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The rising incidence of cancer has led to an increased number of adult children impacted by parental cancer. Previous research primarily focused on younger individuals, leaving a gap in understanding the experiences of adult children aged 20–35.
Objectives
To examine a model that integrates the interrelationships among the disease’s characteristics (i.e., disease stage), illness representations, coping strategies, and posttraumatic growth (PTG) in young adults with parents diagnosed with cancer. In addition, we examined indirect relationships involving illness representations as independent variables, coping strategies as mediators, and PTG as the outcome variable.
Purpose
The rising incidence of cancer has led to an increased number of adult children impacted by parental cancer. Previous research primarily focused on younger individuals, leaving a gap in understanding the experiences of adult children aged 20–35. This study examines a model that integrates the interrelationships among the disease’s characteristics (i.e., disease stage), illness representations, coping strategies, and posttraumatic growth (PTG) in young adults with parents diagnosed with cancer. In addition, we examined indirect relationships involving illness representations as independent variables, coping strategies as mediators, and PTG as the outcome variable.
Methods
A cross-sectional survey was conducted with 109 adult children (ages 20–35) of cancer patients. Data were collected using the Posttraumatic Growth Inventory, the Brief Illness Perception Questionnaire, and the COPE questionnaire. Path analysis was performed to test the study’s hypotheses.
Results
The findings revealed that illness representations and coping strategies accounted for significant variance in PTG. Higher perceived severity of the parent’s illness was associated with greater use of problem-focused and emotion-focused coping strategies, which were linked to higher PTG. Lower perceived control over the illness was associated with less use of problem-focused coping and subsequently lower PTG.
Conclusions
This study underscores the importance of subjective perceptions and coping strategies in fostering PTG among young adults with parents diagnosed with cancer. The findings highlight the need for tailored psychosocial interventions to enhance adaptive illness representations and effective coping strategies, promoting resilience and growth in this unique demographic.
Coping styles can be improved by dyadic palliative care interventions and may alleviate patients’ and family caregivers’ distress. Moreover, family caregivers’ preloss resilience protects against depression after bereavement. This study aimed to determine the types of coping styles can be encouraged to increase resilience.
Methods
A self-reported questionnaire survey was administered to family caregivers at the 4 palliative care units, and their resilience was assessed using the Connor–Davidson Resilience Scale (CD-RISC) and their coping styles were assessed using the Brief Coping Orientation to Problem Experienced, as well as their background characteristics.
Results
Among 291 caregivers with a mean CD-RISC score of 56.2 (standard deviation: 16.13), internal locus of control, educational level, and history of psychotropic drug use were associated with resilience. After adjusting for the aforementioned factors, more frequent use of positive coping styles such as active coping (Spearman’s ρ = 0.29), acceptance (ρ = 0.29), positive reframing (ρ = 0.29), planning (ρ = 0.24), and humor (ρ = 0.18), was found to be associated with higher resilience. On the contrary, more frequent use of negative coping styles such as behavioral disengagement (ρ = −0.38), self-blame (ρ = −0.27), and denial (ρ = −0.14) was found to be associated with less resilience.
Significance of results
By assessing internal locus of control, educational level, and history of psychotropic medication use of family caregivers, as factors associated with their respective resilience, may help identify less resilient family caregivers who are at risk for developing major depression after bereavement. In addition, coping skill-based educational interventions targeting patients and their family caregivers that focus on specific coping styles associated with resilience may increase family caregivers’ resilience, resulting in less emotional distress and a lower risk of major depression after bereavement.
The current study aimed to test the association between environmental degradation, eco-anxiety and post-traumatic symptoms, and whether coping strategies mediate the association between these variables among a sample of Palestinian adults. The sample of our study consisted of 554 Palestinian adults, of whom 392 identified as female and 162 as male. Participants’ age ranged from 19 to 54 years old (M = 35.8, SD = 12.31). They were all recruited from online advertisements, e-mail campaigns and social media. The findings of our study revealed that post-traumatic stress symptoms positively correlated with environmental degradation, eco-anxiety and avoidant coping and negatively correlated with problem-focused coping and emotion-focused coping. Results of structural equation modeling revealed that coping strategies mediated the association between environmental degradation, echo-anxiety and post-traumatic stress symptoms. The findings of our study emphasize the need for tailored psychological support and coping strategies for individuals experiencing eco-anxiety and post-traumatic stress symptoms in the face of environmental challenges.
