Article

A long and resilient life: the role of coping strategies and variability in their use in lifespan among women

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Abstract

Objectives: Associations of stress-related coping strategies with lifespan among the general population are understudied. Coping strategies are characterized as being either adaptive or maladaptive, but it is unknown the degree to which variability in tailoring their implementation to different contexts may influence lifespan. Method: Women (N = 54,353; Mage = 47) completed a validated coping inventory and reported covariate information in 2001. Eight individual coping strategies (e.g., Acceptance, Denial) were considered separately. Using a standard deviation-based algorithm, participants were also classified as having lower, moderate, or greater variability in their use of these strategies. Deaths were ascertained until 2019. Accelerated failure time models estimated percent changes and 95% confidence intervals (CI) in predicted lifespan associated with coping predictors. Results: In multivariable models, most adaptive and maladaptive strategies were associated with longer and shorter lifespans, respectively (e.g., per 1-SD increase: Active Coping = 4.09%, 95%CI = 1.83%, 6.41%; Behavioral Disengagement = -6.56%, 95%CI = -8.37%, -4.72%). Moderate and greater (versus lower) variability levels were similarly and significantly related to 8-10% longer lifespans. Associations were similar across age, racial/ethnic, residential income, and marital status subgroups. Conclusions: Findings confirm the adaptive and maladaptive nature of specific coping strategies, and further suggest benefits from both moderate and greater variability in their use for lifespan among women.

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... Previous studies have conceptualized regulatory flexibility as the amount of the numerical variability observed in the frequency use of distinct strategies (Cheng et al., 2014;Blanke et al., 2020). For instance, using a standard deviation-based algorithm , 2024bBlanke et al., 2020), lower variability (displaying high evenness in scores across strategies) suggests all strategies are used at a fairly equal frequency across situations, greater variability (displaying high unevenness in scores across strategies) suggests only a few strategies are frequently used, and moderate variability (displaying moderate unevenness in scores across strategies) suggests several strategies are used with varied frequencies and possibly reflects an effort to find the best strategy for each situation. Emerging research shows the predictive value of such variability in long-term health outcomes, such as longevity , 2024b. ...
... For instance, using a standard deviation-based algorithm , 2024bBlanke et al., 2020), lower variability (displaying high evenness in scores across strategies) suggests all strategies are used at a fairly equal frequency across situations, greater variability (displaying high unevenness in scores across strategies) suggests only a few strategies are frequently used, and moderate variability (displaying moderate unevenness in scores across strategies) suggests several strategies are used with varied frequencies and possibly reflects an effort to find the best strategy for each situation. Emerging research shows the predictive value of such variability in long-term health outcomes, such as longevity , 2024b. ...
... We examined associations of affect regulation indicators (i.e., general and emotion-specific strategies, and variability in their use) and allostatic load using 17 years of follow-up data available from the MIDUS. Based on prior work examining these strategies with health outcomes , 2024bNg et al., 2024), we hypothesized that strategies typically deemed adaptive relate to lower allostatic load, while strategies usually seen as maladaptive relate to higher allostatic load. Given limited work on regulatory variability and health Ng et al., 2024;Cheng et al., 2014), we examined this association without a priori hypotheses. ...
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Significance Optimism is a psychological attribute characterized as the general expectation that good things will happen, or the belief that the future will be favorable because one can control important outcomes. Previous studies reported that more optimistic individuals are less likely to suffer from chronic diseases and die prematurely. Our results further suggest that optimism is specifically related to 11 to 15% longer life span, on average, and to greater odds of achieving “exceptional longevity,” that is, living to the age of 85 or beyond. These relations were independent of socioeconomic status, health conditions, depression, social integration, and health behaviors (e.g., smoking, diet, and alcohol use). Overall, findings suggest optimism may be an important psychosocial resource for extending life span in older adults.
