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Orthorexia nervosa represents a controversial phenomenon in the realm of eating practices, characterized by an obsessive fixation on consuming only foods deemed 'healthy', and a preoccupation with food purity. While the existing literature has identified the presence of stressful behaviors among individuals with orthorexia, the precise factors and circumstances eliciting these stress-inducing emotions remain the subject of ongoing inquiry. This study aims to explore the triggers and situations that precipitate stressful beliefs and emotions among individuals who self-identify as preoccupied with healthy eating, as well as the coping mechanisms developed to manage these feelings. Through conducting one-to-one interviews with thirteen individuals, thematic analysis was employed to elucidate the nuances of their experiences. Participants articulated concerns regarding the contamination of foods available in supermarkets and restaurants, thereby prompting the meticulous selection of food sources and aversion to dining out. The prospect of trying new foods and engaging in social gatherings involving food emerged as anxiety-inducing scenarios, prompting individuals to adhere to monotonous dietary patterns and impose self-isolation. Additionally, medical appointments were perceived as stressful, driven by health concerns underpinning the adoption of stringent dietary practices. These findings underscore the spectrum of fears and coping mechanisms exhibited by individuals with orthorexia nervosa, which hold profound implications for their overall well-being. [ABSTRACT FROM AUTHOR]

Throughout the cancer trajectory, parents of childhood cancer survivors (CCSs) may experience mental and social challenges requiring continual adaptation to cancer-induced stress. Using Lazarus and Folkman's Transactional Model of Stress and Coping framework, this qualitative study aimed to describe Hispanic parents' psychological health and explore their coping strategies. Purposive sampling was used to recruit 15 Hispanic caregivers from a safety-net hospital in Los Angeles County. To be eligible, participants had to be: the primary caregiver of a CCS who had completed active treatment, the primary caregiver or child self-identified as Hispanic, and proficient in English or Spanish. The interviews lasted approximately 60 min, were audio-recorded (in English and Spanish), and professionally transcribed. Data were analyzed following a thematic content analysis with deductive and inductive approaches on Dedoose. Participants described high levels of stress and fear when their child was diagnosed with cancer. They also shared experiencing symptoms of social anxiety, post-traumatic stress disorder, and depression. Participants' coping strategies were encompassed by three major themes: problem-focused, emotion-focused, and avoidant coping strategies. Problem-focused coping strategies included self-efficacy, behavioral change, and social support. Emotion-focused coping strategies included religious practices and positive reframing. Avoidant coping strategies included denial and self-distraction. Despite the evident disparities in psychological health for Hispanic parents of CCSs, gaps remain in designing a culturally tailored program to help alleviate the caregiver burden. This study provides insights regarding coping strategies that Hispanic caregivers use to deal with the psychological impact of their child's cancer diagnosis. Our findings also delve into the contextual and cultural factors that impact psychological adjustment.

Face recognition abilities vary tremendously in the general population. People at the lower end of the spectrum, those with developmental prosopagnosia, report stress, anxiety or social interaction issues due to their poor face recognition abilities. It is thus important to develop adequate diagnostic tools convenient to use for clinicians and to examine relationships between face recognition skills and negative affects. In the present study, we provide a validated French translation of the 20-item prosopagnosia index (PI20), a self-report measure used to detect people with developmental facial identity recognition deficits (Shah et al., 2015; Tsantani et al., 2021). We also examined links between face recognition skills measured with the PI20 and a standard face recognition test (Cambridge face memory test-CFMT; Duchaine & Nakayama, 2006) and measures of social anxiety (social interaction anxiety scale, social phobia scale) and negative affects (state trait anxiety scale, Beck depression inventory). We did not find any significant correlation between the CFMT and measures of psychosocial well-being and only found a weak positive association between the PI20 and social interaction anxiety. Although this association is weak and warrants further research, raising awareness about developmental face recognition issues may help improve the well-being of people with facial identity recognition deficits and provide new investigation or intervention avenues for clinicians who treat patients with social interaction anxiety.

