Coping with stressful events: influence of parental alcoholism and race in a community sample of women.
Among women with alcoholic parents, race differences in coping are unclear. Black women, less studied than white women, might cope more effectively because of greater support from kin and fictive kin (Haley et al., 1995), or less effectively because of lower socioeconomic status (Proctor & Dalaker, 2003) and their likely experiences of racism and discrimination. Alternatively, commonalities in the experience of living with alcoholic parents may reduce coping differences between black and white women. Understanding racial differences could help practitioners better focus mental health treatment and prevention approaches, targeting services to those in need.
This article focuses on women raised in two-parent families to address gaps in the literature. Coping methods and coping loci were examined as well as the influence of childhood stressors (for example, physical abuse) and resources (for example, adolescent social support) on current adulthood coping, and the influence of the childhood coping resources of self-esteem and social support on current adulthood coping.
DEFINITIONS AND TYPES OF COPING
Researchers and clinicians have long been interested in how psychological factors such as coping moderate the relationship between everyday stressors and emotional and physical illness (Somerfield & McCrea, 2000). More recently, interest has shifted to factors contributing to resilience or resistance to illness in spite of high levels of stress (Holahan & Moos, 1990). Coping may be a crucial process in stress resistance; for example, engaging in positive health practices can delay illness, and using social support and other constructive coping can reduce mental health symptoms after major losses and trauma (Holahan & Moos, 1994; Moos, 2002; Perrott, Morris, Martin, & Romans, 1998; Somerfield & McCrea). Coping refers to what a person actually thinks and does in a situation (Folkman & Lazarus, 1980), that is, the thoughts and actions people undertake on their own behalf as they attempt to avoid or lessen the impact of life problems. Coping serves to change the situation, to manage the meaning of the situation to reduce the threat, or to keep the symptoms within manageable bounds; coping can help with discrete events or continuing problems (Pearlin & Schooler, 1978).
Approach and Avoidant Coping
Approach coping reflects cognitive and behavioral efforts to master or resolve life stressors; avoidant coping involves attempts to deny, minimize, or escape the stressful situation (Moos, 1992b). Approach coping is considered to be superior to avoidant coping (Kobasa, Maddi, & Kahn, 1982; Moos & Billings, 1982) because it is associated with more self-confidence and less dysfunction (Moos, 2002). Moos recently concluded that although some evidence suggests that both approach and avoidant coping may contribute to adaptation, approach coping may lead to more positive psychosocial outcomes. In psychodynamic theory, avoidance is widely seen as a costly coping method (Consedine, Magai, & Bonanno, 2002). Empirical studies support this view: Greater family conflict was found among alcoholic patients and their spouses who relied on avoidant coping, and their children had more emotional problems (Moos, Finney, & Cronkite, 1990).
However, Pearlin and Schooler (1978) demonstrated that avoidant coping can be adaptive. They found that coping by "selective ignoring" and focusing on the positive aspects of a situation was effective in responding to economic stressors; in contrast, avoidant coping was not effective in marital relationships and parenting as it increased stress. Furthermore, emotional avoidance was found to be psychologically adaptive in longitudinal studies of 116 cardiac patients (Ginzburg, Solomon, & Bleich, 2002) and 42 recent widows and widowers (Bonanno, Keltner, Holen, & Horowitz, 1995).
Lazarus and Folkman (1984) and Cronkite and Moos (1984) distinguished between coping methods that characterize what people think and do and are related to handling difficult situations (for example, use of prayer) and coping resources that people have available for dealing with life problems. Such resources can be social, for example, social supports; or psychological, for example, self-esteem. Having strong coping resources can moderate the negative consequences of stress and lessen the influence of stress even if weaker coping responses are used (Pearlin & Schooler, 1978).
COPING AMONG WOMEN WITH AND WITHOUT ALCOHOLIC PARENTS
Studies on coping among individuals with alcoholic parents have been limited by the use of clinical samples (for example, Hart & McAleer, 1997; Scavnicky-Mylant, 1990), the lack of clear criteria for assessing parental alcoholism (for example, Hart & McAleer), participants' awareness of the research purpose (for example, Easley & Epstein, 1991; Gondolf & Ackerman, 1993), and failure to adjust for other parental conditions, family circumstances, or respondent personality (Palmer, 1997).
Kelly and Myers (1996) studied female undergraduate students with and without alcoholic parents and found no significant differences in the coping methods used for problems with their parents. Examining a middle-aged, middle-class, community sample of white women, Domenico and Windle (1993) found that women with alcoholic parents reported higher levels of distress as parents, more avoidant coping, and inability to control their children. However, group differences were often small.
Coping Resources: Social Support and Self-esteem
Studies have generally found no differences in social support by parental alcoholism (Kashubeck, 1994; Rodney, 1994; Rodney & Rodney, 1996). Rodney found that black college students with and without alcoholic parents were generally similar, but those with alcoholic parents reported less informational and emotional support from their mothers. Domenico and Windle (1993), in a community sample, found that middle-aged white women with alcoholic parents reported lower perceived social support, including both emotional support and material aid.