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Inconsistent associations have been reported between perceived stress and C-reactive protein (CRP), a marker of systemic inflammation. We previously observed a male-specific inverse relationship between perceived stress and CRP in a cross-sectional study. In the present study, we examined the longitudinal association between changes in perceived stress and CRP, and further analyzed whether changes in coping strategies and social support modify this association. This study included 8454 participants in both a baseline survey and a follow-up survey 5 years later. Psychosocial measures (i.e. perceived stress, coping strategies, and social support) and CRP concentrations were measured by identical means in both surveys. Consistent with our previous findings, increased perceived stress was significantly associated with lower CRP in men (ptrend = .037), but not in women. Increased “emotional expression,” a coping strategy, was also associated with lower CRP in women (ptrend = .024). Furthermore, interactions between perceived stress and a coping strategy (positive reappraisal) or social support on CRP were found in men (pinteraction = .007 and .038, respectively); the above inverse association between stress and CRP was not detected for participants with diminished positive reappraisal or social support. In conclusion, increases in perceived stress during a 5-year period were associated with decreases in CRP among healthy men, and the observed association was possibly modified by coping strategy or social support.
Article
Nearly half of all cancer deaths are attributable to preventable causes, primarily unhealthy behaviours such as tobacco use, alcohol use and overeating. In this review, we argue that people engage in these behaviours, at least in part, as a means of regulating their affective states. To better understand why people engage in these behaviours and how researchers might design interventions to promote the selection of healthier methods for regulating affect, we propose a conceptual model of affect regulation. We synthesise research from both the stress and coping tradition as well as the emotion and emotion regulation tradition, two literatures that are not typically integrated. In so doing, we indicate where researchers have made headway in understanding these behaviours as affect regulation and note how our model could be used to structure future work in a way that would be particularly advantageous to cancer control efforts.
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The authors compared the ability of the National Death Index and the Equifax Nationwide Death Search to ascertain deaths of participants in the Nurses' Health Study. Each service was sent information on 197 participants aged 60–68 years in 1989 whose deaths were reported by kin or postal authorities and 1,997 participants of the same age who were known to be alive. Neither service was aware of the authors' information regarding participants' vital status. The sensitivity of the National Death Index was 98 percent and that of Equifax was 79 percent. Sensitivity was similar for women aged 65–68 years; however, for women aged 61–64 years, the sensitivity of the National Death Index was 97.7 percent compared with 60.2 percent for Equifax. The specificity of both services was approximately 100 percent. The contrast between the sources of these databases and the matching algorithms they employ has implications for researchers and for those planning health data systems.
Article
We have summarized the evolution of the Nurses’ Health Study (NHS), a prospective cohort study of 121 700 married registered nurses launched in 1976; NHS II, which began in 1989 and enrolled 116 430 nurses; and NHS3, which began in 2010 and has ongoing enrollment. Over 40 years, these studies have generated long-term, multidimensional data, including lifestyle- and health-related information across the life course and an extensive repository of various biological specimens. We have described the questionnaire data collection, disease follow-up methods, biorepository resources, and data management and statistical procedures. Through integrative analyses, these studies have sustained a high level of scientific productivity and substantially influenced public health recommendations. We have highlighted recent interdisciplinary research projects and discussed future directions for collaboration and innovation.
Article
Aims: Coping strategies may be significantly associated with health outcomes. This is the first study to investigate the association between baseline coping strategies and cardiovascular disease (CVD) incidence and mortality in a general population cohort. Methods and results: The Japan Public Health Center-based prospective Study asked questions on coping in its third follow-up survey (2000-04). Analyses on CVD incidence and mortality included 57 017 subjects aged 50-79 without a history of CVD and who provided complete answers on approach- and avoidance-oriented coping behaviours and strategies. Cox regression models, adjusted for confounders, were used to determine hazard ratios (HRs) according to coping style. Mean follow-up time was 7.9 years for incidence and 8.0 years for mortality.The premorbid use of an approach-oriented coping strategy was inversely associated with incidence of stroke (HR = 0.85; 95% CI, 0.73-1.00) and CVD mortality (HR = 0.74; 95% CI, 0.55-0.99). Stroke subtype analyses revealed an inverse association between the approach-oriented coping strategy and incidence of ischaemic stroke (HR = 0.79; 95% CI, 0.64-0.98) and a positive association between the combined coping strategy and incidence of intra-parenchymal haemorrhage (HR = 2.03; 95% CI, 1.01-4.10). Utilizing an avoidance coping strategy was associated with increased mortality from ischaemic heart disease (IHD) only in hypertensive individuals (HR = 3.46; 95% CI, 1.07-11.18). The coping behaviours fantasizing and positive reappraisal were associated with increased risk of CVD incidence (HR = 1.24; 95% CI, 1.03-1.50) and reduced risk of IHD mortality (HR = 0.63; 95% CI, 0.40-0.99), respectively. Conclusion: An approach-oriented coping strategy, i.e. proactively dealing with sources of stress, may be associated with significantly reduced stroke incidence and CVD mortality in a Japanese population-based cohort.
