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Family caregivers of terminal cancer patients often experience substantial emotional burden. This study assessed depression, anxiety, stress, and coping–distress associations among caregivers in Eastern India to inform culturally sensitive interventions.
Methods
A cross-sectional survey was conducted among 100 adult caregivers of terminal cancer patients at a tertiary care hospital in Kolkata. Participants were recruited via systematic random sampling and interviewed using a structured proforma, the 21-item Depression, Anxiety and Stress Scale (DASS-21) and the Brief-COPE inventory. Descriptive statistics summarized demographics and caregiving characteristics. Spearman’s rank correlation was used to assess associations between psychological distress and coping domains, with p < 0.05 considered statistically significant.
Results
Caregivers (median age 43 years; 70% male) were predominantly the patient’s children (67%). Median DASS-21 scores indicated moderate depression (16), anxiety (14), and stress (16). Coping scores indicated low-to-moderate use of problem-focused (1.875 ± 0.321), emotional (1.871 ± 0.269), and avoidant coping (1.865 ± 0.266). Emotional coping correlated significantly with anxiety (ρ = 0.301, p = 0.002), depression (ρ = 0.317, p = 0.001), and stress (ρ = 0.293, p = 0.003). Depression also correlated with stress and problem-focused coping, while stress correlated with avoidant coping.
Significance of results
Caregivers experienced considerable psychological burden, with emotional coping consistently linked to distress. These associations likely reflect reactive adaptation rather than inherent maladaptiveness. Results highlight an urgent need to recognize caregiver distress within oncology settings and to develop culturally informed psychosocial interventions in palliative care, particularly in low-resource environments. Such efforts could enhance both caregiver well-being and quality of end-of-life care.
Healthcare personnel exhibit higher levels of anxiety and depression, with differences in the use of coping strategies to manage stressful situations.
Aims
To assess which coping strategies, sociodemographic factors and job-related variables predict anxiety and/or depression among healthcare professionals.
Method
A total of 744 participants, including physicians, nurses and nursing assistants were involved in a cross-sectional study.
Results
The ordinary least squares estimator was used to estimate the parameters. The results identified negative self-focus (β = 0.42, β = 0.45, p < 0.001), positive reappraisal (β = −0.20, β = −0.30, p < 0.001) and open emotional expression (β = 0.12, p < 0.001; β = 0.08, p < 0.01), as coping strategies significantly associated with anxiety and depression. Additionally, seeking social support was related to depressive symptoms (β = −0.02, p < 0.01), but not of anxiety. Interestingly, avoidant coping was associated with lower levels of both anxiety and depression (β = −0.14, p < 0.001). The absence of family responsibilities was associated with lower levels of anxiety and depression (β = −0.11, β = −0.10, p < 0.001). Being male was linked to lower anxiety levels (β = −0.11, p < 0.001), while being female was associated with greater depressive symptoms (β = 0.09, p < 0.01). Holding the position of nursing assistant was identified as a variable associated with anxiety and depression (β = 0.08, p < 0.05; β = 0.06, p < 0.05).
Conclusions
These results are essential for tailoring interventions aimed at occupational health.
This chapter examines the interaction between working memory and emotional wellbeing, highlighting the value of counselling for individuals with dyslexia. The authors stress that working-memory limitations not only affect academic or occupational performance but also contribute to emotional stress, frustration, and anxiety – especially when these difficulties are misunderstood or misattributed. Drawing on psychological theory and clinical experience, the chapter outlines how counselling can support clients in building self-awareness, managing emotional responses, and developing practical coping strategies. The therapeutic process often involves education about thinking, helping individuals understand how working-memory deficits affect their behaviour, and reframing past negative experiences in a more constructive light. Stress, anxiety, and low confidence can exacerbate cognitive overload, creating a feedback loop of underperformance and distress. Counselling can break this cycle by fostering emotional regulation and building self-efficacy. The chapter underscores the importance of a client-centred, non-pathologising approach, where individuals feel listened to and empowered. It also stresses the need for mental health professionals to understand cognitive profiles so that therapeutic interventions are tailored and relevant. Overall, the integration of cognitive and emotional support is shown to be key in helping individuals with dyslexia live more confident, adaptive lives.