To better understand factors supporting young people's (age <18 years) mental health during pandemic-type conditions, we aimed to identify whether coping strategies adopted during the COVID-19 pandemic could be dichotomised according to manifesting positive or negative psychological outcomes. Medline, EMBASE, CINAHL, PsycINFO, Scopus and ASSIA databases were used to identify empirical studies that examined coping strategies used by young people experiencing psychological challenges during COVID-19.
Results
Twenty-five international studies were included, identifying that coping strategies adopted could be significantly dichotomised according to reducing or exacerbating psychological challenges. Positive coping strategies were proactive and solutions-oriented, whereas negative coping strategies were more avoidant and emotion-oriented.
Clinical implications
An internal locus of control may account for why adolescents exercised more proactive coping compared with their younger counterparts, although parents of younger children may offset the impact of stressors by drawing on a proposed coping framework emphasising proactivity and engagement. This would be an invaluable addition to future pandemic preparedness planning cycles.
Edited by
David Kingdon, University of Southampton,Paul Rowlands, Derbyshire Healthcare NHS foundation Trust,George Stein, Emeritus of the Princess Royal University Hospital
Differences in reciprocal social interaction and communication, intense focal interests, repetitive movements and sensory sensitivities. There are no traits or sensitivities that are unique to autistic people, but the combination of features and the degree to which they occur is what characterises the condition. There is ongoing debate about whether autism is a disorder, a condition or a naturally occurring difference. The lifetime experiences of autistic adults through into older life are still largely unknown. It is important to treat co-occurring conditions in autistic people with the evidence-based treatments used for non-autistic people until and unless clear evidence emerges showing a different approach is preferable. Autism is not a mental illness or learning disability. Rather, it is a difference where traits and sensitivities can have positive and negative impacts on a person’s life, and these impacts can change at different times or in different circumstances. It is vital to recognize and understand autism in order to make reasonable adjustments to the assessment and treatment plans when treating co-occurring disorder in an autistic person.
To investigate food insecurity and related coping strategies, and their associations with the risk of anxiety and depression, among South African households with children.
Design:
Nationally representative cross-sectional study. Tools for assessing food insecurity, coping strategies, risk of anxiety and depression were assessed from the Community Childhood Hunger Identification Project, Coping Strategies Index, Generalised Anxiety Disorder-7 and Patient Health Questionnaire-9, respectively. We used ordered logistic regression to test associations of food insecurity and coping strategies with the risk of anxiety and depression. Moderating effects of each coping strategy were tested in the associations of food insecurity with anxiety and depression.
Setting:
South Africa, post COVID-19 restrictions, May–June 2022.
Participants:
1,774 adults, weighted to 20,955,234 households.
Results:
Food insecurity prevalence was 23·7 % among households with children. All coping strategies were used to some extent, but relying on less preferred and less expensive foods was the most used strategy (85·5 % of food-insecure households). Moving to a higher level of food insecurity was associated with >1·6 greater odds of being in a higher risk of anxiety and depression. Sending a household member to beg for food was the strongest associated factor (OR = 1·7, P < 0·001). All coping strategies partly moderated (lessened) the associations of food insecurity with a higher risk of anxiety and depression.
Conclusions:
Food insecurity among households with children was high following the COVID-19 pandemic. Collaborative efforts between government, private sector and civil society to eradicate food insecurity should prioritise poorer households with children, as these populations are the most vulnerable.
Olanzapine is an atypical neuroleptic indicated for treatment of various psychiatric disorders, but it has also several indications in palliative care (PC) patients: opioids misuse, nausea not related to chemotherapy, anorexia-cachexia syndrome, and sleep and mood disorders. Peripheral and facial edema are a rare side effect of the treatment with olanzapine. I report a case of an advanced cancer patient cared receiving PC who developed moderate tongue edema on day 1 of a low dose of olanzapine.
Methods
A patient with advance and metastatic colon cancer presented moderate tongue edema on day 1 of a low dose (2.5 mg) of olanzapine for the treatment of his nausea, anorexia-cachexia syndrome, and mood disorder (mainly anxiety).
Results
The patient discontinued the drug with resolution of the edema. The day after he called our outpatients’ service, a prompt physical examination, together with blood tests, excluded other differential diagnosis.
Significance of results
To the best of our knowledge, this is the second case reporting head and neck localized edema due to olanzapine treatment in a patient with advanced cancer receiving PC. Considering the increasing use of olanzapine as off-label treatment in these patients (often for cluster symptoms), our report could help clinicians in daily practice and researchers on put a deeper focus on indications for olanzapine in PC.
