Maladaptive coping styles moderate the relationship between information on cancer treatment and psychosocial symptoms: an Italian multicenter study.

Objectives: Disclosing information on diagnosis, prognosis and treatment is a delicate process in oncology, although awareness levels have over time increased in people with cancer. However, individual characteristics should be considered when communicating difficult information. We conducted a multicentric study to explore the moderating role of coping styles on the relationship between information about cancer, quality of life and psychological distress. Methods: In the period between October 2015 and February 2016, 288 patients with a diagnosis of a solid tumor were recruited from seven Italian oncology units. All participants were administered the Distress Thermometer (DT), the Mini-Mental Adjustment to Cancer (Mini-MAC), the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30), and the EORTC QLQ 25-item information module (INFO25). We explored the moderating effect of coping style with quality of life (QoL) and distress (DT) as dependent variables and information on cancer treatment as independent variable. Results: Low levels of anxious preoccupation significantly moderated the relationship between information on treatment and QoL (R2 6%, p < 0.001), while low and medium levels of hopelessness significantly moderated the relationship between information on treatment and DT (R2 = 14%, p = 0.033). Adaptive coping strategies, such as fighting spirit and fatalism, and borderline strategies such as avoidance, did not play a role in this relationship. Conclusion: Taking into account and evaluating coping mechanisms in cancer care is a priority when disclosing information on treatments, in order to tailor communication style to individual features.

A mixed-methods stress audit with midwives in the United Kingdom.

PROBLEM: UK midwives report high work-related stress, which can negatively impact their health and wellbeing, with many considering leaving the profession. BACKGROUND: An occupational stress audit guides the implementation of stress management intervention, by identifying which stressors have the most negative impact and why, and highlighting "at risk" groups. AIM: To conduct a concurrent mixed-methods stress audit with UK midwives in an NHS Trust. METHODS: Seventy-one midwives (Mage= 39 years, SD = 11) completed a survey assessing stressors (e.g., relationships), stress appraisals (i.e., challenge vs. threat), coping strategies (e.g., avoidance-focused), and outcomes (i.e., mental health, performance, and intention to leave). Ten midwives (Mage = 42 years, SD = 10) participated in semi-structured interviews. FINDINGS: Quantitative data revealed that more work-related demands, poorer peer support and relationships, and threat appraisals predicted worse mental health. Moreover, less control and more work-related demands predicted poorer performance, while less control, poorer manager support, more change-related demands, and threat appraisals predicted greater intention to leave. Qualitative data generated three themes: organisational pressures exacerbated by unexpected changes; individualised responses but largely debilitative emotions; and personal coping and power of social support. DISCUSSION AND CONCLUSION: This study offered a comprehensive and novel insight into the stress experiences of UK midwives, highlighting targets for future stress management interventions, including key stressors (e.g., manager support), underlying mechanisms (e.g., stress appraisals), and "at-risk" groups (e.g., night shift workers). Practical recommendations are provided for stakeholders operating at multiple levels (e.g., midwife, trust, policy) to better support midwives with work-related stress.

Associations between mental health symptoms, trauma, quality of life and coping in adults living in Ukraine: A cross-sectional study a year after the 2022 Russian invasion.

We aimed to assess the mental health of adults living in Ukraine one year after onset of the Russo-Ukrainian war, along with quality of life and coping strategies. Quota sampling was used to collect online survey data from 2364 adults aged 18-79 years living in Ukraine from April 5, 2023 to May 15, 2023. Among adults living in Ukraine, 14.4 % had probable post-traumatic stress disorder (PTSD), another 8.9 % had complex PTSD (CPTSD), 44.2 % had probable depressive disorder, 23.1 % had anxiety disorder and 38.6 % showed significant loneliness. In adjusted models, the number of trauma events experienced during the war showed a dose-response association with PTSD/CPTSD and was associated with depressive disorder and anxiety disorder. Quality of life domains, particularly physical quality of life, were negatively associated with PTSD/CPTSD, depressive disorder, anxiety disorder, and number of trauma events. Maladaptive coping was positively associated with depressive disorder, anxiety disorder, PTSD/CPTSD and loneliness. All quality of life domains were positively associated with using adaptive coping strategies. Mental health disorders are highly prevalent in adults living in Ukraine one year into the war. Policy and services can promote adaptive coping strategies to improve mental health and quality of life for increased resilience during war.