Mentalising skills may be conceptualised as composed by both personal and interpersonal competencies, in turn shaped by early adverse experiences and coping strategies. Although cross-sectional observations described a role for mentalising skills in burnout development, large-scale longitudinal studies on the topic remain limited, especially in relation to psychiatry training.
Aims
The primary aim was to investigate protective and risk factors for higher burnout scores across time. Secondary aims included testing whether psychiatry exhibited different burnout scores across time in comparison to other medical residents.
Method
A cohort of 1803 medical residents (1131 psychiatry residents) was assessed for mentalising skills, conceptualised as composed of emotional regulation (Difficulties in Emotion Regulation Scale), interpersonal competencies (Interpersonal Competence Questionnaire), coping strategies (Coping Orientation to Problems Experienced) and burnout dimensions (Maslach Burnout Inventory). One-year follow-up was available for 520 psychiatry residents (73.03% response rate) and 234 other medical residents (35.94% response rate). Longitudinal mixed models and bivariate latent change models were employed.
Results
Across all residents, greater levels of burnout were associated with higher scores in insecure attachment, emotional dysregulation and maladaptive coping, as well as lower scores in interpersonal skills. Attending at least one supervision per month was associated with lower burnout scores across time. According to a bivariate latent change model, emotional regulation improvements through years were associated with lower burnout scores across time. In psychiatry residents, lower burnout scores across time were observed as compared to other medical residents. Psychiatry residents benefited from a higher protective effect of interpersonal competencies (group by moderator by time interaction) and coping strategies against burnout.
Conclusions
Mentalising skills may mitigate burnout development. Training in psychiatry emerged as a potential mitigating factor against burnout increases. Structured supervisions may foster professional development and emotional resilience.
This study aims to address a critical gap in literature by examining the mediating role of coping strategies in the relationship between mental health issues and food addiction among university students, contributing to the understanding of how stress management mechanisms affect addictive eating behaviours during this vulnerable period. A cross-sectional, quantitative study was conducted with 1947 students enrolled at a university in Istanbul during the 2024–2025 academic year. Data were collected online, using a Personal Information Form, the Depression-Anxiety-Stress-21 Scale (DASS-21), the Coping Orientation to Problems Experienced Inventory (Brief COPE) and the Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0). Data were analysed using Pearson’s correlation analysis, multiple regression analysis and PROCESS Macro Model 4. Moderate, positive and statistically significant correlations were observed between depression, anxiety and stress levels and food addiction (r = 0·398–0·417; P < 0·001). Multiple regression analysis demonstrated that mental health issues explained 20·8 % of the variance in food addiction scores. Mediation analyses indicated that adaptive coping strategies (e.g. humour, acceptance and using instrumental social support) and maladaptive coping strategies (e.g. restraint coping, behavioural disengagement and suppression of competing activities) significantly mediated the relationship between mental health issues and food addiction. Mental health issues represent a substantial risk factor for food addiction among university students in metropolitan areas, influenced by their coping strategies. Promoting adaptive coping strategies and reducing maladaptive ones are essential for preventing food addiction. These findings underscore the need to integrate psychological support and stress management into intervention programmes targeting university students.
Sex differences in psychosis pathoetiology are insufficiently understood. This study explores how childhood adversity (CA) and coping mechanisms relate to psychosis expression (PE) across males and females in the general population.
Methods
Data from the TwinssCan project (males: n = 312; females: n = 478) were used. The Childhood Trauma Questionnaire assessed CA domains. The Utrecht Coping List assessed coping strategies. Psychosis expression was assessed using the Community Assessment of Psychic Experiences (CAPE). Mixed linear regression analyses examined sex-stratified associations of CAPE scores with CA, coping strategies, and their interactions.
