Russ V. Reynolds

The hierarchical factor structure of the coping strategies inventory

The structure of coping was examined in three studies by means of Wherrys approach to hierarchical factor analysis. A hierarchical model with three levels was identified that included eight primary factors, four secondary factors, and two tertiary factors. The eight primary factors (problem solving, cognitive restructuring, emotional expression, social support, problem avoidance, wishful thinking, self-criticism, and social withdrawal) identified dimensions of coping found in previous empirical research and theoretical writing. The emergence of the four secondary and two tertiary factors provided empirical support for two theoretical hypotheses concerning the structure of coping. Support for the constructs of problem- and emotion-focused coping hypothesized by Lazarus was obtained at the secondary level, and support for the constructs of approach and avoidance coping hypothesized by many theorists was obtained at the tertiary level. These findings suggest that both formulations may describe the structure of coping, albeit at different levels of analysis.

A self-management program for adult asthma. Part I: Development and evaluation☆☆☆★★★

BACKGROUND We developed and evaluated a self-management program for adult asthma. In developing the program, we considered questions of format and behavior control. The format we selected included components known to be effective in educational settings. We regulated asthma management behavior through the introduction of environmental cues. METHODS Seventy-six subjects, whose asthma was generally under medical control, were assigned randomly to either a treatment group or a waiting-list control group. Those in the treatment group were exposed to a 7-week program that incorporated proven features of providing effective training and establishing behavioral control. Subsequently, subjects in the control group received the treatment. Short-term evaluation of the treatment was made after the subjects in the experimental group were trained but before the control subjects were trained. Long-term evaluation was conducted after both groups of subjects were trained. RESULTS Over the short term, self-management training led to fewer asthma symptoms and physician visits and improvement in asthma management skills and cognitive abilities. Over the long term, self-management training was related to lower asthma attack frequency, reduced medication use, improvement in cognitive measures, and increased use of self-management skills. CONCLUSIONS The program improved asthma management in patients whose conditions were already under good medical control. The effects of the program were apparent a year after the conclusion of self-management training.

A method for studying controlled substance use: a preliminary investigation.

This study examined relapse following treatment in a smoking reduction program. Twenty-two smokers with an average daily smoking rate of 25.7 cigarettes were provided a reduction-oriented smoking self-management program. Subjects were then classified on the basis of their reduction at posttreatment. A 50% or greater reduction from pretreatment qualified subjects as successful reducers. To provide further understanding of controlled smoking, subjects who successfully maintained at least a 50% reduction (at three month follow-up) were compared to those subjects who were unable to maintain that level of reduced smoking. A set of cognitive, smoking history, and reduction motivation variables were used to compare the two groups in a stepwise discriminant function analysis. Two variables, internal locus of control and self-label as a nonsmoker, produced an overall correct classification rate of 88.9%. Multiple regression analyses further demonstrated the importance of these two cognitive variables; self-label and internal locus of control accounted for 50.4% of the variance in smoking at three months follow-up. The implications of these findings for future study of controlled smoking are discussed.

Psychological Theory, Assessment, and Interventions for Adult and Childhood Asthma

Although the symptoms that comprise asthma were described by many ancient writers, a precise definition of asthma has eluded scholars and scientists alike. As Sol Permut observed, “It’s like love—we all know what it is, but who would trust anybody else’s definition?” (cited in Gross, 1980, p. 203). Gross (1980) suggested that Permut undoubtedly made his remarks because the etiology or etiologies are obscure, the clinical picture is diverse, and the pathophysiological mechanisms are seemingly multiple, yet it borders or overlaps other conditions to the extent that it makes it necessary to decide “what is asthma and what is not,” if we wish to communicate what is being referred to. (p. 203)