Stress, burnout and coping among nurses working on acute medical wards and in the community: A quantitative study.

BACKGROUND: Psychological distress can cause burnout, which affects mental and physical well-being. It is important to identify factors associated with psychological distress and physical discomfort and how nurses deal with these problems. AIM: The aim was to investigate distress, burnout and coping among community nurses (CN) and hospital nurses (HN). APPROACH AND METHODS: In this cross-sectional study, 409 nurses completed three questionnaires: Perceived Stress Scale (PSS), Copenhagen Burnout Inventory (CBI) and Ways of Coping (WOC). FINDINGS: Participants younger than 40 demonstrated significantly more distress and burnout than those older than 40 years. Participants who had moderate and high distress on the PSS were significantly more at risk for experiencing personal, work-related and patient-related burnout. A significant positive correlation was found between distress and behavioural escape-avoidance, cognitive escape-avoidance and distancing. Significant positive correlations were also seen between all the subscales of the CBI and behavioural escape-avoidance, cognitive escape-avoidance and distancing. Positive significant correlation was also obtained between staff resources and distress and personal-related and work-related burnout. Negative correlation was demonstrated between staff resources and patient-related burnout. Participants with longer work experience were less likely to report moderate or high distress, and those who scored higher on personal burnout and behavioural escape-avoidance were more likely to have moderate or high distress. CONCLUSION: The results of this study call for increased attention to the younger generation in the nursing profession. The results also validate the need to investigate further the correlation between distress, burnout and coping and how these issues might influence each other among nurses working in the community and hospitals. Findings should be taken with precaution, they do not describe in detail what underlying factors contribute to distress and discomfort found in this study, they do, however, indicate certain coping strategies nurses use to deal with distress and burnout.

An Examination of John Henryism in Adults Living with Sickle Cell Disease.

BACKGROUND: John Henryism (JH) is a behavioral predisposition for high-effort coping with adversity. JH has been associated with hypertension in Black Americans with low socioeconomic status (SES) and is also found to be associated with psychological well-being. Sickle cell disease (SCD), a rare genetic disease largely affecting Black Americans in the United States, presents as a chronic condition that may benefit from a deeper understanding of the impact of JH on overall health. PURPOSE: This study examined the association between high and low JH and diastolic blood pressure, systolic blood pressure, hypertension prevalence, and sleep function. We relied on the biopsychosocial transaction model to adjust for relevant clinical and sociodemographic variables. METHODS: This was a cross-sectional secondary analysis of 274 adults with SCD living in the United States and recruited between 2014 and 2020. Study visits consisted of physical examinations, medical history, demographic, and psychosocial questionnaires. Adjusted linear regressions estimated associations between high and low JH and diastolic and systolic blood pressure as well as self-reported sleep function. Multivariable logistic regression was used to examine associations with hypertension prevalence. RESULTS: High JH was significantly associated with lower diastolic blood pressure (ß = - 2.98; 95% confidence interval = - 5.92, - 0.04) but higher sleep dysfunction (ß = 2.76; 95% confidence interval = 1.45, 4.07). CONCLUSIONS: Overall, we found positive psychological coping resources associated with high JH, with the exception of sleep. CLINICALTRIALS: gov Identifier: NCT02156102.

Emotional preparedness for human body donor dissection in premedical education: A pilot program evaluation.

Dissection of bodies provided by donors continues to be utilized as a critical part of medical education. It also represents a rite of passage that socializes students to prepare them for the stress that comes with working in a clinical environment as a medical professional. Just as proper guidance in acquiring technical skills is critical in anatomy education, there is an important need for proper emotional guidance throughout the human dissection process. A pilot curriculum was developed by an interdisciplinary faculty team to emotionally prepare students for their first visit to the anatomy laboratory. Students were first-year foundation premedical students who had expressed an interest in visiting the laboratory. Pre- and post-visit surveys were conducted to explore students' emotional responses to a first visit to the anatomy laboratory and their utilization of coping strategies. The survey findings show an overwhelming favorable feeling in anticipation of the human gross anatomy laboratory visit. About 20% of the students experienced anxiety at the anticipation of the laboratory visit, but only 5.3% experienced anxiety during the visit. The decrease in the number of students experiencing anxiety may be attributed to the interventions introduced before and during the visit. Talking with a close friend was the main coping strategy utilized by 63% of students experiencing fear or anxiety during and after the laboratory visit. The findings from this program evaluation provide a better understanding of student emotional preparedness and utilization of coping strategies, which may help prepare and guide future students for the dissection experience.