The COVID-19 global pandemic had a major impact on older people's mental health and resulted in changes in alcohol use, with more older adults increasing than decreasing consumption levels among the general population. So far, no studies have focused on older people who were already experiencing problem alcohol use. This qualitative research is the first to provide a nuanced understanding of changes to drinking patterns among older adults engaged in alcohol treatment during the COVID-19 pandemic, and the implications of these for practice. We conducted 30 semi-structured interviews with people in alcohol treatment aged 55+ living in urban and rural areas across the UK. Data were analysed using thematic analysis. We found that changes in alcohol use varied depending on the social, economic and health impacts of the pandemic on older adults. Boredom, lack of adequate medical or emotional support, and key life changes experienced during the pandemic (such as bereavement or retirement) increased the risk of increased drinking. Moreover, some people in longer-term alcohol treatment were struggling to maintain abstinence due to lack of face-to-face peer support. For others, decreased drinking levels were a side-effect of lockdown policies and restrictions, such as alcohol-related hospitalisations, closure of social spaces or inability to source alcohol; these also supported those who decided to cut down on drinking shortly before the pandemic. Generally, older adults who developed home-based interests and self-care practices managed lockdown best, maintaining abstinence or lower risk drinking levels. Based on these results, we argue that multilevel interventions aimed at strengthening resilience are required to reduce drinking or maintain abstinence among older adults. Such interventions should address three domains: individual (coping strategies and mindset), social (support networks), and structural (access to resources). In preparation for supporting older alcohol users through prospective future pandemics, building digital literacy and inclusion are essential.
Previous research has highlighted the importance of past life experiences in the theoretical and conceptual understanding of loneliness. However, adding a lifecourse perspective to loneliness research remains underexplored. To comprehend the complexity of loneliness in old age, it is crucial to pay attention to the lifecourse perspective. This study addresses an important lifecourse perspective on loneliness through an in-depth, narrative approach. Building on the cognitive discrepancy theory, this study examines how precipitating events and coping strategies throughout the lifecourse may influence current feelings of loneliness in older adults. We qualitatively examined the experienced lifecourse of 20 lonely older adults living in Belgium by applying a modified version of the McAdams life-story interview scheme. Next, we conducted eight member-check interviews. A first finding provided insight into the importance of precipitating events during the lifecourse for current loneliness. The results pointed not only to the lifelong impact of events during childhood and adulthood, which may lead to vulnerability to loneliness later in life: unrealised life events (e.g. not being able to have children) as well as events with no impact earlier in life nevertheless turned out to be relevant in the emergence of loneliness later in life. Second, the narratives revealed that several older adults who experienced loneliness earlier and later in life continued to use the same coping strategies throughout the lifecourse, whereas by contrast some older adults adapted their coping strategies based on previous experiences and improved their loneliness-coping skills. It also appeared that changes in people's resources, such as the presence of physical limitations, may make it more difficult to cope with loneliness in later life. The discussion makes a plea for lifelong prevention of and attention to loneliness.
Family carers of people living with motor neurone disease (MND) face continuous changes and losses during the progression of the disease, impacting on their emotional wellbeing. Carers’ emotions might affect their engagement in everyday activities and their caring role. However, how carers manage their emotions and which strategies they identify as useful to cope with them while caring is under researched.
Objective
To identify the emotional experiences and coping strategies of MND family carers while caring the person living with MND.
Methods
We conducted 14 semi-structured interviews with family carers currently supporting people living with MND living in the UK. Interviews were audio/video recorded and professionally transcribed verbatim. We analyzed data inductively within an interpretive descriptive approach, using reflexive thematic analysis.
Results
Three key themes were generated from the analysis. Destabilization of diagnosis reflected the devastating impact the diagnosis had on carers, characterized by initial overwhelming emotions. Adapting to new circumstances and identifying coping strategies captured how carers experienced everyday changes and losses and how they gradually adjusted to the situation by identifying coping strategies to be able to manage arising emotions. Maintaining emotional coping encompassed how carers used individual strategies they had tried before and had worked for them to cope emotionally with the continuous changes and losses while preserving their emotional wellbeing.
Significance of results
Our findings suggest that carers of people living with MND embark on an emotional journey from the diagnosis of the disease. As the disease progresses, carers adopt coping strategies that best work for them to manage their emotions (e.g., living day by day and seeking support). Understanding the key strategies used to support emotional coping during the caring journey and how carers re-construct their emotional life around MND could help inform future practice and research to better support carers of this population.
