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This study was performed to determine the nature and organisation of specific defense mechanism in myocardial infarct patterns as compared to controls. It is also aimed at describing the organisation of these defenses and their relation to anxiety, depression and aggressivity. The samples consist in two populations of 112 male subjects with and without infarct and matched for age and socio-economic status. The EMO questionnaire of G.O. Baehr and M.E. Baehr and the COPE form from the FIRO scales of Schutz were used for psychological evaluation. The results show that the myocardial patients use more turning-against-self and that the other defence mechanisms do not discriminate between the subgroups. Furthermore, the scores for anxiety, depression, inferiority, hostility are similar in both groups. The patients state less sexual problems and use less fantasies than do normal controles. However, they use more somatic concern, but not significantly as compared to controls. This analysis was also concerned with the correlations between these defenses and affects. Furthermore, both subgroups were subdivided in three subsamples according to the score for turning-against self (high, median, low). Turning-against-self is associated with hostility in the patients while this mechanism is associated with a higher susceptibility to dayly events in normal subjects.
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PMID:[Organisation of defence mechanisms in patients suffering from myocardial infarction (author's transl)]. 92 Feb 23

The diagnosis of PMS depends on the identification of a core symptom complex, including behavioral symptoms of either irritability, accompanied by an internal state of anxiety or depression, and fatigue. (Fatigue is the most common symptom of PMS.) At least one core physical symptoms, bloating of the abdomen or extremities, breast tenderness, and headache also is required to establish the diagnosis. Although these core symptoms are required, none is pathognomonic for the disorder and the timing of the symptoms with respect to the menstrual cycle also must be established. This can only be done accurately using valid and reliable prospective recording instruments, such as COPE. Personality factors, the degree of psychosocial stress faced by the woman, and biochemical markers have little utility in establishing the diagnosis. The literature with respect to the prevalence of PMS in the population, effective treatments for the disorder, and the diagnosis of the disease must be interpreted by recognizing the inclusion in these studies of women with comorbid psychiatric disease, invalid and unreliable symptom inventories, and inadequate characterization of menstrual cycle phases. There are sociologic reasons why the true prevalence and treatment response to interventions may not be seen by the clinician. Nonetheless, the availability of effective treatment for the disorder necessitates accurate diagnosis of the syndrome based on the strict criteria presented. Additional research founded on the development of psychoneuroendocrine models is likely to provide insight into both the pathophysiology and treatment alternatives for PMS.
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PMID:Issues in the diagnosis and research of premenstrual syndrome. 152 87

In this descriptive study of 30 men with chronic genitourinary cancer, subjects were found to have minimal emotional distress in response to a periodic diagnostic procedure (cystoscopy). State anxiety levels and critical thinking ability measured preprocedure were not significantly different from levels obtained six to eight weeks postprocedure in subjects with negative biopsy results. Routine hospitalization for diagnostic monitoring was found, during COPE interview (Weisman & Worden, 1976), to be less stressful than regular work or financial and family concerns. Subjects with higher concurrent life stress had higher state anxiety and achieved less resolution of problems. Although anxiety levels for the group were within normal limits, 33% of the sample were categorized as having high anxiety on at least one testing occasion. This high-anxiety group had more severe behavioral responses, including feelings of depression, helplessness, and inability to set priorities.
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PMID:Stress-coping response to genitourinary carcinoma in men. 656 63

We related reported physical symptoms, cognitive appraisals (e.g., negative style of thinking), and coping strategies (e.g., denial/disengagement strategies) with illness burden across several functional domains separately in subsets of chronic fatigue syndrome (CFS) patients with (n = 26) and without (n = 39) concurrently diagnosed major depressive disorder (MDD). In regard to cognitive appraisal measures, automatic thoughts and dysfunctional attitudes were strongly associated with a higher illness burden, as indicated in sickness impact profile (SIP) scores. Active-involvement coping strategies measured on COPE scales (active coping, planning, and positive reinterpretation and growth) were not associated with SIP scores, while other coping strategies (mental disengagement, behavioral disengagement, and denial) were positively correlated with psychosocial and physical SIP scales, especially those pertaining to interpersonal life-style arenas. After we accounted for the number of different CFS-specific physical complaints reported and DSM-III-R depression diagnosis status, cognitive appraisals and coping strategies predicted a substantial proportion of the variance in the severity of illness burden. For the most part, the magnitude of these relationships between our predictor model variables and illness burden severity was similar in the MDD and non-MDD subgroups.
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PMID:Psychosocial correlates of illness burden in chronic fatigue syndrome. 814 57

Chronic fatigue syndrome (CFS) is a disorder of uncertain aetiology, and there is uncertainty also about the appropriate way in which patients should manage the illness. An illness management questionnaire (IMQ) was designed to assess coping in CFS. This was completed by 207 patients, in parallel with the COPE scales (a general measure of coping that can be applied situationally), and measures of functional impairment, anxiety and depression. The IMQ yielded four factors: maintaining activity, accommodating to the illness, focusing on symptoms and information-seeking. Scales based upon these factors together predicted 26, 27 and 22% of the variance in functional impairment, anxiety and depression, respectively, and each scale had significant relationships with relevant scales of the COPE, supporting the interpretation of the factors. It is suggested that the IMQ may be employed to relate ways of coping to outcomes in CFS, and to assess coping as a mediator of change in cognitive-behavioural interventions.
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PMID:Ways of coping with chronic fatigue syndrome: development of an illness management questionnaire. 835 86