Results
Emotional abuse (EA) was associated with increased total CAPE scores (T-CAPE), explaining the greatest variance among CA across sexes. Sex-specific effects showed that sexual abuse (SA) and physical abuse (PA) were linked to higher T-CAPE in females, whereas physical neglect (PN) was linked to higher T-CAPE in males. Passive-reacting was associated with increased T-CAPE, explaining the greatest variance among coping styles across both sexes. Sex-specific effects showed that, in females, seeking social support was linked to decreased T-CAPE, while emotional expression increased it. The only sex-shared interaction effect was between reassuring thoughts and emotional neglect (EN), associated with decreased T-CAPE. In females, social support (× PA/PN/EA), reassuring thoughts (× PA/PN), and palliative-reacting (× PN/PA) were associated with decreased T-CAPE, while passive-reacting (× EN) increased it. In males, avoidance (× SA/PA) and passive-reacting (× PN) were associated with increased T-CAPE.
Conclusions
Sex differences in the associations of PE with CA and coping underscore the necessity for sex-specific interventions that promote adaptive coping strategies.
Organized crime generates violence, economic instability, and institutional challenges, forcing millions of citizens worldwide to change their place of residence annually. While the experiences of those fleeing violence are well-documented, less attention has been given to frontline workers assisting them. This study addresses this gap by examining the types of coping mechanisms that frontline officials use to protect women escaping organized crime in Mexico. Drawing on 24 in-depth interviews with key actors from governmental and non-governmental organizations, we identify three types of coping mechanisms: individual, institutional, and social. These strategies demonstrate the resilience and ingenuity of workers navigating resource shortages, legal constraints, and personal safety risks. Our findings contribute to the literature on organized crime by illuminating how those working on the ground adapt to systemic deficiencies and protect victims. By understanding these strategies, we hope to inform more effective policies to support frontline officials and mitigate the societal harms of organized crime.
Public governance is inherently normative, so it is important to study the values of public governance – particularly in the present-day context, where, given increasingly differentiated Western public governance, many different values come into play and new value conflicts arise. In this Element, a value-based governance (VBG) perspective is presented. In this perspective, values take center stage as the guiding concept in the theory and practice of public administration and are used as a heuristic to understand and analyze public governance. One section focuses on the advantages and disadvantages of coping strategies used by actors and institutions when dealing with value conflicts. In the final section, the author returns to the practice of public governance: the VBG paradigm entails public governance with normative reasoning. Value-based governance is about bringing the value rationality back in and recognizing intrinsic values. This title is also available as Open Access on Cambridge Core.
The 29-item Body Image Coping Strategies Inventory (BICSI; Cash et al., 2005) assesses three distinct styles respondents use to cope with situational threats to their body image, which are appearance fixing, avoidance, and positive rational acceptance. The BICSI can be administered online or in-person to adolescents or adults; it is free to use. This chapter first discusses the development of the BICSI and then provides evidence of its psychometrics. More specifically, the BICSI has been found to have a 3-factor structure within exploratory and/or confirmatory factor analyses. Internal consistency reliability, test-retest reliability, and construct validity support the use of the BICSI. Next, this chapter provides all BICSI items, instructions for administering the BICSI to participants, the item response scale, and the scoring procedure. Links to known translations are provided. Logistics of use, such as how to obtain the scale, permissions, copyright, and contact information, are provided for readers.
Chapter 7 addresses the challenges of water supply during floods focusing on flood relief/emergency relief operations settings rather than well-organised urban ones. The chapter outlines principles for planning, source identification, water development and quality control in emergency flood situations. It explores key aspects like potable water availability, including quantity, quality, sources, accessibility and reliability. The care and preparation of water supply systems from various sources are discussed, along with emergency preparedness, treatment plant operation, chemical conservation, water testing, bacteriological tests, and disinfection methods. The chapter concludes with insights into water purification techniques and overall management of water supply and quality issues during flood emergencies.
Through a range of coping strategies, individuals seek to manage the stressors to which they are exposed, employing cognitive and behavioral responses that shape their emotional regulation of such events. Emergency first responders are routinely subjected to high-stress situations due to the nature of their duties and the continuous care of critically ill patients. This sustained exposure significantly increases their vulnerability to the development of mental health disorders, notably posttraumatic stress disorder (PTSD).
Objective:
The aim of this study was to determine the coping strategies used by first responders when facing critical incidents and their association with PTSD.
