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Background and Purpose: Although the Brief COPE is a widely used instrument to measure coping, its factor structure is understudied in young adults. The purpose of this article was to determine the psychometric properties of the dispositional version of the Brief COPE among young adults. Methods: Two hundred young adults completed the dispositional version of the Brief COPE. Measures of depression, anxiety, and stress tested predictive validity. Confirmatory factor analyses and exploratory structural equation modeling were conducted. Results: The final model achieved good fit (minimum discrepancy/degrees of freedom = 1.59; comparative fit index =.93; standardized root mean square residual =.07). Three second-order factors were identified: adaptive (α =.81), support (α = 78), and disengaged coping (α = 71). Adaptive and disengaged coping were differentially associated with mental health outcomes. Conclusions: The results are consistent with a growing body of evidence to support the construct validity of the Brief COPE. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) affect 22–75% of American young adults. ACEs are associated with adverse health outcomes that begin in young adulthood. Yet, scant research has examined if coping can mediate the relationship between ACEs and adverse outcomes. The current study determined if coping mediates the relationship between ACEs and body mass index (BMI), substance use, and mental health outcomes in young adults. A community sample of 100 White and 100 Black young adults 18–34 years of age participated in a cross-sectional study conducted via Zoom conferencing. Participants provided demographic data, height/weight, and completed measures of ACEs, coping, substance use, and mental health outcomes. Coping was measured using an established three-factor model consisting of adaptive, support, and disengaged coping. Structural equation modeling (SEM) examined the relationships of ACEs to outcomes as mediated by coping. Participants were predominantly female (n = 117; 58.5%) and mid-young adult (M = 25.5 years; SD = 4.1). SEM results indicated good model fit: (CMIN/df = 1.52, CFI = 0.94, RMSEA = 0.05 [90% CI = 0.03-0.07], SRMR = 0.06). Only disengaged coping mediated the ACE and substance use (β = 0.36, p =.008), smoking (β = 0.13, p =.004), and mental health (β=-0.26, p =.008) relationships. Disengaged coping styles may be a critical mechanism in developing adverse mental health and substance use outcomes among ACE-exposed individuals. Future ACE and health outcomes research should examine the role of coping. Interventions focusing on adaptive coping may improve the health of individuals exposed to ACEs. [ABSTRACT FROM AUTHOR]

This paper describes the assessment of the psychometric properties of the Brief COPE in a sample of 189 pregnant African-American women. Confirmatory factor analysis (CFA) tested the original 14-factor model, and exploratory structural equation modeling (ESEM) determined whether a reduced number of factors still accounted for inter-item covariances. The CFA replicated 13 of the 14 original factors. After deleting substance use items and allowing for correlated error across the support factors, the 13-factor model achieved an acceptable fit (CMIN/ df = 1.77; RMSEA = 0.06, 95% CI = 0.05–0.07). ESEM resulted in three second-order factors: disengaged, active, and social support coping. Factor items were summed to create subscales with good internal consistency reliability (α =.74–.89). Social support coping and active coping were strongly correlated and accounted for nearly the same variance in four different psychological/affect scales, while disengaged coping was clearly distinct. [ABSTRACT FROM AUTHOR]

Introduction. Belief in one's ability to control pain is a significant predictor of health outcomes and is related to improved functional status. The purpose of this study was to introduce a novel formulation of the construct, Perceived Control Over Pain and to test its effects on functional status. Methods. Participants (N=301) were primarily African American (92%); and were adults with low income attending a primary care clinic and reporting pain within the past 2 weeks. A cross-sectional design was used with confirmatory factor analysis and structural equation modeling. The Perceived Control Over Pain construct consisted of four measures--two specific measures of control over pain and two general measures of control over life events. Perceived Control Over Pain has not been defined in this way previously. Results. Mean worst pain scores for the past week were 8.4, where "0" (no pain) to "10" (pain as bad as you can imagine). The model demonstrated good construct validity for the components of pain, Perceived Control Over Pain and functional status. Mediation by Perceived Control Over Pain was partial but strong, accounting for a reduction of 29% in the effect of pain on functional status. Discussion. In minority populations with low income, factors such as perceived control over pain and its effect on the outcome of patient function need to be considered. Improving Perceived Control Over Pain has the potential for improving patients' feelings of life control and purpose or meaning in life, and psychological and physical functioning for adults living with pain. [ABSTRACT FROM AUTHOR]

The article focuses on a study which aims to identify distress-intensity cut-points of the Respiratory Distress Observation Scale, an innovative solution to assessment when a dyspnea report cannot be elicited. It notes that the Respiratory Distress Observation Scale has acceptable reliability and validity psychometrics, and signifies patient's need for palliation of respiratory distress. Conclusion of the study is offered.

