Jeannine Monnier

Gender and coping: The dual-axis model of coping

Examined a dual-axis model of coping that included both action (active vs. passive) and social dimensions (prosocial vs. antisocial) of coping strategies among a combined sample of students and community residents. We developed an assessment device to represent the model and allow investigation. Mixed support for the model and instrument were noted. Women were more prosocial than men in their coping, but no less active. Men were more likely to use antisocial and aggressive, but less assertive coping strategies than women. More prosocial, action coping strategies were also more likely to be related to greater sense of mastery and more liberal gender-role orientation. Antisocial and passive strategies tended to be related to lower mastery and more traditional gender-role orientation. Active coping was related to lower emotional distress for men and women, but both prosocial and antisocial coping were related to greater emotional distress for men, suggesting that men may have a narrower band of beneficial coping strategies than do women.

Trauma among female veterans: a critical review.

This article reviews the literature documenting the nature and prevalence of traumatic experiences, trauma-related mental and physical health problems, and service use among female veterans. Existing research indicates that female veterans experience higher rates of trauma exposure in comparison to the general population. Emerging data also suggest that female veterans may be as likely to be exposed to combat as male veterans, although not as directly or as frequently. Female veterans also report high rates of posttraumatic stress disorder, which has been associated with poor psychiatric and physical functioning. Although sexual assault history has been related to increased medical service use, further research is needed to understand relationships between trauma history and patterns of medical and mental health service use. Researchers also are encouraged to employ standardized definitions of trauma and to investigate new areas, such as treatment outcomes and mediators of trauma and health. Policy and practice implications are discussed.

Conservation of Resources and Traumatic Stress

Conservation of resources (COR) theory has been developed as a general stress theory that helps delineate both why certain circumstances are stressful and the process of people’s reactions to stressful circumstances (Hobfoll, 1988, 1989; Hobfoll & Lilly, 1993). As a general theory of stress, it can help us understand both the similarities and differences inherent in traumatic stress as compared to major stressors, everyday stressors, and minor hassles. If the theory is truly helpful, it can further aid in informing interventions aimed at benefiting victims of traumatic stress. This chapter focuses on COR theory as it applies to traumatic stress and emphasizes how it helps us to understand stress reactions, recovery, and lifelong sequelae. Hopefully, it will also help the reader frame other chapters in this volume and provide a general guide for understanding the nature and treatment of traumatic stress.

There's more than rugged individualism in coping. Part 1: Even the Lone Ranger had Tonto.

Abstract A multiaxial model of coping and instrument were developed to explore communal aspects of coping and move beyond the current individualistic perspective. The model suggests that coping strategies differ on level of activity, prosocial and antisocial demeanor, and directness. Individualistic models of coping tend to ignore the social aspects of coping and neither see prosocial coping as healthy nor antisocial coping as unhealthy, despite a wealth of psychological theory that conceptualizes healthy functioning as both active and prosocial. Individualistic models also imply that direct action is preferred, whereas communal models emphasize that social coping may often be indirect. In a series of studies we found support for the muitiaxial model among both student and inner-city samples. Women were found to be as active as men, but more prosocial in their coping. Men were more antisocial in their coping. Indirect coping, however, was either less well conceptualized or measured as the results regardin...

Generalized anxiety disorder in women.

Women have a higher prevalence of GAD than do men. This ratio holds true in most clinical and general-population samples. Some variations exist, with evidence to suggest the strong impact of environment and life events. Women are sensitive to lifetime adversity and exacerbation of symptoms in conjunction with their menstrual cycle. Comorbidity is a crucial diagnostic factor when treating anyone with GAD, especially women. Most notably, high comorbidity with other anxiety disorders, MDD and alcohol-abuse disorder occurs for women. Overall, although the prevalence of women with GAD is greater than that of men with GAD, the course of illness and prognosis are not qualitatively different. Across varied methodology, data suggest gender-related differences in the metabolism and potentially in the effects and side effects of the various benzodiazepines and antidepressant psychopharmacologic treatments of GAD. Additional research is needed to better understand these differences.

Female veterans seeking medical care at Veterans Affairs primary care clinics: psychiatric and medical illness burden and service use.