Article
Background: Psychological stress is a modifiable risk factor for health outcomes and can be managed through coping mechanisms. Biological and behavioral hypotheses have been proposed to explain the association between stress coping strategies and cancer outcomes. Methods: The Japan Public Health Center-based study asked questions on coping behaviors in its 10-year follow-up survey. 55,130 subjects aged 50-79 without a history of cancer diagnosis and who provided complete answers on coping were included in analyses on cancer incidence and mortality. Hazard Ratios (HR) according to coping style were determined using Cox regression models adjusted for known confounders for cancer. Results: Mean follow-up time was 9.5 years for cancer incidence and 9.8 years for cancer mortality. The utilization of the approach-oriented coping strategy (HR=0.85, 95% CI: 0.72-0.99) and a behavior of positive reappraisal (HR=0.84, 95% CI: 0.72-0.97) was associated with a reduced risk of cancer mortality. The approach-oriented coping strategy was further associated with localized cancer incidence (HR=1.13, 95% CI: 1.01-1.27) and screening-detected cancers (HR=1.35, 95% CI: 1.15-1.58). The avoidance oriented coping strategy was inversely associated with cancer incidence (HR=0.69, 95% CI: 0.50-0.94) only after excluding events occurring in the first three years of follow-up. Conclusion: The results of this study may favor the behavioral hypothesis to explain associations between premorbid coping styles and cancer outcomes.
Article
Five years ago, the American Heart Association (AHA) launched a bold new initiative to begin promoting "cardiovascular health" in individuals and the population, in addition to continuing its decades-long fight to reduce cardiovascular and stroke mortality and decrease cardiovascular disease (CVD) risk. This shift in priorities came as a result of a "quiet revolution,"(1) turning the adverse-outcomes-oriented and risk-focused perspective on its head, and instead focusing on creating the opportunity for promoting and preserving attributes associated with healthy, CVD-free longevity. The first-ever formal definition for this construct of cardiovascular health, published in 2010,(2) was based on a broad review of the literature designed to determine groups of factors associated with excellent prognosis in long-term CVD-free survival and quality of life. It was designed to be simple, accessible and actionable, allowing all patients, clinicians and communities to focus on improving cardiovascular health. And it was crafted in a way so that it could be measured in the broad US population and major subgroups, monitored over time, and influenced by AHA's portfolio of programs.(2) Although the entire spectrum of cardiovascular health was captured (from birth through living with CVD), a critical observation was the recognition of an "ideal cardiovascular health" phenotype that consisted of the simultaneous presence of ideal levels of seven health behaviors and health factors: smoking status, physical activity, eating pattern, body weight, and blood cholesterol, blood glucose and blood pressure levels.
Article
Objective: To investigate associations between personality facets and survival during an 8-year follow-up. Methods: In 597 Medicare recipients (age, 66-102 years) followed up for approximately 8 years, personality domains and facets were assessed using the Revised NEO Personality Inventory (NEO-PI-R). This study builds on a previous study which used proportional hazards regression to test whether the NEO-PI-R factor and selected facet scores were associated with mortality risk. That study revealed that the neuroticism facet impulsiveness, agreeableness facet straightforwardness, and conscientiousness facet self-discipline were related to lower risk during 4 years of follow-up. We extended the follow-up period by 4 years, examined all 30 facets, and used accelerated failure time modeling as an additional analytic approach. Unlike proportional hazards regression, accelerated failure time modeling permits inferences about the median survival length conferred by predictors. Each facet was tested in a model that included health-related covariates and NEO-PI-R factor scores for dimensions that did not include that facet. Results: Over the 8-year follow-up period, impulsiveness was not significant, each standard deviation of straightforwardness was associated with an 11% increase in median survival time and, when dichotomized, higher self-discipline was associated with a 34% increase in median survival time. Each standard deviation of altruism, compliance, tender-mindedness, and openness to fantasy was associated with a 9% to 11% increase in median survival time. Conclusions: After extending the follow-up period from 4 to 8 years, self-discipline remained a powerful predictor of survival and facets associated with imagination, generosity, and higher-quality interpersonal interactions become increasingly important.
