Susan Folkman's research while affiliated with University of California, San Francisco and other places

Publications (134)

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Hope is discussed in many literatures and from many perspectives. In this chapter, hope is discussed from the vantage of psychology and stress and coping theory. Hope and psychological stress share a number of formal properties: both are contextual, meaning-based, and dynamic, and both affect well-being in difficult circumstances. Two assumptions u...
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Objective: Evidence links depression and stress to more rapid progression of HIV-1 disease. We conducted a randomized controlled trial to test whether an intervention aimed at improving stress management and emotion regulation, mindfulness-based stress reduction (MBSR), would improve immunological (i.e. CD4+ t-cell counts) and psychological outcom...
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Objective: We conducted a randomized controlled trial to determine whether IRISS (Intervention for those Recently Informed of their Seropositive Status), a positive affect skills intervention, improved positive emotion, psychological health, physical health, and health behaviors in people newly diagnosed with HIV. Method: One-hundred and fifty-n...
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Scientists Making a Difference is a fascinating collection of first-person narratives from the top psychological scientists of the modern era. These readable essays highlight the most important contributions to theory and research in psychological science, show how the greatest psychological scientists formulate and think about their work, and illu...
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We used a stress and coping model to examine the association of dispositional mindfulness, defined as the tendency to intentionally bring non-judgmental attention and awareness to one's experience in the present moment, with psychological and physical health in adults with HIV. Data were collected at baseline of a randomized controlled trial of Min...
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Background and objectives: The NIH Toolbox for Neurological and Behavioral Function assessment battery contains measures in the domains of cognitive function, motor function, sensory function, and emotional health. It was designed for use in epidemiological and clinical trials health-related research. Design: This paper describes the first phase...
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Increasing evidence suggests that positive affect plays an important role in adaptation to chronic illness, independent of levels of negative affects like depression. Positive affect may be especially beneficial for people in the midst of severe stress, such as the diagnosis of human immunodeficiency virus (HIV). As medical treatments for HIV have...
Chapter
Hope is discussed in many literatures and from many perspectives. In this essay hope is discussed from the vantage of psychology and stress and coping theory. Hope and psychological stress share a number of formal properties: both are contextual, meaning-based, and dynamic, and both affect well-being in difficult circumstances. Two assumptions unde...
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Here is a monumental work that continues in the tradition pioneered by co-author Richard Lazarus in his classic book Psychological Stress and the Coping Process. Dr. Lazarus and his collaborator, Dr. Susan Folkman, present here a detailed theory of psychological stress, building on the concepts of cognitive appraisal and coping which have become ma...
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Stress has been shown to deplete the self-regulation resources hypothesized to facilitate effective role functioning. However, recent research suggests that positive affect may help to replenish these vital self-regulation resources. Based on revised Stress and Coping theory and the Broaden-and-Build theory of positive emotion, three studies provid...
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A key strategy in preparing a grant proposal is to think about the proposal from the perspective of a reviewer. Reviewers work very hard. Each reviewer is assigned a set of proposals that must be reviewed by a deadline, usually within just a few weeks. This work requires a great deal of concentration and reflection, and it also requires time taken...
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In October 2007, a National Center for Complementary and Alternative Medicine (NCCAM)-sponsored workshop, entitled "Applying Principles from Complex Systems to Studying the Efficacy of CAM Therapies," was held at Georgetown University in Washington, DC. Over a 2-day period, the workshop engaged a small group of experts from the fields of complement...
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Hope is discussed in many literatures and from many perspectives. In this essay hope is discussed from the vantage of psychology and stress and coping theory. Hope and psychological stress share a number of formal properties: both are contextual, meaning-based, and dynamic, and both affect well-being in difficult circumstances. Two assumptions unde...
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The objective of this paper is to evaluate the educational value of a documentary film about family caregiving for patients with brain tumors. The method used in this study is a pre-post survey among neurosurgeons, neuro-oncologist, and other clinician viewers. Viewers evaluated the film highly and reported an intention to change their practice as...