Studies of the effects of parental alcoholism on self-esteem are mixed: Some reported a negative effect (Domenico & Windle, 1993; Fox & Gilbert 1994); others found none (Menees, 1997; Rodney & Rodney, 1996; Werner & Broida, 1991). For example, Menees, studying undergraduate students, using several standardized scales, found no relationship between parental alcoholism and self-esteem and no strong evidence that coping methods or resources mediated that relationship.
COPING METHODS AND COPING RESOURCES
Black people when compared with white people have relied more on religious coping methods, including prayer (Ell & Nishimoto, 1989; Steffen, Hinderliter, Blumenthal, & Sherwood, 2001) and church attendance (Johnson, Thomas, & Matre, 1990), which are approach methods. The cognitive technique of restructuring, also an approach method, is used more by white people (Ell & Nishimoto).
Social networks have been measured by number of contacts and satisfaction with networks. Some studies have demonstrated stronger social networks among black people (for example, Ball, Warheit, Vandiver, & Holzer, 1980; Smerglia, Deimling, & Barresi, 1988); others have shown that black people have smaller networks than white people (for example, Wallsten, 2000). Additional studies have shown mixed results: Black people reported greater satisfaction with their social support (Steffen et al., 2001) and greater closeness among network members (Keith, Kim,& Schafer, 2000), but smaller networks (Keith et al.; Steffen et al.). In a recent meta-analysis, Gray-Little and Hafdahl (2000) found that black men and women had higher self-esteem scores than their white counterparts.
THE PRESENT STUDY
Because social work practitioners often work with women who have alcoholic parents, they could benefit from information about whether these women, as a group, cope similarly or more poorly when compared with women who have nonalcoholic parents. Given that adults with alcoholic parents have been shown to have more stressful childhood home environments (Fergusson et al., 1996; Kelleher et al., 1994; Menees & Segrin, 2000), we might expect that parental alcoholism would be related to less functional coping methods and weaker resources. Alternatively, the opposite could be true because the experience of high stress is sometimes related to resilience.We examined a community sample of 290 women with and without alcoholic parents to determine how they coped with stress. Specifically, we examined how growing up in a two-parent family with one or more alcoholic parents affects womens' coping methods. Racial differences in coping could have implications for case planning and intervention; thus, we wanted to explore the influence of race to fill a gap in research on racial differences in coping. The sample included women oversampled for black race and alcoholic parents because women with alcoholic parents and black women constitute a small proportion of the community population. We oversampled for both of these characteristics to ensure sufficient numbers for statistical analysis. Finally, the study examined whether coping in this adult female population was influenced by childhood stressors in addition to parental alcoholism (for example, sexual abuse, physical abuse), as well as childhood resources (for example, social support in adolescence), and adulthood resources (for example, current social support). Thus, two primary questions were addressed: (1) Does coping vary by parental alcoholism or race? and (2) How is coping in adulthood affected by childhood stressors and resources and by adulthood resources?
Participants and Procedures
Participants were white women and black women 21 to 60 years old. They were required to have lived in the same household with their mother and father for at least 10 years from birth to age 18, to increase comparability in family composition and ensure that women with alcoholic parents lived with their parents for a substantial period in childhood. Participants were recruited through newspaper advertisements, flyers posted in the metropolitan area, and community contacts in African American neighborhoods (Clay, Ellis, Amodeo, Fassler, & Griffin, 2003). The study was described to participants as a "family study" to minimize the bias that could result if participants with alcoholic parents anticipated that their parents' drinking or themselves as children of alcoholics was the focus of the study. During the telephone screening, questions about parental drinking history were interspersed with general family background items. Because our goal was to recruit equal numbers of black and white women with alcoholic parents and black and white women with nonalcoholic parents, we enrolled women regardless of race or parental alcoholism until we met our quota for one of those categories; then we excluded women as appropriate.
All participants were asked to identify a sibling close in age to participate as a collateral informant. Siblings had to be at least 21 and had to have lived in the same household with the respondent during childhood. Siblings completed a mailed questionnaire covering family background, including parental alcoholism and psychopathology. Sibling data were used as a reliability check for respondent data, but were not required because some participants would have no siblings, siblings who were too young, or siblings who had not lived with them in childhood. Our goal was a sibling participation rate or 50 percent; we achieved a rate of 49 percent. The study was approved by the Boston University Institutional Review Board.
We used a combination of standardized measures that have been used on both community and patient populations, items designed for this study, and a face-to-face interview of 15 to 45 minutes to elicit sensitive information about childhood experiences and to confirm parental alcoholism and psychiatric problems. Amodeo, Griffin, Fassler, and Clay, who have extensive interviewing experience, conducted all interviews. Participants received $50 for completion of the study.
Coping Methods and Coping Foci. To assess adult coping methods, we used the Coping Responses Inventory (CRI):Adult [Health and Daily Living, 32-item version] Form B Manual, Moos, 1992a); validity and reliability for this instrument have been well-established (Moos, 1992a). Responses were categorized as approach or avoidant. Approach includes active cognitive coping and active behavioral coping. Active cognitive coping refers to the use of logical analysis, that is, attempts to understand and mentally prepare for a stressor and its consequence; and positive reappraisal, that is, attempts to restructure a problem in a positive way without denial. Active behavioral coping refers to seeking guidance or support, that is, attempts to take action to deal directly with the problem. Avoidant coping includes resigned acceptance, that is, attempts to react to the problem by accepting it; emotional discharge, that is, indirect attempts to reduce tension by expressing feelings, such as displacing anger on others; and alternative rewards, that is, attempts to get involved in substitute activities such as drinking or taking drugs. The 32 items can also be categorized as one of five coping loci: logical analysis, information seeking, problem solving, affective regulation, and emotional discharge. The CRI is suitable for healthy adults and can be administered as a self-report inventory. Participants were instructed to name an important problem or life stressor in the past year. Problems selected included births, deaths, serious illness, assault, trouble with neighbors or coworkers, losing or gaining a job, and trouble with extended family. Participants were then instructed to indicate which of the 32 coping responses they used in dealing with this event, on a four-point Likert scale. Response options were no; yes, once or twice; yes, sometimes; and yes, fairly often.