Research on stress and its influence on health and well-being has flourished for several decades, examining as predictors such psychosocial variables as personality and coping. This work now often targets multiethnic samples. Because many potential participants lack facility in English, a need exists for translations of measures into other languages. We translated 6 instruments into Spanish and studied their characteristics. Of these, 3 were measures of personality qualities: the Life Orientation Test--Revised (Scheier, Carver, & Bridges, 1994), the Behavioral Inhibition/Behavioral Activation Scales (Carver & White, 1994), and the Measure of Body Apperception (Carver et al., 1998). The others were the Brief COPE (Carver, 1997), the Center for Epidemiological Studies--Depression Scale (Radloff, 1977), and an abbreviated version of the Profile of Mood States (McNair, Lorr, & Droppelman, 1971). Correlations between English and Spanish versions in bilingual samples were all above. 72, except for the COPE's Behavioral Disengagement scale. Alpha reliabilities of the Spanish versions were comparable to those of the English versions. Correlations among measures in a sample of cancer patients were similar across languages.
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PMID:Coping, mood, and aspects of personality in Spanish translation and evidence of convergence with English versions. 1077 33

OBJECTIVE: Irritable bowel syndrome has no observable symptom markers and there is little that the medical profession can do to help sufferers. Psychotherapy, antidepressants and drugs aimed at the most problematic symptoms have been shown to have limited efficacy. In an attempt to help understand the illness better, and to suggest alternative forms of intervention, the study tested whether outcome might be influenced by patients' representation of their illness and by their coping strategies. METHOD: All members of the IBS Network (an independent charitable support network based in the UK) were invited to participate via their quarterly newsletter, and 209 completed questionnaires were returned. Participants completed the Illness Perception Questionnaire (IPQ), the COPE, and the Hospital Anxiety and Depression Scale (HADS), and rated their quality of life and their satisfaction with their health. RESULTS: The reporting of serious consequences was associated with lower quality of life and lower satisfaction with health, and with higher scores for anxiety and depression (p <.001). Weaker control beliefs were related to lower quality of life, lower satisfaction with health, and higher depression scores (p <.01). Lower illness scores were associated with more satisfaction with health (p <.01), but not with quality of life (p >.05). Psychological causal attribution of IBS was positively correlated with anxiety (p <.001) and depression (p <.01). Path analyses based on multiple linear regression demonstrated that (1) the reporting of serious consequences was a strong independent predictor of outcome; (2) coping mediated the link between representation and outcome; and (3) when predicting depression, coping strategies predicted coping independently of representation dimensions. CONCLUSIONS: The findings indicate that the illness representations of IBS sufferers can have significant implications for outcome. Therapeutic interventions based on illness representations may prove useful for treatment.
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PMID:Illness representation, coping and outcome in irritable bowel syndrome (IBS). 1261 92

Over three-quarters of women experience some physical and emotional changes associated with the menstrual cycle. Irritability, tension, fatigue, depression, breast tenderness and bloating are among the most common premenstrual symptoms. Approximately 5-10% of women of childbearing age experience premenstrual symptoms to a degree that disrupts their functioning in the home or workplace and that meet criteria for premenstrual dysphoric disorder (PMDD). Serotonergic antidepressants are clearly effective for PMDD, with about 60% of subjects responding to this treatment in controlled studies. Oral contraceptives are commonly used to treat premenstrual symptoms but are an understudied intervention with no information on their efficacy for PMDD). The recent introduction of an oral contraceptive (Yasmin, Schering AG, Berlin, Germany), containing low-dose ethinylestradiol (EE) combined with a new progestogen, drospirenone (DRSP), may offer clinical efficacy for PMDD as a result of the unique pharmacological profile of this progestogen, which is a spirolactone derivative with antimineralocorticoid and antiandrogenic activity. A randomized, placebo-controlled study of DRSP/EE in women with PMDD found a consistently greater reduction of symptoms-from baseline for all 22 premenstrual symptoms assessed (using the Calendar of Premenstrual Experiences, COPE) and for the four statistically derived symptom factors in the group taking DRSP/EE compared to the placebo group. For appetite, acne and food craving (factor 3), the difference between the DRSP/EE group and the placebo group was statistically significant (p = 0.027). These preliminary results suggest the beneficial effect of DRSP/EE on PMDD and offer an alternative class of medication that also provides the range of benefits of oral contraception for women with PMDD.
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PMID:Evaluation of a unique oral contraceptive (Yasmin) in the management of premenstrual dysphoric disorder. 1265 4