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The narrative responses of 32 people with AIDS or cancer with survival prognoses of 6 months to a year to monthly interview questions about their daily lives were analysed with a team-based qualitative methodology. Two groups emerged: (a) a Maintained Lifeworld Group characterised by one or more of the following: continued engagement with family, f...
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Understanding the malleable determinants of cellular aging is critical to understanding human longevity. Telomeres may provide a pathway for exploring this question. Telomeres are the protective caps at the ends of chromosomes. The length of telomeres offers insight into mitotic cell and possibly organismal longevity. Telomere length has now been l...
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To determine whether new-onset clinical depression emerges over time, and whether positive and negative mood levels change among patients with terminal cancer. In this two-site study, 58 cancer patients seen at least twice were interviewed monthly until death or study termination. Major measures included the Patient Health Questionnaire-9, Holland...
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The six articles that comprise the special section on stress and coping each illuminate a different facet of the stress process. The issues addressed in these studies of dyadic coping, collective trauma, gender issues, and protective coping provide new information and, as is inevitable, raise new questions. Several studies also demonstrate some of...
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Mediators of childhood sexual abuse (CSA) and HIV risk behavior were examined for men-who-have-sex-with-men (MSM). Data from a dual frame survey of urban MSM (N=1078) provided prevalence estimates of CSA, and a test of two latent variable models (defined by partner type) of CSA-risk behavior mediators. A 20% prevalence of CSA was reported. For MSM...
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For many decades, the stress process was described primarily in terms of negative emotions. However, robust evidence that positive emotions co-occurred with negative emotions during intensely stressful situations suggested the need to consider the possible roles of positive emotions in the stress process. About 10 years ago, these possibilities wer...
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The extent to which religiosity is related to well-being may differ as a function of race/ethnicity, education or income. We asked 155 caregivers to complete measures of religiosity, prayer, physical symptoms and quality of life. Lower education and, to a lesser extent, lower income were correlated with religiosity and prayer. There were few direct...
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Background Providing home care for a child with a chronic illness can be stressful for the family. The purpose of this paper is to examine patterns of caregiving and the associated psychological impact on maternal caregivers of children with sickle cell disease (SCD).ProcedureFourteen maternal caregivers of children with SCD were interviewed as par...
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Marcus and Grollman miss the mark in their critique of the National Center for Complementary and Alternative Medicine (NCCAM) (“Review for NCCAM is overdue,” D. M. Marcus and A. P. Grollman, Policy Forum, 21 July, p. 301). We believe that NCCAM, under the leadership of Stephen Straus and
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We propose an integrative risk factor framework to enhance understanding of individual differences in adjustment to bereavement and to encourage more systematic analysis of factors contributing to bereavement outcome (e.g., examination of interactions between variables and establishing pathways in the adaptation process). The examination of individ...
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Investigate the psychometric characteristics of the coping self-efficacy (CSE) scale, a 26-item measure of one's confidence in performing coping behaviors when faced with life challenges. Data came from two randomized clinical trials (N1=149, N2=199) evaluating a theory-based Coping Effectiveness Training (CET) intervention in reducing psychologica...
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A Spanish translation of the Ways of Coping (WOC-S) questionnaire was administered to three samples of Latinos sampled from Mexico City, Puerto Rico, and the San Francisco Peninsula, respectively. The factor structure of the WOC-S was assessed with both exploratory and confirmatory factor analyses. The factor structure that emerged was found to hav...
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ABSTRACT In this study we introduce the concept of centrality in an attempt to assess individual differences in the meaning underlying daily hassles Central hassles are defined as those which reflect important ongoing themes or problems in the person's life The characteristics of central hassles, and their role in psychological and somatic health,...
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This study approached pediatric adherence practices from the perspective of mothers of children with HIV in the USA. The study aimed to articulate what is involved in the daily life experience of giving or supervising a child's HIV medication (i.e., adherence practices) in order to clarify, in more dynamic terms than is often found in adherence res...
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We compared types, amounts, and costs of home care for children with HIV and chronic illnesses, controlling for the basic care needs of healthy children to determine the economic burden of caring for and home care of chronically ill children. Caregivers of 97 HIV-positive children, 101 children with a chronic illness, and 102 healthy children were...
