculty of Science, The University of Newcastle, Australia
| | - Brigitta Tapp
- School of Psychology, Faculty of Science, The University of Newcastle, Australia
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21
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Weiss NH, Peasant C, Sullivan TP. Avoidant Coping as a Moderator of the Association Between Childhood Abuse Types and HIV/Sexual Risk Behaviors. Child Maltreat 2019; 24:26-35. [PMID: 30124064 DOI: 10.1177/1077559518793228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Women who experience intimate partner violence (IPV) report high rates of HIV/sexual risk behaviors. Childhood abuse has been linked to HIV/sexual risk behaviors among IPV-victimized women; however, limited research has examined factors that may influence this association. The current study tested the moderating role of avoidant coping in the relation between childhood abuse types (physical, emotional, and sexual) and HIV/sexual risk behaviors. Participants were 212 community women currently experiencing IPV (mean age = 36.63 years, 67.0% African American). Higher levels of avoidant coping were related to more severe childhood abuse types. Severity of childhood abuse types was associated with greater HIV/sexual risk behaviors. Avoidant coping moderated the relation between childhood sexual abuse severity and HIV/sexual risk behaviors, such that this association was significant for IPV-victimized women with high (but not low) levels of avoidant coping. Findings suggest the utility of targeting avoidant coping in interventions aimed at preventing or reducing HIV/sexual risk behaviors among IPV-victimized women with a history of childhood sexual abuse.
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Affiliation(s)
- Nicole H Weiss
- 1 Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | | | - Tami P Sullivan
- 3 Division of Prevention and Community Research, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Abstract
Background: A dysfunctional use of coping strategies has repeatedly been linked to suicidal behaviour in non-psychiatric populations. However, data regarding association between coping strategies and suicidal behaviour in psychiatric populations are limited.Aims: The aim of the study was to investigate the possible relationship between self-reported suicide risk, suicidal ideation and coping strategies in three psychiatric cohorts.Method: Three cohorts of psychiatric patients were involved in the study; recent suicide attempters (n = 55), suicide attempters at follow-up 12 years after a suicide attempt (n = 38) and patients with ongoing depression without attempted suicide (n = 72). Patients filled in the self-rating version of The Suicide Assessment Scale (SUAS-S) from which items no. 17-20 addressing current suicidal ideation were extracted. To investigate coping strategies, the Coping Orientation of Problem Experience Inventory (COPE) was used.Results: In all cohorts, regression analyses showed that only avoidant coping was significantly correlated with the scores of SUAS-S adjusted for covariates. The items no. 17-20 correlated significantly to avoidant coping but not with other coping strategies in all cohorts.Conclusion: The results of this study indicate that among coping strategies only avoidant coping may be associated with suicide risk in psychiatric patients independently of history of attempted suicide.
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Affiliation(s)
- Livia Ambrus
- Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden, and
| | | | - Marie Asp
- Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden, and
| | - Sofie Westling
- Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden, and
| | - Åsa Westrin
- Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden, and
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Abstract
The aim of this study was to explore cancer survivors' return to work (RTW) experience with a specific focus on the adjustment and coping process underlying their journey. The study was conducted in the Southern Cape, South Africa, with eight cancer survivors having returned to work following successful treatment of various types of cancer. Unstructured interviews were conducted and data were analysed following the principles of hermeneutic phenomenological reflection and analysis. Four themes emerged, representing the changing adjustment responses and coping during the RTW journey. Participants evolve from being overwhelmed with emotions and applying avoidant coping to seeking understanding and positive affectivity in their attempt to comprehend the reality of their situation. Participants' external locus of control change to a more active approach and problem-solving orientation, demonstrating a need to take control and responsibility. Ultimately, adjustment and coping become most constructive when cancer survivors resolve to re-assess life and self through meaning-making, resulting in renewed appreciation of life, appropriate life style changes, and regained confidence in their relational role. A process perspective is proposed to facilitate an understanding of, and working with, cancer survivors' transition through the RTW journey towards optimal coping phases.