IntroductionMeaning-making coping is used by people with cancer to help them deal with the stress and emotional turmoil associated with their diagnosis. It is a multifaceted approach that can be influenced by cultural, existential, and personal factors. Research on meaning-making coping among Filipinos diagnosed with cancer is sparse. This study examines how a sample of Filipino people with cancer cope with their illnesses.MethodsWe employed a qualitative approach. The study involved 20 participants with various types of cancer in the Philippines who were selected through purposive sampling and agreed to be interviewed.ResultsThe thematic analysis of the interviews revealed the application of both religious and secular meaning-making coping by participants. The study also confirmed the potential influence of culture on coping strategies.DiscussionThe results indicate that religion plays a significant role in Filipino coping mechanisms, given that the Philippines is predominantly a Christian nation. Additionally, the findings highlight the importance of close family ties in Filipino culture and how it contributes to coping with cancer.

BackgroundThere are numerous wars and ongoing political violence in Palestine and little is known about how they have affected Palestinian undergraduate students’ mental health and coping strategies. This study aimed to assess the prevalence of depression, and anxiety symptoms and coping mechanisms among Palestinian university students during the times of current political violence in Palestine after October 7, 2023.MethodsA cross-sectional descriptive study design was utilized for a sample of students from 3 universities in Palestine (Al Quds University, Hebron University, and An-Najah University) and 1815 participants responded. Data were collected using self-reported questionnaires, including Hospital Anxiety and Depression Scale (HADS) and Brief COPE scale. Person correlation test, chi-square test, and bivariate analysis were performed to examine the associations between research variables.ResultsThe estimated prevalence of depression was 65.9, and 60.9% for anxiety. The logistic regression showed that students from the Arts Faculty, females, and those with working parents were significantly more likely to experience depression and anxiety symptoms. Also, active coping, emotional support, and humor reduced the likelihood of experiencing depression symptoms, while active coping, positive reframing, humor, and acceptance decreased the likelihood of developing anxiety symptoms. Further, the study found that using religion, self-blame, denial, and behavioral disengagement increased the likelihood of depression symptoms while planning, venting, religion, self-blame, denial, and behavioral disengagement increased the likelihood of anxiety symptoms.ConclusionThe study found that political violence often leads to symptoms of depression and anxiety among undergraduates. Furthermore, the use of maladaptive coping mechanisms increases the likelihood that these symptoms will occur. Providing immediate assistance to university students affected by political violence and conflicts is crucial for their emotional and mental recovery and coping with difficulties.

ObjectiveTo better understand the experience of parents with neonates with congenital heart diseases (CHD) admitted to a neonatal intensive care unit (NICU) in order to identify challenges faced by parents and discover support strategies helpful in positive coping.Study designProspective cohort study of parents of neonates with CHD. Parents completed a questionnaire with open ended questions regarding their experience and feeling during the hospitalization within one week of the child discharge from the NICU. Krippendorff's content analysis was used to examine data.ResultsSixty-four parents participated. Three themes were highlighted – Dialectical parental experiences, Suboptimal Parental Experiences and Positive Parental Experiences – describing the state of being and feelings that these parents face. Through this analysis, we were able to develop clinical considerations and identify coping strategies.ConclusionThe understanding of parental experience and challenges when dealing with their child admitted in the NICU is crucial to identify coping strategies to promote adaptation and enhance the development of positive coping mechanisms.

Background: Polycystic Ovarian Syndrome, was previously thought to be an endocrine condition. Research has now demonstrated that polycystic ovarian syndrome affects a patient's quality of life and is a metabolic, hormonal and psychosocial condition. Women's joys are disrupted by PCOS because the stigma attached to hyperandrogenism is strongly felt and may harm women's psychological development. Methods: The aim of the study was to comprehend the psychosocial problems experienced by women in Kashmir and to obtain a thorough understanding of the coping mechanisms employed by women with PCOS. The research design was both qualitative and quantitative in nature. Thematic analysis was used to derive themes from the data. Sampling was purposeful in nature. Results: The study underscores that women with PCOS encounter numerous difficulties encompassing social and psychological aspects. Psychological issues like mood swings, stress, anxiety and sleeping disorders are prevalent among women with PCOS. Furthermore, the research has revealed that menstrual disorders significantly contribute to depression in women. The study also highlights a connection between infertility and psychological problems. Conclusion: In conclusion, the research underscores the multifaceted challenges faced by individuals with PCOS. Therefore, understanding these issues is crucial for developing effective coping mechanisms and improving the quality of life for women dealing with PCOS.