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Recent research has indicated that many people faced with highly aversive events suffer only minor, transient disruptions in functioning and retain a capacity for positive affect and experiences. This article reports 2 studies that replicate and extend these findings among bereaved parents, spouses, and caregivers of a chronically ill life partner...
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To examine the economic and psychologic costs of care provided by maternal caregivers to children with gastrostomy tube (GT) feedings. We conducted a 3-site study of primary maternal caregivers of 101 chronically ill children, with (n = 50) and without (n = 51) enteral nutrition support by GT to determine the time spent providing technical care, no...
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Coping, defined as the thoughts and behaviors used to manage the internal and external demands of situations that are appraised as stressful, has been a focus of research in the social sciences for more than three decades. The dramatic proliferation of coping research has spawned healthy debate and criticism and offered insight into the question of...
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This randomized clinical trial was designed to compare the effects of a theory-based coping effectiveness training (CET) intervention with an active informational control (HIV-Info) condition and a waiting-list control (WLC) condition on psychological distress and positive mood in HIV-seropositive gay men. The authors recruited 149 self-identified...
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This study reports on a preliminary uncontrolled study of a treatment for couples in which one partner is diagnosed with a terminal illness. In this study nine couples, in which one partner was diagnosed with a terminal illness and had less than 18 months to live, were offered eight sessions of couples therapy. Follow-up data were available for six...
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The purpose of the current study was to document the course and 1-month post-bereavement predictors of both positive and negative psychological states in bereaved gay male caregivers for 3 years following the death of their partners. The results show that although the patterns of post-bereavement depressive mood and positive psychological states we...
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Mistakes are inevitable in medicine. To learn how medical mistakes relate to subsequent changes in practice, we surveyed 254 internal medicine house officers. One hundred and fourteen house officers (45%) completed an anonymous questionnaire describing their most significant mistake and their response to it. Mistakes included errors in diagnosis (3...
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This descriptive study explores the nature, experience, and benefits of private prayer among maternal caregivers of children with HIV. Colloquial and meditative prayer were used frequently, in the course of daily activities. Among other benefits, prayer was used to shift attitudes and emotions toward positive perspectives. Positive states of mind g...
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The reformulated learned helplessness (RLH) diathesis–stress model of depression (L. Y. Abramson, M. E. P. Seligman, & J. D. Teasdale, 1978) was tested using the explanatory style scores of 30 gay male caregivers. Scores were derived from interviews immediately following AIDS-related bereavement. Concurrently, questionnaire measures of depressive s...
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The authors examined goodness of fit between controllability appraisals and coping in 82 HIV+ and 162 HIV-gay men experiencing the chronic stress of caregiving and 61 HIV+ gay men who were not caregiving. Multiple assessments of each individual over a 2-year period allowed replication of prior cross-sectional research examining goodness of fit, as...
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This study describes three tacit definitions of informal caregiving and explores the extent to which differences in these tacit definitions explain variation in caregivers' negative mood over time. There is a growing need to understand the sources of stress and gratification for informal caregivers. Tacit definitions of informal caregiving refer to...
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The objectives of the study were to compare different aspects of social support between caregiving partners of men with AIDS and partners of healthy men and to examine the association of social support with positive and negative mood. Data were collected in a longitudinal study of 244 gay male caregivers and 61 comparison gay male noncaregivers. Me...
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There is growing interest in positive aspects of the stress process, including positive outcomes of stress and antecedents that dispose individuals to appraise stressful situations more as a challenge than as a threat. Less attention has been given to the adaptational significance of positive emotions during stress or to the coping processes that s...
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The associations among coping, mood, and health variables were examined prospectively over 2 years in 86 HIV positive (HIV+) and 167 HIV negative (HIV-) gay men undergoing the stress of AIDS-related caregiving. Path models suggested that including both positive and negative mood and the men's associated coping strategies increases understanding of...