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Affiliation(s)
- Antoni Barnard
- Department of Industrial and Organisational Psychology, University of South Africa, Pretoria, South Africa;
| | - Loraine Clur
- Employee Wellness Consultant, Southern Cape, South Africa
| | - Yvonne Joubert
- Department of Human Resources Management, University of South Africa, Pretoria, South Africa
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Ganly TJ, Salmon K, McDowall J. Is remembering less specifically part of an avoidant coping style? Associations between memory specificity, avoidant coping, and stress. Cogn Emot 2016; 31:1419-1430. [PMID: 27603316 DOI: 10.1080/02699931.2016.1227304] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Individuals higher on avoidant coping may remember fewer specific autobiographical memories and more nonspecific memories on the Autobiographical Memory Test (AMT) in order to protect themselves from the painful emotions accompanying some specific memories. Habitually remembering this way (overgeneral memory) may be a risk factor for depression. In Studies 1 and 2 (nondepressed samples), avoidant coping was associated with more specific memories and fewer overgeneral memories, at odds with the functional avoidance view. In Study 3 (depressed sample), there were no significant relationships between AMT indices and avoidant coping. Results are discussed in light of ironic process theory.
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Affiliation(s)
- Timothy J Ganly
- a School of Psychology , Victoria University of Wellington , Wellington , New Zealand
| | - Karen Salmon
- a School of Psychology , Victoria University of Wellington , Wellington , New Zealand
| | - John McDowall
- a School of Psychology , Victoria University of Wellington , Wellington , New Zealand
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25
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Knafo A, Guilé JM, Breton JJ, Labelle R, Belloncle V, Bodeau N, Boudailliez B, de la Rivière SG, Kharij B, Mille C, Mirkovic B, Pripis C, Renaud J, Vervel C, Cohen D, Gérardin P. Coping strategies associated with suicidal behaviour in adolescent inpatients with borderline personality disorder. Can J Psychiatry 2015; 60:S46-54. [PMID: 25886671 PMCID: PMC4345850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 12/01/2014] [Indexed: 03/07/2023]
Abstract
OBJECTIVES To compare the coping strategies of adolescents with borderline personality disorder (BPD) to the coping strategies of adolescents without BPD, and to explore the association of coping with suicidal ideation and attempts among adolescents with BPD. METHOD Adolescent inpatients (n = 167) aged 13 to 17 years were admitted after suicide attempts and evaluated within 10 days, using the abbreviated version of the Diagnostic Interview for Borderlines-Revised, the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version supported by a team consensus best estimate method for the primary diagnosis, the Adolescent Coping Scale, and the Columbia-Suicide Severity Rating Scale. RESULTS Firstly, compared with adolescents without BPD, adolescents with BPD relied more on nonproductive coping strategies, mostly avoidant strategies, and less on productive coping strategies. Secondly, coping appeared as a factor associated with suicidal ideation in adolescents with BPD. While while controlling for age, sex, and depression, multivariate analyses showed a significant positive association between the coping strategy to focusing on solving the problem and suicidal ideation. CONCLUSION The use of avoidant strategies by adolescents with BPD could be viewed as attempts to increase emotional regulation. Problem-solving strategies in the immediate aftermath of a suicide attempt may prevent adolescents with BPD from overcoming a crisis and may increase suicidal ideation.
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Affiliation(s)
- Alexandra Knafo
- Psychiatry Resident, Service de Psychopathologie de l’Enfant et de l’Adolescent et Unité de Médecine de l’Adolescent, Centre Hospitalier Universitaire d’Amiens, Université Picardie Jules Verne, Amiens, France
| | - Jean-Marc Guilé
- Professor and Department Head, Service de Psychopathologie de l’Enfant et de l’Adolescent et Unité de Médecine de l’Adolescent, Centre Hospitalier Universitaire d’Amiens, Université Picardie Jules Verne, Amiens, France; Associate Professor, Département de Psychiatrie, Université de Montréal, Montréal, Québec; Assistant Professor, Division of Child Psychiatry, Department of Psychiatry, McGill University, Montréal, Québec; Researcher, Centre de recherche de l’Institut universitaire en santé mentale de Montréal, site de l’Hôpital Rivière-des-Prairies, Montréal, Québec
| | - Jean-Jacques Breton
- Associate Professor, Département de Psychiatrie, Université de Montréal, Montréal, Québec; Researcher, Centre de recherche de l’Institut universitaire en santé mentale de Montréal, l’Hôpital Rivière-des-Prairies, Montréal, Québec
| | - Réal Labelle
- Psychologist and Researcher, Clinique des troubles de l’humeur and Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Hôpital Rivière-des-Prairies, Montréal, Québec; Full Professor, Département de psychologie, Université du Québec à Montréal, Montréal, Québec; Associate Professor, Département de psychiatrie, Université de Montréal, Montréal, Québec
