Den negative indflydelse af traumer, hvad enten de skyldes naturkatastrofer eller er forårsagede af mennesker, er veldokumenteret for både børn og voksne. Dog eksisterer der ikke ligeså meget viden om, hvilke faktorer, der influerer på den post-traumatiske udviklingsproces. Det er dog netop denne viden, der kan have en afgørende betydning for familiemedlemmer og professionelle, som ønsker at hjælpe og støtte traumatiserede. Coping strategier er én ting der i litteraturen har vist at være en relevant variabel i denne sammenhæng.
Lazarus og Folkman definerede coping eller mestring som ‘konstant foranderlige kognitive og adfærdsmæssige forsøg på at håndtere specifikke eksterne og/el. interne krav, som vurderes udfordrende eller overstigende af de ressourcer personen har til rådighed’. Denne definition virker på mange måder stadig til at udgøre kernen af konceptet ligesom at den dækker over en lang række forskellige måder at prøve at klare sine problemer på.
Skinner og kollegaer har identificeret en lang række copingstrategier som de adskiller som værende stile af arten ’tilnærmende vs. undgående’ (eng: approach vs. avoidance), emotions-fokuseret vs. problem-fokuseret (eng: emotion-focused vs, problem-focused) og engageret vs uengageret (eng: engagement vs disengagement).
Der findes i litteraturen en lang række yderligere copingstile som Videnscenteret har været en del af at undersøge. Et eksempel på dette er undersøgelser af sammenhængen mellem børn copingstile og deres selv-rapporterede niveauer af traume- and belastningssymptomer efter en eksplosionsulykke i et boligområde.
The purpose of the study was to investigate Wallander and Varni's (1998) disability-stress coping model in a sample of 105 Icelandic parents of chronically ill children. The Revised Adult Attachment Scale (RAAS), the Attributional Scale (AS), the Defence Style Questionnaire (DSQ), the Sense of Coherence Scale (SOC), the World Assumption scale (WAS), The Coping Style Questionnaire (CSQ), The Impact on Family scale (IFS), the Trauma Symptom Checklist (TSC), and the Harvard Trauma Questionnaire (HTQ), were completed by the parents of children with various diseases. Despite the heterogeneity of the sample in terms of disease type, PTSD was present in 13.2% of the parents and an additional 28.6% had subclinical PTSD. Emotional coping, extent of daily care, time since diagnosis, and changes in employment due to the disease explained 71% of the variance in HTQ total score.
Guðmundsdóttir, H., Guðmundsdóttir, D., & Elklit, A. (2006). Risk and resistance factors for psychological distress in Icelandic parents of chronically ill children: An application of the the Wallander and Varni’s disability-stress coping model. Clinical Psychology in Medical Settings, 13, 299-306.
Background: The negative impact of trauma on children and adolescents is well documented. However, few studies have investigated the relationship between coping and trauma and distress symptoms after man-made disasters, especially those not related to war. Objective: This study investigated the relationship between children’s coping styles and their self-reported levels of trauma and distress symptoms after an explosion disaster in a residential area. Method: Participants were recruited through the local public school that served the affected residential area. A total of 333 children and adolescents from grades 3 through 10 participated in the study 16 months after the explosion. All participants filled out questionnaires to assess their trauma and distress symptoms as well as their coping strategies. The adolescents answered additional questions about pre-, peri-, and post-traumatic factors and filled out questionnaires about their trauma and distress symptoms, including aspects of somatization and negative affectivity. Results: The following variables were associated with a higher degree of trauma symptoms for children in grades 6 through 10 and explained 39% to 48% of the unique variance in these symptoms: female gender; the experience of traumatic events pre-disaster; the destruction of property or danger to life occurring during the disaster; the experience of traumatic events post-disaster; and the use of self-blame, emotion regulation, wishful thinking, and cognitive restructuring. For the younger children, pre-, peri-, and post-disaster factors were not measured. However, female gender and the use of self-blame as a coping strategy explained 26% of the variance in trauma symptoms. Conclusions: This study generally supports the findings of the limited literature addressing coping skills after man-made disasters. However, contrary to previous findings in community samples after episodes of terrorism, adaptive coping strategies such as cognitive restructuring were found to influence the variance of trauma and distress symptoms.
Elmose, M., Elklit, A. & Duch, Christina. (2016) Children’s coping styles and trauma symptoms after an explosion disaster. Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 4(3), 132-140.