Climate change threatens smallholder farmers' productivity, revenue generation, and increases household food insecurity. Thus, adaptation and coping strategies are paramount for smallholder farming households to mitigate these impacts of climate change. This study used a bibliometric analysis to examine smallholder farmers’ coping and adaptation strategies to climate change (SFCA-SCC) research trends from 2010 to 2022. A total of 1635 papers were analysed from Scopus and Web of Science (WoS) databases to characterize the field and observe research trends. The articles from these databases demonstrate an upward trend in publications (54–300) over the period under study, signifying the importance of research on adaptation and coping strategies of climate change. The research findings showed that majority of studies originated from institutions in industrialized countries, while very few did so from emerging economies. According to the findings, smallholder farmers have embraced a range of adaptation and coping mechanisms to mitigate the impacts of climate change, such as altering planting schedules, and diversifying crop varieties among others. It is imperative for African researchers and institutions to engage in more research aimed at developing strategies to mitigate the risks posed by climate change.

Background: The prevalence of compassion fatigue (CF) and secondary traumatic stress (STS) has been studied with a predominant focus on medical care professionals, indicating a significant presence of STS and CF among them. The present study has identified a dearth in the representation of mental healthcare professionals (MHPs), grouped by psychiatrists, clinical psychologists, psychiatry nurses, and psychiatric social workers within the Indian context. Aim: To assess the degree of CF and STS and the subsequent coping mechanisms adopted by MHPs. Materials and Methods: This study followed a cross-sectional research design. There were 75 participants selected using purposive sampling and administered scales that measured CF, STS, and coping strategies adopted by the participants. Results: There is a strong presence of CF in MHPs along with problem-focused coping as the preliminary approach to STS. Participants with average or higher scores in STS had higher intrusion scores. Higher STS scores tend to have avoidant coping styles in comparison to the larger sample. Female participants indicated higher levels of CF and STS than their male counterparts. Conclusion: The study emphasizes on the immediate requirement to address and manage CF levels among the MHPs and focus on the factors that continue to aggravate STS.

Background: Work-related stress is the reaction individuals may have when faced with work expectations and forces that are not in tandem with their skill set and capacities and which frustrate their ability to cope. Coping strategies are paradigms used to limit the impact of stressful experiences, thus inhibiting the psychological and physical responses and making it more possible to maintain normal functioning at the time. Aim: This study aims to determine how bankers cope with stress from work in Ado-Ekiti, Southwest Nigeria. Materials and Methods: This cross-sectional study was done among three hundred and two bankers in Ado-Ekiti, Ekiti state. A sociodemographic questionnaire was designed to obtain data on the sociodemographic characteristics of the respondents, while coping with work-related stress was assessed with The Brief Coping Orientation to Problems Experienced (Brief-COPE). Results: Two hundred and ninety-eight respondents (98.7%) used adaptive coping strategies, while four (1.3%) did not use them. One hundred and ninety-seven respondents (65.2%) used maladaptive strategies, while one hundred and five respondents (34.8%) did not cope with them. In essence, the majority of the respondents used adaptive strategies to cope with stress. Conclusion: Most of the bankers utilized adaptive strategies in coping with work-related stress.

Being exposed to bullfighting during childhood generates a growing social debate, that stirs up both opposing and supporting arguments that confront cultural transmission with the protection of childhood. This study seeks to analyze how viewing bullfighting shows affects the emotional well-being of Spanish and Portuguese children. Children who had watched bullfighting shows were compared to others who had never watched them. For the accomplishment of this study, 128 children took part, of which 84 were Portuguese and 44 were Spanish. Overall, 86 children had watched bullfighting shows and 42 had not. The scores related to problem-focused coping, positive affect, active resolution, and seeking information and guidance were significantly higher in those children who had watched bullfighting shows. No significant differences were found related to nationality. The cognitive interpretation of this real and/or audiovisual content and the need to continue studying this practice is under discussion.

