Age of onset of epilepsy: its effects on coping strategies

Abstract

Research into the use of coping strategies to reduce emotional distress from negative life events has identified specific subscales within the more general concepts of problem-focused and emotionfocused coping. This study presents a preliminary assessment of the ultilization of coping strategies during stressful incidents among people with epilepsy, and the differences which may arise as a result of the age of onset of the disorder. Twenty early-onset and 20 late-onset patients were asked to complete a questionnaire using subscales from the «Ways of Coping» scale (Aldwin and Revenson 1987) and from the «COPE» scale (Carver et al 1989). Data were also obtained from two groups of 20 subjects without epilepsy, matched for age and sex with the patient groups (a total of 80 subjects included in the study). Results indicated that subjects with epilepsy attempted to minimize problems more than non-epileptic subjects. Adult onset of the disorder appeared to increase the use of negotiation, acceptance and self-blame. Thus, there appear to be some significant differences in the types of coping strategy employed in stressful situations, with the late-onset group tending to utilize strategies that may be considered maladaptive, perhaps in an initial adjustment to the disorder.     

Power motivation,illness, coping strategies and psychological stress in police trainees

Abstract

Research suggests that there are substantial differences in the ways in which people cope with strcss, and that certain coping strategies buffer the degree of psychological and physical illness resulting from stress. Furthermore, personality, the situational context and subjective appraisal of the situation are believed to mediate coping behaviour and its effectiveness. The present investigation reports the results of two studies of the relationship between coping behaviour and the personality disposition need for power, taking into account the environment and the subject's appraisal of the situation. Highly power-motivated individuals were hypothesized to utilize emotion-focused coping strategies more than problem-focused coping strategies, to find the training environment stressful and anxietyprovoking, and to report more illness, than low power-motivated individuals. A 19-wcck policc academy training programme was used to measure these relationships in 34 police trainees. Thc results did not support all hypotheses. Findings are discussed with reference to sample characteristics, training intensity, and the empirical work in this area.     

Job stress,burnout and substance use among urban transit operators: The potential mediating role of coping behaviour

Abstract

Urban transit operators, compared to other occupational groups, have higher rates of mortality and morbidity. A major risk factor is the highly stressful objective environment. This study used structural equation modelling to test a model hypothesizing that transit operators’ coping behaviours in responding to daily job hassles mediate the associations of work stress with burnout and substance use. The study sample consisted of 1231 transit operators who participated in the San Francisco MUNI Health and Safety Study. The results showed a direct and strong association between transit operators’ daily job stress and symptoms of occupational burnout even when a series of controls and coping behaviours were considered. In addition, use of “disengage-deny” and escapist strategies to cope with job stress was positively associated with burnout; the job stress–burnout association was partially mediated through such coping practices. Daily job stress was related to substance use only indirectly and mediated through burnout and use of “disengage-deny” and escapist coping strategies. “Disengage-deny” coping strategies might help reduce substance use whereas escapist coping strategies might increase such use. Overall, our findings suggest that coping behaviour may be an important correlate of transit operators’ ill health. Interventions enabling healthy coping behaviours may help reduce health risks for this occupational group.     

Power motivation, illness, coping strategies and psychological stress in police trainees

Research suggests that there are substantial differences in the ways in which people cope with strcss, and that certain coping strategies buffer the degree of psychological and physical illness resulting from stress. Furthermore, personality, the situational context and subjective appraisal of the situation are believed to mediate coping behaviour and its effectiveness. The present investigation reports the results of two studies of the relationship between coping behaviour and the personality disposition need for power, taking into account the environment and the subject's appraisal of the situation. Highly power-motivated individuals were hypothesized to utilize emotion-focused coping strategies more than problem-focused coping strategies, to find the training environment stressful and anxietyprovoking, and to report more illness, than low power-motivated individuals. A 19-wcck policc academy training programme was used to measure these relationships in 34 police trainees. Thc results did not support all hypotheses. Findings are discussed with reference to sample characteristics, training intensity, and the empirical work in this area.     