Parental Alcoholism. To assess parental alcoholism, we used the Children of Alcoholics Screening Test (CAST) (Jones, 1981), a 30-item self-report screening tool widely used for assessing parental alcoholism among different age groups. A cutoff score of six is recommended, as it corresponds to a DSM-IV diagnosis of alcohol dependence with a sensitivity of 78 percent and a specificity of 98 percent (Charland & Cote, 1998). Each item was asked for mothers and fathers separately, with strong reliability in our sample (alpha = .97 and .96 for fathers and mothers, respectively).
Adulthood Stressors and Resources. Self-esteem was measured using the Rosenberg Self-Esteem Scale, a 10-item self-report scale (Rosenberg, 1972). Social support was measured using the brief, self-report Sarason Social Support Questionnaire (Sarason, Sarason, Shearin, & Pierce, 1987) that has been widely used in clinical and community settings and provides scores for social support satisfaction from several sources. Both measures showed strong reliability in our sample (alphas = .87 and .93 for self-esteem and social support, respectively). To measure current stress, we used the Negative Life Change Events Scale (Moos, Cronkite, Billings, & Finney, 1984). This scale has been widely used on both community and patient populations, with good reliability and validity. Scores depend on how many of 15 events occurred over the past 12 months; items include separation or divorce, deaths of close friends or family, unemployment or job loss, and legal problems. We replaced two of the original items (loss of something of sentimental value and substantial decrease in income) with two others (medical condition, also from Moos et al., 1984, and care for an aging parent).
Childhood Stressors and Resources. We used the Family Environment Scale (FES) (Moos & Moos, 1981) to assess cohesion, expressiveness, conflict, and organization. All scales demonstrated strong reliability in our sample (alpha = .80, .72, .81, and .76 for cohesion, expressiveness, conflict, and organization, respectively). The Timeline Follow-back method was used in the interview. Originally developed to assist recall of drinking (Sobell & Sob ell, 1992), this technique uses a calendar to anchor the-respondent in time and has been expanded to include recall of other behaviors (compare Crosby, Stall, Paul, Barrett, & Midanik, 1996; Midanik, Hines, Barrett, Paul, Crosby & Stall, 1998). A timeline from birth to 21 was presented to the respondent for identification of key childhood events such as divorces, births, and deaths and a review of who lived in the household over time. To assess adolescent social support, a childhood coping resource, we asked participants to indicate whether any confidant was available to provide emotional support during adolescence. To assess the stressors of physical and sexual abuse, parental violence, and psychiatric problems, we used questionnaire items and follow-up questions in the interview. Siblings, in their completion of questionnaires on childhood family experiences, indicated which family members, if any, had had the earlier-mentioned experiences. A psychiatric problem was defined as a formal psychiatric diagnosis, a psychiatric hospitalization or medication, or a suicide attempt during the respondent's childhood.
Two-way analyses of variance were used to compare continuous variables by race and parental alcoholism, and chi-square for categorical variables. Continuous variables included those from the standardized scales described earlier (that is, CRI, CAST, FES, self-esteem, satisfaction with social support), as well as age and socioeconomic status, measured by years of education. To examine continuous and categorical predictors of continuous outcomes simultaneously, we used multiple regression analyses. Using the Bonferroni correction, the p cutoff of .05 becomes .002, as noted in the tables. However, given the exploratory nature of this study, p values of [less than or equal to] .05 are reported.
Characteristics of Participants Participants were heterogeneous, with black women somewhat older and less educated than white women (see Table 1). Ninety-four percent of the women were raised by two biological parents; the others had one or two stepparents. Among those with alcoholic parents, their CAST scores were 6 to 27, with mothers' scores similar to fathers' (15.8 [+ or -] 6.7, compared with 17.0 [+ or -] 5.6). Duration of parents' alcohol problems during the participant's childhood was substantial (11.2 [+ or -] 4.8 years for one to two alcoholic parents), yet most alcoholic parents (69.1 percent of fathers and 73.9 percent of mothers) received no treatment. Concordance between participants and siblings on the CAST was high for both mothers (r = .78,p < .01) and fathers (r = .75,p < .01). Sibling-pair agreement was 91.6 percent (131/143) on whether the parent had a drinking problem.