Methods:
A cross-sectional analytical study was conducted in 2022. All first responders from a volunteer fire department in a major Colombian city who voluntarily agreed to participate were included in the study. The participants were 28 ambulance crew members and 187 firefighters. Descriptive statistics were used for data analysis, and logistic regression models were applied to assess associations with PTSD. Principal components analysis was used to compute total scores, while the Lasso Method identified significant predictors.
Results:
The first responders most often employed avoidance and denial as coping strategies in response to the demands of their work in the prehospital field. After witnessing devastating events, many of them turned to religion for stress relief.
Conclusions:
The study identified the use of maladaptive strategies associated with PTSD among staff, making it critical to develop training programs that help first responders cope with critical incidents by developing adaptive coping skills.
Attachment style is widely recognized as influential in shaping responses to bereavement and prolonged grief disorder (PGD). Although theorized extensively, empirical clarity regarding how attachment styles specifically impact PGD symptoms and therapeutic implications remains limited. This study aimed to identify cognitive-behavioral mechanisms linking attachment styles to PGD symptoms.
Methods
Data were collected from a community sample of 695 bereaved adults. Network analysis explored interactions between attachment styles (anxious and avoidant) and various cognitive-behavioral factors associated with PGD, including appraisals, memory characteristics, maladaptive coping strategies, and a sense of social disconnection.
Results
The findings reveal attachment styles as peripheral within the network, suggesting that their direct influence on PGD symptoms may be less central than previously theorized. However, anxious attachment correlated positively with injustice rumination and altered social self, while avoidant attachment was positively associated with perceived loss of future and relationships and preferences for solitude, and negatively associated with proximity-seeking behaviors and fear of losing connection to the deceased. Cognitive-behavioral factors, particularly memory characteristics and social disconnection, held central positions within the network, mediating relationships between attachment styles and PGD.
Conclusions
Attachment styles indirectly influence PGD through cognitive-behavioral pathways rather than exerting strong direct effects. By bridging the gap between attachment theory and cognitive-behavioral approaches to grief, this study offers a more nuanced understanding of its relationship with PGD and points toward potential new avenues for future interventions aimed at addressing attachment-related challenges in bereaved individuals.
This study aims to determine the factors associated with pregnant women’s perceived stress and coping styles after the devastating earthquake in Turkey.
Methods
This descriptive and cross-sectional study was conducted with 419 pregnant women between March 15 and May 15, 2023. Data were collected through the “Personal Information Form,” the “Perceived Stress Scale,” and the “Coping with Earthquake Stress Scale.”
Results
In this study, while the variables of employment status (P = 0.045) and number of pregnancies (P = 0.004) affected perceived stress, the variables of age (P = 0.049), income status (P = 0.003), place of residence (P = 0.036), and employment status (P = 0.001) were found to affect coping skills with earthquake stress. The Religious Coping sub-scale was a predictive factor on perceived stress (P = 0.002). In addition, a negative and linear relationship was found between the mean total score of the Perceived Stress Scale, the “Religious Coping” (P = 0.006, r = -0.134), “Positive Reappraisal” (P = 0.031, r = -0.106), and the total score of Coping with Earthquake Stress Scale (P = 0.005, r = -0.135).
Conclusions
This study found that there were some factors affecting the perceived stress and coping strategies of women after the earthquake, and the pregnant women used coping skills more as their perceived stress decreased; especially, they used religious coping and positive reappraisal strategies more.
In Ukraine, patients and their family members face numerous barriers to health care services. In response, they use coping strategies, that are manifold and complex activities aimed at overcoming these barriers, the financial burden of the treatment, and the poor quality of health care services. These activities include formal and informal practices. Based on representative survey data from 2015 (N = 2,022), we identify patterns in the use of coping strategies, specific coping strategies used to secure good quality consultation and treatment, and analyse opinions and actions towards coping practices. We further analyse the factors associated with the last experience of coping and look at patterns of connection building. We find that the chances of using both money and connection as a coping strategy are higher for people with incomplete higher and highest levels of education. The size of this effect increases with the level of education. Older people, people with better health, and people with a higher opinion of the state use informal practices less, while women are more active in developing connections. The closer the relationship is with a medical doctor, the higher is the chance that such connection will be used in case of health service consumption.
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.