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Perceived stress, coping, and adjustment in adolescents
Journal of Adolescent Health 38 (2006) 409 – 415
Original article
Perceived stress, coping, and adjustment in adolescents Petra Hampel, Ph.D.* and Franz Petermann, Ph.D. Center of Clinical Psychology and Rehabilitation, University of Bremen, Bremen, Germany Manuscript received September 8, 2004; manuscript accepted February 22, 2005
Abstract
Purpose: To investigate age and gender effects on perceived interpersonal stress, coping with interpersonal stressors, and psychological adjustment among early and middle adolescents. Furthermore, the associations of perceived stress and coping with adjustment were examined. Methods: The sample included 286 Austrian adolescents aged 10 to 14 years who attended the fifth to seventh grade. Self-report data on perceived stress, coping, as well as emotional and behavioral problems, were assessed. Results: Fifth graders scored lower on maladaptive coping strategies and externalizing problems and reported more adaptive coping strategies than sixth and seventh graders. Compared with boys, girls evaluated a higher amount of perceived interpersonal stress and used more social support. Additionally, girls scored higher on maladaptive coping strategies and emotional distress and scored lower on distraction than boys. Problem-focused and emotion-focused coping were negatively related to emotional and behavioral problems, whereas perceived stress and maladaptive coping was positively associated with adjustment problems. These relations were stronger in female than in male adolescents. Conclusions: Evaluating multidimensional coping patterns is supported. Particularly, implementation of primary preventive programs during late childhood is suggested. © 2006 Society for Adolescent Medicine. All rights reserved.
Key words:
Adolescents; Perceived stress; Coping; Adjustment
Recent research provided evidence for an augmented prevalence of behavioral and emotional problems in adolescence [1–3]. Thereby, more consistencies for increases in externalizing problems have been found [1,2]. Specifically, increases in internalizing disorders are reported among girls and externalizing disorders among boys [1]. Investigating the relationship between symptoms of psychopathology and psychological stress, Compas et al [4] have found that critical life events were not predictive of emotional and behavioral symptoms in adolescents. Interestingly, those critical life events have been shown to exert a cumulative adverse effect with daily stressors on adolescent emotional and behavioral symptoms [5], especially during periods of a heightened stress level [6]. *Address correspondence to: Dr. Petra Hampel, Center of Clinical Psychology and Rehabilitation, University of Bremen, Grazer Str. 6, 28359 Bremen, Germany. E-mail address: [email protected]
Further results have indicated that coping strategies were more closely related with psychological adjustment than stressors [6,7]. Overall, by distinguishing coping styles in more direct coping modes (i.e., problem-focused, primary control, or approach coping) and more indirect coping efforts (emotion-focused, secondary control, or avoidance coping); (for review see [8]), problem-focused coping was negatively associated, but emotion-focused coping positively correlated with internalizing and externalizing disorders [9]. However, some results suggest that adaptive and maladaptive coping strategies are confounded in these dichotomized dimensions. Thus, results strongly indicate that coping should be operationalized by a multidimensional concept (cf. [8,10]). Similar to Seiffge-Krenke [6] and Connor-Smith and Compas [11], in the present study a threefactor model of coping was examined to avoid a confounding of adaptive and maladaptive coping strategies. Thereby, coping styles were differentiated in two adaptive coping styles (emotion- and problem-focused coping) and one mal-
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adaptive coping style, which were represented by nine coping strategies. Emotion-focused coping comprised of minimization and distraction, problem-focused coping consisted of situation control, positive self-instructions, and social support; maladaptive coping included passive avoidance, rumination, resignation, and aggression. In general, previous studies have shown that adaptive coping strategies were linked with better psychological adjustment, but maladaptive coping strategies were related to less adjustment (e.g., [6,7,11–16]). Studies on the relationship between stress, coping, and psychological adjustment point to the importance of individual factors. Thereby, age and gender have contributed significantly to differences in the development of adolescent psychological symptoms. Despite these mixed results, findings can be summarized as follows: with increasing age, heightened stress was reported [17,18]. Additionally, maladaptive emotion-focused coping increased with age in some studies [9,19], but the adaptive emotion-focused coping strategy distraction decreased [20 –22]. For problemfocused coping strategies such as problem-solving a stable time course can be assumed, but meta-cognitive strategies such as cognitive restructuring enhanced during adolescence [6,20]. Maladaptive coping strategies such as resignation, rumination, aggression, and avoidance increased during adolescence [6,20,21]. In sum, adolescents are characterized by heightened stress levels and a maladaptive coping pattern, which are related to psychological malfunctioning. With regard to gender differences, increased perceived stress related to interpersonal stressors has been found in adolescent girls [22–26]. These stressors were associated with depression in girls but not in boys [25]. Moreover, girls applied more support seeking [19 –21,27,28]. In contrast, they scored higher on maladaptive emotional coping such as emotional ventilation [10,19], as well as maladaptive cognitive strategies such as avoidance and resignation [20,21,23]. Concerning the interaction effect, compared with younger girls, adolescent girls (aged 11 to 13) were characterized by a heightened perceived stress and a maladaptive coping pattern with decreased positive self-instructions and distraction in conjunction with increased rumination and resignation [21]. Nolen-Hoeksema [29] argued that ruminative coping is the most important risk factor for the development of depression in adolescent girls. To conclude, due to their augmented perceived stress and maladaptive coping pattern, early and middle adolescent girls are prone to develop internalizing disorders (cf. [29,30]). The main purpose of the present study was to investigate age and gender effects on perceived stress related to interpersonal stressors, coping with interpersonal stressors, and psychological adjustment among early and middle adolescents. Age-related increases in maladaptive coping and psychological symptoms were expected. Furthermore, it was predicted that girls, compared with boys, show higher interpersonal stress, a maladaptive coping pattern, and more
internalizing problems. In contrast, it was hypothesized that boys report more externalizing problems. The second aim of this study was to examine the associations of perceived stress and coping with emotional and behavioral problems. It was expected that adaptive coping is inversely linked with adjustment problems and maladaptive coping is positively linked. Method Sample and procedure Subjects of the present study were 286 adolescents recruited from three junior high schools in Graz, Austria. They were aged from 10 to 14 years (M ⫽ 11.89, SD ⫽ .96, 131 males, 155 females) and attended the fifth grade (n ⫽ 86, 37 males, 49 females, M ⫽ 10.78, SD ⫽ .50 years), sixth grade (n ⫽ 91, 43 males, 48 females, M ⫽ 11.86, SD ⫽ .51 years), and seventh grade, respectively (n ⫽ 109, 51 males, 58 females, M ⫽ 12.79, SD ⫽ .47 years). A chisquare test conducted on gender by grade indicated an equal distribution of sample sizes (2 (2) ⫽ .4, ns). Most of the sample (95.1%) were German native speakers; parents evaluated their socioeconomic status as average (28%) or good (72%). Moreover, parents estimated their children’s mental health. Participants were not diagnosed with psychiatric disorders. Subjects and their parents gave their written informed consent before the start of the study. The study was conducted in accordance with the guidelines of the Institutional Review Board of the University of Bremen (Germany). Twenty percent of the parents and subjects approached refused to participate in the study. Adolescents were asked to complete measures during class time supervised by trained graduate students of psychology. Measures Perceived stress. Stress related to interpersonal stressors was assessed by three items. Adolescents were asked to report how strongly they felt bothered by malicious gossip and by arguments with parents and a friend. Perceived stress was evaluated on a 5-point Likert scale, ranging from not at all (0) to strongly (4). The internal consistency measured by Cronbach alpha for the scale consisting of these three items was .65. Coping strategies. Coping strategies were measured by the German Coping Questionnaire for Children and Adolescents (Stressverarbeitungsfragebogen für Kinder und Jugendliche, SVF-KJ; [21,31,32]). In this self-report measure, coping responses were answered in relationship to two stress domains: interpersonal and academic stressors. The instrument consisted of 36 coping responses for each stress domain, measuring 9 coping strategies that were represented by 4 items each. Adolescents indicated on a 5-point Likert scale (0 ⫽ not at all, 4 ⫽ in any case) the likelihood
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of each coping response used. In the present study, coping with interpersonal stressors was analyzed, as social stressors were assumed to be more important in relationship to emotional and behavioral problems (cf. [9]). The factorial structure of the SVF-KJ has been validated in Hampel et al [31]. Assignments of items were confirmed by factor analysis in the present study. Likewise, factor analysis of subscales replicated three coping styles, which accounted for 66% of the total variance for coping with interpersonal stressors. According to Lazarus and Folkman [33], two adapative coping styles were labeled “emotionfocused coping” and “problem-focused coping.” Emotionfocused coping was represented by minimization (e.g., I say to myself: ‘It isn’t serious’) and distraction/recreation (e.g., I’m playing something). Problem-focused coping was composed by situation control (e.g., I try to figure out, what the problem is), positive self-instructions (e.g., I say to myself: “I can make it”), and social support (e.g., I’m asking for somebody’s advice). The third factor was labeled “maladaptive coping” and consisted of passive avoidance (e.g., I’d like to stay in bed), rumination (e.g., the situation rushes into my mind over and over again), resignation (e.g., I want to give up), and aggression (e.g., I’m getting a bad temper). Internal consistencies for the coping strategies used with interpersonal stressors ranged from .66 to .84 (mean Cronbach alpha ⫽ .72, Fisher’s z-transformed); Cronbach alphas for the emotion-focused, problem-focused, and maladaptive coping were .70, .82, and .82, respectively.
