Abstract
Third-molar extraction patients (N=231) underwent one of five preparatory interventions offering different levels of relaxation, control, and self-efficacy to evaluate the relative importance of each of these elements of coping in the context of an acute stressor. Prior to surgery subjects completed measures of monitoring and blunting. Results indicated that relaxation, perceived control, and self-efficacy were each significant, and roughly equivalent, contributors to coping, and operated in an additive way. Intervention type, and the interaction of intervention type with blunting score, significantly predicted distress prior to and during surgery. It was concluded that no single element is crucial to effective coping and that interventions that provide more coping elements are generally superior. Additionally, the interaction of coping style with intervention is as strong a contributor to coping outcome as the other factors. Those who prefer to distract themselves may benefit most from interventions that require the least possible personal investment of effort and attention.
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References
Auerbach, S. M. (1973). Trait-state anxiety and adjustment to surgery.J. Consult. Clin. Psychol. 40: 264–271.
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavior change.Psychol. Rev. 84: 191–215.
Bandura, A. (1982). Self-efficacy in human agency.Am. Psychol. 37: 122–147.
Benson, H. (1975).The Relaxation Response, Avon, New York.
Bernstein, D. A., and Kleinknecht, R. A. (1982). Multiple approaches to the reduction of dental fear.J. Behav. Ther. Exp. Psychiat. 13: 1223–1227.
Borkovec, T. D., and Nau, S. D. (1972). Credibility of analogue therapy rationales.J. Behav Ther. Exp. Psychiat. 3: 257–260.
Cohen, J., and Cohen, P. (1975).Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences, Lawrence Erlbaum, Hillsdale, NJ.
Corah, N. L. (1973). Effect of perceived control on pedodontic patients.J. Dent. Res. 52: 1261–1264.
Corah, N. L., Bissell, G. D., and Illig, S. J. (1978) Effect of perceived control on stress reduction in adult dental patients.J. Dent. Res. 57: 74–76.
Croog, S. H., Baume, R., and Nalbandian, J. (1994). Pain response after psychological preparation for repeated surgery: Control and positive affect enhancement.J. Am. Dent. Assoc. 125: 2–9.
Davison, G. C., and Valins, S. (1969) Maintenance of self-attributed and drug-attributed behavior change.J. Pers. Soc. Psychol. 11: 25–33.
DeMartino, B. K. (1987). Anxiety: Dental overview.Dent. Clin North Am. 31: 11–16.
Gatchell, R. (1980). Effectiveness of two procedures for reducing dental fear: Group-administered desensitization and group education and discussion.J. Am. Dent. Assoc. 101: 634–637.
Gattuso, S. M., Litt, M. D., and Fitzgerald, T. (1992). Coping with gastrointestinal endoscopy: Self-efficacy enhancement and coping style.J. Consult. Clin. Psychol. 60: 133–139.
Gendzilov, A. V., Alexandrin, G. P., Simonov, N. N., Evtjuhin, A. T., and Bobrov, U. F. (1977). The role of stress factors in the postoperative course of patients with rectal cancer.J. Surg. Oncol. 9: 517–523.
Gil, K. M. (1984). Coping effectively with invasive medical procedures: A descriptive model.Clin. Psychol. Rev. 4: 339–362.
Johansson, P., and Berggren, U. (1992). Assessment of dental fear: A comparison of two psychometric instruments.Acta Odont. Scan. 50: 43–49.
Johnson, J. E., Dabbs, J. M., and Leventhal, H. (1970). Psychosocial factors in the welfare of surgical patients.Nurs. Res. 19: 18–29.
Kendall, P. C., and Watson, D. (1981). Psychological preparation for stressful medical procedures. In Bradley, L. A., and Prokop, C. K. (eds.),Medical Psychology: Contributions to Behavioral Medicine, Academic Press, New York, pp. 197–221.
Kent, G., and Gibbons, R. (1987) Self-efficacy and the control of anxious cognitions.J. Behav. Ther. Exp. Psychiat. 18: 33–40.
Kleinknecht, R. A., Klepac, R. K., and Alexander, L. D. (1973). Origins and characteristics of fear of dentistry.J. Am. Dent. Assoc. 86: 842–848.
Klepac, R. K. (1986). Fear and avoidance of dental treatment in adults.Ann. Behav. Med. 8: 17–22.