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Although research on coping over the past 30 years has produced convergent evidence about the functions of coping and the factors that influence it, psychologists still have a great deal to learn about how coping mechanisms affect diverse outcomes. One of the reasons more progress has not been made is the almost exclusive focus on negative outcomes...
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This study of rituals of dying and death is based on narrative accounts of fifty-two gay men whose partners died of AIDS in the San Francisco Bay Area between 1991 and 1994. Sixty-seven percent of the deaths occurred at home, 71 percent of the caregiving partners were present at the time of death, and 71 percent of the dying partners chose crematio...
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Carver et al. challenge the importance assigned to personal control over desired outcomes as a determinant of distress in stressful situations. The authors contend that it is the expectancy of a positive outcome, and not control over achieving that outcome, that matters. The authors argue that both outcome and control expectancies can matter with r...
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This article describes the interplay among theory, research and practice regarding the maintenance of psychological well-being during serious illness. The ideas emerged from two independent lines of work, one that evolved through clinical practice within the medical model, the other that evolved through theory and field research within a behavioral...
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This article describes the interplay among theory, research and practice regarding the maintenance of psychological well‐being during serious illness. The ideas emerged from two independent lines of work, one that evolved through clinical practice within the medical model, the other that evolved through theory and field research within a behavioral...
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Self-interest is not the only motivator to sexual safety among sexually active gay men. Indeed, limits to a self-interest prevention paradigm are significant, and growing. Semi-structured qualitative interviews in two cities with an ethnically diverse cohort of mixed-status, sexually active gay men reveal a wide range of other-sensitive motivators...
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The purpose of this study was to examine depressive symptomatology in three Latino groups: Mexicans living in Mexico City, Latino immigrants living in the South Bay area of San Francisco, and Puerto Ricans living on the island of Puerto Rico. The Spanish version of the Center for Epidemiological Studies Depression Scale (CES-D) was used as part of...
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This article is a follow-up study of bereaved caregiving male partners of men with AIDS (T.A. Richards & S. Folkman, 1997). The earlier study examined spiritual beliefs, experiences, and practices reported in interviews with 125 caregivers conducted 2 and 4 weeks following bereavement. This follow-up study reports qualitative and quantitative data...
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The present study followed a group of 100 gay men up to 1 year before and 1 year after losing a partner to AIDS (University of California, San Francisco Coping Project). Following bereavement, participants were at increased risk for engaging in unprotected anal intercourse: at 4 to 6 months for HIV-negative men and at 8 to 12 months for HIV-positiv...
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To determine the extent to which homosexual men dying of the acquired immunodeficiency syndrome (AIDS) receive medication intended to hasten death. To assess the impact on caregivers of administering medications intended to hasten death. In a prospective study of caregiving partners of men with AIDS (n = 140), characteristics of the ill partner, th...
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This study draws on the narrative accounts of caregiving events provided by 100 HIVnegative and HIV-positive partners of men with AIDS during their partners' illness. The narratives contain rich detail about the wide range of skills that these men developed over the course of their caregiving. These skills, which go beyond the kinds of assistance w...
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Providing care to a spouse or partner who is dying and then losing that person are among the most stressful of human experiences. A longitudinal study of the caregiving partners of men with AIDS showed that in addition to intense negative psychological states, these men also experienced positive psychological state states throughout caregiving and...
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Spiritual phenomena were spontaneously reported in interviews of 68 of 125 recently bereaved HIV-positive and HIV-negative partners of men who died from AIDS. Spiritual schemas involving beliefs, experiences, rituals, social support, and roles were used to help assimilate the fact of death and were appraised as sources of solace and meaning. The re...
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This prospective 2-year study examines suicidal ideation in 86 HIV-positive and 167 HIV-negative caregiving partners of men with AIDS. One hundred and fifty-six of the caregivers became bereaved during the course of the study. The study focuses on the relationship between suicidal ideation and bereavement status (bereaved vs non-bereaved), HIV sero...
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This study examines the effects of caregiving and bereavement on psychosocial resources in HIV+ and HIV- caregivers of men with AIDS. We explored three hypotheses regarding these effects: the "wear and tear" hypothesis, which asserts that the chronic stress of caregiving and bereavement diminishes resources; the "enhancement" hypothesis, which asse...