grade level (fifth, sixth, and seventh grade) and gender as between-subjects factors were carried out. In the present study, analyses on subscales were considered to examine age and gender differences in coping in more detail. With regard to multiple tests, the alpha level of the three multivariate analyses was corrected by Bonferroni procedure (p ⬍ .016). Effects on the three items of perceived stress, nine coping strategies, and four narrow-band scales were examined by univariate analyses of variance (ANOVAs). Post hoc mean comparisons using t-tests were performed to locate differences among the three age groups. To investigate the associations of perceived interpersonal stress and coping styles with emotional and behavioral problems, Pearson correlations were calculated. Thereby, a three-dimensional concept of coping was used to isolate effects of adaptive and maladaptive coping strategies. Moreover, instead of analyzing three single items, a total score for perceived interpersonal stress was used to minimize Type I error. As gender has been shown to exert a significant influence on perceived interpersonal stress, coping, and adjustment scores, correlation analyses were separately performed for both genders (cf. [9]). To control for the alpha error, only correlation coefficients with a significance level higher than p ⬍ .001 were considered.
Emotional and behavioral problems. The German version of the Reynolds Adolescent Adjustment Screening Inventory (RAASI; [34) was used to assess self-reported emotional and behavioral problems. The RAASI consisted of the following four subscales represented by 32 items: antisocial behavior (e.g., I broke the rules at school or at home), anger control problems (e.g., I lost my temper), emotional distress (e.g., I felt depressed or sad), and negative self (e.g., I felt good about myself). For a better understanding, the expression “positive self” used by Reynolds [34] was changed into “negative self.” In accordance to Reynolds, all items measured positive self but the raw scores were inverted for further statistical analyses. Adolescents indicated the frequency of each behavior or mood during the last 6 months on a 3-point Likert scale (0 ⫽ never or almost never, 1 ⫽ sometimes, 2 ⫽ nearly all the time). A good reliability and validity has been demonstrated for the RAASI [34]. With the present sample, factor analysis on the items supported the assignment of items to four factors, explaining 47% of the total variance. Internal consistencies measured by Cronbach alpha for antisocial behavior were .82, anger control problems .77, emotional distress .87, and negative self .64.
Perceived stress. A MANOVA revealed a significant main effect of gender, but the main effect of grade level and the interaction effect were not statistically significant (Wilks’ FGRADE (6,556) ⫽ 1.23, ns; Wilks’ FGENDER (3,278) ⫽ 7.89, p ⬍ .001; Wilks’ FGRADE by GENDER (6,556) ⫽ 1.21, ns). Means and SDs for both main effects are depicted in Table 1. Univariate ANOVAs yielded significant gender main effects on all items; compared with boys, girls reported higher interpersonal stress.
Statistical analyses. Multivariate analyses of variance (MANOVAs) on perceived stress, coping strategies, and narrow-band scales of psychological adjustment using the
Results Age and gender differences
Coping strategies. A MANOVA investigating the different utilization of coping strategies revealed significant main effects of the grade level and gender (Wilks’ FGRADE (18,554) ⫽ 2.40, p ⬍ .001; Wilks’ FGENDER (9,272) ⫽ 3.71, p ⬍ .001). The grade-by-gender interaction effect was not significant (Wilks’ F (18,544) ⫽1.00, ns). Means and SDs for both main effects are presented in Table 2. For age group differences, univariate ANOVAs yielded significant main effects of grade level on the emotion-focused strategy distraction, all problem-focused coping strategies as well as on the maladaptive coping strategy aggression. Post hoc Student’s t-tests suggested that fifth graders used significantly more distraction, positive self-instructions, and social support than both older age groups. Moreover, fifth graders employed substantially more situation control than seventh graders. Finally, fifth graders scored significantly lower on aggression than both older age groups. With regard to gen-
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Table 1 Means (M) and standard deviations (SD) for perceived interpersonal stress for main effects of grade level and gender and summary of ANOVA results Scale
Grade level Grade 5 (n ⫽ 86)
PA FA MG
Grade 6 (n ⫽ 91)
Gender Grade 7 (n ⫽ 109)
Male (n ⫽ 131)
Factor Female (n ⫽ 155)
M
SD
M
SD
M
SD
M
SD
M
SD
1.38 1.49 1.16
(1.30) (1.22) (1.14)
1.49 1.92 1.30
(1.21) (1.28) (1.20)
1.47 1.82 1.24
(1.14) (1.16) (1.11)
1.28 1.42 0.97
(1.13) (1.20) (1.01)
1.59 2.03 1.46
(1.26) (1.18) (1.20)
Grade
Gender
Grade by gender
F (2,280)
F (1,280)
F (2,280)
.17 3.45* .56
4.29* 19.14*** 13.18***
.74 .26 2.33
PA ⫽ argument with parents; FA ⫽ argument with a friend; MC ⫽ malicious gossip. * p ⬍ .05; *** p ⬍ .001.
der differences, univariate ANOVAs revealed significant gender main effects on the emotion-focused strategy distraction, the problem-focused strategy social support, and the maladaptive coping strategies passive avoidance, rumination, and resignation, suggesting that girls employed significantly more social support, passive avoidance, rumination, and resignation but less distraction than boys.
Associations of perceived stress and coping with emotional and behavioral problems For girls, perceived interpersonal stress was substantially related with more anger control problems and emotional distress (Table 4). Emotion-focused coping was negatively correlated with all subscales. Problem-focused coping was negatively associated with anger control problems and negative self. Additionally, maladaptive coping was positively related to anger control problems, emotional distress, and negative self. For boys, perceived interpersonal stress was substantially linked with emotional distress. Emotion-focused coping was not substantially associated with adjustment scores. Problem-focused coping was negatively correlated with negative self only. Maladaptive coping was positively related to emotional distress and negative self.
Emotional and behavioral problems. A MANOVA examining effects of grade level and gender on the subscales revealed significant main effects of grade level and gender (Wilks’ FGRADE (8,554) ⫽ 3.12, p ⬍ .01; Wilks’ FGENDER (4,277) ⫽ 5.79, p ⬍ .001). The interaction effect was not statistically significant (Wilks’ F (8,554) ⫽ 1.77, p ⬍ .10). Means and SDs for both main effects are shown in Table 3. Univariate ANOVAs yielded significant main effects of grade level on antisocial behavior and anger control problems. Post hoc Student’s t-tests detected that fifth graders reported significantly less antisocial behavior and anger control problems than both older age groups. Univariate ANOVAs provided a significant effect of gender on emotional distress, suggesting that girls reported more emotional distress than boys.