Standardized Scales: Psychometric Properties
Internal consistency was satisfactory among our participants for the 16 standardized scales used. Alphas for the eight scales that did not focus on coping were all satisfactory ([greater than or equal to] .72), as indicated in the Measures section. Reliability testing yielded moderate to strong alphas for the three coping methods: active cognitive =.70 (11 items, range = 0 to 3.3), active behavioral =.74 (13 items, range 0 to 39), and avoidant =.67 (8 items, 0 to 24), and moderate alphas for the five coping foci: logical analysis =.63 (4 items, 0 to 12), information seeking = .65 (7 items, 0 to 21), problem solving = .62 (5 items, 0 to 15), affective regulation =.57 (6 items, 0 to 18), and emotional discharge = .50 (6 items, 0 to 18). The low alphas for some of the coping subscales would be expected based on the small number of items; the overall coping index, however, has good reliability. These scores were similar to or stronger than reliability scores reported for the original test participants (Moos, 1992a). Reliability for the black women in our sample was equal to or stronger than that for the white women on all eight CRI indices.
Coping, by Parental Alcoholism Status and Race
For the first research question, coping methods and loci were examined by race and parental alcoholism (Table 2a). Women with alcoholic parents scored higher than women without alcoholic parents on avoidant coping [F(1, 288) = 11.27, p < .001], but were similar on active cognitive and behavioral coping. Effect sizes for the three coping methods were < 0.1. Women did not differ by race on any scale. We further examined each of the 32 CRI coping items. The 10 items that differed by parental alcoholism status, race, or the interaction of the two are presented (Table 2a).Women with an alcoholic parent were more likely to use prayer and these avoidant coping items: reduced tension by eating more, refused to believe it, and took it out on others. White women reported four approach coping items (accepted it, talked with a friend, let my feelings out, and sought help from those with similar experiences) more often than did black women. However, white women used prayer less often. Some race differences varied by parental alcoholism, including "prayed" (among white women, but not black women, women with parental alcoholism prayed more), "got busy with other things" (among those with alcoholic parents, white women were less likely and black women were more likely), "seek help from those with similar experiences" (among black women only, those with parental alcoholism were more likely), and "reduce tension by exercising more" (among those with alcoholic parents, white women were less likely and black women were more likely).
The coping loci showed only one significant main effect (Table 2b):Women with parental alcoholism scored higher than women without parental alcoholism on emotional discharge [F(1, 284) = 5.77,p < .02]. The interaction between parental alcoholism and race was significant for affective regulation: Among those with alcoholic parents, white women scored lower on affective regulation, whereas black women scored higher.
Coping, by Childhood Stressors and Resources
To understand whether childhood stressors and resources predicted coping, we tested models for the five childhood stressors (that is, physical and sexual abuse, parental violence, parental psychopathology, family conflict, and parental alcoholism) entered alone; then the four childhood resources (that is, family organization, cohesion, expressiveness, and adolescent social support) entered alone; then only the significant variables adjusted for race and parental alcoholism (Table 3a). Family cohesion and expressiveness were not significant for any of the coping methods or loci. The model predicting avoidant coping was strongest; the models predicting active coping showed low explained variance. Greater family conflict and an absence of adolescent social support were associated with more avoidant coping, with race again not significant. White race, child sexual abuse, and adolescent social support were associated with more active behavioral coping. Greater family conflict was associated with more active cognitive coping; race was not significant. Parental alcoholism was not significant in any of the models.
The models to predict coping loci from childhood stressors and resources were low in explained variance (Table 3a, last three columns). Greater family conflict was associated with more logical analysis and emotional discharge, and adolescent social support was associated with more information seeking. None of the remaining predictors was significantly related to the coping foci. Problem solving and affective regulation are not presented, as none of the predictors were significant in the multivariate models.
Coping, by Current Resources
Two coping resources, satisfaction with social support and self-esteem, were compared by coping methods and loci, adjusted for race and parental alcoholism (Table 3b). Satisfaction with social support was not related to coping methods, whereas better self-esteem was associated with more active cognitive coping and less avoidant coping (higher self-esteem scores indicate worse self-esteem). White women scored higher on active behavioral coping and lower on avoidant coping than black women. Although the models for the two types of approach coping showed low explained variance, the model for avoidant coping was moderately strong, primarily because of the effect of self-esteem.
Self-esteem predicted three of the five coping foci when adjusted for race and parental alcoholism: Better self-esteem was associated with more logical analysis and problem solving and less emotional discharge (Table 3b). Greater satisfaction with social support predicted more information seeking only. White women scored higher on logical analysis than did black women, and parental alcoholism was not related to any of the coping foci. Although the model for emotional discharge was moderately strong because of the effect of self-esteem, explained variance was low for the remaining models.
We considered whether stress, as measured by negative life events within the past year, might have an effect on coping methods and foci. The analyses shown in Table 3b were repeated, controlling for negative life events. The effect of the two coping resources was unchanged, with similar explained variance for the eight adjusted models (that is, increases from 0 to 3.2 percent). Although the results remained as described earlier, there was a direct relationship between number of negative life events and use of avoidant and emotional discharge coping.
This study examined coping in a community sample of 290 black women and white women over-sampled for black race and parental alcoholism. All participants grew up in two-parent families. Women with alcoholic parents used more avoidant coping and also used more prayer. White women were more likely to use approach responses, except for prayer. Participants as a whole had lower avoidant than approach coping scores, in part, because there were fewer avoidant questions; thus, this result would be expected and is similar to earlier studies (Moos, 1992a) using this scale. However, fewer items did not entirely account for the difference in this sample.
