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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 of instrument development for the stress and self-efficacy subdomain of emotional health. Based on an extensive literature review and expert consultation, 127 measures were initially considered for inclusion in this subdomain, including measures of stress, self-efficacy, emotion regulation, and coping. Results: Several measures, including emotion regulation and measures of coping strategies, did not meet criteria that were a priori established for inclusion. Psychometric properties of the remaining candidate measures were evaluated using data from five independent samples (combined N = 3175). Confirmatory and exploratory factor analyses indicated the Perceived Stress Scale and the General Self-Efficacy Scale each assessed single dimensions. Conclusions: Based on their psychometric performance, these two instruments were selected for inclusion and subsequent national norming for the NIH Toolbox. [ABSTRACT FROM AUTHOR]

ABSTRACT 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 the revised Stress and Coping theory and the Broaden-and-Build theory of positive emotion, three studies provide evidence of the potential adaptive function of positive affect in the performance of roles for participants experiencing stress. Participants were students (Study 1), caregivers of children with illness (Study 2), and individuals recently diagnosed with HIV (Study 3). In cross-sectional analyses, using role functioning as an indicator of self-regulation performance, we found that positive affect was significantly correlated with better self-regulation performance, independent of the effects of negative affect. The effects were not as strong longitudinally, however, and there was little evidence of a reciprocal association between increases in positive affect and improvements in role functioning over time. The results provide some modest support for hypotheses stemming from the Broaden-and-Build model of positive emotion and revised Stress and Coping theory, both of which argue for unique adaptive functions of positive affect under stressful conditions. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

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 underlie this essay: (1) hope is essential for people who are coping with serious and prolonged psychological stress; and (2) hope is not a perpetually self-renewing resource; it has peaks and valleys and is at times absent altogether. The relationship between hope and coping is dynamic and reciprocal; each in turn supports and is supported by the other. This relationship is illustrated with two adaptive tasks common across situations that threaten physical or psychological well-being—managing uncertainty and coping with a changing reality. The essay describes ways in which coping fosters hope when it is at low ebb as well as ways in which hope fosters and sustains coping over the long term. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

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 complementary and alternative medicine (CAM) research and complexity science to discuss and examine ways in which complexity science can be applied to CAM research. After didactic presentations and small-group discussions, a number of salient themes and ideas emerged. This paper article describes the workshop program and summarizes these emergent ideas, which are divided into five broad categories: (1) introduction to complexity; (2) challenges to CAM research; (3) applications of complexity science to CAM; (4) CAM as a model of complexity applied to medicine; and (5) future directions. This discusses possible benefits and challenges associated with applying complexity science to CAM research. By providing an introductory framework for this collaboration and exchange, it is hoped that this article may stimulate further inquiry into this largely unexplored area of research. [ABSTRACT FROM AUTHOR]

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 a result of watching the film. Following viewing, participants felt more strongly that “all families of patients with brain cancers should meet with a social worker” ( P = 0.01) and that “family caregivers greatly impact the health of patients” ( P = 0.002), and they were less likely to believe that “supporting family caregivers is primarily someone else's job” ( P = 0.009). A documentary film about family caregiving is an effective educational tool to increase awareness among neurosurgery/neuro-oncology clinicians about the importance and needs of family caregivers of patients with brain tumors. [ABSTRACT FROM AUTHOR]

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, friends, and community; the ability to relinquish untenable goals and substitute new, realistic ones; engagement in spirituality and a spiritual practice; and, (b) a Lifeworld Interrupted Group characterised by one or more of the following: relocation just before or during the study, cognitive impairment, commitment to untenable goals, ongoing substance abuse. Understanding how people with a terminal illness can maintain a lifeworld and experience well-being while also managing the physical challenges of their illness could help inform the support offered by professional and family caregivers to improve care recipients' quality of life. [ABSTRACT FROM AUTHOR]