Discussion The first aim of this study was to examine age and gender effects on perceived interpersonal stress, coping with interpersonal stressors, and psychological adjustment among ad-
Table 2 Means (M) and standard deviations (SD) for coping strategies for main effects of grade level and gender and summary of ANOVA results Scale
Grade level Grade 5 (n ⫽ 86)
MIN DIS STC POS SOS PAV RUM RES AGG
Grade 6 (n ⫽ 91)
Gender Grade 7 (n ⫽ 109)
Male (n ⫽ 131)
Factor Female (n ⫽ 155)
Grade
Gender
Grade by gender
M
SD
M
SD
M
SD
M
SD
M
SD
F (2,280)
F (1,280)
F (2,280)
2.27 2.06a 2.94a 2.92a 2.69a 1.63 2.04 0.91 1.33a
(.78) (.80) (.68) (.78) (.87) (.88) (.90) (.76) (.81)
2.09 1.79b 2.74a,b 2.64b 2.16b 1.76 2.04 1.02 1.58b
(.85) (.86) (.73) (.70) (1.01) (.98) (1.01) (.75) (.87)
2.28 1.70b 2.66b 2.61b 2.12b 1.90 2.07 1.17 1.68b
(.78) (.78) (.71) (.80) (.92) (.96) (.94) (.84) (.74)
2.27 1.94 2.75 2.76 2.10 1.64 1.81 0.85 1.47
(.82) (.75) (.75) (.71) (.98) (.89) (.97) (.70) (.81)
2.17 1.76 2.78 2.68 2.48 1.89 2.25 1.21 1.60
(.80) (.88) (.69) (.82) (.92) (.98) (.89) (.83) (.81)
1.92 5.16** 4.22* 4.78** 11.82*** 2.05 .01 2.84 5.14**
.83 3.94* .04 1.03 10.32** 5.16* 14.03*** 15.11*** 2.34
1.58 .01 1.60 .52 3.28* .40 1.72 .41 .21
Mean scores with different indices are significant at the .05 level using t-tests. MIN ⫽ minimization; DIS ⫽ distraction/recreation; STC ⫽ situation control; POS ⫽ positive self-instructions; SOS ⫽ social support; PAV ⫽ passive avoidance; RUM ⫽ rumination; RES ⫽ resignation; AGG ⫽ aggression. * p ⬍ .05; ** p ⬍ .01; *** p ⬍ .001.
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Table 3 Means (M) and standard deviations (SD) for emotional and behavioral problems for main effects of grade level and gender and summary of ANOVA results Scale
Grade level Grade 5 (n ⫽ 86) M a
AB AC ED NS
.18 .37a .56 .51
Grade 6 (n ⫽ 91)
SD
M
SD
b
(.23) (.29) (.35) (.35)
.31 .49b .64 .59
(.31) (.38) (.46) (.35)
Gender Grade 7 (n ⫽ 109) M b
.39 .51b .56 .53
Male (n ⫽ 131)
Factor Female (n ⫽ 155)
SD
M
SD
M
SD
(.41) (.38) (.44) (.37)
.33 .47 .48 .52
(.32) (.34) (.34) (.34)
.28 .45 .68 .56
(.36) (.38) (.46) (.38)
Grade
Gender
Grade by gender
F (2,280)
F (1,280)
F (2,280)
9.95*** 4.16* 1.28 1.20
1.63 .17 16.03** 1.38
.01 .57 1.44 2.32
Mean scores with different indices are significant at the .05 level using t-tests. AB ⫽ antisocial behavior; AC ⫽ anger control problems; ED ⫽ emotional distress; NS ⫽ negative self * p ⬍ .05; ** p ⬍ .01; *** p ⬍ .001.
olescents aged 10 to 14 years. Therefore, adolescents were asked to complete the German Coping Questionnaire for Children and Adolescents designed by Hampel et al [31], which assessed nine coping strategies representing the coping styles “emotion-focused coping,” “problem-focused coping,” and “maladaptive coping.” Moreover, stress related to three common interpersonal stressors was examined. Finally, externalizing problems (antisocial behavior, anger control problems) and internalizing problems (emotional distress and negative self) were measured by the RAASI designed by Reynolds [34]. Previous studies in adolescents provided some evidence for the reliability and validity of comparable coping styles and psychological adjustment scores (e.g., [6,9]). As expected, adolescents in the sixth and seventh grade were characterized by decreases in adaptive coping strategies and increases in maladaptive coping strategies. Moreover, consistent with the hypotheses, externalizing Table 4 Pearson correlations of perceived stress and coping with emotional and behavioral problems Score
Girls (n ⫽ 155) PS EMO PRB MCO Boys (n ⫽ 131) PS EMO PRB MCO
Emotional and behavioral problems AB
AC
ED
NS
.25** ⫺.29*** ⫺.24** .26**
.33*** ⫺.33*** ⫺.36*** .47***
.52*** ⫺.42*** ⫺.27** .57***
.21** ⫺.38*** ⫺.41*** .37***
.06 ⫺.07 ⫺.21* .14
.28** ⫺.23** ⫺.27** .26**
.34*** ⫺.08 ⫺.06 .45***
.25** ⫺.18* ⫺.33*** .31***
AB ⫽ antisocial behavior; AC ⫽ anger control problems; ED ⫽ emotional distress; NS ⫽ negative self; PS ⫽ perceived stress; EMO ⫽ emotion-focused coping; PRB ⫽ problem-focused coping, MCO ⫽ maladaptive coping. Correlations with p ⬍ .001 are significant after Bonferroni correction. * p ⬍ .05; ** p ⬍ .01; *** p ⬍ .001.
problems were increased. Unexpectedly, age group differences in internalizing problems failed to reach significance. Thus, in good agreement with the literature, a maladaptive coping pattern was found in middle adolescents (aged 12–14 years [6,20,21]). Supporting earlier results, this maladaptive coping pattern was accompanied by enhanced behavioral problems (cf. [1,2]). The stability in emotional problems was also reported by Cohen et al [1] and Dekovic et al [2]. With regard to gender, girls, compared with boys, have shown higher perceived interpersonal stress. In addition, they applied more support seeking but less distraction on social stress encounters, scored higher on passive avoidance, rumination, and resignation, and reported more emotional distress than boys. These results are in line with findings showing increased responses to interpersonal stressors in girls [22,24 –26]. Additionally, results on support seeking are congruent with previous findings, suggesting that girls strongly rely on social relationships [6,19,24,25,30]. Rudolph [24] emphasized that the enormous concern about social relationships moderates the vulnerability of girls to emotional problems, such as deficits in self-esteem or anxiety/depression. Other studies provided evidence for the negative impact of rumination on the development of emotional disorders in girls [13,29]. Unexpectedly, girls and boys did not differ in externalizing problems that may be due to the restricted age group and the sample belonging to middle-class families. In contrast to other studies, interaction effects were not ascertained; studies investigating German children and adolescents aged 8 to 14 years have found increased perceived interpersonal stress and a maladaptive coping pattern among female adolescents compared with female children [21]. Thus, these interaction effects may be attributed to different age groups. The second aim of this study was to determine the associations of perceived interpersonal stress and coping styles with emotional and behavioral problems. For boys, results support only a negative relation of perceived in-
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terpersonal stress with emotional distress. In girls, perceived interpersonal stress was related to anger control problems and emotional distress. These findings point to the assumption that perceived interpersonal stress may have a negative impact on emotional and behavioral problems in girls but a singular negative influence on emotional problems in boys. Consistent with recent results, problem-focused coping was associated with less adjustment problems [9], which also confirms other results that active or approach coping is a protective factor for internalizing disorders [15]. As predicted, emotion-focused coping, which was represented by adaptive coping strategies, was related to less adjustment problems. Accordingly, in a study conducted by Wadsworth and Compas [16], secondary control coping, which was similarly operationalized as the emotion-focused coping in the present study, was related to fewer anxiety/depression and aggression problems. These findings lend support to the assumption that the positive correlations found in the study by Compas et al [9] are explained by the operationalization of this scale. These authors mentioned that the majority of their items that measured emotion-focused coping reflected aggressive behavior. In line with the literature on maladaptive coping strategies such as anger, avoidant, or disengagement coping, in the present study maladaptive coping was associated with more emotional and behavioral problems [6,7,11–16]. Thus, some support was found that maladaptive coping is a risk factor in the development of emotional and behavioral symptoms in adolescence. In the present study, these relations were higher in girls than in boys, confirming earlier results [9,12]. It can be assumed that girls are more responsive to interpersonal stressors and are characterized by increased efforts in coping with social stressors. In sum, this study provided evidence for a maladaptive coping pattern in middle adolescents. Moreover, a heightened perceived interpersonal stress and a maladaptive coping pattern have been shown in girls. The results point to the importance of the implementation of primary preventive programs in children. Additionally, secondary preventive programs that are constructed in dependence of age and gender should be conducted. Those programs were evaluated to improve children’s and adolescents’ coping strategies and their well-being (for review see [35]). Results of this study are limited to the sample, which included European adolescents of middle-class families. Furthermore, findings relied on the use of selfreport data, and a causal directionality has to be determined by longitudinal studies. Conclusively, in the majority of earlier studies in which a dichotomization of coping styles was applied, adaptive and maladaptive coping strategies were confounded. The three-dimensional concept of coping, which differentiates between two adaptive styles and one maladaptive coping style and is
represented by nine coping strategies, is supported by the results of this study. A multidimensional assessment of coping enables a detailed diagnosis of deficits and resources that can be modified by therapeutic interventions. Furthermore, a better evaluation of therapeutic effects can be obtained.