| | - Vincent Belloncle
- Psychiatrist, Département de pédiatrie médicale, Fédération hospitalo–universitaire de psychiatrie de l’enfant et de l’adolescent, Centre hospitalier universitaire de Rouen et Centre hospitalier du Rouvray, Université de Rouen, Rouen, France
| | - Nicolas Bodeau
- Statistics Engineer and Data Manager, Service de Psychiatrie de l’Enfant et de l’Adolescent, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique–Hopitaux de Paris et Université Pierre et Marie Curie, Paris, France
| | - Bernard Boudailliez
- Professor and Department Head, Service de pédiatrie et Unité de Médecine de l’Adolescent, Centre Hospitalier Universitaire d’Amiens, Université Picardie Jules Verne, Amiens, France
| | - Sébastien Garny de la Rivière
- Psychiatry Resident, Service de Psychopathologie de l’Enfant et de l’Adolescent et Unité de Médecine de l’Adolescent, Centre Hospitalier Universitaire d’Amiens, Université Picardie Jules Verne, Amiens, France
| | - Brahim Kharij
- Psychiatry Resident, Service de Psychopathologie de l’Enfant et de l’Adolescent et Unité de Médecine de l’Adolescent, Centre Hospitalier Universitaire d’Amiens, Université Picardie Jules Verne, Amiens, France
| | - Christian Mille
- Professor, Service de Psychopathologie de l’Enfant et de l’Adolescent et Unité de Médecine de l’Adolescent, Centre Hospitalier Universitaire d’Amiens, Université Picardie Jules Verne, Amiens, France
| | - Bojan Mirkovic
- Psychiatrist, Fédération hospitalo–universitaire de psychiatrie de l’enfant et de l’adolescent, Centre hospitalier universitaire de Rouen, Rouen, France; PhD Student, Inserm U1079, Université de Rouen, Rouen, France
| | - Cornelia Pripis
- Senior Psychiatrist, Service de Psychopathologie de l’Enfant et de l’Adolescent et Unité de Médecine de l’Adolescent, Centre Hospitalier Universitaire d’Amiens, Université Picardie Jules Verne, Amiens, France
| | - Johanne Renaud
- Child and Adolescent Psychiatrist, Standard Life Centre for Breakthroughs in Teen Depression and Suicide Prevention, Douglas Mental Health University Institute, Montréal, Québec; Medical Chief, McGill Group for Suicide Studies, McGill University, Montréal, Québec
| | - Christine Vervel
- Head, Service de Pédiatrie, Centre Hospitalier de Compiègne, Compiègne, France
| | - David Cohen
- Professor and Department Head, Service de Psychiatrie de l’Enfant et de l’Adolescent, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique–Hopitaux de Paris et Université Pierre et Marie Curie, Paris, France; Researcher, CNRS UMR 7222 Institut des Systèmes Intelligents et Robotiques, Université Pierre et Marie Curie, Paris, France
| | - Priscille Gérardin
- Professor and Department Head, Département de pédiatrie médicale, Fédération hospitalo–universitaire de psychiatrie de l’enfant et de l’adolescent, Centre Hospitalier universitaire de Rouen et Centre hospitalier du Rouvray, France, Rouen et Rouvray, France; Researcher, Laboratoire Psy-NCA-EA-4700, Université de Rouen, Rouen, France
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Sterk CE, Klein H, Elifson KW. The Relationship between Sexual Coping and the Frequency of Sexual Risk among 'At Risk' African American Women. Womens Health Urban Life 2011; 10:56-80. [PMID: 23843727 PMCID: PMC3703672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study examines the relationship between one specific type of avoidant coping behavior-namely, having sex to cope with one's worries or problems-and the frequency with which 'at risk' women engage in risky sexual relations. Face-to-face interviews were conducted with 221 African American women drug abusers in the Atlanta, Georgia metropolitan area. The community identification process was used for recruitment, with additional recruitment done via targeted sampling. A variety of demographic characteristics, background and experiences measures, childhood maltreatment experiences, substance use-related measures, psychosocial and attitudinal items, and relationship characteristics were examined for their influence both on the frequency of engaging in risky sex and the extent to which women had sex to cope. Multivariate analysis revealed that having sex to cope was a statistically-significant predictor of the frequency with which women engaged in risky sexual behaviors. A separate analysis of the predictors of having sex to cope yielded seven items that were important for understanding the extent to which women engaged in sexual coping: age, number of health information sources, amount of physical abuse, reasons for not using condoms, overall attitudes toward condom use, level of partner communication, and the amount of help available from one's support network. The intervention-related implications of these findings are discussed, emphasizing the needs: to target younger women, to target and help survivors of childhood maltreatment to deal with unresolved issues, to make attitudes toward using condoms more conducive, to improve partner communication, and to bolster support network relationships.
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