Findings of more avoidant coping by women with alcoholic parents contrast with other studies showing no differences, or very small differences. Because our sample lived with their parents for at least 10 years, the effects of alcoholic parents may be greater. These women with alcoholic parents may have become overreliant on avoidant coping, having used it routinely to protect themselves from painful family situations; such overreliance may have been effective (Pearlin & Schooler, 1978). Perhaps different life stressors call appropriately for different coping strategies. However, use of avoidant coping can take an emotional toll (Merrill, Thoresen, Sinclair, Gold, & Milner, 2001 ; Moos, 2002; Perrott et al., 1998), so social workers in health and mental health settings can be helpful to clients if they screen for parental alcoholism. For those clients in need, education and skill practice on more effective coping may help prevent mental health and medical problems.
White women endorsed approach coping more often than did black women, although black women used prayer more often. It may be that black women depended more on avoidant coping; alternatively, perhaps in spite of endorsing avoidant methods, they used prayer as their major coping strategy. In this sample, black women were somewhat older and more likely to have children, but had similar years of education. Possibly, different coping responses were appropriate, based on these women's different life situations. Banyard and Graham-Bermann (1993) proposed a greater focus on the ways in which social forces based on gender, race, socioeconomic status, age, and sexual orientation influence coping. They suggested that a black woman who, for example, uses avoidant coping in dealing with racial discrimination at work may know that the economic benefits of that response outweigh the gains from approach coping.
Childhood stressors and resources were only moderately successful in predicting adult coping responses. Not surprisingly, negative childhood family environment and absence of adolescent social supports were associated with avoidant coping and emotional discharge. Race was not related to avoidant coping, but white race predicted approach coping. Concerning coping resources, it is not surprising that better self-esteem was associated with higher scores on approach coping methods and loci, and lower scores on avoidant coping methods and foci: Self-esteem is a personal resource on which one can draw in appraising the level of threat posed by stressful situations and in feeling confident about dealing with them.
The CRI focused on a specific stressor, with no measure of number of current stressful events, which limits interpretation of the data. Because all participants lived in two-parent families during childhood, the findings cannot be generalized to women who lived in one-parent families or lived apart from their alcoholic parents for long periods in childhood. Furthermore, alcoholic fathers were much more prevalent than alcoholic mothers. Al-though the study did not use random selection, the community sample avoided some of the bias inherent in relying on clinic patients or college students. Study strengths include triangulation of research methods, standardized measures and multiple indicators, and a balanced sample by race and parental alcoholism. Sibling collaterals and two-parent Families are innovations in studies of this population.
Prospective studies are needed to examine the effects on adult adjustment and coping among women with alcoholic mothers only and with alcoholic fathers only. Such studies would also assist in delineating coping responses that women with and without alcoholic parents use when experiencing common and predictable life changes, current stressful events, crisis situations, and chronic stressors. Answers are needed to questions such as: How do alcoholic parents cope with life circumstances and what influence do these patterns have on the coping of their offspring? Are some coping strategies more appropriate in particular stressful situations? To what extent do individuals use avoidant coping to "buy time" as they work their way to fixture use of more approach coping responses?
Understanding coping better could help social workers develop psychoeducational methods to teach clients with alcoholic parents preferred coping strategies; if directed to children, such intervention might prevent later medical and mental health problems. However, as Moos (2002) pointed out, helping clients to change themselves is only one aspect of a needed response. Some social problems require the intervention of social systems. Thus, social workers need to educate families about the likely effects of untreated alcoholism, to encourage earlier treatment, and to raise public awareness that it is a treatable condition for which effective strategies are available.
Original manuscript received September 24, 2004
Final revision received July 7, 2006
Accepted August 10, 2006
Ball, R.. E., Warheit, G.J., Vandiver, J. S., & Holzer, C. E. III (1980). Friendship networks: More supportive of. low-income black women? Ethnicity, 7, 70-77.
Banyard, V. L., & Graham-Bermann, S. A. (1993). Can yeomen cope? A gender analysis of theories or" coping with stress. Psychology of Women Quarterly, 17, 303-318.
Bonanno, G. D., Keltner, D., Holen, A., & Horowitz, M.J. (1995). When avoiding unpleasant emotions might not be such a bad thing: Verbal-autonomic response dissociation and midlife conjugal bereavement. Journal of Personality and Social Psychology, 69, 975-989.
Charland, H., & Cote, G. (1998).The Children of Alcoholics Screening Test (CAST): Test retest reliability and concordance validity. Journal of Clinical Psychology, 54, 995-1003.
Clay, C. M., Ellis, M. A., Amodeo, M., Fassler, I., & Griffin, M. L. (2003). Recruiting a community sample of African American subjects: The nuts and bolts if a successful effort. Families in Society, 84, 396-404.
Consedine, N. S., Magai, C., & Bonanno, G. A. (2002). Moderators of the emotion inhibition-health relationship: A review and research agenda. Review of General Psychology, 6, 204-228.
Cronkite, R. C., & Moos, R. H. (1984). The role of predisposing and moderating factors in the stress-illness relationship. Journal of Health and Social Behavior, 25, 372-393.
Crosby, G. M., Stall, R. D., Paul, J. P., Barrett, D. C., & Midanik, L. T. (1996). Condom use among gay/bisexual male substance abusers using the timeline follow-back method. Addictive Behaviors, 21, 249-257.