References [1] Cohen P, Cohen J, Kasen S, et al. An epidemiological study of disorders in late childhood and adolescence. I. Age- and genderspecific prevalence. J Child Psychol Psychiatry 1993;34:851– 67. [2] Dekovic M, Buist KL, Reitz E. Stability and changes in problem behavior during adolescence: latent growth analysis. J Youth Adolesc 2004;33:1–12. [3] Steinhausen H-C, Winkler Metzke C, Meier M, et al. Prevalence of child and adolescent psychiatric disorders: the Zürich epidemiological study. Acta Psychiatr Scand 1998;98:262–71. [4] Compas BE, Howell DC, Phares V, et al. Risk factors for emotional and behavioral problems in young adolescents: a prospective analysis of adolescent and parental stress and symptoms. J Consult Clin Psychol 1989;57:732– 40. [5] Wagner BM, Compas BE, Howell DC. Daily and major life events: a test of an integrative model of psychosocial stress. Am J Community Psychol 1988;16:189 –205. [6] Seiffge-Krenke I. Causal links between stressful events, coping style, and adolescent symptomatology. J Adolesc 2000;23:675–91. [7] Herman-Stahl MA, Stemmler M, Petersen AC. Approach and avoidant coping: implications for adolescent mental health. J Youth Adolesc 1995;24:649 – 65. [8] Compas BE, Connor-Smith JK, Saltzman H, et al. Coping with stress during childhood and adolescence: problems, progress, and potential in theory and research. Psychol Bull 2001;127:87–127. [9] Compas BE, Malcarne VL, Fondacaro KM. Coping with stressful events in older children and young adolescents. J Consult Clin Psychol 1988;56:405–11. [10] Connor-Smith JK, Compas BE, Wadsworth ME, et al. Responses to stress in adolescence: measurement of coping and involuntary stress responses. J Consult Clin Psychol 2000;68:976 –92. [11] Connor-Smith JK, Compas BE. Vulnerability to social stressors: coping as a mediator or moderator of sociotropy and symptoms of anxiety and depression. Cognit Ther Res 2002;26:39 –55. [12] Galaif ER, Sussman S, Chou CP, et al. Longitudinal relations among depression, stress, and coping in high risk youth. J Youth Adolesc 2003;32:243–58. [13] Garnefski N, Boon S, Kraaji V. Relationships between cognitive strategies of adolescents and depressive symptomatology across different types of life event. J Youth Adolesc 2003;32:401– 8. [14] Seiffge-Krenke I, Klessinger N. Long-term effects of avoidant coping on adolescents= depressive symptoms. J Youth Adolesc 2000;29:617– 30. [15] Steinhausen H-C, Winkler Metzke C. Risk, compensatory, vulnerability, and protective factors influencing mental health in adolescence. J Youth Adolesc 2001;30:259 – 80. [16] Wadsworth ME, Compas BE. Coping with family conflict and economic strain: the adolescent perspective. J Res Adolesc 2002;12:243– 74. [17] Ge X, Lorenz FO, Conger RD, et al. Trajectories of stressful life events and depressive symptoms during adolescence. Dev Psychol 1994;30:467– 83. [18] Larson R, Ham M. Stress and “storm and stress” in early adolescence: the relationships of negative events with dysphoric affect. Dev Psychol 1993;29:130 – 40.
Hampel and Petermann / Journal of Adolescent Health 38 (2006) 409 – 415 [19] Frydenberg E, Lewis R. Boys play sport and girls turn to others: age, gender and ethnicity as determinants of coping. J Adolesc 1993;16: 253– 66. [20] Donaldson D, Prinstein M, Danovsky M, Spirito A. Patterns of children=s coping with life stress: implications for clinicians. Am J Orthopsychiatry 2000;70:351–9. [21] Hampel P, Petermann F. Age and gender effects on coping in children and adolescents. J Youth Adolesc 2005;34:73-83. [22] Spirito A, Stark LJ, Grace N, et al. Common problems and coping strategies reported in childhood and early adolescence. J Youth Adolesc 1991;20:531– 44. [23] Griffith MA, Dubow EF, Ippolito MF. Developmental and crosssituational differences in adolescents’ coping strategies. J Youth Adolesc 2000;29:183–204. [24] Rudolph KD. Gender differences in emotional responses to interpersonal stress during adolescence. J Adolesc Health 2002;30(suppl):3– 13. [25] Rudolph KD, Hammen C. Age and gender as determinants of stress exposure, generation, and reactions in youngsters: a transactional perspective. Child Dev 1999;70:660 –77. [26] Stark LJ, Spirito A, Williams CA, et al. Common problems and coping strategies: findings with normal adolescents. J Abnorm Child Psychol 1989;17:203–12.
415
[27] de Anda D, Baroni S, Boskin L, et al. Stress, stressors and coping strategies among high school students. Child Youth Serv Rev 2000; 22:441– 63. [28] Roecker CE, Dubow EF, Donaldson D. Cross-situational patterns in children’s coping with observed interpersonal conflict. J Clin Child Psychol 1996;25:288 –99. [29] Nolen-Hoeksema S. Sex differences in unipolar depression: evidence and theory. Psychol Bull 1987;101:259 – 82. [30] Compas BE, Orosan PG, Grant KE. Adolescent stress and coping: implications for psychopathology during adolescence. J Adolesc 1993;16:331– 49. [31] Hampel P, Petermann F, Dickow B. The German Coping Questionnaire by Janke and Erdmann adapted for children and adolescents (German). Göttingen, Hogrefe, 2001. [32] Hampel P, Dickow B, Petermann F. Reliability and validity of the German Coping Questionnaire for Children and Adolescents (German). Z Diff Diagn Psychol 2002;23:273– 89. [33] Lazarus RS, Folkman S. Stress, Appraisal and Coping. New York, NY: Springer, 1984. [34] Reynolds WM. Reynolds Adolescent Adjustment Screening Inventory – RAASI. Odessa, FL: Psychological Assessment Resources, 2001. [35] Maag JW, Kotlash J. Review of stress inoculation training with children and adolescents. Behav Modif 1994;18:443– 69.