Book reviews and books received

Abstract

In the field of stress research it is often assumed that social support as well as coping behaviour contributes to feelings of health and well-being. However, until now it has not been altogether clear whether a main-effect model or a buffer model was the more appropriate for explaining the role of these factors in response to stressful situations. In this paper, a research project is described in which both the direct and indirect effects of social support and coping were studied in the work situation of nurses. The results offer more support for a main-effect model than for a buffer or moderating-effect model, especially with regard to the coping strategies ‘active problem-solving’ and ‘palliative behaviour’. However, some moderating effects on nurses‘ reactions to their work situation were found for social support and for ‘comforting cognitions’ as a coping strategy.     

Depression and coping mechanisms in prisoners

In an attempt to identify the number, nature, and effectiveness of coping mechanisms used by long-term prisoners to cope with stress, a sample of inmates was administered scales measuring depression, coping strategies, and sensation-seeking. It was found that the prisoners' depression scores were very high, placing several inmates into the category of severe clinical depression. However, the number of coping mechanisms used by prisoners to deal with a stressful situation was not reflected by the depression scores. Extensive use of coping mechanisms was, if anything, associated with an increased level of depression. The expected relationship between sensation-seeking and proneness to depression in prison failed to emerge.     

A study of coping: Successful recovery from severe burnout and other reactions to severe work-related stress

This is a qualitative study of the situational determinants of coping with severe reactions to work-related stress, including burnout. The successful resolution of the crisis caused by an incapacity to work due to physical and emotional exhaustion is documented in an exploratory study of broad coping processes and specific strategies involved. Subjects were recruited from a large territory (the province of Quebec in Canada). Comparative analysis of the accounts of the 20 human service workers and 16 other professionals led to the identification of a common process typified by six consecutive stages: admitting the problem, distancing from work, restoring health, questioning values, exploring work possibilities and making objective changes. The recovery process is long and takes from 1 to 3 years. The ultimate strategy utilized by most of the subjects was to change their objectivc working conditions. Various strategies for identity reinforcement (seeking reassurance, understanding causes, seeking support) were observed in addition to the stages. Three-fifths of the subjects resorted to formal psychotherapy in the first sample. The recovery process appears to be of a psychosocial nature. This characteristic may render it sensitive to social context; although it has been observed in two samples, it would require testing in different working conditions and different countries.     

The role of social support and coping behaviour in nursing work: Main or buffering effect?

In the field of stress research it is often assumed that social support as well as coping behaviour contributes to feelings of health and well-being. However, until now it has not been altogether clear whether a main-effect model or a buffer model was the more appropriate for explaining the role of these factors in response to stressful situations. In this paper, a research project is described in which both the direct and indirect effects of social support and coping were studied in the work situation of nurses. The results offer more support for a main-effect model than for a buffer or moderating-effect model, especially with regard to the coping strategies 'active problem-solving' and 'palliative behaviour'. However, some moderating effects on nurses' reactions to their work situation were found for social support and for 'comforting cognitions' as a coping strategy.     

Endocrine markers during a job intervention

An intervention consisting of a thorough examination of the psychological worksite problems and a follow-up with feedback and recommendations was made in four different office worksites. One of the sites («active» group) was more organizational change-oriented than the others («passive» group). The course was followed before, three times during the 3 months of the intervention, and 4 months after the end of it, by means of three endocrine plasma markers: cortisol, prolactin and testosterone. In both study groups the prolactin levels increased in women during the starting phase of the intervention, whereas in men prolactin levels remained stable with a tendency (p=0.06) towards lowered prolactin levels during the end phase of the intervention in the active group. Cortisol levels increased markedly in the passive group and tended to decrease in the active group during the intervention (two-way interaction p=0.003), particularly in men. These findings may be indicative of feelings of uneasiness. Testosterone increased in the active group only, particularly at the beginning of the intervention and particularly in women, and also increased in a non-intervention control group. Testosterone levels are associated with anabolic activity. An increase may be indicative of a «placebo effect» of the intervention. Testosterone changes were still clearly observable after 4 months.     

Changing work environments: Innovative coping responses to occupational stress

To what degree do individuals adapt their work environments in response to occupational stress? The research reported below addresses this question through a qualitative questionnaire survey that assesses the extent to which innovation is used as a stress coping strategy amongst health care professionals (community and hospital nurses, administration workers and paramedics; N = 333). Overall, 32% of these workers reported a coping response subsequently coded as innovative, and significant between-occupational group differences in the frequency of usage were found. Overwork, procedural difficulties and dealing with others were the stressors eliciting the greatest number of innovative coping responses. The study indicated that such responses were perceived as an effective and important way of dealing with occupational stress. It is concluded that stress management programmes that encourage individuals to change workplace factors through innovation, would be a worthwhile addition to interventions that emphasize individual adaptation to stressful work environments.     

