Review: Families & Change: Coping With Stressful Events and Transitions

A review of Families & Change: Coping With Stressful Events and Transitions-4th edition by Sharon J. Price, Christine A. Price and Patrick C. McKenry.

Stress and coping in African American grandparents who are raising grandchildren

Over the years, substantial increases have occurred in the number of children being raised by their grandparents. A small number of studies have reported that grandparents raising grandchildren experience an increase in stress due to the demands of caregiving. The primary objectives of this study were to: (1) determine the degree of stress in African American (AA) grandparents who are raising their grandchildren age 12 years or younger; (2) identify the variables pertaining to the demographic characteristics of the grandparent caregiver and characteristics of the caregiving situation; (3) identify the coping strategies reported by AA grandparents; and (4) identify the relative importance of demographic and situational variables pertaining to the grandparent caregiver and caregiving situation, and coping strategies in influencing the degree of stress experienced. ^ An exploratory, descriptive, cross sectional design was used to study stress and coping in 50 AA grandparents who ranged in age from 44–87 years (M = 63.12). Data were collected via one personal interview in January/February 2001 at area senior centers or churches which the grandparent attends in Harris County, Texas. Five home interviews were done as requested by grandparents. ^ The instruments used to measure stress and coping were the Parenting Stress Index developed by Abidin and Folkman and Lazarus' Ways of Coping Questionnaire. Results of the study found that the grandparents is this study were a highly stressed group. Ninety-four percent of the sample demonstrated a “clinically significant” level of stress. Situational variables associated with lower stress levels were use of counseling, use of special school programs such as tutoring and special education, and increased length of caregiving (>5 years). ^ The most frequently used coping strategies overall were seeking social support and positive reappraisal. Six coping strategies were significantly correlated to lower reported stress: positive reappraisal, accepting responsibility, confrontive coping, self-control, planful problem solving, and distancing. ^ The findings from this study have limited generalizability. Nonetheless, this study was useful in adding to the limited amount of literature on AA grandparents who are rearing their grandchildren. The results clearly suggest the need for affordable counseling, support groups, education related to available resources, stress management, and interventions that increase the use of coping strategies found to reduce perceived stress. Future research should investigate levels of stress in AA and other grandparent caregivers longitudinally, as well as focus on stress and coping in grandparents raising grandchildren with special needs. ^

Family stress, coping, communication, and adaptation in unintended adolescent pregnancy

Objective. This study examines post-crisis family stress, coping, communication, and adaptation using the Double ABC-X Model of Family Adaptation in families with a pregnant or postpartum adolescent living at home. ^ Methods. Ninety-eight pregnant and parenting adolescents between ages 14 and 18 years (Group 1 at 20 or more weeks gestation; Group 2 at delivery and 8 weeks postpartum) and their parent(s) completed instruments congruent with the model to measure family stress, coping, communication, and adaptation. Descriptive family data was obtained. Mother-daughter data was analyzed for differences between subjects and within subjects using paired t-tests. Correlational analysis was used to examine relationships among variables. ^ Results. More than 90% of families were Hispanic. There were no significant differences between mother and daughter mean scores for family stress or communication. Adolescent coping was not significantly correlated to family coping at any interval. Adolescent family adaptation scores were significantly lower than mothers' scores at delivery and 8 weeks postpartum. Mean individual ratings of family variables did not differ significantly between delivery and 8 weeks postpartum. Simultaneous multiple regression analysis showed that stress, coping, and communication significantly influenced adaptation for mothers and daughters at all three intervals. The relative contributions of the three independent variables exhibited different patterns for mothers and daughters. Parent-adolescent communication accounted for most of the variability in adaptation for daughters at all three intervals. Daughters' family stress ratings were significant for adaptability (p = .01) during the pregnancy and for cohesion (p = .03) at delivery. Adolescent coping (p = .03) was significant for cohesion at 8 weeks postpartum. Family stress was a significant influence at all three intervals for mothers' ratings of family adaptation. Parent-adolescent communication was significant for mother's perception of both family cohesion (p < .001) and adaptability (p < .001) at delivery and 8 weeks, but not during pregnancy. ^ Conclusions. Mothers' and daughters' ratings of family processes were similar regarding family stress and communication, but were significantly different for family adaptation. Adolescent coping may not reflect family coping. Family communication is a powerful component in family functioning and may be an important focus for interventions with adolescents and parents. ^

