Date on Master's Thesis/Doctoral Dissertation

8-2009

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department (Legacy)

Department of Educational and Counseling Psychology

Committee Chair

Possel, Patrick

Committee Co-Chair (if applicable)

Stringfield, Samuel

Author's Keywords

Meaning-making; Coping; Inflammatory bowel disease; Stress-related growth; Chronic illness

Subject

Inflammatory bowel diseases--Patients--Psychology; Adjustment (Psychology); Sick--Psychology

Abstract

Inflammatory Bowel Disease (IBD) is a chronic illness with the potential to affect many areas of one's life through painful physical symptoms and psychological distress. Despite the debilitating nature and increasing prevalence of IBD, there is little research addressing the coping processes and related psychological adjustment among individuals living with the disease. Moreover, there has been no research conducted investigating how those with IBD make meaning out of their illness experience. Research conducted with other illness populations suggests that meaning making, a specific type of coping may have important implications for psychological adjustment. This cross-sectional study examines the coping processes and psychological adjustment of individuals diagnosed with IBD, while testing the tenets of the meaning making model of coping proposed by Park and Folkman (1997). This model is based on the assumptions that (a) psychological distress arises from discrepancies between the appraised meaning of a stressful event and one's global beliefs and goals, and (b) people engage in meaning making behaviors (e.g., reappraisals) to reduce the discrepancy and alleviate distress. A sample of 229 individuals with IBD, recruited through online support groups/message boards, completed an online survey. The survey contained measures assessing participants' views of their illness, disease-related variables (e.g., length of time since diagnosis), coping efforts, and psychological adjustment, specifically stress-related growth. Data were analyzed through the use of both qualitative and quantitative techniques, including multiple linear regression, Spearman Rho correlation procedures, and structural equation modeling (SEM). The findings revealed gender differences in meaning making coping efforts. Specifically females report greater use of emotional processing and religious coping, but not positive reframing. Age and level of education were not significantly related to meaning making coping efforts. None of the sociodemographic variables tested (age, gender, education level) were significantly related to reports of stress-related growth. The results provided uneven support for the meaning making model across four hypotheses. Specifically, discrepancies between one's appraised meaning of IBD and his/her global beliefs and goals were significantly related to level of psychological distress. Interestingly, level of psychological distress was not related to meaning making coping efforts. Meaning making coping efforts (i.e., positive reframing, emotional processing, and religious coping) were significantly related to reports of stress-related growth. The meaning making model of coping wasn't fully supported by the data in the present study; however, important implications for this burgeoning area of research are presented.

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