Taking action to cope with stress not necessarily best strategy

November 22, 1999

When confronting stressful circumstances, attempting to take action may not always be the most appropriate coping strategy, according to results of a study of patients with functional dyspepsia, a painful gastrointestinal condition with no known cause.

Functional dyspepsia patients made little attempt to alter their coping strategy regardless of whether they were able to control a stressful event or not. These patients consistently favored action-oriented strategies, attempting to problem-solve or otherwise confront the issue head-on. People without chronic health problems and rheumatic patients, in contrast, reserved action-oriented strategies for controllable events but employed more passive strategies - such as, diverting their attention or seeking support from others - when encountering uncontrollable events.

"Action-oriented coping strategies may not be useful in handling all stressful life events, especially for uncontrollable stressful situations in which nothing can be done to alter the occurrence of their consequences," said Cecilia Cheng, PhD, lead author of the study. "Consistent use of action-oriented coping may create considerable psychological strains in addition to the already heightened anxiety level of functional dyspepsia patients."

"Our results suggest that the non-discriminative coping pattern is a psychological factor associated with functional dyspepsia symptoms," said Cheng. The researchers from Hong Kong University of Science and Technology and University of Hong Kong report their research in the November/December issue of Psychosomatic Medicine.

Functional dyspepsia is frequently described as "indigestion" and can be accompanied by nausea, gas, feelings of fullness, and gnawing or burning pain in the upper abdomen or chest. Unlike stomach ulcers or other gastrointestinal conditions, there is no known cause for functional dyspepsia, but psychological factors have long been suspected to be involved.

The researchers interviewed 30 patients with functional dyspepsia, 30 patients with arthritis or other rheumatic conditions, and 30 people without chronic health problems. All participants were asked to describe "events that had a large effect on their lives," the degree to which they could control the circumstances, and the way they coped.

Functional dyspepsia patients also reported symptoms of anxiety that were more than twice as severe as those reported by the other two groups.
The research was supported by a major competitive research grant from the Hong Kong Research Grants Council.

Psychosomatic Medicine is the official peer-reviewed journal of the American Psychosomatic Society, published bimonthly. For information about the journal, contact Joel E. Dimsdale, MD, at 619-543-5468.

Posted by the Center for the Advancement of Health < http://www.cfah.org > For information about the Center, call Petrina Chong, < pchong@cfah.org > 202-387-2829.

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