Teacher stress during an autumn term in Finland: Four types of stress processes

This Finnish study examines teachers' stress in order to clarify how stress manifests itself and to describe any observed differences in the teachers' background, personality and coping variables. The research design was longitudinal. One hundred and fifty-three teachers made repeated assessments (six in all) of the indicators of stress (subjective mood ratings) by means of questionnaires during the autumn term of 1983. The background variables were based on questionnaire responses gathered in the autumn of 1983. Four different teacher groups emerged according to the type of stress reported: (1) teachers who were exhausted throughout the term; (2) those who recovered from stress on the first weekends of the term but not later on; (3) those not at all stressed, and (4) teachers feeling tired and anxious at the beginning and at the end of the term. The four teacher groups differed with regard to their personality characteristics and coping strategies.     

Trauma,coping resources,and family functioning in emergency services personnel: A comparative study

In this study a sample of male, shift-working, operational ambulance officers were compared with a group of male shift-workers from a range of occupations in which exposure to traumatic events was not inherent in the role ( N = 71). Three dimensions of family functioning were examined: intimacy, conflict, and parenting styles, with respect to occupational type (i.e. work-related exposure to trauma) and accounting for personal resources (coping). Personal resources were found to have a significant impact on the dimensions of family functioning. Furthermore, differences emerged in the pattern of coping between the two groups. Ambulance officers demonstrated a more varied repertoire of personal resources than the control group. Social support was found to be the sole predictor of intimacy and conflict levels in the control sample. However, in the ambulance group social support was predictive of intimacy levels, rational-cognitive strategies were predictive of conflict levels, and self-care, social support, and rational-cognitive strategies were all significantly correlated with the three dimensions of family functioning.     

Trauma, coping resources, and family functioning in emergency services personnel: A comparative study

In this study a sample of male, shift-working, operational ambulance officers were compared with a group of male shift-workers from a range of occupations in which exposure to traumatic events was not inherent in the role ( N = 71). Three dimensions of family functioning were examined: intimacy, conflict, and parenting styles, with respect to occupational type (i.e. work-related exposure to trauma) and accounting for personal resources (coping). Personal resources were found to have a significant impact on the dimensions of family functioning. Furthermore, differences emerged in the pattern of coping between the two groups. Ambulance officers demonstrated a more varied repertoire of personal resources than the control group. Social support was found to be the sole predictor of intimacy and conflict levels in the control sample. However, in the ambulance group social support was predictive of intimacy levels, rational-cognitive strategies were predictive of conflict levels, and self-care, social support, and rational-cognitive strategies were all significantly correlated with the three dimensions of family functioning.     

Job stressors,coping, and psychological distress among Japanese employees: Interplay between active and non-active coping

In this study the sole and the combined effects of active and non-active forms of coping on psychological distress across various kinds of job stressors were examined. Data on job stressors, coping and psychological distress were obtained from 4487 male employees of a research institute in the automobile industry in Japan (mean age=36.27 years, SD = 7.43). A hierarchical moderated multiple regression analysis was conducted to estimate and test the significance of the main effects and their interactions. The results show that although active coping was effective in decreasing psychological distress regardless of the type of job stressor, the effectiveness was weaker in situations that require effortful coping, such as role ambiguity and insufficient authority. Furthermore, the effectiveness of active coping was influenced by the other strategies, especially in effortful coping situations. While distancing or seeking social support improved the effectiveness, restraint coping reduced it. These results suggest that the type of non-active coping that individuals combine with active coping can be critical in determining health outcomes in more complex and effortful coping situations. Consideration of the coping combinations, not merely the situational context, is important in explaining how the work environment influences employees' psychological distress.     

Worry Over Technological Activities and Life Concerns

A common mental response to risk is worry. Though generally associated with fear and anxiety, worry is primarily a cognitive activity that can, under some circumstances, be beneficial for developing coping strategies to deal with stressful events. The present study reports an assessment of worry done both before and after the reactor accident at Three Mile Island (TMI). Worries over nuclear risks were assessed in the context of central life concerns such as financial, physical, and interpersonal well-being. The TMI incident elevated nuclear energy worries to a level near those of central life concerns. The productive value of worry is discussed in terms of its relationship with opportunities for personal control.     