Interactive Health Technology Tool for Kidney Living Donor Assessment to Standardize the Informed Consent Process: Usability and Qualitative Content Analysis.

BACKGROUND: Kidney living donation carries risks, yet standardized information provision regarding nephrectomy risks and psychological impacts for candidates remains lacking. OBJECTIVE: This study assesses the benefit of interactive health technology in improving the informed consent process for kidney living donation. METHODS: The Kidney Hub institutional open portal offers comprehensive information on kidney disease and donation. Individuals willing to start the kidney living donation process at Helsinki University Hospital (January 2019-January 2022) were invited to use the patient-tailored digital care path (Living Donor Digital Care Path) included in the Kidney Hub. This platform provides detailed donation process information and facilitates communication between health care professionals and patients. eHealth literacy was evaluated via the eHealth Literacy Scale (eHEALS), usability with the System Usability Scale (SUS), and system utility through Likert-scale surveys with scores of 1-5. Qualitative content analysis addressed an open-ended question. RESULTS: The Kidney Hub portal received over 8000 monthly visits, including to its sections on donation benefits (n=1629 views) and impact on donors' lives (n=4850 views). Of 127 living kidney donation candidates, 7 did not use Living Donor Digital Care Path. Users' ages ranged from 20 to 79 years, and they exchanged over 3500 messages. A total of 74 living donor candidates participated in the survey. Female candidates more commonly searched the internet about kidney donation (n=79 female candidates vs n=48 male candidates; P=.04). The mean eHEALS score correlated with internet use for health decisions (r=0.45; P<.001) and its importance (r=0.40; P=.01). Participants found that the Living Donor Digital Care Path was technically satisfactory (mean SUS score 4.4, SD 0.54) and useful but not pivotal in donation decision-making. Concerns focused on postsurgery coping for donors and recipients. CONCLUSIONS: Telemedicine effectively educates living kidney donor candidates on the donation process. The Living Donor Digital Care Path serves as a valuable eHealth tool, aiding clinicians in standardizing steps toward informed consent. TRIAL REGISTRATION: ClinicalTrials.gov NCT04791670; https://clinicaltrials.gov/study/NCT04791670. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2021-051166.

The double mediating effect of stress regulation and life satisfaction on music use as a coping mechanism and happiness in Chinese older adults during the COVID-19 pandemic.

BACKGROUND: This study investigated the relationship between music use as a coping mechanism and subjective happiness among Chinese older adults (COAs) during Coronavirus disease 2019 (COVID-19); it also focused on the mediating effect of stress regulation by music and life satisfaction in this relationship. METHODS: Participants were 329 male and female Chinese adults aged 60 years or older. Data were collected using the Sojump application for an online survey. The double mediating effect was analyzed using PROCESS Macro 3.5 Model 6. RESULTS: The results revealed that music use as a coping mechanism and stress regulation by music were not significantly correlated with subjective happiness of COAs, whereas these were positively correlated with their life satisfaction. Additionally, life satisfaction of COAs was positively correlated with subjective happiness. Stress regulation by music and life satisfaction completely mediated the relationship between music use as a coping mechanism and subjective happiness of COAs during COVID-19. In the double mediation model, music use as a coping mechanism positively influenced stress regulation by music (ß = 0.704), stress regulation by music positively influenced life satisfaction (ß = 0.162), and life satisfaction positively influenced subjective happiness (ß = 0.498). CONCLUSION: Therefore, music can promote happiness in COAs in stressful situations through stress regulation and life satisfaction.

International medical learners and their adjustment after returning to their countries of origin: a qualitative study.