Climate change poses significant challenges for smallholder farmers worldwide, particularly in regions like sub-Saharan Africa, including Ethiopia, requiring effective coping strategies for resilience. This study examines farmers’ exposure to climatic shocks and their adoption of coping strategies. Findings from a survey of 646 farm households and qualitative discussions revealed farmers’ high vulnerability to climate-related hazards. Smallholder farmers rely on ex-ante coping strategies, including early planting (48.5%), income diversification (41.3%), increasing savings (42 %), water management (39.2%), and sowing drought-resistant varieties (37%). Similarly, they resort to ex-post coping techniques, such as reducing expenses (46.1%), utilizing savings (41.6%), changes in consumption patterns (39.5%), seeking assistance from relatives (23.5%), borrowing (17.6%), selling assets (11.9%), and migration for employment (8.7%). Farmers also encounter constraints such as limited access to weather information, inadequate extension services, weak institutional support, insufficient skills, high poverty levels, and limited access to innovations. Factors like land size, climate training, self-efficacy, cost-effectiveness perception, and hazard consequence perception positively influence farmers’ adoption of proactive strategies against climate change, while being male, older, less educated, owning a farm, limited access to extension services, and market constraints hinder anticipatory measures. Additionally, household head being male, education level, farm experience, land ownership, and access to climate information positively impact the implementation of ex-post strategies, whereas age, agroecology, infrequent extension worker visits, and limited road access have negative effects. Enhancing access to climate information, institutional support, and design policy with an understanding of these multifaceted contexts could substantially improve smallholder farmers’ resilience to climate change.

This article presents data collected through Computer-Assisted Web Interviewing (CAWI), conducted in Italy with the aim of exploring the Italian population's reaction to the Russian invasion of Ukraine in February 2022 and monitoring this reaction for the first six months of the attack through a six-round survey. Each round involved a representative sample of approximately 1010 (1007–1015) Italian adult citizens. Participants were asked questions about emotional reactions to the Russian invasion, coping strategies used, solidarity behaviour toward Ukrainian refugees, perceptions of refugees as a threat to the country, trust in national and international authorities to manage the international situation, and prospects for the future. Demographic data on the respondents were also collected. The survey design was developed by a research group from two universities (the University of Salento and the University of Foggia) and a European research centre, EICAP (European Institute of Cultural Analysis for Policy). The data provided in this article is a resource for researchers, public authorities, and other parties interested in surveying and studying public opinion. This dataset can be used to explore a wide range of topics, including prosocial behaviour and attitudes towards refugees in humanitarian emergencies.

Background: Compared to other occupational groups, first responders (FR) experience worse mental health outcomes due to duty-related trauma and occupational stressors. Despite their best efforts, they bring this stress home to friends and family. Consequently, FR and their supporters suffer from increased psychosocial difficulties and experience stigma and other barriers to help-seeking. Prior work offers little opportunity for open dialogue and shared understanding of the repercussions of this occupation for all members of the first responder community.In this qualitative study, we aimed to: (i) explore the lived experience of Irish FR and their family members (FM) related to occupational stressors, and (ii) identify opportunities to engage FM with existing organizational supports available for FR. Methods: Using a community based participatory research (CBPR) approach, we conducted six focus groups involving a total of fourteen participants comprising FR, organizational representatives, and FM. All focus groups were audio recorded, transcribed, and analyzed using reflexive thematic analysis. Findings: FR and FM shared their experiences of both joining and learning to live as members of the FR community in Ireland. Through our analysis, we identified a main theme of ‘crossing thresholds’, characterizing their transformative learning experiences. This learning experience includes recognizing the consequences of this new role for them as individuals and for their relationships. Participants also shared how they have learned to cope with the consequences of their roles and what they need to better support each other. Conclusions: FM are often unheard, hidden members of the first responder community in Ireland, highlighting an unmet need for FR organizations to acknowledge FM role in supporting FR and to provide them with the appropriate training and resources required. Training for new recruits needs to move beyond the tokenistic involvement of FM and encourage knowledge sharing among experienced and novice members. Cultural change is required to support help-seeking among FR and foster a sense of peer support and community among families.