Domenico, D., & Windle, M. (1993). Intrapersonal and interpersonal functioning among middle-aged female adult children of alcoholics. Journal of Consulting and Clinical Psychology, 61, 659-666.
Easley, M. J., & Epstein, N. (1991). Coping with stress in a family with an alcoholic parent. Family Relations, 40, 218-224.
Ell, K. O., & Nishimoto, R. H. (1989). Coping resources in adaptation to cancer: Socioeconomic and racial differences. Social Service Review, 63, 433-446.
Fergusson, D. M., Lynskey, M. T., & Horwood, L. J. (1996). Childhood sexual abuse and psychiatric disorder in young adulthood: Prevalence of sexual abuse and factors associated with sexual abuse. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1355-1364.
Folkman, S., & Lazarus, R. S. (1980). An analysis of coping in a middle-aged community sample. Journal of Health and Social Behavior, 21, 219-239.
Fox, K. M., & Gilbert, B. O. (1994). The interpersonal and psychological functioning of women who experienced childhood physical abuse, incest, and parental alcoholism. Child Abuse & Neglect, 18, 849-858.
Ginzburg, K., Solomon, Z., & Bleich, A. (2002). Repressive coping style, acute stress disorder, and posttraumatic stress disorder after myocardial infarction. Psychosomatic Medicine, 64, 748-757.
Gondolf, E. W, & Ackerman, R. J. (1993). Validity and reliability of an "Adult Children of Alcoholics" Index. International Journal of the Addictions, 28, 257-269.
Gray-Little, B., & Hafdahl, A. R. (2000). Factors influencing racial comparisons of self-esteem: A quantitative review. Psychological Bulletin, 126, 26-54.
Griffin, M. L., Amodeo, M., Fassler, I. R., Ellis, M. A., & Clay, C. M. (2005). Mediating factors for the long-term effects of parental alcoholism in women: The contribution of other childhood stresses and resources. American Journal on Addictions, 14, 18-34.
Haley, W. E., West, C. A. C., Wadley, V. G., Ford, G. R., White, F. A., Barrett, J. J., Harrell, L. E., & Roth, D. L. (1995). Psychological, social and health impact of caregiving: A comparison of black and white dementia family caregivers and noncaregivers. Psychology and Aging, 10, 540-552.
Hart, K. E., & McAleer, M. (1997). Anger coping style in adult children of alcoholics. Addiction Research, 5, 473-485.
Harter, S. L. (2000). Psychosocial adjustment of adult children of alcoholics: A review of the recent empirical literature. Clinical Psychology Review, 20, 311-337.
Holahan, C. J., & Moos, R. H. (1990). Life stressors, resistance factors, and improved psychological functioning: An extension of the stress resistance paradigm. Journal of Personality and Social Psychology, 58, 909-917.
Holahan, C. J., & Moos, R. H. (1994). Life stressors and mental health: Advances in conceptualizing stress resistance. In W R. Avison & I. H. Gotlib (Eds.), Stress and mental health: Contemporary issues and prospects for the future (pp. 213-238). New York: Plenum Press.
Johnson, D. G., Thomas, S. J., & Matre, M. (1990). Race, social ties, social support, and subjective well-being: Evidence from a community study. Sociological Focus, 23, 341-354.
Jones, J. W. (1981). The Children of Alcoholics Screening Test (CAST). Chicago: Family Recovery Press.
Kashubeck, S. (1994). Adult children of alcoholics and psychological distress. Journal of Counseling and Development, 72, 538-543.
Keith, P. M., Kim, S., & Schafer, R. B. (2000). Informal ties of the unmarried in middle and later life: Who has them and who does not? Sociological Spectrum, 20(2), 221-238.
Kelleher, K., Chaffin, M., Hollenberg, J., & Fischer, E. (1994). Alcohol and drug disorders among physically abusive and neglectful parents in a community-based sample. American Journal of Public Health, 84, 1586-1590.
Kelly, V. A., & Myers, J. E. (1996). Parental alcoholism and coping: A comparison of female children of alcoholics with female children of non-alcoholics. Journal of Counseling & Development, 74, 501-504.
Kobasa, S. C., Maddi, S. R., & Kahn, S. (1982). Hardiness and health: A prospective study. Journal of Personality and Social Psychology, 47(1), 168-177.
Lazarus, R. S., & Folkman, S. (1984). Stress appraisal and coping. New York: Springer.
Menees, M. M. (1997). The role of coping, social support, and family communication in explaining the self-esteem of adult children of alcoholics. Communication Reports, 10(1), 9-19.
Menees, M. M., & Segrin, C. (2000). The specificity of disrupted processes in families of adult children of alcoholics. Alcohol and Alcoholism, 35, 361-367.
Merrill, L. L., Thomsen, C. J., Sinclair, B. B., Gold, S. R., & Milner, J. S. (2001). Predicting the impact of child sexual abuse on women: The role of abuse severity, parental support, and coping strategies. Journal of Consulting and Clinical Psychology, 69, 992-1006.
Midanik, L. T., Hines, A. M., Barrett, D. C., Paul, J. P., Crosby, G. M., & Stall, R. D. (1998). Self-reports of alcohol use, drug use, and sexual behavior: Expanding the timeline follow-back technique. Journal of Studies on Alcohol, 59, 681-689.