INTRODUCTION: International medical trainees, including residents and fellows, must cope with many challenges, such as differences in cultural hierarchical systems, languages, and acceptance. Nonetheless, the need for adjustment perpetuates even after training is completed abroad. When some international trainees return to their countries of origin, they continue to face adjustment challenges due to reverse culture shock. Others must make many further readjustments. This study presents an exploration of the adjustment and coping strategies of international medical learners after returning to their countries of origin upon completion of their programs. METHOD: This study employed a qualitative approach grounded in interpretivism and utilised inductive thematic analysis following Braun and Clarke's method. Semi-structured, in-depth individual interviews were employed to explore the participants' coping strategies. Participants included international medical learners who were (1) international medical graduates who had already returned to their countries of origin, (2) non-Canadian citizens or nonpermanent residents by the start of the programs, and (3) previously enrolled in a residency or fellowship training programme at the University of Toronto, Ontario, Canada. RESULTS: Seventeen participants were included. Three main themes and seven subthemes were created from the analysis and are represented by the Ice Skater Landing Model. According to this model, there are three main forces in coping processes upon returning home: driving, stabilising, and situational forces. The sum and interaction of these forces impact the readjustment process. CONCLUSION: International medical learners who have trained abroad and returned to their countries of origin often struggle with readjustment. An equilibrium between the driving and stabilising forces is crucial for a smooth transition. The findings of this study can help stakeholders better understand coping processes. As healthy coping processes are related to job satisfaction and retention, efforts to support and shorten repatriation adjustment are worthwhile.

Loneliness and risky behaviours among mobile fishers in Elmina, Ghana: a convergent parallel mixed-method study.

BACKGROUND: Loneliness affects individuals of all age groups, and mobile fishers are susceptible to loneliness due to the nature of their occupation. However, there is no study examining loneliness and risky behaviours among fishers in Ghana. Therefore, the purpose of this study was to examine fishers' mobility history, prevalence of loneliness, predictors of loneliness, effects of loneliness on fishers, coping strategies to address loneliness, and prevalence of risky behaviour among fishers in Elmina, Ghana. METHODS: This is a convergent parallel mixed-method study involving 385 fishers in Elmina. A questionnaire and interview guides were used to collect data from respondents. Descriptive statistics, Pearson's chi-square and Fisher exact tests, and binary logistic regression were used to analyse the quantitative data, while the qualitative data were analysed thematically. RESULTS: From the quantitative findings, most fishers were mobile (54.5%) and travelled alone (45.7%). Approximately 83% of the fishers experienced loneliness. Male fishers (AOR = 0.049; 95% CI = 0.003-0.741; p-value = 0.030), fishers affiliated with the African Traditionalist religion (AOR = 0.043; 95% CI = 0.002-0.846; p-value = 0.038), and fishers who travelled with their working colleagues (AOR = 0.002; 95% CI = 0.000-0.023; p-value = ≤ 0.001), were less likely to be experience loneliness. Feeling bored, isolated and worried/anxious were the main perceived effects of loneliness. Alcohol consumption and finding a companion to spend time with were the main strategies fishers used to cope with their loneliness. Most male fishers consumed alcohol (92.5%; p-value = ≤ 0.001) and spent time with companions (73.5%; p-value = ≤ 0.001) to cope with their loneliness. The quantitative and qualitative findings showed that fishers engaged in risky behaviours (excessive alcohol consumption, casual sex, and smoking marijuana and tobacco). From the quantitative findings, more male fishers engaged in excessive alcohol consumption (97.6% vs. 74.5%; p-value = ≤ 0.001), casual sex (88.2% vs. 61.7%, p-value = ≤ 0.001), smoking marijuana (43.0% vs. 13.0%, p-value = ≤ 0.001) and tobacco (49.4% vs. 19.1%; p-value = 0.001) than female fishers. CONCLUSIONS: Loneliness and risky behaviours were common among fishers. Therefore, there is an urgent need to design interventions to help reduce loneliness and risky behaviour among fishers.

The cross-cultural adaptation of Chinese international students: an empirical study on sequential-mediated effects.

Using convenience sampling and snowball sampling methods, data from 432 Chinese international students in 10 countries, including the United Kingdom, South Korea, and the United States, were collected to construct a multivariate sequential-mediated mixed model for cross-cultural adaptation. SPSS 23.0 and AMOS 23.0 were employed for aggregated validity, discriminant validity, and sequential-mediated effects analysis. The study found that: Cultural adaptation stress is negatively correlated with positive coping and positively correlated with negative coping, with negative coping having a significant negative impact during the cross-cultural adaptation process. Positive coping is positively correlated with sports participation, while negative coping is negatively correlated with sports participation. Sports participation is positively associated with in-group identification and negatively associated with out-group bias. In-group identification has a positive impact on cross-cultural adaptation, whereas out-group bias cannot effectively predict cross-cultural adaptation.