Klepac, R. K., Dowling, J., and Hauge, G. (1982). Characteristics of clients seeking therapy for the reduction of dental avoidance: Reactions to pain.J. Behav. Ther. Exp. Psychiat. 13: 293–300.
Litt, M. D. (1988a). Cognitive mediators of stressful experience: Self-efficacy and perceived control.Cog. Ther. Res. 12: 241–260.
Litt, M. D. (1988b). Self-Efficacy and perceived control: Cognitive mediators of pain tolerance.J. Pers. Soc. Psychol. 54: 149–160.
Litt, M. D., Nye, C. and Shafer, D. (1993). Coping with oral surgery by self-efficacy enhancement and perceptions of control.J. Dent. Res. 72: 1237–1243.
Logan, H. L., Baron, R. S., Keeley, K., Law, A., and Stein, S. (1991). Desired and felt control as mediators of stress in a dental setting.Health Psychol. 10: 352–359.
Ludwick-Rosenthal, R. and Neufeld, R. W. J. (1988). Stress management during noxious medical procedures. An evaluative review of outcome studies.Psychol. Bull. 104: 326–342.
Martelli, M. M., Auerbach, S. M., Alexander, J., and Mercuri, L. G. (1987). Stress management in the health care setting: Matching interventions with patient coping styles.J. Consult. Clin. Psychol. 55: 201–207.
Miller, S. M. (1987). Monitoring and blunting: Validation of a questionnaire to assess styles of information seeking under threat.J. Pers. Soc. Psychol. 52: 345–353.
Miller, S. M. (1988). The interacting effects of coping styles and situational variables in gynecologic settings: Implications for research and treatment.J. Psychosom. Obstet. Gynecol. 9: 23–34.
National Institute of Dental Research and Office of Medical Publications, National Institutes of Health (1979).Removal of Third Molars NIH Consensus Development Conference Summary No. 2 (November), U.S. Government Printing Office, Washington, DC.
Norusis, M. J. (1988).SPSS/PC+ Advanced Statistics V2.0, SPSS, Chicago.
Ozer, E. M., and Bandura, A. (1990). Mechanisms governing empowerment effects: A self-efficacy analysis.J. Pers. Soc. Psychol. 58: 472–486.
Pawlicki, R. (1987). Psychologic interventions for the anxious dental patient.Anesth. Prog. 34: 220–227.
Rosenthal, R., and Rosnow, R. L. (1985).Contrast Analysis: Focused Comparisons in the Analysis of Variance, Cambridge University Press, Cambridge.
Scott, L. E., and Clum, G. A. (1984). Examining the interaction effects of coping style and brief interventions in the treatment of postsurgical pain.Pain 20: 279–291.
Shipley, R. H., Butt, J. H., Horwitz, B., and Farbry, J. E. (1978). Preparation for a stressful medical procedure: Effect of stimulus pre-exposure and coping style.J. Consult. Clin. Psychol. 46: 499–507.
Shipley, R. H., Butt, J. H., and Horwitz, E. A. (1979). Preparation to re-experience a stressful medical examination: Effect of repetitious videotape exposure and coping style.J. Consult. Clin. Psychol. 47: 485–492.
Sime, A. M. (1976). Relationship of pre-operative fear, type of coping, and information received about surgery to recovery from surgery.J. Pers. Soc. Psychol. 34: 716–724.
Spielberger, C. D., Auerbach, S. M., Wadsworth, A. P., Dunn, T. M., and Taulbee, E. S. (1973). Emotional reaction to surgery.J. Consult. Clin. Psychol. 40: 33–38.
Suls, J., and Fletcher, B. (1985). The relative efficacy of avoidant and nonavoidant coping strategies: A meta-analysis.Health Psychol. 4: 249–288.
Tabachnik, B. G., and Fidell, L. S. (1989).Using Multivariate Statistics, 2nd ed., Harper & Row, New York.
Thompson, S. C. (1993). Naturally occurring perceptions of control: A model of bounded flexibility. In Weary, G., Gleicher, F., and Marsh, K. L. (Eds.),Control Motivation and Social Cognition, Springer-Verlag, New York, pp. 74–93.
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Litt, M.D., Nye, C. & Shafer, D. Preparation for oral surgery: Evaluating elements of coping. J Behav Med 18, 435–459 (1995). https://doi.org/10.1007/BF01904773
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DOI: https://doi.org/10.1007/BF01904773