This Article aims to introduce the translation and the validation of a multidimensional measure of coping strategies: the Brief COPE, in a French population. The coping concept comes from psychological studies that were conducted on stress. In the conceptual analysis of stress by Lazarus and Folkman, coping works with two cognitive appraisals performed by the person concerning the perception of a threatening situation and his or her available resources to deal with it. Coping is defined as "cognitive and behavioural efforts to master, reduce, or tolerate the internal and/or external demands that are created by the stressful transaction". The Brief COPE is the abridged version of the COPE inventory and presents fourteen scales all assessing different coping dimensions: 1) active coping, 2) planning, 3) using instrumental support, 4) using emotional support, 5) venting, 6) behavioural disengagement, 7) self-distraction, 8) self-blame, 9) positive reframing, 10) humor, 11) denial, 12) acceptance, 13) religion, and 14) substance use. Each scale contains two items (28 altogether). This inventory has the advantage of being built from acknowledged theoretical models (Lazarus' transactional model of stress, 1984; behavioral self-regulation model, Carver and Scheier, 1981, 1998). It can be used to assess trait coping (the usual way people cope with stress in everyday life) and state coping (the particular way people cope with a specific stressful situation). As is the COPE inventory, the Brief COPE is a measure used for many health-relevant studies: drugs addiction, ageing, breast cancer, depression, AIDS. Both measures are widely used in Anglophone countries and translated in many Languages. Today, the COPE inventory has been validated among Estonian, Croatian, Chinese, and Italian populations and the Brief COPE is also validated among Spanish people. Thus, the worldwide use of this coping inventory should allow a broad comparison of medical and psychological research for coping strategies regarding every kind of pathologies. Thus, we were led to present the translation and the validation of this measure in a French population. Two studies are presented in this Article: the first one describes the validation of the inventory in a dispositional format (trait coping) and the second one the validation of the inventory in a situational format (state coping). The French version of Brief COPE, which was used for both studies, was back-translated and analysed by the Brief COPE Author: Charles S. Carver. For study 1, 834 first Year university students answered the Brief COPE in its dispositional format. To study the factor structure of the Brief COPE, we used structural equation modeling and the LISREL software. Results show that the expected theoretical structure and the observed one fit adequately (c2=606, p<0,05, RMSEA=0,04, GFI>0,95, AGFI>0,92, RMR<0,03). In order to study convergent and discriminant validity of Brief COPE, self-esteem (SEI, Rosenberg, 1979), perceived stress (PSS, Cohen et al., 1983), and psychological distress (GHQ-12, Goldberg, 1972) measures were used. Results show that functional coping strategies (eg, active coping) are linked to good self-esteem, to lower perceived stress, and to lower psychological distress, whereas less functional strategies (eg, denial or self-blame) are widely linked to poor self-esteem, to a high perceived stress, and to psychological distress. Study 1 shows also several significant gender differences. Study 2 describes the Brief COPE validation in its situational format. 178 additional students answered this version. The method that was used is the same the one developed by Lazarus and his colleagues for the WCC validation. Participants were asked to recall and think about the most stressful event they had experienced during the past two Months. They were also to give an account of how much that situation mattered to them. They had to evaluate their capacity to control the situation and indicated whether they felt the situation was amenable to change. The study includes only peoples only people who labeled an event as "important" or "very important". Here again LISREL was used to study the factor structure of the Brief COPE. The results emphasise - as in study 1 - that the expected theoretical structure and the observed one fit adequately (c2=391, p<0,05, RMSEA<0,05, GFI=0,87, AGFI=0,80, RMR<0,06). Differences among means showed how the perceived control of the situation and how the perception of its favourable evolution influenced the coping strategies used (eg, humour or denial). Results in both studies indicate good psychometric properties for the Brief COPE in its French version, whatever the format (ie, dispositional or situational). Thus French searchers have a relevant tool on hand to measure as accurately as possible the coping strategies someone used in everyday life (strategies interfering on health, on a long scale), or in distressful situations (eg, serious illness, traumas). The fact that this easy-to-use coping measure is worldwide spread among medical and psychological studies allows a better broadcast and comparison of results whatever the pathology.
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PMID:[Multidimensional assessment of coping: validation of the Brief COPE among French population]. 1502 85

Minimally invasive direct coronary artery bypass (MIDCAB) surgery has been shown to be a promising technique for surgical treatment of single or double vessel disease. However, little is known about quality of life, mood state or coping in this group of patients. The records of 55 consecutive patients who underwent MIDCAB surgery at Harefield Hospital between April 1999 and May 2001 were reviewed. In order to assess quality of life, mood state and coping, patients were contacted by telephone to conduct a semi-structured interview and were subsequently sent four questionnaires. The measures used were the Hospital Anxiety and Depression Scale, the Short Form Health Survey, the WHOQoL-BREF and the COPE. Forty-eight patients were contacted by telephone, forty-four of whom returned the completed questionnaires. Overall ratings of quality of life were excellent for the majority of patients, and rates of anxiety and depression were lower than previously found following coronary artery bypass surgery. It is concluded that following MIDCAB surgery quality of life and mood state outcomes are encouraging. However, a prospective, longitudinal study is now required to further elucidate the relationship between quality of life, mood state and coping and to identify predictive factors for physical and psychological outcome following this new surgical technique.
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PMID:Quality of life and coping following minimally invasive direct coronary artery bypass (MIDCAB) surgery. 1523 5


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