Flexible males, reactive females: faecal glucocorticoid metabolites indicate increased stress in the colonist population, damping with time in males but not in females.

Individuals colonizing new areas at expanding ranges encounter numerous and unpredictable stressors. Exposure to unfamiliar environments suggests that colonists would differ in stress levels from residents living in familiar conditions. Few empirical studies tested this hypothesis and produced mixed results, and the role of stress regulation in colonization remains unclear. Studies relating stress levels to colonization mainly use a geographical analysis comparing established colonist populations with source populations. We used faecal glucocorticoid metabolites (FGMs) to assess both spatial and temporal dynamics of stress levels in an expanding population of midday gerbils (Meriones meridianus). We demonstrated that adult males and females had higher FGM levels in newly emerged colonies, compared with the source population, but differed in the pattern of FGM dynamics post-foundation. In males, FGM levels sharply decreased in the second year after colony establishment. In females, FGM levels did not change with time and remained high despite the decreasing environmental unpredictability, exhibiting among-individual variation. Increased stress levels of colonist males damping with time post-colonization suggest they are flexible in responding to immediate changes in environmental uncertainty. On the contrary, high and stable over generations stress levels uncoupled from the changes in the environmental uncertainty in female colonists imply that they carry a relatively constant phenotype associated with the reactive coping strategy favouring colonization. We link sex differences in consistency and plasticity in stress regulation during colonization to the sex-specific life-history strategies.

The Association Between Mindfulness Facets and Substance Use via Emotional Psychopathology and Coping Motives in Argentinian College Students.

Background: Prior studies suggest that lower levels of mindfulness contribute to the motivation of using alcohol to cope with distress. Research examining this possibility is scarce or limited to alcohol, but not marijuana, related outcomes. Objectives: We examined separate models (for alcohol and for marijuana) to determine the associations between trait mindfulness (describing, acting with awareness, non-judging, non-reactivity) and alcohol and marijuana outcomes (use indicators and negative consequences) via emotional psychopathology (i.e., a latent variable assessing symptoms of depression and anxiety) and alcohol/marijuana coping motives. Results: The final analytic sample consisted of 456 participants (Mean age = 22.96 ± 3.12 years; 66.2% women) for the alcohol model; and 232 participants (Mean age = 22.96 ± 3.01 years; 66.2% women) for the marijuana model. Two path models were conducted, such that indirect paths were examined for each trait mindfulness facet on alcohol/marijuana outcomes (e.g., describing → emotional psychopathology → alcohol coping motives → binge drinking frequency). Within the comprehensive alcohol model, describing, acting with awareness, non-judging and non-reactivity were associated with less binge drinking frequency and lower number of alcohol-related negative consequences via lower severity of emotional psychopathology symptoms and lower endorsement of drinking to cope motives. For the marijuana model, describing, acting with awareness, and non-judging of inner experience were associated with less marijuana quantity (grams) consumed and lower number of marijuana-related negative consequences via lower severity of emotional psychopathology symptoms and lower endorsement of marijuana coping motives. Conclusions: Prevention and intervention programs of alcohol and marijuana in Argentina may benefit from improving mindfulness skills and targeting emotional psychopathology and motives to use drugs, to prevent or reduce negative drug-related consequences.

Evaluation of the coping attitudes of Alzheimer patients' relatives from the perspectives of depression, anxiety and guilt.

This study aims to assess coping attitudes in primary caregivers of individuals diagnosed with Alzheimer's disease residing in an institution, and to evaluate the association between coping attitudes and levels of guilt, depression, and anxiety among caregivers. The sample of this study consists of 150 individuals with relatives diagnosed with Alzheimer. The Beck Anxiety Inventory, the Coping Attitudes Scale, the Guilt Inventory, and the Beck Depression Inventory were used in the present study. It was determined that the participants' coping levels were below the average score and that they frequently used problem focus coping attitudes. A positive relationship was found between the emotion focused, nonfunctional coping levels of the participants and their continuous guilt, anxiety and depression levels. Depression and guilt has a strong effect on coping attitudes, while anxiety was determined to be a moderate predictive variable. Findings show that caregivers with depression, anxiety and continuous guilt use non-functional and emotional coping more frequently.

