Sickle cell disease pain in children and adolescents: change in pain frequency and coping strategies over time

Examined 9-month follow-up data obtained from children and adolescents with sickle cell disease (SCD) and their parents participating in a longitudinal study of pain coping strategies. Of 87 subjects completing the baseline assessment of pain coping strategies, 70 (80%) of their parents completed a structured pain interview assessing their child's health care use and activity reduction during painful episodes over the follow-up period. Regression analyses controlling for age and pain frequency revealed that baseline Coping Attempts were associated with higher levels of school, household, and social activity during painful episodes. Baseline Passive Adherence was associated with more frequent health care contacts during the subsequent 9 months. Increases in Negative Thinking over time were associated with further increases in health care contacts during the follow-up period. Comparing pain coping strategies assessed at baseline to pain coping strategies measured at follow-up revealed that pain coping strategies were relatively stable over time for younger children but changed more for adolescents.     

Changes in beliefs, catastrophizing, and coping are associated with improvement in multidisciplinary pain treatment.

To examine the associations between changes in cognitions and coping and multidisciplinary pain treatment outcomes, the authors had 141 patients with chronic pain complete measures of adjustment, beliefs, catastrophizing, and coping; in addition, their significant others rated patient physical functioning at pretreatment, posttreatment, and 6- and 12-month follow-ups. Decreases in guarding and resting and in the belief that pain signals damage were associated with decreases in patient disability. Increases in perceived control over pain and decreases in catastrophizing and in the belief that one is disabled were associated with decreases in self-reported patient disability, pain intensity, and depression. The results are consistent with the hypothesis, derived from cognitive-behavioral models of chronic pain, that the outcomes of multidisciplinary pain treatment are associated with changes in patient cognitions and coping responses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Follow-up of coping skills training in adults with sickle cell disease: Analysis of daily pain and coping practice diaries.

This study examined the 3-month follow-up effects of a pain coping skills intervention in African American adults with sickle cell disease. Sixty-seven participants were randomly assigned to either a coping skills condition or a disease-eduction control condition. Multivariate analyses applied to summary measures of coping, laboratory pain perception, and clinical measures indicated that participants in the coping intervention reported significantly lower laboratory pain and significantly higher coping attempts at 3-month follow-up in comparison with the control condition. Multilevel random effects models applied to prospective daily diaries of daily pain, health care contacts, and coping practice indicated that on pain days when participants practiced their strategies, they had less major health care contacts in comparison with days when they did not use strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Telepathology diagnosis of prostrate needle biopsies

Studies have found that coping strategies are significant predictors of pain report, health care use, and psychosocial adjustment in children with sickle cell disease (SCD); however, the mechanisms of the relationship are not clear. In this study, 41 children with SCD completed a laboratory pain task to analyze their pain perception under standardized conditions. Sensory decision theory analyses were used to analyze the pain perception data. Children and their parents also completed measures of coping strategies and adjustment. Hierarchical regression analyses controlling for the child's age indicated that children who reported using active cognitive and behavioral coping strategies had a lower tendency to report pain during the laboratory pain task. Results are discussed in terms of the utility of using laboratory pain models with children and the need for future intervention studies to target coping strategies in children with SCD pain.     

Sickle cell disease pain: Relation of coping strategies to adjustment.

This study examines pain coping strategies in a relatively neglected pain population, sickle cell disease (SCD) patients. Seventy-nine patients diagnosed with SCD were given a structured interview to assess pain, activity level, and health care use during painful episodes. Patients also completed the SCL-90—R as an index of psychological distress and the Coping Strategies Questionnaire. Regression analyses controlled for age, sex, and disease severity measures. Results indicated that the coping strategies factors were important predictors of pain and adjustment. Individuals high on Negative Thinking and Passive Adherence had more severe pain, were less active and more distressed, and used more health care services. Individuals high on Coping Attempts were more active during painful episodes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Older adults' recovery from surgery for osteoarthritis of the knee: Psychosocial resources and constraints as predictors of outcomes.

The authors investigated psychosocial resources (positive support, active coping) and psychosocial constraints (negative support, avoidant coping) as predictors of improvement in the health of 63 older adults undergoing surgery for osteoarthritis of the knee. Following surgery, patients and social partners are motivated both to strive for the appetitive goal of recovery (approach), and to protect themselves from pain and impairment (avoidance). The authors assessed resources and constraints 6 weeks after surgery as predictors of outcomes (improvement in knee pain, knee functioning, and psychological well-being) 6 months after surgery. The constraints patients encountered early in recovery were strong predictors of poor recovery. Although resources were associated with some improvement, these effects were largely accounted for by constraints. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Protective and exacerbating factors in children and adolescents with fibromyalgia.

