Stella Dorz

Coping strategies: Evidence for cross-cultural differences? A preliminary study with the Italian version of coping orientations to problems experienced (COPE)

Abstract The internal structure of the COPE inventory (Carver, Scheier & Weintraub, 1989), a questionnaire which measures 15 different coping strategies, was studied. The Italian version of COPE was administered to 521 undergraduate students. Alpha and test-retest reliabilities were very similar to those obtained in the above American study. A rotated factor analysis resulted in 13 factors, which came out in a different order with respect to those obtained in the original study. A second-order factor analysis yielded five factors similar to those obtained by Carver etal., except for ‘Turning to religion’, which was present in the Italian study only. It is concluded that the Italian version of COPE has good construct validity and that the traditional taxonomy of coping strategies should also be studied in the light of transcultural differences.

Predicting Burnout Among HIV/AIDS and Oncology Health Care Workers

Psychological stress and coping strategies in staff working with AIDS and with cancer patients were assessed using self-report methods. The Maslach Burnout Inventory (MBI), Coping Orientations to Problems Experiences (COPE), State-Trait Anxiety Inventory (STAI) and Depression Questionnaire (DQ) were completed by staff from 20 hospitals of North-Center Italy, including 268 doctors and nurses working with people with AIDS and 260 doctors and nurses working in oncology. Few significant differences were found between two units on the MBI, COPE subscale and depression/anxiety. When a Bonferroni corrected p level of p < 0.0025 was used, the difference on Emotional Exhaustion (EE) subscale of MBI still remained statistically significant, indicating greater exhaustion in the oncology staff. The regression analysis suggested that the negative aspects of burnout were predicted primary by professional status (being a doctor), type of unit (oncology), depression and the use of the humor as a coping strategy. In contrast personal accomplishment was better predicted by positive coping strategies (i.e. planning, restraint coping, non-denial) and low level of anxiety.

A study of the psychometric properties of the Obsessive Beliefs Inventory and Interpretations of Intrusions Inventory on clinical Italian individuals.

Forty-three individuals with obsessive-compulsive disorder (OCD), 17 with generalized anxiety disorder (GAD) and 50 non-clinical controls (SC), completed the Italian versions of the Obsessive Beliefs Questionnaire (OBQ) and the Interpretations of Intrusions Inventory (III), along with measures of obsessive-compulsive (OC) symptoms, depression, anxiety and worry. OBQ and III showed an excellent reliability and temporal stability. The six OBQ subscales were reasonably distinct from each other, whereas the three subscales of the III were highly interrelated. The OBQ, and in less measure the III, discriminated between OCD, GAD, and normal controls. In the OCD cohort, the two instruments correlated moderately with a measure of obsessive-compulsive symptoms but also with a measure of worry. However, a linear regression analysis evidenced a specific relationship between the OBQ and obsessive-compulsive symptoms over and above worry. Overall, at least three cognitive domains (intolerance of uncertainty, excessive concern about the importance of controlling ones thoughts and perfectionism) seemed specific to OCD, whereas overimportance of thoughts and inflated responsibility barely discriminate clinically anxious individuals from non-clinical ones. It is concluded that OBQ and III are useful measures in Italian individuals and that more research is warranted to possibly refine these two instruments.

Evaluation of adherence to antiretroviral therapy in Italian HIV patients.

We studied factors associated with treatment adherence in 88 male and 21 female adults (age range, 24-65 years) with HIV infection undergoing therapy with HIV-1 protease inhibitors (PIs) in Italy. Data on sociodemographic variables, clinical and psychological symptoms, treatment compliance, physician/patient relationship, and psychosocial characteristics were obtained by means of semistructured interviews. Every subject also compiled two self-report questionnaires: Coping Orientations to Problem Experiences (COPE) and Medical Outcomes Study-HIV (MOS-HIV) in order to evaluate the use of coping strategies and quality of life. We found a high rate of adherence to HIV therapies (almost 90% of patients had taken at least 80% of medication in the previous 7 days). No significant differences were found between adherence and nonadherence groups as measured by self-report. Few significant differences were found when data laboratory were used. When a Bonferroni corrected p level of <0.001 was used, only a comparison on Mental Disengagement subscale of COPE was statistically significant.

Coping and cognitive processing style in HIV-positive subjects.

Background: People’s reactions to traumatic events are mediated by their subjective style of coping. This is of particular importance for HIV+ patients, mainly in the first phases of the disease. This work aimed at examining whether an ‘acceptance’ style of coping, as opposed to a ‘mental disengagement’ style, selectively influences the first stages of the processing of neutral, emotional and HIV-related information. Method: Two groups of 11 HIV+ asymptomatic subjects were chosen according to their coping strategies, acceptance or mental disengagement, as measured by Coping Orientations to the Problems Experienced (COPE). Twenty-two patients completed the Emotional Stroop Task and an incidental memory recognition task containing neutral, emotional and HIV-related stimuli. Results: Analysis of reaction times (RTs) on the Emotional Stroop Task showed that HIV+ subjects have longer RTs for emotional and HIV-related than for neutral words. Instead, no effect was found as regards interaction with style of coping. Conclusion: Results confirmed a processing bias of emotional information, whereas Acceptance and Mental disengagement strategies, as measured by the COPE scales, did not appear to influence information processing.

Obsessive Compulsive Disorder Cognitions Across Cultures

Publisher Summary This chapter reviews cross-cultural research on obsessive compulsive disorder (OCD) symptoms and cognitions and present cross-cultural data about cognitive phenomena in OCD. Several epidemiological researches disclose differences in OCD prevalence across cultures, and such differences might be considered possible clues regarding cultural influences on this form of psychopathology. Epidemiological research also inquired into the demographic variables associated with OCD. OCD in adults appears to have an equal gender distribution, although differences have been reported in some symptom categories, such as contamination/washing which may be more prevalent in women. Obsessive compulsive patients are less likely to be married than age matched controls. Lastly, there is conflicting evidence about the role of intelligence, social class, and birth order. Culture provides the categories, explanatory frames, and idioms for responding to physiological symptoms and also plays a significant role in structuring pathologies of cognitions themselves. Thus, culture may differently shape beliefs or core cognitive schemas thought to be etiologically relevant to OCD.

Hoarding Symptoms Are Not Exclusive to Hoarders

Hoarding disorder (HD) was originally conceptualized as a subcategory of obsessive compulsive disorder (OCD), and numerous studies have in fact focused exclusively on investigating the comorbidity between OCD and HD. Hoarding behavior can nevertheless also be found in other clinical populations and in particular in patients with eating disorders (ED), anxiety disorders (AD), major depression (MD), and psychotic disorders (PD). The current study was carried out with the aim of investigating, using a validated instrument such as the Saving Inventory-Revised (SI-R), the presence of HD symptoms in patients diagnosed with ED, AD, MD, and PD. Hoarding symptomatology was also assessed in groups of self-identified hoarders and healthy controls. The results revealed that 22.5% of the ED patients exceeded the cut-off for the diagnosis of HD, followed by 7.7% of the patients with MD, 7.4% of the patients with AD, and 5.9% of the patients with PD. The patients with ED had significantly higher SI-R scores than the other groups in the Acquisition and Difficulty Discarding scales while the AD, MD, and PD patients were characterized exclusively by Difficulty Discarding. These data suggest to clinicians that hoarding symptoms should be assessed in other types of patients and especially in those affected by Bulimia and Binge eating.