The Role of Perceived Stress in the Relation between Childhood Maltreatment and Severity of Alcohol Use Disorder: A Mediation Analysis.

INTRODUCTION: Experiences of Childhood Maltreatment (CM) relate to relapse and lower treatment success in Alcohol Use Disorder (AUD), one of the most prevalent substance use disorders. However, the exact mechanisms of this relationship still remain unclear. This study examines perceived stress and "drinking to cope with negative affect" (coping) as possible mediators in this relationship. Moreover, it aims at uncovering the differential effects of the subtypes of CM. METHODS: N = 96 individuals (42% women; mean age 41 ± 13 years) including healthy controls and individuals with varying severity of AUD and CM completed the Alcohol-Dependence Scale, Childhood Trauma Questionnaire, Perceived Stress Scale and German Inventory of Drinking Situations. Mediation analyses including perceived stress as a mediator between CM (and subtypes) and severity of AUD, as well as a serial mediation of the relationship between CM and AUD severity by perceived stress and coping were conducted. RESULTS: Perceived stress significantly mediated the relation between CM and AUD severity and the serial mediation by perceived stress and coping turned out significant. Subtype-specific analyses did not yield significant results. CONCLUSION: This study reinforces perceived stress as a potential mechanism in the relation between CM and AUD severity. Moreover, coping further mediated the relationship between CM and AUD severity. Our results suggest including screening for CM (subtypes) in clinical routine in order to individually emphasize interventions focusing on stress regulation, as well as on developing healthy coping mechanisms, in patients with AUD. This might prevent heightened stress sensitivity, relapse and further maintenance of AUD.

The Antecedent of Nurses' Revenge and Gossiping Behaviors: Gender Microaggression Experiences.

Background and Purpose: Microaggressions that are not intended to cause deliberate harm to the target are frequently encountered in health communications. Individuals who are the targets of microaggressions may develop emotional and behavioral responses as coping strategies. This study seeks to provide needed clarity on the relationship between microaggression, gossip, and revenge. Methods: A quantitative method was used to collect data. Nurses working in public hospitals in Turkey participated in this study and provided valuable data for the final analysis and the acquisition of conclusion. Results: The findings indicated that the increasing effect of gender microaggressions on organizational gossip occurred both directly and indirectly through vengeful feelings. Moreover, the indirect impact of gender microaggression through revenge was moderated by gender. Implication for Practice: Given the subtle and ambiguous nature of microaggression, this study develops the implications of gender microaggression within emotional and behavioral constructs and has explanatory contributions through the development of direct and indirect relationships.

Associations of Coping Strategies With Glycemic and Psychosocial Outcomes Among Adolescents With Type 1 Diabetes Experiencing Diabetes Distress.

BACKGROUND: Many adolescents with type 1 diabetes experience diabetes distress which is associated with suboptimal glycemic and psychosocial outcomes. The ways in which adolescents respond to diabetes distress may serve as a risk or protective factor for these outcomes, but few studies have examined the coping strategies adolescents use to manage diabetes distress. PURPOSE: To examine the association of coping strategies with glycemic and psychosocial outcomes among adolescents experiencing diabetes distress. METHODS: Participants included 198 adolescents with elevated diabetes distress who completed baseline data for a randomized controlled trial (Mage = 15.3 ± 1.4, 58% female, 58% non-Hispanic White, MA1c = 9.1 ± 2.1%). Adolescents reported on their use of coping strategies related to diabetes stressors, including primary control engagement coping (e.g., problem-solving), secondary control engagement coping (e.g., positive thinking), and disengagement coping (e.g., avoidance). Adolescents also completed measures of diabetes distress, quality of life, and resilience. HbA1c data were extracted from electronic medical records and at-home kits. RESULTS: Higher use of primary control engagement coping was associated with better glycemic and psychosocial outcomes. Secondary control engagement coping was associated with better psychosocial outcomes but not glycemic outcomes. Greater use of disengagement coping strategies was associated with poorer glycemic and psychosocial outcomes. All associations were significant after adjusting for adolescent sex, age, race/ethnicity, and continuous glucose monitor use. CONCLUSIONS: These results build on prior findings by including a more diverse sample of adolescents and highlight the value of promoting engagement coping strategies and discouraging the use of disengagement coping strategies among adolescents experiencing diabetes distress. CLINICAL TRIAL INFORMATION: NCT03845465.