Original article
Perceived stress, coping, and adjustment in adolescents Petra Hampel, Ph.D.* and Franz Petermann, Ph.D. Center of Clinical Psychology and Rehabilitation, University of Bremen, Bremen, Germany Manuscript received September 8, 2004; manuscript accepted February 22, 2005
Abstract
Purpose: To investigate age and gender effects on perceived interpersonal stress, coping with interpersonal stressors, and psychological adjustment among early and middle adolescents. Furthermore, the associations of perceived stress and coping with adjustment were examined. Methods: The sample included 286 Austrian adolescents aged 10 to 14 years who attended the fifth to seventh grade. Self-report data on perceived stress, coping, as well as emotional and behavioral problems, were assessed. Results: Fifth graders scored lower on maladaptive coping strategies and externalizing problems and reported more adaptive coping strategies than sixth and seventh graders. Compared with boys, girls evaluated a higher amount of perceived interpersonal stress and used more social support. Additionally, girls scored higher on maladaptive coping strategies and emotional distress and scored lower on distraction than boys. Problem-focused and emotion-focused coping were negatively related to emotional and behavioral problems, whereas perceived stress and maladaptive coping was positively associated with adjustment problems. These relations were stronger in female than in male adolescents. Conclusions: Evaluating multidimensional coping patterns is supported. Particularly, implementation of primary preventive programs during late childhood is suggested. © 2006 Society for Adolescent Medicine. All rights reserved.
Key words:
Adolescents; Perceived stress; Coping; Adjustment
Recent research provided evidence for an augmented prevalence of behavioral and emotional problems in adolescence [1–3]. Thereby, more consistencies for increases in externalizing problems have been found [1,2]. Specifically, increases in internalizing disorders are reported among girls and externalizing disorders among boys [1]. Investigating the relationship between symptoms of psychopathology and psychological stress, Compas et al [4] have found that critical life events were not predictive of emotional and behavioral symptoms in adolescents. Interestingly, those critical life events have been shown to exert a cumulative adverse effect with daily stressors on adolescent emotional and behavioral symptoms [5], especially during periods of a heightened stress level [6]. *Address correspondence to: Dr. Petra Hampel, Center of Clinical Psychology and Rehabilitation, University of Bremen, Grazer Str. 6, 28359 Bremen, Germany. E-mail address: [email protected]
Further results have indicated that coping strategies were more closely related with psychological adjustment than stressors [6,7]. Overall, by distinguishing coping styles in more direct coping modes (i.e., problem-focused, primary control, or approach coping) and more indirect coping efforts (emotion-focused, secondary control, or avoidance coping); (for review see [8]), problem-focused coping was negatively associated, but emotion-focused coping positively correlated with internalizing and externalizing disorders [9]. However, some results suggest that adaptive and maladaptive coping strategies are confounded in these dichotomized dimensions. Thus, results strongly indicate that coping should be operationalized by a multidimensional concept (cf. [8,10]). Similar to Seiffge-Krenke [6] and Connor-Smith and Compas [11], in the present study a threefactor model of coping was examined to avoid a confounding of adaptive and maladaptive coping strategies. Thereby, coping styles were differentiated in two adaptive coping styles (emotion- and problem-focused coping) and one mal-
1054-139X/06/$ – see front matter © 2006 Society for Adolescent Medicine. All rights reserved. doi:10.1016/j.jadohealth.2005.02.014
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adaptive coping style, which were represented by nine coping strategies. Emotion-focused coping comprised of minimization and distraction, problem-focused coping consisted of situation control, positive self-instructions, and social support; maladaptive coping included passive avoidance, rumination, resignation, and aggression. In general, previous studies have shown that adaptive coping strategies were linked with better psychological adjustment, but maladaptive coping strategies were related to less adjustment (e.g., [6,7,11–16]). Studies on the relationship between stress, coping, and psychological adjustment point to the importance of individual factors. Thereby, age and gender have contributed significantly to differences in the development of adolescent psychological symptoms. Despite these mixed results, findings can be summarized as follows: with increasing age, heightened stress was reported [17,18]. Additionally, maladaptive emotion-focused coping increased with age in some studies [9,19], but the adaptive emotion-focused coping strategy distraction decreased [20 –22]. For problemfocused coping strategies such as problem-solving a stable time course can be assumed, but meta-cognitive strategies such as cognitive restructuring enhanced during adolescence [6,20]. Maladaptive coping strategies such as resignation, rumination, aggression, and avoidance increased during adolescence [6,20,21]. In sum, adolescents are characterized by heightened stress levels and a maladaptive coping pattern, which are related to psychological malfunctioning. With regard to gender differences, increased perceived stress related to interpersonal stressors has been found in adolescent girls [22–26]. These stressors were associated with depression in girls but not in boys [25]. Moreover, girls applied more support seeking [19 –21,27,28]. In contrast, they scored higher on maladaptive emotional coping such as emotional ventilation [10,19], as well as maladaptive cognitive strategies such as avoidance and resignation [20,21,23]. Concerning the interaction effect, compared with younger girls, adolescent girls (aged 11 to 13) were characterized by a heightened perceived stress and a maladaptive coping pattern with decreased positive self-instructions and distraction in conjunction with increased rumination and resignation [21]. Nolen-Hoeksema [29] argued that ruminative coping is the most important risk factor for the development of depression in adolescent girls. To conclude, due to their augmented perceived stress and maladaptive coping pattern, early and middle adolescent girls are prone to develop internalizing disorders (cf. [29,30]). The main purpose of the present study was to investigate age and gender effects on perceived stress related to interpersonal stressors, coping with interpersonal stressors, and psychological adjustment among early and middle adolescents. Age-related increases in maladaptive coping and psychological symptoms were expected. Furthermore, it was predicted that girls, compared with boys, show higher interpersonal stress, a maladaptive coping pattern, and more
internalizing problems. In contrast, it was hypothesized that boys report more externalizing problems. The second aim of this study was to examine the associations of perceived stress and coping with emotional and behavioral problems. It was expected that adaptive coping is inversely linked with adjustment problems and maladaptive coping is positively linked. Method Sample and procedure Subjects of the present study were 286 adolescents recruited from three junior high schools in Graz, Austria. They were aged from 10 to 14 years (M ⫽ 11.89, SD ⫽ .96, 131 males, 155 females) and attended the fifth grade (n ⫽ 86, 37 males, 49 females, M ⫽ 10.78, SD ⫽ .50 years), sixth grade (n ⫽ 91, 43 males, 48 females, M ⫽ 11.86, SD ⫽ .51 years), and seventh grade, respectively (n ⫽ 109, 51 males, 58 females, M ⫽ 12.79, SD ⫽ .47 years). A chisquare test conducted on gender by grade indicated an equal distribution of sample sizes (2 (2) ⫽ .4, ns). Most of the sample (95.1%) were German native speakers; parents evaluated their socioeconomic status as average (28%) or good (72%). Moreover, parents estimated their children’s mental health. Participants were not diagnosed with psychiatric disorders. Subjects and their parents gave their written informed consent before the start of the study. The study was conducted in accordance with the guidelines of the Institutional Review Board of the University of Bremen (Germany). Twenty percent of the parents and subjects approached refused to participate in the study. Adolescents were asked to complete measures during class time supervised by trained graduate students of psychology. Measures Perceived stress. Stress related to interpersonal stressors was assessed by three items. Adolescents were asked to report how strongly they felt bothered by malicious gossip and by arguments with parents and a friend. Perceived stress was evaluated on a 5-point Likert scale, ranging from not at all (0) to strongly (4). The internal consistency measured by Cronbach alpha for the scale consisting of these three items was .65. Coping strategies. Coping strategies were measured by the German Coping Questionnaire for Children and Adolescents (Stressverarbeitungsfragebogen für Kinder und Jugendliche, SVF-KJ; [21,31,32]). In this self-report measure, coping responses were answered in relationship to two stress domains: interpersonal and academic stressors. The instrument consisted of 36 coping responses for each stress domain, measuring 9 coping strategies that were represented by 4 items each. Adolescents indicated on a 5-point Likert scale (0 ⫽ not at all, 4 ⫽ in any case) the likelihood
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of each coping response used. In the present study, coping with interpersonal stressors was analyzed, as social stressors were assumed to be more important in relationship to emotional and behavioral problems (cf. [9]). The factorial structure of the SVF-KJ has been validated in Hampel et al [31]. Assignments of items were confirmed by factor analysis in the present study. Likewise, factor analysis of subscales replicated three coping styles, which accounted for 66% of the total variance for coping with interpersonal stressors. According to Lazarus and Folkman [33], two adapative coping styles were labeled “emotionfocused coping” and “problem-focused coping.” Emotionfocused coping was represented by minimization (e.g., I say to myself: ‘It isn’t serious’) and distraction/recreation (e.g., I’m playing something). Problem-focused coping was composed by situation control (e.g., I try to figure out, what the problem is), positive self-instructions (e.g., I say to myself: “I can make it”), and social support (e.g., I’m asking for somebody’s advice). The third factor was labeled “maladaptive coping” and consisted of passive avoidance (e.g., I’d like to stay in bed), rumination (e.g., the situation rushes into my mind over and over again), resignation (e.g., I want to give up), and aggression (e.g., I’m getting a bad temper). Internal consistencies for the coping strategies used with interpersonal stressors ranged from .66 to .84 (mean Cronbach alpha ⫽ .72, Fisher’s z-transformed); Cronbach alphas for the emotion-focused, problem-focused, and maladaptive coping were .70, .82, and .82, respectively.