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 linked to chronic stress exposure and depression. This raises the question of mechanism: How might cellular aging be modulated by psychological functioning? We consider two psychological processes or states that are in opposition to one another–threat cognition and mindfulness–and their effects on cellular aging. Psychological stress cognitions, particularly appraisals of threat and ruminative thoughts, can lead to prolonged states of reactivity. In contrast, mindfulness meditation techniques appear to shift cognitive appraisals from threat to challenge, decrease ruminative thought, and reduce stress arousal. Mindfulness may also directly increase positive arousal states. We review data linking telomere length to cognitive stress and stress arousal and present new data linking cognitive appraisal to telomere length. Given the pattern of associations revealed so far, we propose that some forms of meditation may have salutary effects on telomere length by reducing cognitive stress and stress arousal and increasing positive states of mind and hormonal factors that may promote telomere maintenance. Aspects of this model are currently being tested in ongoing trials of mindfulness meditation. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether new-onset clinical depression emerges over time, and whether positive and negative mood levels change among patients with terminal cancer. Methods: 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 System of Beliefs Inventory, and Positive and Negative Affect Schedule. Results: At study entry, 7% of patients had major depressive disorder; another 9% had depressive symptoms but no Axis I diagnosis. Twenty-two percent were taking antidepressants. During visits ranging from 2 to 21 per patient, 76% of patients never had a depression diagnosis, 3% were always depressed, and 14% became depressed for the first time, almost exclusively at their final visit before death. Scores on positive mood were equivalent to or higher than scores on negative mood and did not change over time. Cancer site, hospice, spiritual beliefs, income, and caregiver mood were unrelated to depression. Spiritual beliefs were, however, associated with positive mood, hope, and better quality of life. Conclusions: In this exploratory study, terminally ill patients approaching death experienced positive as well as negative mood although a significant minority met criteria for major depression at the last visit before death. The findings suggest that major depression is not an inevitable part of the dying process in patients with terminal cancer. Further, the appropriateness of classifying sadness, loss of interest and thoughts that one would be better off dead in the last days of life as psychopathology should be reconsidered. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

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 were incorporated into a revision of stress and coping theory (Folkman, 1997). This article summarizes the research reported during the intervening 10 years that pertains to the revised model. Evidence has accumulated regarding the co-occurrence of positive and negative emotions during stressful periods; the restorative function of positive emotions with respect to physiological, psychological, and social coping resources; and the kinds of coping processes that generate positive emotions including benefit finding and reminding, adaptive goal processes, reordering priorities, and infusing ordinary events with positive meaning. Overall, the evidence supports the propositions set forth in the revised model. Contrary to earlier tendencies to dismiss positive emotions, the evidence indicates they have important functions in the stress process and are related to coping processes that are distinct from those that regulate distress. Including positive emotions in future studies will help address an imbalance between research and clinical practice due to decades of nearly exclusive concern with the negative emotions. [ABSTRACT FROM AUTHOR]

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 relationships of religiosity and prayer with quality of life and health symptoms. However, the relationships became significant when education and, to a lesser degree, income were taken into account. Prayer was associated with fewer health symptoms and better quality of life among less educated caregivers. [ABSTRACT FROM AUTHOR]

Objectives. 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. Design. Data came from two randomized clinical trials (N1 = 149, N2 = 199) evaluating a theory-based Coping Effectiveness Training (CET) intervention in reducing psychological distress and increasing positive mood in persons coping with chronic illness. Methods. The 348 participants were HIV-seropositive men with depressed mood who have sex with men. Participants were randomly assigned to intervention and comparison conditions and assessed pre- and post-intervention. Outcome variables included the CSE scale, ways of coping, and measures of social support and psychological distress and well-being. Results. Exploratory (EFA) and confirmatory factor analyses (CFA) revealed a 13-item reduced form of the CSE scale with three factors: Use problem-focused coping (6 items, α = .91), stop unpleasant emotions and thoughts (4 items, α = .91), and get support from friends and family (3 items, α = .80). Internal consistency and test-retest reliability are strong for all three factors. Concurrent validity analyses showed these factors assess self-efficacy for different types of coping. Predictive validity analyses showed that residualized change scores in using problem- and emotion-focused coping skills were predictive of reduced psychological distress and increased psychological well-being over time. Conclusions. The CSE scale provides a measure of a person's perceived ability to cope effectively with life challenges, as well as a way to assess changes in CSE over time in intervention research. [ABSTRACT FROM AUTHOR]