We discuss how children’s executive functions (EFs) and self-regulation (SR) contribute to coping by supporting positive adaptation in contexts of stress and adversity. We first describe literature linking EFs and SR to the most frequently studied child coping strategies, noting commonalities and identifying empirical gaps. Next, we synthesize how EFs and SR relate to adaptation in adverse contexts, which we conceptualize as reflecting successful coping. We highlight studies in which EFs and SR moderate and mediate the effects of adversity on developmental outcomes and discuss needed research extensions to address coping strategies and behaviors. In the final section, we raise future directions for studying EFs and SRs in the context of coping, including (1) improved assessments; (2) a reconceptualization of what is adaptive and maladaptive; (3) an understanding of promotive aspects of adversity; (4) examinations of dyadic, family, classroom, and communal co-regulation processes that affect and co-produce individual-level processes; and (5) the identification of processes that promote coping-relevant EFs and SR. We underscore the need for scholarship about EFs, SR, and coping beyond Western, Educated, Industrialized, Rich, and Democratic (WEIRD) contexts to reflect the diverse cultures, experiences, stressors, and resources children experience globally.
Developmental research in human cognition has provided compelling evidence about how neurocognitive systems underlying the voluntary control of attention and self-regulation greatly contribute to the individual’s success in a wide range of aspects of life, such as academic and professional performance, social adjustment, and well-being (Moffit et al., 2011). In relation to this, much evidence shows the importance of attention regulation for children’s ability to cope with stressful life events. In the current chapter, we intend to provide a model for integrating research in temperament and cognitive development to understand the role played by self-regulatory processes on the development of coping responses to deal with adverse situations.
This chapter makes explicit the role of context and coping processes for identity formation among diverse youths. The study of coping is enriched by a human developmental theoretical approach that acknowledges the shared status of vulnerability for all humans given that encountered risks are mitigated (or not) by myriad protective factors and accompany all individuals’ developmental journeys. The application of Spencer’s phenomenological variant of ecological systems theory facilitates the study of coping strategies. The authors discuss the social ramifications of endemic economic inequality on developmental contexts, which frames the cultivation of coping strategies, i.e., whether adaptive or maladaptive; thus, experiences ultimately become incorporated into an individual’s identity. To highlight the multifaceted nature of risk, the chapter examines the experiences of Black youths in urban areas and the radiating effects of the exogenous shocks on youths’ domains of development. The authors call for new avenues of study and the provision of risk-mitigating supports to ensure cultivation of productive adaptive coping strategies, which enhance diverse youths’ positive identity outcomes.
To investigate food insecurity and related coping strategies among South African households and their associations with anxiety and depression.
Design:
Cross-sectional study. Food insecurity and coping strategies were assessed using a modified Community Childhood Hunger Identification Project and the Coping Strategies Index questionnaires. The Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 were used to assess anxiety and depression risk. Ordered logistic regressions were used to test associations of food insecurity and related coping strategies with anxiety and depression.
Setting:
South Africa during COVID-19, October 2021.
Participants:
Nationally representative sample of 3402 adults, weighted to 39,640,674 South African households.
Results:
About 20·4 % of South African households were food insecure, with the most affected being from the lowest socio-economic groups. Shifting from ‘food secure’ to ‘at risk’ or from ‘at risk’ to ‘food insecure’ group was associated with 1·7 times greater odds of being in a higher category of anxiety or depression (P < 0·001). All coping strategies were used to some extent in South African households, with 46·0 % relying on less preferred and less expensive foods and 20·9 % sending a household member to beg for food. These coping strategies were mostly used by food-insecure households. Although the odds of moving to a higher category of anxiety and depression were observed among all coping strategies (all P < 0·001), begging for food was associated with the highest odds (OR = 2·3).
Conclusions:
Food insecurity remains a major health threat in South Africa. Public measures to address mental health should consider reductions in food insecurity as part of their strategy.
The investigators conducted a psychosocial needs assessment of mesothelioma patients through self-report measures of quality of life (QOL), coping, depression, and social support.
Methods
Patients with malignant pleural mesothelioma (MPM) (N = 67) completed a battery of assessments at a single timepoint after being approached during routine medical oncology clinic appointments or by letter.
Results
Participants were predominately male (70.0%; n = 47) and ranged in age from 35 to 83 years old (M = 65.61, SD = 9.71). Most participants were white (88.0%; n = 59), and 10.0% (n = 7) were identified as Hispanic. The majority were married or living with a partner (93.0%; n = 62) and had some college or more education (64.0%; n = 43). Fourteen percent of participants (n = 11) endorsed significantly elevated depression symptoms. No significant demographic or clinical differences in depressed compared to nondepressed participants were observed, with a trend toward those identifying as Hispanic and those who were divorced as being more likely to be depressed. For the total sample, the most frequently endorsed coping strategies were active coping, emotional support, and acceptance.