Moos, R. H. (1992a). Coping Responses Inventory: Adult form manual. Palo Alto, CA: Center for Health Care Evaluation, Stanford University and Department of Veterans Affairs Medical Centers.
Moos, R. H. (1992b). Stress and coping theory and evaluation research: An integrated perspective. Evaluation Review, 16, 534-553.
Moos, R. H. (2002). The mystery of human context and coping: An unraveling of clues. American Journal of Community Psychology, 30, 67-88.
Moos, R. H., & Billings, A. G. (1982). Conceptualizing and measuring coping resources and processes. In L. Goldberger & S. Brenznitz (Eds.), Handbook of stress: Theoretical and clinical aspects (pp. 212-230). New York: Macmillan.
Moos, R. H., Cronkite, R. C., Billings, A. G., & Finney, J. W. (1984). Health and daily living form manual. Palo Alto, CA: Social Ecology Laboratory, Veterans Administration and Stanford University Medical Center.
Moos, R. H., Finney, J., & Cronkite, R. (1990). Alcoholism treatment: Context, process, and outcome. New York: Oxford University Press.
Moos, R. H., & Moos, B., (1981). Family Environment Scale manual, Palo Alto, CA: Consulting Psychologist Press.
Palmer, N. (1997). Resilience in adult children of alcoholics: A nonpathological approach to social work practice. Health & Social Work, 22, 201-209.
Pearlin, L. I., & Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 19, 2-21.
Perrott, K., Morris, E., Martin, J, & Romans, S. (1998). Cognitive coping styles of women sexually abused in childhood: A qualitative study. Child Abuse & Neglect, 22, 1135-1149.
Proctor, B. D., & Dalaker, J. (2003). Poverty in the United States: 2002 (U. S. Census Bureau, Current Population Reports, p. 60-222). Washington, DC: U. S. Government Printing Office.
Rodney, H. E. (1994). What differentiates ACOAs and non-ACOAs on a black college campus? Journal of American College Health, 43, 57-63.
Rodney, H. E., & Rodney, L. (1996). An exploratory study of African American collegiate adult children of alcoholics. Journal of American College Health, 44, 267-272.
Rosenberg, M. (1972). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.
Sarason, I. G., Sarason, B. R., Shearin, E. N., & Pierce, G. R. (1987). A brief measure of social support: Practical and theoretical implications. Journal of Social and Personal Relationships, 4, 497-510.
Scavnicky-Mylant, M. (1990). The process of coping among young adult children of alcoholics. Issues in Mental Health Nursing, 11, 125-139.
Segrin, C., & Menees, M. M. (1996). The impact of coping styles and family communication on the social skills of children of alcoholics. Journal of Studies on Alcohol, 57, 29-33.
Smerglia, V. L., Deimling, G. T., & Barresi, C. M. (1988). Black/white family comparisons in helping and decision-making networks of impaired elderly. Family Relations, 37, 305-309.
Sobell, L. S., & Sobell, M. B. (1992). Timeline follow-back: A technique for assessing self-reported alcohol consumption. In R. Z. Litten & J. P. Allen (Eds.), Measuring alcohol consumption psychosocial and biochemical methods (pp. 41-72). Totowa, NJ: Humana Press.
Somerfield, M. R., & McCrea, R. R. (2000). Stress and coping research. American Psychologist, 55, 620-625.
Steffen, P. R., Hinderliter, A. L., Blumenthal, J. A., & Sherwood, A. (2001). Religious coping, ethnicity, and ambulatory blood pressure. Psychosomatic Medicine, 63, 523-530.
Wallsten, S. S. (2000). Effects of caregiving, gender, and race on the health, mutuality, and social supports of older couples. Journal of Aging and Health, 12, 90-111.
Werner, L. J., & Broida, J. P. (1991). Adult self-esteem and locus of control as a function of familial alcoholism and dysfunction. Journal of Studies on Alcohol, 52, 249-252.
Maryann Amodeo, PhD, MSW, is professor of clinical practice, School of Social Work, Boston University, 264 Bay State Road, Boston, MA 02215; e-mail: email@example.com. Margaret L. Griffin, PhD, is senior research associate, Irene Fassler, MSW, is research assistant, Cassandra Clay, MSW, is clinical professor, and Michael A. Ellis, MSW, is research assistant, School of Social Work, Boston University. The authors wish to thank the Greater Boston Council on Alcoholism for providing partial funding for this research. A poster was presented at a meeting of the College on Problems of Drug Dependence, June 2005, Orlando, FL.