The article discusses a study that evaluated the Fall Risk Model for Injection Drug Users by assessing the association between injection drug use, chronic venous insufficiency and lower extremity impairment. The study examined the relationship between the Tinetti balance and gait total score and the role of injection drug use in fall risk. It was found that fall risk was associated with route of drug use.

Objective: This study tested a model of cancer‐related pain and functional status in African American patients, including beliefs about the ability to control pain as a key determinant of distress and functional status. Methods: Baseline data from a randomised clinical trial consisting of clinical and patient‐reported outcomes were used. Participants were 228 African American patients experiencing moderate to severe pain within the past 2 weeks. The model comprised four latent constructs: pain, perceived control over pain, pain‐related distress and functional status. Confirmatory factor analysis was used to validate the factor structure of the measurement model. Structural equation modelling was used to estimate direct and mediated effects. Results: The measurement model fit well (RMSEA = 0.06, SRMR = 0.05) with all loadings significant (p < 0.05). The structural model also fit well (RMSEA = 0.04, SRMR = 0.05). The complex mediated pathway from pain to functional status through perceived control over pain and pain‐related distress was strong and significant (specific indirect effect = −0.456, p = 0.004). Mediation by perceived control accounted for a 47% reduction of the effects of pain on functional status. Conclusion: If these results hold up longitudinally, interventions to increase perceived control over pain have the potential to improve functional status by decreasing pain‐related distress. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented about a tool developed for palliative care at home called the Respiratory Distress Observation Scale (RDOS).

Background Symptoms of depression have been related to lower gestational age and preterm birth (<37 completed weeks gestation). Leisure time physical activity may have protective effects on preterm birth; however, less has been published with regard to other domains of physical activity such as walking for a purpose (e.g., for transportation) or the pathways by which symptoms of depression impact gestational age at birth. Methods This was a secondary analysis of available data of African American women. Women were interviewed within 3 days after birth. We proposed a model in which walking for a purpose during pregnancy mediated the effects of symptoms of depression (measured by the 20-item Center for Epidemiologic Studies-Depression [CES-D] scale) on gestational age at birth in a sample of 1,382 African American women. Results Using structural equation modeling, we found that the direct effect of CES-D scores of 23 or greater, which have been correlated with major depression diagnosis, on gestational age at birth was -4.23 ( p < .001). These results indicate that symptoms of depression were associated with a decrease in gestational age at birth of 4.23 days. Walking for a purpose mediated the effect of CES-D scores of 23 or greater on gestational age at birth. Conclusions Compared with African American women without symptoms of depression, African American women who had symptoms of depression walked less for a purpose during their pregnancy and delivered infants with lower gestational age at birth. If not medically contraindicated, clinicians should incorporate walking as part of prenatal care recommendations and reassure women about safety of walking during pregnancy. [ABSTRACT FROM AUTHOR]

Living in a lower-quality neighborhood is associated with higher levels of depressive symptoms in the general population as well as among pregnant and postpartum women. However, little is known of the important pathways by which this association occurs. We proposed a model in which perceived stress and social support mediated the effects of neighborhood quality on depressive symptoms during pregnancy (measured by the 20-item Center for Epidemiologic Studies-Depression, CES-D, scale) in a sample of 1383 African American women from the Detroit metropolitan area interviewed during their delivery hospitalization. Using structural equation modeling (SEM), we built a latent variable of neighborhood quality using 4 measures (neighborhood disorder, neighborhood safety/danger, walking environment, overall rating). We then tested two SEM mediation models. We found that lower neighborhood quality was associated with higher prevalence of depressive symptoms during pregnancy (standardized total effect = .16, p = .011). We found that perceived stress partially mediated the neighborhood quality association with depressive symptoms. Although the association of social support with depressive symptoms was negligible, social support mediated associations of neighborhood quality with perceived stress [standardized path coefficient = .38 (.02), p = .009]. Our results point to the need for public health, health care, as well as non-health related interventions (e.g. crime prevention programs) to decrease overall exposure to stressors, as well as stress levels of women living in poor quality neighborhoods. Interventions that increase the levels of social support of women during pregnancy are also needed for their potential to decrease stress and ultimately improve mental health at this important time in the life course. [ABSTRACT FROM AUTHOR]