Significance of results
The present study did not identify any clear correlates of depression or QOL among patients with MPM. This research contributes to the small literature on psychosocial functioning in patients with MPM and provides putative directions for future larger studies and the development of interventions to provide appropriate support to diverse patients with MPM.
The objective of the present work was to characterize the coping strategies used by first responders to emergencies in the face of exposure to traumatic events.
Methods:
A systematic search was performed in the databases MEDLINE (Ovid), EMBASE, LILACS (Latin American and Caribbean Literature in Health Sciences), and the Cochrane Central Registry of Controlled Clinical Trials (CENTRAL) from their inception through February 2022. First responders to emergencies with training in the prehospital area and who used validated measurement instruments for coping strategies were included.
Results:
First responders to emergencies frequently used nonadaptive coping strategies, with avoidance or disconnection being one of the main strategies, as a tool to avoid confronting difficult situations and to downplay the perceived stressful event. The nonadaptive coping strategies used by these personnel showed a strong relationship with posttraumatic stress disorder (PTSD) symptoms, burnout syndrome, psychiatric morbidity, and chronic stress. As part of the adaptive strategies, active coping was found, which includes acceptance, positive reinterpretation, focusing on the problem, self-efficacy, and emotional support, either social or instrumental, as protective strategies for these personnel.
Conclusions:
Developing adaptive coping strategies, whether focused on problems or seeking emotional support, can benefit emergency personnel in coping with stressful situations. These coping strategies should be strengthened to help prevent people from experiencing long-term negative effects that could arise from the traumatic events to which they are exposed. Active coping strategies instead of avoidance strategies should be promoted.
This chapter describes some of the interventions that currently exist for children, young people and families, those which have been evaluated and the results for these evaluations have been reported. More rigorous methodologies are needed to evaluate the effectiveness of interventions, to ensure that they, in effect, support children, young people and families. Comparison between interventions is difficult because they use different measures and compare different outcomes. The more effective interventions share core components but are also flexible to adapt to the specific needs of families. These core components include the provision of information, improve communication, emotional skills, increase social support and coping skills.
This study aimed to articulate the roles of social support and coping strategies in the relation between childhood maltreatment (CM) and subsequent major depressive disorder (MDD) with a comprehensive exploration of potential factors in a longitudinal community-based cohort. Parallel and serial mediation analyses were applied to estimate the direct effect (DE) (from CM to MDD) and indirect effects (from CM to MDD through social support and coping strategies, simultaneously and sequentially). Sociodemographic characteristics and genetic predispositions of MDD were considered in the modeling process. A total of 902 participants were included in the analyses. CM was significantly associated with MDD (DE coefficient (β) = 0.015, 95% confidence interval (CI) = 0.002∼0.028). This relation was partially mediated by social support (indirect β = 0.004, 95% CI = 0.0001∼0.008) and negative coping (indirect β = 0.013, 95% CI = 0.008∼0.020), respectively. Social support, positive coping, and negative coping also influenced each other and collectively mediated the association between CM and MDD. This study provides robust evidence that although CM has a detrimental effect on later-on MDD, social support and coping strategies could be viable solutions to minimize the risk of MDD. Intervention and prevention programs should primarily focus on weakening negative coping strategies, then strengthening social support and positive coping strategies.
Mothers of terminally ill children experience chronic stress that can lead to physical and emotional exhaustion. A better understanding of their experiences, resources, and vulnerabilities can help plan psychological interventions.
Objectives
The research is aimed to study mothers’ appraisals of their life situation related to the child’s terminal illness and their coping strategies.
Methods
Participants: 21 women (aged 26-49) whose children were patients at the hospice. Women answered a set of open-ended questions and completed questionnaires: “Appraisal Criteria of the Difficulty of a Life Situation”, “Types of Orientations in Difficult Situation”, “Ways of Coping Checklist”. Data were analyzed with Pearson’s r.
Results
Planned coping was associated with evaluations of opportunity (r=0.78) and threat to the future (r=0.61). Despite the deteriorating health status of most of the children, women reported a high degree of subjective control. This might be related to outside help. Participants stated that helping by the family, doctors, and psychologists was essential. Unexpectedly, the “need for a quick and active response” score correlates with that for the coping strategy “fantasizing” (r=0.62). This can be explained by the depletion of resources; deprivation of sleep and active rest is often observed. An important feature is that half of the participants report high self-blame.
Conclusions
We suggest that self-blame, an analysis of opportunities, and probable future scenarios are important psychotherapy targets for mothers of terminally ill children. The consequences of threat appraisal are twofold: admitting the threat can be painful, but it also mobilizes one’s energy. Funding: The study was funded by RFBR, project number 20-013-00838.