The availability of personal and external coping resources: Thier impact on job stress and employee attitudes during organizational restructuring

This study examines the relationships among personal coping resources, social support, external coping resources, job stressors and job strains in a sample of 110 American Telephone and Telegraph employees undergoing a major organizational restructuring. The study expanded on a model suggested by Ashford (1988) by defining another category of coping resources that employees may draw upon to deal with the stressors and strains which occur during major organizational changes. External coping resources were defined as those which provided employees with a sense of 'vicarious control' in stressful situations. Results indicated that personal coping resources, social support and external coping resources had a direct effect upon job stressor and strain levels. No 'buffering' effect of these coplng resources was found. Hierarchical regression analyses indicated that external coping resources added to the prediction of job stressors and strains even when pertonal coping resources and social support were entered first into the prediction questions.     

The occupational stress indicator locus of control scale: Should this be regarded as a state rather than trait measure?

Robertson et al (1990) concluded that the Occupational Stress Indicator's (OSI) locus of control scale did not have an acceptable level of validity. The present study compared two groups of health service employees, categorized on the basis of their obtained OSI locus of control scale scores as having 'high' versus 'low' control, on a number of other OSI scales. Subjects who regard themselves as having 'high' control reported significantly less work pressure, employed certain coping strategies more frequently, reported lower ill health scores and were more job satisfied. The findings are theoretically consistent with the argument that the OSI locus of control scale is a subjective measure of an individual's appraisal of their control at work (i.e. a state measure) rather than a trait construct as measured by Rotter's scale (as used in the OSI validity study by Robertson et al).     

Job stressors, coping, and psychological distress among Japanese employees: interplay between active and non-active coping

In this study the sole and the combined effects of active and non-active forms of coping on psychological distress across various kinds of job stressors were examined. Data on job stressors, coping and psychological distress were obtained from 4487 male employees of a research institute in the automobile industry in Japan (mean age=36.27 years, SD = 7.43). A hierarchical moderated multiple regression analysis was conducted to estimate and test the significance of the main effects and their interactions. The results show that although active coping was effective in decreasing psychological distress regardless of the type of job stressor, the effectiveness was weaker in situations that require effortful coping, such as role ambiguity and insufficient authority. Furthermore, the effectiveness of active coping was influenced by the other strategies, especially in effortful coping situations. While distancing or seeking social support improved the effectiveness, restraint coping reduced it. These results suggest that the type of non-active coping that individuals combine with active coping can be critical in determining health outcomes in more complex and effortful coping situations. Consideration of the coping combinations, not merely the situational context, is important in explaining how the work environment influences employees' psychological distress.     

Lifestyle habits,substance use and predictors of job burnout in professional working women

Abstract

This study explores differences in self-reported lifestyle habits, substance use (alcohol, drugs and smoking) and predictors of job burnout in a sample of 879 professional working women employed in dental health ofices in a cross-sectional design. Job burnout was measured using the Maslach Burnout Inventory (MBI) and self-reported substance use and lifestyle habits were assessed using the Stress Assessment Profile. Self-reported drinking, smolung and drug use were only modestly correlated with each other in this sample. Employed women with higher levels of drinking reported significantly lower quality overall lifestyle practices, eating/nunition habits, and more frequent use of avoidant coping strategies in the face of work and life hassles compared to non-drinkers. Women who smoked also reported significantly lower overall lifestyle practices and eating/nutrition habits. Those who reported using drugs for recreational purposes reported significantly greater hassles, poorer lifestyle habits, a less hardy outlook on life, and more frequent use of dysfunctional coping strategies. Although women who reported using drugs experienced significantly higher interpersonal burnout (depersonalization) compared to non-drug users, in general, self-reported substance use was not significantly related to job burnout. After controlling for age and psychological distress, perceived stress, type A behaviour, cognitive hardiness and lifestyle habits significantly contributed to predictions of job burnout in multiple regression analyses. Despite methodological limitations, the prevalence of substance use found in this study supports previous research findings. Professional working women who practise poor lifestyle and health habits appear to be at risk of experiencing job burnout.