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Although theoretical and empirical work on topics related to meaning and meaning making proliferate, careful evaluation and integration of this area have not been carried out. Toward this end, this article has 3 goals: (a) to elaborate the critical dimensions of meaning as it relates to stressful life events and conditions, (b) to extend the transa...
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Narratives of 30 caregivers were scored for appraisals and coping responses following the death of their partners from AIDS. Appraisals were identified as valenced beliefs, emotions, and goal outcomes, whereas coping responses included goals and plans of action. The proportion of positive appraisals predicted long-term goals and plans and psycholog...
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Four teams of investigators, representing distinct theoretical perspectives, independently analyzed the same bereavement narratives of 30 men whose partners had died of AIDS within the previous month. The data came from a longitudinal study of the caregiving partners of men with AIDS. Caregivers were interviewed with an open-ended format 2 weeks an...
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Most research on coping with chronic stress tends to focus inquiry on strategies that help the person manage stressor-related demands. In the case of coping with a debilitating illness, for example, the search often focuses on strategies that are related to managing the primary consequences of the illness, including disease-related limited mobility...
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The associations between stress, physical health, psychosocial resources, coping, and depressive mood were examined in a community sample of African American gay, bisexual, and heterosexual men (N = 139). Data were collected from physical exams and in-person interviews. In our theoretical framework, depressive mood scores were regressed first on st...
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Heterosexual transmission of HIV is rising in the US but male-to-male sex and IV drug use still are the major modes of HIV transmission. In developing countries heterosexual transmission has always been responsible for the majority of HIV cases. The new HIV infection rate in the US is increasing quickly among youth ethnic minorities and the urban p...
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Prebereavement predictors of the course of postbereavement depressive mood were examined in 110 gay men who were their partner's caregiver until the partner's death of AIDS. In all, 37 HIV+ and 73 HIV- bereaved caregiving partners were assessed bimonthly throughout a 10-month period beginning 3 months before and ending 7 months after the partner's...
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This prospective study of a cohort of human immunodeficiency virus positive (HIV+) and HIV negative (HIV-) caregiving partners of men with AIDS examined the contextual effects of caregiving and bereavement on coping and the association between coping and positive and negative mood during the five months leading up to their partner's death and the f...
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Psychological stress is thought to undermine host resistance to infection through neuroendocrine-mediated changes in immune competence. Associations between stress and infection have been modest in magnitude, however, suggesting individual variability in stress response. We therefore studied environmental stressors, psychobiologic reactivity to str...
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This study examines factors associated with caregiver burden in 82 HIV-positive (HIV+) and 162 HIV-negative (HIV-) partners of men with AIDS. We expected HIV+ caregivers to report more burden than HIV- caregivers because of the toll of their disease on their resources. HIV+ caregivers did report more burden and, compared with the HIV- caregivers, t...
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The stress associated with HIV infection and the psychological impact of that stress have been documented. The complex issues that HIV-positive individuals encounter in managing their disease were described. The existing research on behavioral interventions designed to provide strategies to assist HIV-positive individuals cope with their disease wa...
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HIV disease presents profound challenges to primary caregivers including adjusting to the care recipient's disease progression, having increasing responsibilities for decision making as the disease progresses, responding to unexpected improvement, having to deal with a virtually uncontrollable disease, and managing role conflict and fatigue. Caregi...
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Socioeconomic status (SES) is consistently associated with health outcomes, yet little is known about the psychosocial and behavioral mechanisms that might explain this association. Researchers usually control for SES rather than examine it. When it is studied, only effects of lower, poverty-level SES are generally examined. However, there is evide...
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We examined how house officers coped with serious medical mistakes to gain insight into how medical educators should handle these situations. An anonymous questionnaire was mailed to 254 house officers in internal medicine asking them to describe their most important mistake and their response to it; 45% (N = 114) reported a mistake and completed t...