Article
This article reports the frequency of the use of coping scales in academic journals published from 1998 to 2010. Two thousand empirical journal articles were selected from the EBSCO database. The COPE, Ways of Coping Questionnaire, Coping Strategies Questionnaire, Coping Inventory for Stressful Situations, Religious-COPE and Coping Response Inventory were frequently mentioned. In particular, the COPE (20.2%) and Ways of Coping Questionnaire (13.6%) were used the most frequently. In this literature reviewed, coping scales were most often used to assess coping with health issues (e.g. illness, pain and medical diagnoses) over other types of stressors, and patients were the most frequent participants. Further, alpha coefficients were estimated for the COPE subscales, and correlations between the COPE subscales and coping outcomes were calculated, including depressive symptoms, anxiety, negative affect, psychological distress, physical symptoms and well-being. Copyright © 2013 John Wiley & Sons, Ltd.
Article
The past decade and a half has witnessed a renewed interest in the study of affective processes. James Gross' process model of emotion regulation has provided a theoretical framework for this approach. This model stipulates that individuals have a repertoire of emotion regulation strategies they use in order to modify their affect and/or the situations eliciting such affect. However, empirical investigations of the use of emotion regulation strategies have largely oversimplified this model by assuming that individuals use only one regulation strategy to manage the affect elicited by a given emotion-eliciting stimulus or situation. This is problematic because it has resulted in a limited understanding of the complex process by which individuals select and implement regulation strategies. In this brief report, we present findings suggesting that people spontaneously use multiple emotion regulation strategies in response to a brief disgust-eliciting film clip. We discuss implications for future empirical work on emotion regulation strategies.
Article
The Ways of Coping Questionnaire (WCQ) by S. Folkman and R. S. Lazarus (1988) has been used widely; however, few studies have evaluated this assessment tool in research concerning populations from different income levels and ethnic backgrounds. The purpose of this study was to compare the endorsement of the 8 coping strategies as outlined by Folkman and Lazarus's original research with Caucasian, middle class participants to the endorsement of coping approaches in a low income, primary care sample. Results suggest that low income individuals report utilizing greater rates of coping strategies overall and specifically employ emotion-focused coping strategies more than Folkman and Lazarus's original sample. Ethnic differences within the present study's low income sample were also examined and suggest that even within this low income sample, African Americans use certain emotion-focused coping strategies significantly more than Caucasian participants.
Article
In their definition of modern nursing, the Royal College of Nursing emphasizes the importance of caring. However, there is little other than anecdotal evidence that female qualified staff nurses are more caring and compassionate than average individuals. A study was carried out to test, under scientific conditions with a case control study, the hypothesis that staff nurses are no more caring than average female individuals. Using the ten-item personality inventory (TIPI) questionnaire, a statistical comparison was made between 174 volunteer female staff nurses and data for 760 adult female controls extracted from the TIPI instrument's original validation study. The questionnaire measures each of the five major facets of personality: openness, extroversion, conscientiousness, agreeableness and neuroticism. Agreeableness, which is a tendency to be compassionate, considerate and cooperative, was used as a proxy measure for 'caring'. Data were analysed using unpaired Student's t-tests. Female staff nurses recorded significantly higher scores than female controls concerning the personality traits extroversion, agreeableness, conscientiousness and emotional stability (P<0.05). The analysis demonstrates that in direct comparison to normal adult females, staff nurses are significantly more caring, conscientious and resilient individuals. The personality traits found in female staff nurses complement their profession and to some extent justify the caring, compassionate nurse stereotype. Whether career nursing self-selects these qualities or to what extent nursing staff develop aspects of their personality as a product of experience is a subject for debate.
Article
We performed a series of meta-analyses examining the associations between coping and health-related outcomes in nonclinical adult samples. Results revealed that problem-focused coping was positively correlated with overall health outcomes, whereas confrontive coping, distancing, self-control, seeking social support, accepting responsibility, avoidance, and wishful thinking were each negatively correlated with overall health outcomes. Neither planful problem solving nor positive reappraisal was significantly associated with overall health outcomes in our analyses. However, type of health outcome (i.e., physical vs. psychological) and situational characteristics (i.e., stressor type, controllability, and duration) moderated many of the overall associations.
Self-reported measures available: COPE. Retrieved
  • C S Carver
Carver, C. S. (2019). Self-reported measures available: COPE. Retrieved August, 2020 from https://local.psy.miami.edu/ people/faculty/ccarver/availbale-self-report-instruments/cope/.