Background: Numerous studies have reported the prevalence of psychological issues in anesthesia professionals during stressful situations like the COVID-19 pandemic; however, there are limited data exploring the coping strategies and work satisfaction in this workforce during the pandemic. Methodology: In this observational cross-sectional study, three validated questionnaires, namely, the Depression, Anxiety and Stress Scale 21, the Brief-Coping Orientation to Problems Experienced inventory, and the Work-related Sense of Coherence (Work-SoC) scale, were handed out to 150 anesthesia health-care providers (doctors and allied health staff [AHS]). The prevalence of depression, anxiety, and stress; Work-SoC conditions; and coping strategies were compared between groups of participants based on age (

Neuromuscular diseases (NMD) cover a broad spectrum of different rare diagnoses in which the primary lesion is in the peripheral nervous system. The impairment caused by an NMD does not only interfere with physical status but also has a clear impact on health-related quality of life (HRQoL). It is therefore essential to know the coping style used by these patients. This study aims to analyze the coping strategies in a sample of people with NMD and how their coping style affects their HRQoL. This cross-sectional study included 61 adult patients diagnosed with a rare NMD. WHO-DAS II, SIP, SF-36, and COPE-60 instruments were administered. The results showed that people affected by NMDs tend to use more frequent coping strategies such as active planning, personal growth, and acceptance. In contrast, the least-used strategies were restraint, mental disengagement, venting, humor, and religion, which affected HRQoL negatively. Moreover, the degree of disability was a relevant variable, with an impact on HRQoL. Social support can be considered the main coping strategy that leads to an improvement in the psychosocial HRQoL (β = 503, p < 0.001). These findings are relevant to clinical practice, given the need to understand the coping variable to improve HRQoL.

The study presents findings on comparative analysis of household food insecurity status among rice farmers in the Savanna and the Rainforest agro-ecological zones in Southwest States, Nigeria. Primary data were used and obtained through the administration of a well structured questionnaire. A multistage random sampling was used to select 577 rice farmers in the study area. Data were analyzed using descriptive statistics, household food insecurity access (HFIA) scale, household food insecurity access prevalence (HFIAP) scale, likert scale and linear regression model. The results revealed that majority of the rice farmer’s fall within 31-50 years of age bracket, with household size of 5-8 persons, married, with farming experiences and have small farm size. The findings from average household food insecurity access scale scores in the Savanna and the Rainforest agro-ecological zones were 4.0 (mildly food insecure) and 5.2 (moderately food insecure) respectively. The results of HFIAP indicator revealed that about 39.1% and 33.5% of respondents were classified as food secure, 8% and 13.9% were mildly food insecure, 15.1% and 22.2% were moderately food insecure and 37.8% and 30.4% were severely food insecure in the Savanna and the Rainforest agro-ecological zones respectively. The major coping strategies adopted by the respondents against food insecurity include reduce the quantity of food consumed and eating but not satisfied. The linear regression model revealed that age, sex, years in school, farm size, household size, farming experience, rice farming experience and tenure system significantly affect household’s food insecurity status. To transport from food insecure to food secure, age, sex, years in school, farm size, household size, farming experience, rice farming experience and tenure system alleviation policies are imperative.

Female minorities are represented scarcely in leadership positions within STEM. Previous research focused on increasing STEM education of minorities, not exploring the underlying issues affecting these groups in the workforce. It has driven the relevance of this study, which focuses on examining the intersectional experiences of cisgender, female minority leaders on their career paths, and examines the coping mechanisms which created resilience allowing these women to rise to high-level positions in STEM. The theoretical construct used is the 360-Degree Gender Sphere, which describes the barriers that prevent women from moving up the corporate ladder. The results of the study indicate that minority women who are leaders in STEM fields did indeed face a 360-Degree Gender Sphere, in particular challenges and obstacles from direct leaders, family, gender structures, themselves, peers and social norms. Further, they were encapsulated by a “360-degree intersectionality sphere” a peripheral and tangentially related outer layer of challenges and obstacles, including cultural stereotypes, cultural micro-attacks, cultural macro-aggressions, microaggressions from the H/R environment, cultural isolation, cultural doubts, cultural naivety, cultural micro-attacks, cultural stereotypical threats and geographical cultural macroaggression. The results also showed that women overcame these difficulties by creating resilience to these challenges that influenced their practice, education and leadership. The impact of this research can be useful in the process of initiating and shaping impulses for changes in society, women's communities, business, geopolitical formations and political systems in the world. The practical significance of this study is that it deepens the knowledge and equips minority females with information and skills for self-realization and successful career building in STEM fields.