grade level (fifth, sixth, and seventh grade) and gender as between-subjects factors were carried out. In the present study, analyses on subscales were considered to examine age and gender differences in coping in more detail. With regard to multiple tests, the alpha level of the three multivariate analyses was corrected by Bonferroni procedure (p ⬍ .016). Effects on the three items of perceived stress, nine coping strategies, and four narrow-band scales were examined by univariate analyses of variance (ANOVAs). Post hoc mean comparisons using t-tests were performed to locate differences among the three age groups. To investigate the associations of perceived interpersonal stress and coping styles with emotional and behavioral problems, Pearson correlations were calculated. Thereby, a three-dimensional concept of coping was used to isolate effects of adaptive and maladaptive coping strategies. Moreover, instead of analyzing three single items, a total score for perceived interpersonal stress was used to minimize Type I error. As gender has been shown to exert a significant influence on perceived interpersonal stress, coping, and adjustment scores, correlation analyses were separately performed for both genders (cf. [9]). To control for the alpha error, only correlation coefficients with a significance level higher than p ⬍ .001 were considered.
Emotional and behavioral problems. The German version of the Reynolds Adolescent Adjustment Screening Inventory (RAASI; [34) was used to assess self-reported emotional and behavioral problems. The RAASI consisted of the following four subscales represented by 32 items: antisocial behavior (e.g., I broke the rules at school or at home), anger control problems (e.g., I lost my temper), emotional distress (e.g., I felt depressed or sad), and negative self (e.g., I felt good about myself). For a better understanding, the expression “positive self” used by Reynolds [34] was changed into “negative self.” In accordance to Reynolds, all items measured positive self but the raw scores were inverted for further statistical analyses. Adolescents indicated the frequency of each behavior or mood during the last 6 months on a 3-point Likert scale (0 ⫽ never or almost never, 1 ⫽ sometimes, 2 ⫽ nearly all the time). A good reliability and validity has been demonstrated for the RAASI [34]. With the present sample, factor analysis on the items supported the assignment of items to four factors, explaining 47% of the total variance. Internal consistencies measured by Cronbach alpha for antisocial behavior were .82, anger control problems .77, emotional distress .87, and negative self .64.
Perceived stress. A MANOVA revealed a significant main effect of gender, but the main effect of grade level and the interaction effect were not statistically significant (Wilks’ FGRADE (6,556) ⫽ 1.23, ns; Wilks’ FGENDER (3,278) ⫽ 7.89, p ⬍ .001; Wilks’ FGRADE by GENDER (6,556) ⫽ 1.21, ns). Means and SDs for both main effects are depicted in Table 1. Univariate ANOVAs yielded significant gender main effects on all items; compared with boys, girls reported higher interpersonal stress.
Statistical analyses. Multivariate analyses of variance (MANOVAs) on perceived stress, coping strategies, and narrow-band scales of psychological adjustment using the
Results Age and gender differences
Coping strategies. A MANOVA investigating the different utilization of coping strategies revealed significant main effects of the grade level and gender (Wilks’ FGRADE (18,554) ⫽ 2.40, p ⬍ .001; Wilks’ FGENDER (9,272) ⫽ 3.71, p ⬍ .001). The grade-by-gender interaction effect was not significant (Wilks’ F (18,544) ⫽1.00, ns). Means and SDs for both main effects are presented in Table 2. For age group differences, univariate ANOVAs yielded significant main effects of grade level on the emotion-focused strategy distraction, all problem-focused coping strategies as well as on the maladaptive coping strategy aggression. Post hoc Student’s t-tests suggested that fifth graders used significantly more distraction, positive self-instructions, and social support than both older age groups. Moreover, fifth graders employed substantially more situation control than seventh graders. Finally, fifth graders scored significantly lower on aggression than both older age groups. With regard to gen-
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Table 1 Means (M) and standard deviations (SD) for perceived interpersonal stress for main effects of grade level and gender and summary of ANOVA results Scale
Grade level Grade 5 (n ⫽ 86)
PA FA MG
Grade 6 (n ⫽ 91)
Gender Grade 7 (n ⫽ 109)
Male (n ⫽ 131)
Factor Female (n ⫽ 155)
M
SD
M
SD
M
SD
M
SD
M
SD
1.38 1.49 1.16
(1.30) (1.22) (1.14)
1.49 1.92 1.30
(1.21) (1.28) (1.20)
1.47 1.82 1.24
(1.14) (1.16) (1.11)
1.28 1.42 0.97
(1.13) (1.20) (1.01)
1.59 2.03 1.46
(1.26) (1.18) (1.20)
Grade
Gender
Grade by gender
F (2,280)
F (1,280)
F (2,280)
.17 3.45* .56
4.29* 19.14*** 13.18***
.74 .26 2.33
PA ⫽ argument with parents; FA ⫽ argument with a friend; MC ⫽ malicious gossip. * p ⬍ .05; *** p ⬍ .001.
der differences, univariate ANOVAs revealed significant gender main effects on the emotion-focused strategy distraction, the problem-focused strategy social support, and the maladaptive coping strategies passive avoidance, rumination, and resignation, suggesting that girls employed significantly more social support, passive avoidance, rumination, and resignation but less distraction than boys.
Associations of perceived stress and coping with emotional and behavioral problems For girls, perceived interpersonal stress was substantially related with more anger control problems and emotional distress (Table 4). Emotion-focused coping was negatively correlated with all subscales. Problem-focused coping was negatively associated with anger control problems and negative self. Additionally, maladaptive coping was positively related to anger control problems, emotional distress, and negative self. For boys, perceived interpersonal stress was substantially linked with emotional distress. Emotion-focused coping was not substantially associated with adjustment scores. Problem-focused coping was negatively correlated with negative self only. Maladaptive coping was positively related to emotional distress and negative self.
Emotional and behavioral problems. A MANOVA examining effects of grade level and gender on the subscales revealed significant main effects of grade level and gender (Wilks’ FGRADE (8,554) ⫽ 3.12, p ⬍ .01; Wilks’ FGENDER (4,277) ⫽ 5.79, p ⬍ .001). The interaction effect was not statistically significant (Wilks’ F (8,554) ⫽ 1.77, p ⬍ .10). Means and SDs for both main effects are shown in Table 3. Univariate ANOVAs yielded significant main effects of grade level on antisocial behavior and anger control problems. Post hoc Student’s t-tests detected that fifth graders reported significantly less antisocial behavior and anger control problems than both older age groups. Univariate ANOVAs provided a significant effect of gender on emotional distress, suggesting that girls reported more emotional distress than boys.