Objectives. 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. Methods. Caregivers of 97 HIV-positive children, 101 children with a chronic illness, and 102 healthy children were surveyed regarding amounts of paid and unpaid care provided. Caregiving value was determined according to national hourly earnings and a market replacement method. Results. Chronically ill children required significantly more care time than HIV-positive children (7.8 vs 3.9 hours per day). Paid care accounted for 8% to 16% of care time. Annual costs were $9300 per HIV-positive child and $25900 per chronically ill child. Estimated national annual costs are $86.5 million for HIV-positive children and $155 to $279 billion for chronically ill children. Conclusions. Informal caregiving represents a substantial economic value to society. The total care burden among chronically ill children is higher than that among children with HIV. [ABSTRACT FROM AUTHOR]

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 why some individuals fare better than others do when encountering stress in their lives. We briefly review the history of contemporary coping research with adults. We discuss three primary challenges for coping researchers (measurement, nomenclature, and effectiveness), and highlight recent developments in coping theory and research that hold promise for the field, including previously unaddressed aspects of coping, new measurement approaches, and focus on positive affective outcomes. [ABSTRACT FROM AUTHOR]

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 grew out of prayer that nurtured gratitude, faith, trust, and wonder. Prayer was used to gain focus and calm, companionship, collaboration, guidance, and moral direction. Results of the study are directed toward the development of spiritual interventions using private prayer and for the development of sensitivity among health care providers. [ABSTRACT FROM AUTHOR]

The purpose of the current study was to document the course and1-month postbereavement predictors of both positive and negative psychological states in bereavedgay malecaregivers for 3 years following the death of their partners.The results show that although the patterns of postbereavement depressive mood and positive psychological states were similar, some of their predictors differed. Given that the processes that produce positive psychological states are not the same as those that produce negative states, our findings support the inclusion of both positive and negative psychological states in studies of postbereavement adjustment. [ABSTRACT FROM AUTHOR]

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 have important similarities and differences compared to that previously reported for members of the predominant United States culture. Across the sampled Latino groups, the WOC-S exhibited evidence of both strong and strict factorial invariance (Meredith, 1993), suggesting it is appropriate for cross-cultural research assessing coping within diverse Latino populations. [ABSTRACT FROM AUTHOR]

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 symptoms (CES-D) and stress (Daily Hassles Scale) were taken along with repeated measures of depressive symptoms at 3, 6, 9, and 12 months following bereavement. As predicted by RLH, the interaction between Explanatory Style and Stress scores predicted subsequent depressive symptoms, with initial stress and initial depressive symptoms assuming a more powerful role early in the recovery process. Implications for treatment and future research are discussed. [ABSTRACT FROM AUTHOR]

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. Measures included perceived positive support; social conflict; sought support; amount, types, and sources of received support; relationships with family; and positive and negative mood. Cross-sectional analyses and changes between baseline and 2 years were examined. No significant differences were found between the caregivers and noncaregivers in most aspects of social support. Regression analyses showed (a) caregiver status was associated with positive and negative mood (caregivers reported lower positive mood and higher negative mood) at baseline, but not at 2 years; (b) perceived support was the only variable significantly associated with positive mood at baseline and at 2 years; and (c) social conflict (at both times) and perceived support, amount of received support, and having a family confidant (at one of the time periods) were associated with negative mood. The findings support the importance of distinguishing between perceptual and behavioral aspects of social support and their relation to both positive and negative mood. [ABSTRACT FROM AUTHOR]

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 science model. Each of these lines of work independently points to the importance of focusing on psychological well-being and the coping processes that support it, as a complement to the traditional focus in both the medical and behavioral sciences on psychiatric symptoms. This article describes a theoretical framework for the discussion of psychological well-being during serious illness. Then, this framework is used to define variables that research indicates contribute specifically to psychological well-being during serious illness, and finally, based on theory and research, a therapeutic program is described for patients with serious illness. The goal of this paper is to encourage researchers and clinicians to give as much attention to the development and maintenance of psychological well-being in the face of serious illness as they do to the etiology and treatment of psychiatric symptoms. Copyright © 2000 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

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 2and 4weeks following bereavement . This follow - up study reports qualitative and quantitative data from 70 members of the earlier cohort , collected 3 to 4 years later , regarding the presence of spiritual phenomena . Spirituality increased or deepened in 77 % of the entire cohort . An ongoing relationship with the deceased partner was reported by 70 % of the cohort . The use of spirituality as coping appeared to decline as the bereaved moved further in time from the loss . Instead , spirituality was identified as a personal governing influence that provided value and direction to the individual . In general , relationships between the expression of spirituality and mood , coping , and physical health symptoms were not statistically significant owing to small samples , but there were medium effect sizes . [ABSTRACT FROM AUTHOR]