With the advent of COVID-19 pandemic, the whole world is overwhelmed with a mood of fear, anxiety, depression and psychological discomfort. The Coronavirus has wrapped all aspects of life with a new mode so that the authorities concerned have imposed stay-at-home orders, curfews and restrictions on mass mobility and daily activities. These restrictions have given rise to unprecedented practices rarely available in pre-Coronavirus era. Consequently, the normal course of life has greatly changed and a new daily routine has been established during the COVID-19 pandemic whose impact on all life activities is characterized by being extensive and having far-reaching consequences. This paper investigates the COVID-19 repercussions in some purposively selected cartoons and comics from different websites. The selected cartoons and comics attempt to establish what may be called covidity, a neologism that requires collective and wide-spread response to the COVID-19 pandemic. It analyzes negative pandemic-related aspects that have bearing especially on travel, religious and sport activities. The study draws upon Kress and Leeuwen’s approach of Visual Grammar (2006) within the framework of social semiotics. The study probes Multimodal Discourse Analysis (MDA), which is mainly applied and opted for deeper examination of visual discourse maintained in the data under discussion. Multimodality is a concept that accounts for different semiotic resources in communication to express certain meanings or ideologies. The paper demonstrates how coping strategies help to alleviate the grim mood created by the pandemic and to get adapted to new circumstances. مع ظهور جائحة كوفيد-19، ساد العالم أجمع حالة من الخوف والقلق والانزعاج النفسي. لقد أضفى فيروس كورونا نمطا جديدا على كافة مناحي الحياة، مما دفع السلطات المعنية لإصدار تعليمات البقاء بالمنازل وحظر التجول والقيود على التنقل الجماعي والأنشطة اليومية. وقد أدت هذه القيود إلى ظهور ممارسات غير مسبوقة قلما تواجدت في فترة ما قبل فيروس كورونا. وبالتالي، تغير المسار الطبيعي للحياة بشكل كبير وظهر روتين يومي جديد خلال جائحة كوفيد-19 والذي كان له تأثير بالغ المدى على جميع أنشطة الحياة. تبحث هذه الدراسة تداعيات كوفيد-19 في بعض الرسوم الكرتونية والرسوم المضحكة المختارة من مواقع الكترونية مختلفة. تهدف البيانات المختارة إلى إرساء ما يمكن تسميته "بالكوفيدية"، وهو مصطلح جديد يتطلب استجابة جماعية وواسعة النطاق لجائحة كوفيد-19، ويحلل الجوانب السلبية المتعلقة بالوباء وتأثيرها لا سيما على السفر والأنشطة الدينية والرياضية. تعتمد الدراسة على منهج كريس وليوين في القواعد النحوية المرئية (2006) في إطار نظرية السيمائية الاجتماعية. كما تبحث الدراسة في تحليل الخطاب المتعدد الوسائط والذي يتم تطبيقه بشكل أساسي في تحليل الخطاب المرئي بصورة أشمل للبينات قيد الدراسة. إن تعدد الوسائط مفهوماً يفسر الوسائل السيمائية المختلفة في التواصل للتعبير عن معاني أو أيدولوجيات معينة. وتكشف الدراسة عن مدى مساهمة تلك الاستراتيجيات في التخفيف من حالة التجهم التي خلّفها الوباء والتأقلم مع الواقع الجديد.

Abstract Background The undergraduate first year of a nursing program is regarded as a difficult and challenging part of the nursing course, due to the variation experienced in the transition from basic to higher education compared to other first-year courses. This causes stress, which could contribute to students’ lack of coping with the transition to the university. These challenges call for coping strategies to ensure resilience among this cohort of undergraduate nursing students. Methods An exploratory descriptive qualitative research design was adopted to assess the coping mechanisms used by first-year nursing students during transition from basic to higher education. Data was gathered through four online focus group discussions which were conducted using the Microsoft Teams app, with participants purposefully selected from the two campuses where the study was conducted. The focus group discussions were recorded and transcribed verbatim for analysis. Data was analysed by the researcher and the co-coder using qualitative content data analysis. Findings Three categories emerged from the data: experiences of transition from basic to higher education, coping with transition from basic to higher education, and recommendations for coping with transition from basic to higher education. Participants expressed that they use the following six coping strategies during the transition from basic to higher education: adaptive coping, appraisal-focused coping, emotion-focused coping, problem-focused coping, social coping, and seeking help from mentors. Conclusions Transition from basic to higher education is challenging for undergraduate first-year nursing students. The study suggests that there is a need to standardize and contextualize the support measures for undergraduate first-year nursing students during their transition from basic to higher education in order to enhance their ability to cope.