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Previous studies in adult populations have demonstrated alterations in immune function after psychologically stressful events, and pediatric research has shown significant associations between stress and various childhood morbidities. However, no previous work has examined stress-related immune changes in children and subsequent illness experience....
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This study examined the relationship between stress, appraised control, and coping and depressive mood in 425 human immunodeficiency virus-positive and -negative gay men in San Francisco. Depressive mood was assessed by self-report in 1988 and 1989. Participants were also surveyed in 1989 on the stress in their lives, their appraised control over t...
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Socioeconomic status (SES) is strongly associated with risk of disease and mortality. Universal health insurance is being debated as one remedy for such health inequalities. This article considers mechanisms through which SES affects health and argues that a broader and more comprehensive approach is needed. Published articles surveyed using MEDLIN...
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Objective. —Socioeconomic status (SES) is strongly associated with risk of disease and mortality. Universal health insurance is being debated as one remedy for such health inequalities. This article considers mechanisms through which SES affects health and argues that a broader and more comprehensive approach is needed.Data Sources. —Published ar...
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We examined the relation between stress, coping, and a high-risk sexual behavior (unprotected anal intercourse) in 398 nonmonogamous gay and bisexual men from the AIDS Behavioral Research Project in San Francisco. Unprotected anal intercourse during the previous month, the amount of stress experienced during the previous month in each of 10 domains...
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Examined the relation between stress, coping, and a high-risk sexual behavior (unprotected anal intercourse [UAI]) in 398 nonmonogamous gay and bisexual men. UAI during the previous month, the amount of stress experienced during the previous month in each of 10 domains, 6 types of coping, and spiritual beliefs and activities were assessed through s...
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A task force on war-related stress was convened to develop strategies for prevention and treatment of psychological, psychosocial, and psychosomatic disorders associated with the Persian Gulf War and other extreme stressors facing communities in general. The task force focused on the return home, reunion, and reintegration of service personnel with...
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surveys orthodox approaches to coping / these traditional approaches to coping are based on two distinct literatures, one associated with animal experimentation and the other with psychoanalytic ego psychology / point out the limitations and defects of each of these approaches (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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During the 1980s, the Berkeley Stress and Coping Project conducted a number of studies about the coping process based on a cognitive theory of stress and coping (Lazarus, 1966; Lazarus & Folkman, 1984). These studies furthered understanding of the coping process, including its multidimensionality, the contextual person and environmental factors tha...

Citations

... The response shift effect of social functioning was found with both the thentest and SEM methods (g = 0.17), hence it can be generalised to the group level. The effect may be explained by adaptive coping, the revision and substitution of unrealistic beliefs (Richards & Folkman, 2000). Since the only treatment-like factor for all patients was the examination at baseline, it might be possible that the effect reflects the impact of the medical examination on the social life of the patients. ...
... In this vein, the workers have the needed energy to healthfully handle job demands (Quinn et al., 2012). This fact of workers feeling recovered and rested may lead them to be more proactive and adaptatively face job demands (Lazarus & Folkman, 1991). In other words, workers with high punctuation in recovery are likely to face job demands as their energy levels allow them to make an effort in solving job problems. ...
... The findings of this study are in line with previous studies which state that women suffer from a high level of depression (Bennett et al., 2013;Kandel, Raveis, & Davies, 1991;& Hoeksema, 2011). Based on the findings of this study, depression among the subjects of the study is in parallel as what has been explained in Lazarus stress theory (Folkman & Lazarus, 2019). Depression is triggered by the presence of stimulus in the form of pressure from the surrounding. ...
... Various measures were used to assess depressive symptoms across the studies, with Beck Depression Inventory (BDI) [20,21,29,30] and Center for Epidemiologic Studies Depression Scale (CES-D) [19,[22][23][24][25][26] being the measures most widely used by the study investigators. Other measures that were used included the 90-item Hopkins Symptom Checklist (SCL-90-R) [30]; Profile of Mood States (POMS) Depression-Dejection subscale [19,31]; and 64-item Revised Sign and Symptom Checklist for Persons with HIV Disease (SSC-HIVrev) [27,32]. ...