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 beyond self-interest whose roles in men's HIV safety decisions have not been recognized. Other-sensitive motivations fall into several categories: altruistic concern for sex partners, personal ethical/moral values, expressed desire for communal/collective survival, concerns about self-definition, and elaborate concerns over the effects of potential HIV infection on family and friends. Other-focused concerns seem to operate as key motivators among these men, lowering risk. Implications of other-sensitive concerns for a new generation of prevention strategies are discussed. [ABSTRACT FROM AUTHOR]

Presents information on the differences in depressive symptomatology in island Puerto Ricans, Mexicans living in Mexico City and Latino immigrants in the United States (US). Relationship between factors associated with immigration and depression in the Latino immigrant sample living in the US; Sampling procedures; Methods; Analysis of data; Findings; Discussion.

The article presents a study regarding HIV prevention and care. It discusses the importance of basic social and behavioral science in the study of HIV and the ethical issues involved in it, as well as the epidemiology of the virus and HIV infections in several countries, including the U.S. Example cases of the application of policies and services for HIV are presented.

The article describes the intervention Coping Effectiveness Training and its impact on HIV patients. It offers an overview of coping effectiveness training for chronic illnesses, like HIV, which include adaptive coping and maladaptive coping. The Coping Effectiveness Training intervention was developed with elements of stress management and based in the theory of stress and coping.

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 asserts that caregiver resources may increase in response to increased demands; and the "personality" hypothesis, which asserts that psychosocial resources reflect stable personality characteristics. We addressed four questions: (a) What are the effects of caregiving on resources? (b) How do these resources vary by the imminence of the partner's death? (c) What is the effect of the partner's death on these resources? and (d) How does the caregivers' HIV serostatus influence the effects of caregiving and bereavement on resources? Support for the personality hypothesis predominated, with some support for the wear and that hypothesis, depending on the resource in question. In general, HIV seropositivity did not pat people at additional risk for resource depletion. [ABSTRACT FROM AUTHOR]

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, were assessed in a sample of 150 community-residing men and women. The results indicate that central hassles vary in content from person to person and touch more on problems with personal needs and deficits in coping skills compared to noncentral hassles. The dimension of centrality was found to play a significant role in the prediction of psychological symptoms. Although the empirical case for the importance of centrality in the stress-illness relationship is inconclusive due to problems of confounding and a cross-sectional rather than longitudinal design, the ideas presented appear promising and provide a basis for further research on psychological vulnerability to stress. [ABSTRACT FROM AUTHOR]

In this article we examine the fundamental premises of our cognitive-relational theory of emotion and coping and assess our progress in examining them through 10 years of programmatic empirical research. Our discussion involves the methatheoretical topics of transaction and relationship, process, and emotion as a system. The person environment relationship is mediated by two key processes: cognitive appraisal and coping. We evaluate the findings of our research on these processes, their dynamic interplay, their antecedents, and their short-term and long-term outcomes. In the final section we highlight major substantive and methodological issues and need to be addressed. These include issues surrounding the theory and measurement of appraisal, functional and dysfunctional coping, causal inference, microanalytic vs macroanalytic research strategies, objective vs subjective approaches and confounding, and the problem of method variance. [ABSTRACT FROM AUTHOR]

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 relationship between spirituality and coping, mood, and physical health was examined. Those reporting spiritual phenomena showed higher levels of depression and anxiety and lower levels of positive states of mind, used more adaptive coping strategies, and reported more physical health symptoms than those who did not report spiritual phenomena. It doesn't matter, for scientific purposes, it doesn't matter at all whether it's true. It doesn't matter whether I'm projecting the events, it doesn't matter whether I'm projecting my own concerns. It was a process, and it functioned, and it's my experience of Michael. I happen to believe that Michael's spirit was there, and that it spoke to me.- Recently bereaved partner of a man who died of AIDS. [ABSTRACT FROM AUTHOR]

Examines a study conducted to determine the extent to which homosexual men who are dying of the acquired immunodeficiency syndrome (AIDS) received medication intended to quicken death. Circumstances surrounding the deaths of men ill with AIDS; Frequency with which narcotic analgesics and sedative medications are given to hasten death; Indepth look at study. INSET: Participants and methods.