Discussion The first aim of this study was to examine age and gender effects on perceived interpersonal stress, coping with interpersonal stressors, and psychological adjustment among ad-
Table 2 Means (M) and standard deviations (SD) for coping strategies for main effects of grade level and gender and summary of ANOVA results Scale
Grade level Grade 5 (n ⫽ 86)
MIN DIS STC POS SOS PAV RUM RES AGG
Grade 6 (n ⫽ 91)
Gender Grade 7 (n ⫽ 109)
Male (n ⫽ 131)
Factor Female (n ⫽ 155)
Grade
Gender
Grade by gender
M
SD
M
SD
M
SD
M
SD
M
SD
F (2,280)
F (1,280)
F (2,280)
2.27 2.06a 2.94a 2.92a 2.69a 1.63 2.04 0.91 1.33a
(.78) (.80) (.68) (.78) (.87) (.88) (.90) (.76) (.81)
2.09 1.79b 2.74a,b 2.64b 2.16b 1.76 2.04 1.02 1.58b
(.85) (.86) (.73) (.70) (1.01) (.98) (1.01) (.75) (.87)
2.28 1.70b 2.66b 2.61b 2.12b 1.90 2.07 1.17 1.68b
(.78) (.78) (.71) (.80) (.92) (.96) (.94) (.84) (.74)
2.27 1.94 2.75 2.76 2.10 1.64 1.81 0.85 1.47
(.82) (.75) (.75) (.71) (.98) (.89) (.97) (.70) (.81)
2.17 1.76 2.78 2.68 2.48 1.89 2.25 1.21 1.60
(.80) (.88) (.69) (.82) (.92) (.98) (.89) (.83) (.81)
1.92 5.16** 4.22* 4.78** 11.82*** 2.05 .01 2.84 5.14**
.83 3.94* .04 1.03 10.32** 5.16* 14.03*** 15.11*** 2.34
1.58 .01 1.60 .52 3.28* .40 1.72 .41 .21
Mean scores with different indices are significant at the .05 level using t-tests. MIN ⫽ minimization; DIS ⫽ distraction/recreation; STC ⫽ situation control; POS ⫽ positive self-instructions; SOS ⫽ social support; PAV ⫽ passive avoidance; RUM ⫽ rumination; RES ⫽ resignation; AGG ⫽ aggression. * p ⬍ .05; ** p ⬍ .01; *** p ⬍ .001.
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Table 3 Means (M) and standard deviations (SD) for emotional and behavioral problems for main effects of grade level and gender and summary of ANOVA results Scale
Grade level Grade 5 (n ⫽ 86) M a
AB AC ED NS
.18 .37a .56 .51
Grade 6 (n ⫽ 91)
SD
M
SD
b
(.23) (.29) (.35) (.35)
.31 .49b .64 .59
(.31) (.38) (.46) (.35)
Gender Grade 7 (n ⫽ 109) M b
.39 .51b .56 .53
Male (n ⫽ 131)
Factor Female (n ⫽ 155)
SD
M
SD
M
SD
(.41) (.38) (.44) (.37)
.33 .47 .48 .52
(.32) (.34) (.34) (.34)
.28 .45 .68 .56
(.36) (.38) (.46) (.38)
Grade
Gender
Grade by gender
F (2,280)
F (1,280)
F (2,280)
9.95*** 4.16* 1.28 1.20
1.63 .17 16.03** 1.38
.01 .57 1.44 2.32
Mean scores with different indices are significant at the .05 level using t-tests. AB ⫽ antisocial behavior; AC ⫽ anger control problems; ED ⫽ emotional distress; NS ⫽ negative self * p ⬍ .05; ** p ⬍ .01; *** p ⬍ .001.
olescents aged 10 to 14 years. Therefore, adolescents were asked to complete the German Coping Questionnaire for Children and Adolescents designed by Hampel et al [31], which assessed nine coping strategies representing the coping styles “emotion-focused coping,” “problem-focused coping,” and “maladaptive coping.” Moreover, stress related to three common interpersonal stressors was examined. Finally, externalizing problems (antisocial behavior, anger control problems) and internalizing problems (emotional distress and negative self) were measured by the RAASI designed by Reynolds [34]. Previous studies in adolescents provided some evidence for the reliability and validity of comparable coping styles and psychological adjustment scores (e.g., [6,9]). As expected, adolescents in the sixth and seventh grade were characterized by decreases in adaptive coping strategies and increases in maladaptive coping strategies. Moreover, consistent with the hypotheses, externalizing Table 4 Pearson correlations of perceived stress and coping with emotional and behavioral problems Score
Girls (n ⫽ 155) PS EMO PRB MCO Boys (n ⫽ 131) PS EMO PRB MCO
Emotional and behavioral problems AB
AC
ED
NS
.25** ⫺.29*** ⫺.24** .26**
.33*** ⫺.33*** ⫺.36*** .47***
.52*** ⫺.42*** ⫺.27** .57***
.21** ⫺.38*** ⫺.41*** .37***
.06 ⫺.07 ⫺.21* .14
.28** ⫺.23** ⫺.27** .26**
.34*** ⫺.08 ⫺.06 .45***
.25** ⫺.18* ⫺.33*** .31***
AB ⫽ antisocial behavior; AC ⫽ anger control problems; ED ⫽ emotional distress; NS ⫽ negative self; PS ⫽ perceived stress; EMO ⫽ emotion-focused coping; PRB ⫽ problem-focused coping, MCO ⫽ maladaptive coping. Correlations with p ⬍ .001 are significant after Bonferroni correction. * p ⬍ .05; ** p ⬍ .01; *** p ⬍ .001.
problems were increased. Unexpectedly, age group differences in internalizing problems failed to reach significance. Thus, in good agreement with the literature, a maladaptive coping pattern was found in middle adolescents (aged 12–14 years [6,20,21]). Supporting earlier results, this maladaptive coping pattern was accompanied by enhanced behavioral problems (cf. [1,2]). The stability in emotional problems was also reported by Cohen et al [1] and Dekovic et al [2]. With regard to gender, girls, compared with boys, have shown higher perceived interpersonal stress. In addition, they applied more support seeking but less distraction on social stress encounters, scored higher on passive avoidance, rumination, and resignation, and reported more emotional distress than boys. These results are in line with findings showing increased responses to interpersonal stressors in girls [22,24 –26]. Additionally, results on support seeking are congruent with previous findings, suggesting that girls strongly rely on social relationships [6,19,24,25,30]. Rudolph [24] emphasized that the enormous concern about social relationships moderates the vulnerability of girls to emotional problems, such as deficits in self-esteem or anxiety/depression. Other studies provided evidence for the negative impact of rumination on the development of emotional disorders in girls [13,29]. Unexpectedly, girls and boys did not differ in externalizing problems that may be due to the restricted age group and the sample belonging to middle-class families. In contrast to other studies, interaction effects were not ascertained; studies investigating German children and adolescents aged 8 to 14 years have found increased perceived interpersonal stress and a maladaptive coping pattern among female adolescents compared with female children [21]. Thus, these interaction effects may be attributed to different age groups. The second aim of this study was to determine the associations of perceived interpersonal stress and coping styles with emotional and behavioral problems. For boys, results support only a negative relation of perceived in-
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terpersonal stress with emotional distress. In girls, perceived interpersonal stress was related to anger control problems and emotional distress. These findings point to the assumption that perceived interpersonal stress may have a negative impact on emotional and behavioral problems in girls but a singular negative influence on emotional problems in boys. Consistent with recent results, problem-focused coping was associated with less adjustment problems [9], which also confirms other results that active or approach coping is a protective factor for internalizing disorders [15]. As predicted, emotion-focused coping, which was represented by adaptive coping strategies, was related to less adjustment problems. Accordingly, in a study conducted by Wadsworth and Compas [16], secondary control coping, which was similarly operationalized as the emotion-focused coping in the present study, was related to fewer anxiety/depression and aggression problems. These findings lend support to the assumption that the positive correlations found in the study by Compas et al [9] are explained by the operationalization of this scale. These authors mentioned that the majority of their items that measured emotion-focused coping reflected aggressive behavior. In line with the literature on maladaptive coping strategies such as anger, avoidant, or disengagement coping, in the present study maladaptive coping was associated with more emotional and behavioral problems [6,7,11–16]. Thus, some support was found that maladaptive coping is a risk factor in the development of emotional and behavioral symptoms in adolescence. In the present study, these relations were higher in girls than in boys, confirming earlier results [9,12]. It can be assumed that girls are more responsive to interpersonal stressors and are characterized by increased efforts in coping with social stressors. In sum, this study provided evidence for a maladaptive coping pattern in middle adolescents. Moreover, a heightened perceived interpersonal stress and a maladaptive coping pattern have been shown in girls. The results point to the importance of the implementation of primary preventive programs in children. Additionally, secondary preventive programs that are constructed in dependence of age and gender should be conducted. Those programs were evaluated to improve children’s and adolescents’ coping strategies and their well-being (for review see [35]). Results of this study are limited to the sample, which included European adolescents of middle-class families. Furthermore, findings relied on the use of selfreport data, and a causal directionality has to be determined by longitudinal studies. Conclusively, in the majority of earlier studies in which a dichotomization of coping styles was applied, adaptive and maladaptive coping strategies were confounded. The three-dimensional concept of coping, which differentiates between two adaptive styles and one maladaptive coping style and is
represented by nine coping strategies, is supported by the results of this study. A multidimensional assessment of coping enables a detailed diagnosis of deficits and resources that can be modified by therapeutic interventions. Furthermore, a better evaluation of therapeutic effects can be obtained.