Coping with advanced cancer: Caregivers and their patients

Background. Being diagnosed with advanced cancer may be one of the most difficult challenges a person faces. To help deal with advanced cancer, patients and caregivers lean towards the coping skills most familiar to them. Depending on the person, one’s coping may either help or perpetuate the problem. ^ Purpose. To identify predictors of negative coping skills among a group patients and caregivers, and to identify the predictors of prolonged grief among a group of providers, 6-months post loss. ^ Methods. Advanced cancer patients and caregivers were interviewed at the time of their enrollment (baseline) and caregivers were interviewed 6 months after the patient’s death (post-loss). Each participant was administered questionnaires regarding demographics, mental health disorders, mental health service use, coping methods, quality of life, and suicide attempts. Patients were asked about their treatment and diagnosis. Other patient-related information was obtained from medical charts. Moreover, caregivers were given an assessment regarding their alcohol and smoking history. ^ Results. Among White patients, positive coping skills were positively correlated with quality of life and negative coping skills were negatively correlated with quality of life. Gender, psychiatric disorders, suicidality, alcohol and smoking history, and treatment and diagnosis, were significantly related to negative coping skills; however this relationship only held for Hispanic patients. Gender and psychiatric disorders demonstrated predictive value for negative coping skills among all patients. On the other hand, psychiatric disorders, major depression, anxiety disorder, suicidality, and alcohol and smoking history, were not significant predictors of which caregivers experienced prolonged grief. ^ Conclusion. There was a significant relationship between quality of life and positive and negative coping skills of patients and negative coping skills for caregivers. Factors such as gender, psychiatric disorders, suicidality, alcohol and smoking history, and treatment and diagnosis demonstrated predictive value for negative coping skills in patients. ^

THE EFFECT OF PERSON-ENVIRONMENT FIT ON THE PSYCHOLOGICAL WELL-BEING OF PSYCHIATRIC AIDES WORKING IN A STATE HOSPITAL (COPING RESOURCES, SOCIAL SUPPORT, OCCUPATIONAL STRESS, LOCUS-OF-CONTROL)

This study addressed two purposes: (1) to determine the effect of person-environment fit on the psychological well-being of psychiatric aides and (2) to determine what role the coping resources of social support and control have on the above relationship. Two hundred and ten psychiatric aides working in a state hospital in Texas responded to a questionnaire pertaining to these issues.^ Person-environment fit, as a measure of occupational stress, was assessed through a modified version of the Work Environment Scale (WES). The WES subscales used in this study were: involvement, autonomy, job pressure, job clarity, and physical comfort. Psychological well-being was measured with the General Well-Being Schedule which was developed by the National Center for Health Statistics. Co-worker and supervisor support were measured through the WES and finally, control was assessed through Rotter's Locus of Control Scale.^ The results of this study were as follows: (1) all person-environment (p-e) dimensions appeared to have linear relationships with psychological well-being; (2) the p-e fit - well-being relationship did not appear to be confounded by demographic factors; (3) all p-e fit dimensions were significantly related to well-being except for autonomy; (4) p-e fit was more strongly related to well-being than the environmental measure alone; (5) supervisor support and non-work related support were found to have additive effects on the relationship between p-e fit and well-being, however no interaction or buffering effects were observed; (6) locus of control was found to have additive effects in the prediction of well-being and showed interactive effects with work pressure, involvement and physical comfort; and (7) the testing of the overall study model which included many of the components mentioned above yielded an R('2) = .27.^ Implications of these findings are discussed, future research suggested and applications proposed. ^

Association of coping styles & adolescent substance use

Adolescent substance use is a serious public health concern with long-lasting consequences. Although specific coping behaviors have been associated with adolescent substance use, less is known about the role of multidimensional coping styles that account for both positive and negative coping behaviors. This study examined the association of coping styles and substance use (alcohol, marijuana, and other illicit drugs) of 1,019 ethnically diverse high school students. Coping styles were categorized by high or low negative coping behaviors (e.g. distraction, social withdrawal, self-criticism, blame others, wishful thinking, resignation, and negative emotional regulation) and high or low positive coping behaviors (e.g. cognitive restructuring, problem-solving, social support, and positive emotional regulation). My hypothesis that high positive coping, regardless of the use of negative coping behaviors, would be protective against substance use was rejected. Logistic regression analyses controlling for age, gender, race, and parent education indicated that adolescents who relied primarily on adaptive coping were 45-67% less likely to report lifetime or past year substance use than any other coping style. However, mixed copers (i.e. high in both positive and negative coping behaviors) were 2 to 3 times as likely to report substance use than their adaptive coping counterparts.^