Presents a study that examined the mistakes reported by internal medicine house officers at their academic training programs in the U.S. Types of mistakes and outcomes of the mistakes; Causes of the medical errors; Effect of the changes in practice on the incidence of medical mistakes.

This study analyzes the ways 100 community-residing men and women aged 45 to 64 coped with the stressful events of daily living during one year. Lazarus's cognitive-phenomenological analysis of psychological stress provides the theoretical framework. Information about recently experienced stressful encounters was elicited through monthly interviews and self-report questionnaires completed between interviews. At the end of each interview and questionnaire, the participant indicated on a 68-item Ways of Coping checklist those coping thoughts and actions used in the specific encounter. A mean of 13.3 episodes was reported by each participant. Two functions of coping, problem-focused and emotion-focused, are analyzed with separate measures. Both problem- and emotion-focused coping were used in 98% of the 1,332 episodes, emphasizing that coping conceptualized in either defensive or problem-solving terms is incomplete -- both functions are usually involved. Intraindividual analyses show that people are more variable than consistent in their coping patterns. The context of an event, who is involved, how it is appraised, age, and gender are examined as potential influences on coping. Context and how the event is appraised are the most potent factors. Work contexts favor problem-focused coping, and health contexts favor emotion-focused coping. Situations in which the person thinks something constructive can be done or that are appraised as requiring more information favor problem-focused coping, whereas those having to be accepted favor emotion-focused coping. There are no effects associated with age, and gender differences emerge only in problem-focused coping: Men use more problem-focused coping than women at work and in situations having to be accepted and requiring more information. Contrary to the cultural stereotype, there are no gender differences in emotion-focused coping. [ABSTRACT FROM AUTHOR]

Evaluates the association between stress, physical health, psychosocial resources and depressive mood in African American gay, bisexual and heterosexuals. Factors that may help reduce vulnerability to the effects of stress; Influence of coping resources including social support; Religiosity - spirituality.

The article presents reply to Marybeth Shinn of the New York University and David H. Krantz of Bell Laboratories, regarding their comments on the article "An analysis of coping in a middle-aged community sample," by the authors. According to the authors, Shinn and Krantz correctly point out that the combinatorial analysis they recently reported may underestimate the consistency of the relative amounts of emotion and problem focused coping used by author's subjects in dealing with diverse stressful encounters. Their suggestion for an alternative technique of measurement is appropriate, but raises some important general issues about coping consistency. One issue concerns the maximum consistency of coping behavior that can be expected across stressful contexts. Even if other analytic procedures, such as the one suggested by Shinn and Krantz, increase the estimate of consistency, authors contend that there will still be substantial variability. Such variability is due to the diversity of situational demands and meanings generated by each stressful context. Indeed, high consistency of coping behaviors could be an indication of rigidity and be associated with pathology. Furthermore, consistency can be viewed not only intraindividually as a function of situational requirements, but interindividually too, since being consistent is probably variable among persons, some of whom are highly flexible and others highly inflexible.

Focuses on the International Scientific Conference on Complementary, Alternative and Integrative Medicine Research Boston, Massachusetts in April 2002. Sponsors of the conference; Total number of studies presented; Information on the studies which focused on herbal pharmacotherapy.

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 respect to distress or psychological well-being; their relative importance is determined by dimensions of the person-environment context including the importance of the outcome, dispositional preferences regarding control, the contingency between personal control and the outcome, self-efficacy expectancies, and the consequences of exercising control for other areas of one's life. [ABSTRACT FROM AUTHOR]

Comments on key issues and developments relevant to the components of counseling programs. Failure of counseling programs to prepare the counselee for life changes related to educational or vocational choice; Need for program components dealing with problem identification, anticipation and coping resources; Need to aid individuals in identifying and coping with distress and problems.

Presents a response by Albert Wu, Susan Folkman, Stephen J. McPhee and Bernard Lo to a letter to the editor about their article 'Do House Officers Learn From Their Mistakes?' in the 1991, vol. 265, issue, which deals with resident physicians.