References [1] Cohen P, Cohen J, Kasen S, et al. An epidemiological study of disorders in late childhood and adolescence. I. Age- and genderspecific prevalence. J Child Psychol Psychiatry 1993;34:851– 67. [2] Dekovic M, Buist KL, Reitz E. Stability and changes in problem behavior during adolescence: latent growth analysis. J Youth Adolesc 2004;33:1–12. [3] Steinhausen H-C, Winkler Metzke C, Meier M, et al. Prevalence of child and adolescent psychiatric disorders: the Zürich epidemiological study. Acta Psychiatr Scand 1998;98:262–71. [4] Compas BE, Howell DC, Phares V, et al. Risk factors for emotional and behavioral problems in young adolescents: a prospective analysis of adolescent and parental stress and symptoms. J Consult Clin Psychol 1989;57:732– 40. [5] Wagner BM, Compas BE, Howell DC. Daily and major life events: a test of an integrative model of psychosocial stress. Am J Community Psychol 1988;16:189 –205. [6] Seiffge-Krenke I. Causal links between stressful events, coping style, and adolescent symptomatology. J Adolesc 2000;23:675–91. [7] Herman-Stahl MA, Stemmler M, Petersen AC. Approach and avoidant coping: implications for adolescent mental health. J Youth Adolesc 1995;24:649 – 65. [8] Compas BE, Connor-Smith JK, Saltzman H, et al. Coping with stress during childhood and adolescence: problems, progress, and potential in theory and research. Psychol Bull 2001;127:87–127. [9] Compas BE, Malcarne VL, Fondacaro KM. Coping with stressful events in older children and young adolescents. J Consult Clin Psychol 1988;56:405–11. [10] Connor-Smith JK, Compas BE, Wadsworth ME, et al. Responses to stress in adolescence: measurement of coping and involuntary stress responses. J Consult Clin Psychol 2000;68:976 –92. [11] Connor-Smith JK, Compas BE. Vulnerability to social stressors: coping as a mediator or moderator of sociotropy and symptoms of anxiety and depression. Cognit Ther Res 2002;26:39 –55. [12] Galaif ER, Sussman S, Chou CP, et al. Longitudinal relations among depression, stress, and coping in high risk youth. J Youth Adolesc 2003;32:243–58. [13] Garnefski N, Boon S, Kraaji V. Relationships between cognitive strategies of adolescents and depressive symptomatology across different types of life event. J Youth Adolesc 2003;32:401– 8. [14] Seiffge-Krenke I, Klessinger N. Long-term effects of avoidant coping on adolescents= depressive symptoms. J Youth Adolesc 2000;29:617– 30. [15] Steinhausen H-C, Winkler Metzke C. Risk, compensatory, vulnerability, and protective factors influencing mental health in adolescence. J Youth Adolesc 2001;30:259 – 80. [16] Wadsworth ME, Compas BE. Coping with family conflict and economic strain: the adolescent perspective. J Res Adolesc 2002;12:243– 74. [17] Ge X, Lorenz FO, Conger RD, et al. Trajectories of stressful life events and depressive symptoms during adolescence. Dev Psychol 1994;30:467– 83. [18] Larson R, Ham M. Stress and “storm and stress” in early adolescence: the relationships of negative events with dysphoric affect. Dev Psychol 1993;29:130 – 40.
Hampel and Petermann / Journal of Adolescent Health 38 (2006) 409 – 415 [19] Frydenberg E, Lewis R. Boys play sport and girls turn to others: age, gender and ethnicity as determinants of coping. J Adolesc 1993;16: 253– 66. [20] Donaldson D, Prinstein M, Danovsky M, Spirito A. Patterns of children=s coping with life stress: implications for clinicians. Am J Orthopsychiatry 2000;70:351–9. [21] Hampel P, Petermann F. Age and gender effects on coping in children and adolescents. J Youth Adolesc 2005;34:73-83. [22] Spirito A, Stark LJ, Grace N, et al. Common problems and coping strategies reported in childhood and early adolescence. J Youth Adolesc 1991;20:531– 44. [23] Griffith MA, Dubow EF, Ippolito MF. Developmental and crosssituational differences in adolescents’ coping strategies. J Youth Adolesc 2000;29:183–204. [24] Rudolph KD. Gender differences in emotional responses to interpersonal stress during adolescence. J Adolesc Health 2002;30(suppl):3– 13. [25] Rudolph KD, Hammen C. Age and gender as determinants of stress exposure, generation, and reactions in youngsters: a transactional perspective. Child Dev 1999;70:660 –77. [26] Stark LJ, Spirito A, Williams CA, et al. Common problems and coping strategies: findings with normal adolescents. J Abnorm Child Psychol 1989;17:203–12.
415
[27] de Anda D, Baroni S, Boskin L, et al. Stress, stressors and coping strategies among high school students. Child Youth Serv Rev 2000; 22:441– 63. [28] Roecker CE, Dubow EF, Donaldson D. Cross-situational patterns in children’s coping with observed interpersonal conflict. J Clin Child Psychol 1996;25:288 –99. [29] Nolen-Hoeksema S. Sex differences in unipolar depression: evidence and theory. Psychol Bull 1987;101:259 – 82. [30] Compas BE, Orosan PG, Grant KE. Adolescent stress and coping: implications for psychopathology during adolescence. J Adolesc 1993;16:331– 49. [31] Hampel P, Petermann F, Dickow B. The German Coping Questionnaire by Janke and Erdmann adapted for children and adolescents (German). Göttingen, Hogrefe, 2001. [32] Hampel P, Dickow B, Petermann F. Reliability and validity of the German Coping Questionnaire for Children and Adolescents (German). Z Diff Diagn Psychol 2002;23:273– 89. [33] Lazarus RS, Folkman S. Stress, Appraisal and Coping. New York, NY: Springer, 1984. [34] Reynolds WM. Reynolds Adolescent Adjustment Screening Inventory – RAASI. Odessa, FL: Psychological Assessment Resources, 2001. [35] Maag JW, Kotlash J. Review of stress inoculation training with children and adolescents. Behav Modif 1994;18:443– 69.