This paper examines degree of traumatisation, defence styles, coping strategies, symptomatology, and social support in a small sample of HIV‐positive men and women in an effort to ascertain the psychological implications of living with Human Immunodeficiency Virus (HIV). Traumatisation and the potentially mediating effects of defence styles have only been the subject of a few studies of HIV positives. The study is based on a socio‐demographic questionnaire, the Impact of Event Scale, the Defence Style Questionnaire, the Coping Styles Questionnaire, the Trauma Symptom Checklist, and the Crisis Support Scale. A degree of traumatisation that warrants treatment was found together with an association between particular coping strategies and symptomatology, and particular defence styles and symptomatology, respectively. Social support had increased over time, which is contrary to other research findings on social support.
Pedersen, S.S. & Elklit, A. (1998). Traumatisation, Psychological Defense Style, Coping, Symptomatology, and Social Support in HIV-positive: A Pilot Study. Scandinavian Journal of Psychology, 39 (2), 55-60. Doi: https://doi.org/10.1111/1467-9450.00056
Individuals generally use the same coping styles across situations. It is important to identify maladaptive coping in adolescents as coping patterns may persist into adulthood, and are associated with mental health. The present study used a cross-sectional design to investigate the combined effect of personality traits, attachment, locus of control, and social support on rational (problem-focused), avoidant, and emotion-focused coping in 320 trauma-exposed adolescents. The combined variables only explained 20-23 % of the variance in avoidant and rational coping, and 49 % of the variance in emotion-focused coping. The largest contributing variable for emotion-focused coping was neuroticism, possibly due to a confounding of emotion-focused coping with distress. Thus, other variables are needed to fully account for coping style choice.
Christiansen, D., Hansen, M. & Elklit, A. (2014). Correlates of coping styles in an adolescent trauma sample. Journal of Child & Adolescent Trauma, 7, 75–85. Doi 10.1007/s40653-014-0011-2.
Christiansen, D., Olff, M. & Elklit, A.: (2014). Parents bereaved by infant death: Sex differences and moderation in PTSD, attachment, coping, and social support. General Hospital Psychiatry, 36, 655–66136. Doi: 10.1016/j.genhosppsych.2014.07.012
Karstoft, K-I., Armour, C., Elklit, A. & Solomon, Z. (2015). The role of locus of control and coping style in predicting longitudinal PTSD-trajectories after combat exposure. Journal of Anxiety Disorders, 32, 89-94. Doi: 10.1016/j.janxdis.2015.03.007
Zerach, G. & Elklit, A. (2017). Polyvictimization and psychological distress in early adolescence: A mediaton model of defense mechanisms and coping styles. Journal of Interpersonal Violence, Doi: 10.1177/0886260517716944.
Fletcher, S., Elklit, A., Shevlin, M. & Armour, C. (2017): Predictors of PTSD treatment response trajectories in a sample of childhood sexual abuse survivors: the roles of social support, coping and PTSD symptom clusters. Journal of Interpersonal Violence, 1-25. Doi: 10.1177/0886260517741212
The aim of the present study was to examine specifically whether the relationship between coping style and symptoms of whiplash injury change as a function of gender. A total of 1709 sufferers of whiplash associated disorder (1349 women, 360 men) belonging to the Danish Society for Polio, Traffic and Accident Victims completed questionnaires measuring demographic and psychological factors (including coping style), and symptoms of whiplash trauma (including pain). Men and women were not found to differ significantly in their use of coping strategies, however emotion focused coping strategies were related significantly more strongly to whiplash related symptoms in men compared to women. Women were found to display more symptoms related to whiplash injury compared to men. Possible reasons for the present findings are discussed in light of related research indicating mood as a potential moderating variable in the relationship between maladaptive coping style and degree of symptoms related to injury in men.
Jones, A. & Elklit, A. (2007). The Association between Gender, Coping, and Whiplash Related Symptoms in Sufferers of Whiplash Associated Disorder. Scandinavian Journal of Psychology,48 (1), 75-80. Doi: 10.1111/j.1467-9450.2006.00543.x
Elklit. A., Palic, S., Lasgaard, M. & Kjær, K. (2012). Social Support, Coping and Posttraumatic Stress Symptoms in Young Refugees. Torture, 22(1), 11-23.
Relevante publikationer:Holmgren, H., Søndergård, H., & Elklit, A. (2003). Stress and coping in traumatized interpreters – a pilot study of refugee interpreters working for a humanitarian organization. Intervention – International Journal of Mental Health, Psychosocial Work and Counselling in Areas of Armed Conflict, 1, (3), 22-27