Objective: To investigate protective and exacerbating factors in the adjustment of youth with juvenile primary fibromyalgia syndrome (JPFS), we examined the relationship of stress, coping strategies, social support, and self-efficacy to quality of life, pain, and depression. Method: Participants were 57 youths (ages 10 to 18 years) and their parents from rheumatology clinics at 2 children's hospitals. The youths self-reported daily hassles, coping strategies, social support, self-efficacy, quality of life, pain, and depression. Parents reported on the youths' major life events and quality of life. Results: In regression analyses, daily hassles, catastrophizing (a coping strategies scale), and self-efficacy predicted child-rated quality of life; self-efficacy predicted pain; and daily hassles predicted depression. Self-efficacy and familial social support moderated the relationship between daily hassles and depression. Conclusions: Daily hassles may be associated with health outcomes for youth with JPFS more than major life events are, and catastrophic thinking and self-efficacy beliefs could be appropriate intervention targets. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping with neck and low back pain in the general population.

This study had 2 objectives: (a) to assess the psychometric properties of the Pain Management Inventory (PMI; G. K. Brown & P. M. Nicassio, 1987) with individuals in the general population with neck or low back pain, and (b) to assess the relationship between pain severity and coping. Data were taken from a mailed survey of a random sample of adults residing in Saskatchewan, Canada. Results validated the 2-factor structure of the PMI and provided evidence for the internal consistency of the coping subscales. Regression analyses revealed that passive coping was associated with being married, greater pain severity, depression, and poor health. Active coping was associated with female gender, higher education, less depression, good health, and frequent exercise. This study provides psychometric data to support the use of the PMI and information about factors associated with use of active and passive coping strategies in pain sufferers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Avoidance coping strategies moderate the relationship between self-efficacy and 5-year alcohol treatment outcomes.

Both self-efficacy and coping strategies are important determinants of functioning for substance use disorder patients, yet little is known about their interrelationship. This study examined the relationship between abstinence self-efficacy and cognitive components of coping (positive reappraisal, cognitive avoidance) for male participants (n = 2,596) from 15 residential substance use disorder treatment programs who were assessed at treatment entry, discharge, and 5-year follow-up. Cognitive avoidance coping moderated the effects of self-efficacy on alcohol use at 5 years, whereas positive reappraisal coping was largely unrelated to outcomes. Specifically, for patients with low self-efficacy, reliance on avoidance coping strategies was associated with poorer alcohol use outcomes, but as self-efficacy increased, the negative influence of avoidance coping strategies diminished. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Illness perceptions, coping and functioning in patients with rheumatoid arthritis, chronic obstructive pulmonary disease and psoriasis

The present cross-sectional study analyzed the extent to which illness perceptions and coping strategies (as measured by the Illness Perception Questionnaire and the Utrecht Coping List, respectively) are associated with levels of daily functioning, as indicated by the Medical Outcomes Study SF-20, and disease-specific measures in 244 adults: 84 with rheumatoid arthritis (RA); 80 with chronic obstructive lung disease (COPD); and 80 with psoriasis. The results of stepwise regression analyses indicated that a strong illness identity, passive coping, belief in a long illness duration, belief in more severe consequences, and an unfavorable score on medical variables were associated with worse outcome on disease-specific measures of functioning and on general role and social functioning. Coping by seeking social support and beliefs in controllability/curability of the disease were significantly related to better functioning. The implications of these findings for future interventions and research are discussed.     

Testing a Model of Pain Appraisal and Coping in Children With Chronic Abdominal Pain.

This prospective study of children with recurrent abdominal pain (N=133; ages 8-15 years) used path analysis to examine relations among dispositional pain beliefs and coping styles, cognitions and behavior related to a specific pain episode, and short- and long-term outcomes. Children believing they could not reduce or accept pain appraised their episode-specific coping ability as low and reported passive coping behavior. Dispositional passive coping had direct effects on both episode-specific passive coping and long-term symptoms and disability. Accommodative coping (acceptance and self-encouragement) was associated with reduced episode-specific distress, which itself predicted reduced depressive symptoms 3 months later. Results suggest that coping-skill interventions for children with chronic pain should target reductions in passive coping and consider the potential benefits of accommodative coping strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of cognitive coping skills training on coping strategies and experimental pain sensitivity in African American adults with sickle cell disease.