Many teens with type 1 diabetes (T1D) experience diabetes distress, or the emotional burden related to living with T1D, which can negatively impact their health and overall well-being. However, few studies have explored how adolescents cope with diabetes distress. In the current study, we examined how different coping strategies related to both physical (glycemic) and psychosocial outcomes among adolescents experiencing diabetes distress. We found that using coping strategies focused on active problem-solving (primary control engagement coping) was linked to better glycemic and psychosocial outcomes. Similarly, adopting a positive mindset (secondary control engagement coping) was associated with improved psychosocial well-being but was not associated with glycemic outcomes. Conversely, the use of avoidance strategies (disengagement coping) was linked to poorer outcomes in both areas. These findings highlight the importance of promoting engagement coping strategies and discouraging the use of disengagement strategies among adolescents experiencing diabetes distress, suggesting potential areas for intervention.

Turmoil.

Description I painted this picture after tearing up over the phone with her parents. "I think she's passing away," I had told them, "You'd better come up to the hospital." Inexperienced as a brand new physician, I felt like I was drowning in my responsibility over the care of my patients. Real people, with real lives, with real consequences to my decisions. It has gotten easier to feel okay while helping other humans pass away. And it sounds a little dramatic, but I've found ways to help myself cope without being stranded by the waves.

Family resilience in a social-ecological context - emotional difficulties and coping strategies.

Introduction: This research explored how crises such as the pandemic influence the family dynamic and the way that the parents and the children face new difficulties and challenges. The present study investigates children's and young people's emotional states, the dimensions of family resilience, and the types of coping strategies and parents' emotional states during the coronavirus pandemic. The final sample for the research was represented by 1,010 parents from Romania. Methods: The present scientific research is a transversal study with the scope to understand the emotional difficulties that parents and children/ young people face and the coping strategies that they adopt in a crisis, such as the time of the coronavirus pandemic. Results: Parents with maladaptive coping strategies are more affected by the pandemic. Also, the results indicate that there is a significant correlation between parental coping strategies and the children's emotional states, and the adaptability level. Therefore, the high scores on the subscales which measure maladaptive coping indicate high scores of the levels of depression, anxiety, and stress of the parents. Family resilience, through the dimension of 'communication and problem-solving in the family' has a moderation role in the relationship between parental depression and the maladaptive coping strategy of rumination. Family resilience through 'maintaining a positive attitude' has a moderation role in the relationship between catastrophizing and the teenagers' level of adaptability. Discussion: The results of the study pointed out the role and place of family resilience within the family system and how a period of crisis can affect this system.

The Role of Intolerance of Uncertainty and Religiousness in Schizotypal Personality and Life Satisfaction: A Cross-Sectional Study.

Intolerance of uncertainty is an important trans-diagnostic determinant of mental disorders. It is related to psychotic symptoms and religiousness. Religiousness is related to schizotypal personality and wellbeing. Therefore, in a cross-sectional study, we studied the effects of intolerance of uncertainty and religiousness on schizotypal personality and the schizotypal personality-mediated effects of intolerance of uncertainty and religiousness on life satisfaction. On a sample of 734 college students (age, M = 20.3, SD = 3.48), intolerance of uncertainty, religiousness, life satisfaction, and schizotypal personality were measured through paper-pencil questionnaires. The results showed that intolerance of uncertainty had positive (direct) relationships with all schizotypal personality dimensions. However, intolerance of uncertainty had positive (mediated by ideas of reference and magical thinking) and negative (mediated by eccentric behavior) indirect effects on life satisfaction. Religiousness had direct as well as indirect (mediated by eccentric behavior) positive effects on life satisfaction. However, the behaving (mediated by ideas of reference) and belonging (mediated by magical thinking) sub-dimensions of religiousness had some indirect negative effects on life satisfaction. Thus, the present study shows that intolerance of uncertainty is an important contributor to psychotic proneness. Religiousness is largely health-enhancing. Moreover, there is a nuanced pattern of interactional relationship between intolerance of uncertainty, religiousness, schizotypal personality, and life satisfaction. We have discussed the theoretical and applied implications of the findings.