ABSTRACT Objective: To examine rates of medical and psychiatric disorders among 187 female veterans recruited at four Veterans Affairs Medical Centers (VAMCs), the recognition of such disorders by VAMC care providers, and the use of relevant medical and mental health services by women both within and outside of the VA setting. Methods: We used a cross-sectional, epidemiological design incorporating self-report measures, structured interviews, and chart reviews to obtain relevant information for analyses. Results: Forty-four percent (43.9%) of women met criteria for at least one psychiatric disorder; 34.0% of these women met criteria for two or more additional psychiatric diagnoses, and concordance rates between interview and chart diagnoses were low. Ninety-five percent (95.2%) of women had a medical condition noted in their charts; 86.6% had two or more additional medical conditions, and a significant number of women had both medical and psychiatric diagnoses. Forty-four percent (43.9%) of women with an identified mental health condition received specialized mental health care by the VA in the past year. Conclusions: Findings from this study suggest that female veterans treated in VAMCs had significant medical and psychiatric problems, and these women might not be getting their health care needs adequately met through the VA health care system. In light of our findings, we discuss relevant implications and future directions for research.

Symptom Patterns and Service Use Among African American and Caucasian Veterans With Combat-Related PTSD

76) combat veterans with posttraumatic stressdisorder (PTSD) at a Veterans Affairs (VA) outpatient PTSD treatment clinic were compared onvariables related to clinical symptoms and VA service use. Groups were compared on relevantinterview (e.g., Clinician Administered PTSD Scale; D. D. Blake et al., 1990) and self-reportmeasures (e.g., Minnesota Multiphasic Personality Inventory–2; J. N. Butcher, W. G. Dahlstrom,J. R. Graham, A. Tellegen, & B. Kaemmer, 1989). Groups were also compared on demographics,psychiatric comorbidity, VA service use, and disability status. Results revealed few significantbetween-groups differences, providing further evidence that African American and Caucasianveterans with PTSD do not differ in manifestation of the syndrome or in use of VA services andbenefits.

Trauma-related Mental Health Needs and Service Utilization Among Female Veterans

Women constitute a growing segment of the military veteran population and researchers have begun to examine the extent to which their mental health needs are appropriately addressed within the Veterans Affairs (VA) healthcare system. Existing research documents high rates of both military and non-military trauma among female veterans; however, little has been done to examine the extent to which female veterans exposed to trauma receive treatment for trauma-related problems such as posttraumatic stress disorder (PTSD) and substance abuse within the VA system. This article reviews the literature documenting a high rate of trauma exposure among female veterans and examines evidence that trauma-related mental health problems, such as PTSD and substance-use problems, are under-diagnosed and under-treated among female veterans in VA healthcare settings. The few available studies examining general service utilization among female veterans are also reviewed, and implications for future research and clinical practice in the area of female veterans’ trauma-related mental health needs and service use patterns are discussed. In order to provide more accurate assessments of female veterans’ trauma-related mental health needs, researchers are encouraged to implement comprehensive trauma assessments as well as clinically valid PTSD and substance abuse diagnostic assessments. Researchers are also encouraged to examine the availability and efficacy of both VA and non-VA mental health services to determine the appropriateness of women’s VA service use patterns. Clinicians providing VA mental health services for women are encouraged to include comprehensive, behaviorally-specific trauma interviews and diagnostic evaluations for PTSD and substance-related problems in their standard assessment protocols.

How antisocial and prosocial coping influence the support process among men and women in the U.S. postal service

The influence of antisocial and prosocial copingon the acquisition of social support and on subsequentpsychological distress among 67 male and 47 femalepostal employees was examined allowing genderdifferences in coping to be studied in a single worksetting. Seventy seven percent of the respondents wereEuropean American, 18% were African American, and theremaining 5% were of varying ethnicities including:Asian American and Latin American. Employingstructural equation modeling, women were found to useprosocial coping as a coping response significantly morethan men, and men were found to use antisocial coping as a coping response significantly more thanwomen. Prosocial strategies were related to increasedworkplace social support in both the short-term andlong-term. Antisocial coping strategies were related to less support from co-workers in theshort-term. Contrary to predictions, antisocial copingstrategies were not related to decreased support acrosstime. Finally, increased social support was related to less psychological distress within eachassessment period.

Intrusive thoughts in posttraumatic stress disorder

This article reviews the literature on prevalence, associated features, assessment, and treatment of intrusive symptoms associated with posttraumatic stress disorder (PTSD). Research indicates that among trauma survivors, intrusive thoughts and imagery are quite common and distressing. It appears that early intrusions may be predictive of long-term distress and that avoidance and suppression can maintain intrusions. The treatment outcome literature for PTSD indicates that current cognitive behavioral treatments are effective in reducing intrusions. New data from a recent treatment outcome study for PTSD with comorbid panic attacks, using Multiple Channel Exposure Therapy, also suggest that this treatment is effective in significantly reducing intrusions.