The present study examined whether training in cognitive coping skills would enhance pain coping strategies and alter pain perception in adults with sickle cell disease (SCD). Sixty-four African Americans with SCD were randomly assigned to either a cognitive coping skills condition (three 45-min sessions in which patients were trained to use 6 cognitive coping strategies) or a disease-education control condition (three 45-min didactic-discussion sessions about SCD). Pain sensitivity to calibrated noxious stimulation was measured at pre- and posttesting, as were cognitive coping strategies, clinical pain, and health behaviors. Results indicated that, compared with the randomly assigned control condition, brief training in cognitive coping skills resulted in increased coping attempts, decreased negative thinking, and lower tendency to report pain during laboratory-induced noxious stimulation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Global impressions versus validated measures of treatment effectiveness in patients with chronic nonmalignant pain.

This study compared global impressions of improvement with validated indices of treatment outcome in patients with chronic nonmalignant pain and explored 2 factors that might mediate reports of improvement: patient status at follow-up and secondary financial gain. Information concerning pain intensity, disability behavior, and secondary financial gain was obtained from 148 patients at intake and from 42 patients at follow-up (a minimum of 6 months postintake). It was found that patients evidenced significantly diminished pain and disability at follow-up. However, patients failed to acknowledge that improvement had occurred on a global impressions measure. Of the validated outcome measures, only reduction in pain intensity was associated with patient status at follow-up, and only number of disability days was associated with the presence of secondary financial gain. These findings suggest that health care professionals and researchers who rely on global measures of improvement may fail to detect important changes in patient functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of self-blame and responsibility in adjustment to inflammatory bowel disease.

Objective: S. C. Roesch and B. Weiner's (2001) theoretical model of adjustment to chronic illness was adapted to examine the role of attributions, avoidant coping strategies, and disease severity in the psychological adjustment of people with inflammatory bowel disease (IBD). Research Method and Design: People with IBD (N = 259) completed an online survey including measures of health-related self-blame and responsibility attributions, disease severity, avoidant coping strategies, and psychological adjustment indexes (coping efficacy, acceptance, and helplessness). Results: Structural equation modeling revealed that avoidant coping mediated the relationship between attributions and psychological adjustment. Attributions of self-blame were directly related to increased avoidant coping, which was in turn associated with poor adjustment. Beliefs about responsibility were associated with decreased use of avoidant coping strategies and subsequently improved psychological adjustment. Higher scores on disease severity were linked to the use of avoidant coping strategies and poor psychological adjustment. Conclusions: Distinguishing between self-blame and responsibility attributions has important implications for understanding the psychological adjustment of individuals with IBD and may be useful for creating intervention strategies aimed at enhancing the psychological functioning of people with IBD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pain coping strategies and depression in rheumatoid arthritis.

A study was conducted to examine the role of pain episodes and the role of active and passive pain coping strategies in depicting depression in 287 patients with rheumatoid arthritis (RA). The independent effects of pain and pain coping strategies, as well as the interaction effects between pain and pain coping strategies on depression, were evaluated cross-sectionally and prospectively over a 6-month interval. The cross-sectional findings revealed that pain, passive coping, and the interaction between pain and passive coping contributed independent variance, all accounting for higher depression. Of principal interest was the finding that the frequent use of passive pain coping strategies in the face of high pain contributed to the most severe level of depression over time. These results were obtained after controlling for the potentially confounding effects of prior depression, functional disability, and medication status. These data imply that there may be a potential benefit of developing techniques to reduce the use of passive pain coping strategies to deal with chronic arthritis pain in cognitive–behavioral pain management programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Age-Related Differences Among Adults Coping With Pain: Evaluation of a Developmental Life-Context Model.

The pain and coping literature is limited because of its almost exclusive focus on young adults. Our goal was to develop and evaluate a theoretically sound model of age-related differences in coping. Age-related increases in emotion-focused and avoidance-oriented coping and decreases in problem-focused coping were expected to arise from age-related differences in life-context (e.g., health status, stress levels) and in the pain experience. Questionnaire data were collected from 280 older and younger adults with pain. Increasing age was associated with lower pain severity/interference and greater perceived control over pain. Life-context partially mediated this relationship. As hypothesized, there were age-related declines in problem-focused coping. Contrary to expectations, however, older adults also used fewer emotion-focused coping strategies. The implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Observed maternal strategies and children's health locus of control in low-income Mexican Americans.