Table 1: Background Characteristics of Participants, by Race (N = 290) Black White Women Women (n = 132) (n = 158) Age (M, SD) (a) 39.7, [+ or -] 9.0 36.3, [+ or -] 11.0 Years education (M, SD) (b) 14.1, [+ or -] 2.2 15.3, [+ or -] 2.0 Employed (% yes) 65.9 68.4 Marital status (% yes) 40.9 32.2 Parents (% yes) (c) 57.6 27.2 Household income (%) Less than $20,001 40.6 41.8 $20,001-40,000 25.8 26.1 More than $40,000 33.6 32.0 (a) t(287.9) = -2.89, p < .004. (b) (266.1) = 4.61, p < .001. (c) [chi square] (1, N = 290) = 27.40, p < .001. Table 2a: Coping Methods and Selected Items (mean scores), by Race and Parental Alcoholism Parental No Parental Alcoholism Alcoholism White Black White Black Women Women Women Women Coping Method (n = 70) (n = 56) (n = 88) (n = 76) Approach coping Active cognitive 19.4 19.4 18.4 18.1 Accepted it 1.4 1.3 1.5 1.1 Prayed 2.2 2.4 1.3 2.3 Active behavioral 21.9 21.7 22.9 20.1 Talked with a friend 2.4 2.2 2.5 2.0 Got busy with other things 1.8 2.0 2.0 1.5 Let my feelings out 2.2 1.8 2.2 1.9 Sought help from those with similar experiences 1.5 1.6 1.7 1.0 Reduce tension by exercising more 0.6 0.7 1.1 0.6 Avoidant coping Avoidance 6.1 6.5 4.4 4.9 Reduce tension by eating more 0.9 1.0 0.7 0.5 Refused to believe it 0.7 0.9 0.4 0.6 Took it out on others 1.1 0.9 0.8 0.6 p Parental Inter- Alcohol- action Coping Method Race ism Approach coping Active cognitive ns ns ns Accepted it .032 ns ns Prayed .001 * .001 * .005 Active behavioral ns ns ns Talked with a friend .001 * ns ns Got busy with other things ns ns .005 Let my feelings out .006 ns ns Sought help from those with similar experiences .024 ns .008 Reduce tension by exercising more ns ns .017 Avoidant coping Avoidance ns .001 * ns Reduce tension by eating more ns .005 ns Refused to believe it ns .002 * ns Took it out on others ns .013 ns * ps < .002 are Bonferroni corrected; ps < .05 also shown. Table 2b: Coping Foci (mean scores), by Race and Parental Alcoholism Parental No Parental Alcoholism Alcoholism White Black White Black Women Women Women Women Coping Foci (n = 70) (n = 56) (n = 88) (n = 76) Approach/Problem- focused Logical analysis 7.4 7.1 7.4 6.6 Information seeking 13.2 12.9 12.9 12.6 Problem solving 8.5 8.9 8.6 8.5 Avoidant/Emotion- focused Emotional discharge 5.0 4.8 4.4 3.9 Affective regulation 8.7 9.4 9.3 8.0 p Parental Inter- Alcohol- action Coping Foci Race ism Approach/Problem- focused Logical analysis ns ns ns Information seeking ns ns ns Problem solving ns ns ns Avoidant/Emotion- focused Emotional discharge ns .017 ns Affective regulation ns ns .037 Notes: * ps < .002 are Bonferroni corrected; ps < .05 are shown. Table 3a: Coping Methods and Foci, by Childhood Stresses and Resources, Adjusted for Race and Parental Alcoholism Methods Active Active Childhood Stressors Behavioral Cognitive Avoidant Parental alcoholism .010 .055 .062 Physical abuse -.070 -- .034 Parental violence -- -- .102 Parental psychiatric problem -- -- -- Sexual abuse .140 * -- -- Family conflict -- .125 * .198 * Childhood resources Family organization -- -- -- Adolescent social support .122 * -- -.208 ** Race -.132 * .004 .055 [R.sup.2] (%) 4.9 * 2.3 15.8 ** Foci Logical Emotional Information Childhood Stressors Analysis Discharge Seeking Parental alcoholism -.010 .023 .064 Physical abuse -- -- -.080 Parental violence -- .117 -- Parental psychiatric problem .110 -- -- Sexual abuse -- .085 -- Family conflict .172 * .167 * -- Childhood resources Family organization -- -- -- Adolescent social support -- -- .147 * Race .072 -.078 -.035 [R.sup.2] (%) 5.4 * 8.3 ** 3.4 * Note: Coefficients are standardized betas;--is used for variables not entered in the final models. * p < .05. ** p < .002. Table 3b: Coping Methods and Foci, by Coping Resources, Adjusted for Race and Parental Alcoholism Methods Coping Active Active Resource Behavioral Cognitive Avoidant Satisfaction with support .084 .014 -.074 Self-esteem -.113 -.171 * .476 ** Parental alcoholism .028 .113 .148 * Race -.147 * -.052 .153 * [R.sup.2] (%) 4.0 * 4.0 * 28.7 ** Foci Coping Logical Problem Affective Resource Analysis Solving Regulation Satisfaction with support -.093 -.015 .033 Self-esteem -.229 ** -.193 * -.071 Parental alcoholism .057 .040 .045 Race -.137 * -.015 -.077 [R.sup.2] (%) 5.5 * 3.5 * 1.2 Foci Coping Emotional Information Resource Discharge Seeking Satisfaction with support .069 .182 * Self-esteem .448 ** -.078 Parental alcoholism .101 .050 Race .01 -.072 [R.sup.2] (%) 19.7 ** 5.1 * Note: Coefficients are standardized betas. * p < .05. ** p < .002.
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|Author:||Amodeo, Maryann; Griffin, Margaret L.; Fassler, Irene; Clay, Cassandra; Ellis, Michael A.|
|Publication:||Health and Social Work|
|Date:||Nov 1, 2007|
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