This study examined the relationship among mothers' health locus of control (HLOC) beliefs, their socialization strategies, and their children's HLOC beliefs in 80 low-income Mexican American families. Maternal socialization strategies were assessed from videotaped interactions of mothers and children engaged in a structured task. Factor analysis of the coded strategies yielded 4 factors: Tell Answer, Teaching, Clarify, and Reinforce. Findings indicated that maternal-health-internally scores negatively predicted mothers' use of the Tell Answer strategies and positively predicted their use of Teaching strategies. Mothers who believed that Powerful Others (e.g., health professionals) controlled their health were more likely to use the Tell Answer strategy. In contrast, mothers who believed that health was due to chance were less likely to use Teaching. Maternal use of Teaching strategies predicted children's internal HLOC, whereas maternal Tell Answer strategies predicted children's external HLOC. Findings suggest that mothers' HLOC beliefs influence the socialization strategies they use and that these strategies are associated with children's HLOC beliefs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological Adjustment of Children With Sickle Cell Disease: Family Functioning and Coping.

Objective: Using a risk and resistance model (J. L. Wallander, J. W. Varni, L. Babani, H. T. Banis, & K. T. Wilcox, 1989) to determine the effects of coping style and family functioning on children's adjustment to sickle cell disease (SCD). Participants: A sample of 73 caregivers and 23 children (ages birth to 18 years) admitted to a hematology acute care unit for pain or fever associated with SCD. Setting: A children's hospital on the East Coast of the United States. Outcome Measures: Disability stress, disease severity, child and parent coping, family functioning, and child adjustment were assessed with standard paper-and-pencil measures. Results: Results provide partial support for J. L. Wallander et al.'s (1989) risk-resistance model. Disability stress did not mediate the relation between disease severity and child adjustment, and severity of medical condition and medical stress did not predict adjustment. Child gender and child age predicted family functioning and child adjustment to SCD. Child or parent coping strategies did not moderate the association of disability stress and child adjustment. Conclusions: Individuals working with patients should be aware of other factors that may affect child outcome above disease severity; specifically, concerns of boys and girls with SCD and their caregivers should be assessed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contributions of leisure to coping with daily hassles in university students' lives.

The purpose of this study was to examine whether and how leisure coping significantly influences immediate coping outcomes (operationalized by coping effectiveness, satisfaction with coping outcomes, and stress reduction), mental health, and psychological well-being, above and beyond the impact of general coping (not directly associated with leisure). University students participated in the research. Overall, the unique contributions of leisure coping were statistically significant for predicting all of the three outcome indicators. Leisure coping beliefs (dispositional coping resources developed through involvement in leisure) significantly contributed to greater immediate coping outcomes, lower mental ill-health, and higher psychological well-being. The other primary dimension of leisure coping, namely, leisure coping strategies (situation-specific behaviours or cognitions available through leisure pursuits), was found to significantly predict greater immediate coping outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of physical health functioning, mental health, and sociodemographic factors in determining the intensity of mental health care use among primary care medical patients.

The present study examined sociodemographic and attitudinal predisposing factors (gender, age, marital status, health insurance, household income, attitudes about mental health care), and need/illness variables (depression severity, physical and mental health functional status) as predictors of past-year mental health care use intensity (i.e., visit counts) and use/nonuse. The sample included 283 adult primary care patients from the Midwestern United States in a cross-sectional study. Nonlinear regression models demonstrated that past-year treatment use intensity was significantly associated with both married status and poorer physical health functioning, while the use (vs. nonuse) of treatment was associated with depression severity. A sociodemographic and attitudinal multivariate predictor model only explained 5% of the variance in treatment use intensity, but a need/illness model significantly contributed an additional 23% variance. Poorer physical health functioning was significant in predicting treatment use intensity, while depression severity was significant in predicting the use (vs. nonuse) of treatment. Results demonstrate the particular importance of physical health problems in determining the intensity of mental health care use, and depression severity in determining the use/nonuse of treatment, notwithstanding the restricted sociodemographic contour of the sample. (PsycINFO Database Record (c) 2010 APA, all rights reserved)