Coping strategies in Iranian families:
Coping and Severity of Behavioural Problems

	Seyyed Davood Mohammadi, Asghar Dadkhah, PhD. University of Social Welfare and Rehabilitation Sciences PhD. Student in department of Clinical Psychology, University of social welfare and rehabilitation
	Dr. Asghar Dadkhah, University of Social Welfare and Rehabilitation Sciences, Evin, Kudakyar Ave., Tehran, 19834, Iran. asgaredu@uswr.ac.ir; mohammadi.sd@gmail.com

ABSTRACT Objective: The aim of this study is assessment of relationship among severity of behavioural problems, coping strategies and styles and investigation of role of gender differences in coping in the Iranian adolescent population. Method: From six secondary schools students in three districts in Tehran 420 students were randomly selected. Participants were asked to complete SDQ and ACI scales. The collected data were analyzed with Pearson Correlation, Multiple Regression and Independent Sample T-test. Results: A negative relationship between Solving the problem and Reference to Others coping styles and severity of behavioural disorder was observed. The results indicated that Solving the problem and Non-productive Coping styles (and consequently coping strategies of these two coping styles) can significantly predict severity of behavioural problems. No gender differences in coping were seen. Discussion: Role of coping in forming behavioural problems for professionals, education systems and families was discussed. Keywords: behavioural problems; coping styles; coping strategies; gender differences; adolescents, students, Iran.

INTRODUCTION

There is growing interest in identifying young children who are at risk for developing behavioural problems. This interest is largely driven by research evidence that shows young children who exhibit behaviour problems, such as aggression and attention difficulties, are at increased risk for continued behavioural difficulties in later childhood and adolescence (Campbell & Ewing, 1990; White, Moffit, Earls, Robins, & Silva, 1990). Moreover, children who have an earlier onset of conduct problems are more likely to demonstrate an increased chronicity and severity of delinquent behaviours than the youth whose onset of conduct problems appears later (Lahey et al., 1999; Tolan & Thomas, 1995).
Given the early onset and relative stability of certain types of behavioural problems, it is important to identify factors that contribute to the emergence of behavioural difficulties in young children for the purpose of early identification and preventive efforts.
Coping is described by Lazarus and Folkman (1984) as effortful cognitive and behavioural responses to stressful situations. Coping responses include actions to alter the stressor (problem-focused coping) and to regulate the emotional arousal associated with or evoked by the stressor (emotion-focusing coping). The successful utilization of coping responses facilitates resilience and adaptation to stressful situations (Garmezy, 1987).
Coping is a multidimensional concept with at least two broad categories: coping styles and coping strategies. Coping styles indicate stable dispositions and patterns of responses that people use to deal with difficulties. Arising from this approach are studies conducted to examine the various typologies of coping styles found in individuals. This approach has been heavily criticized for ignoring the idea that coping responses are more situation-specific and that people cope with different situations using different strategies. Lazarus and Folkman (1984) have suggested two broad types of coping strategies: problem-focused and emotion-focused. Problem-focused coping strategies are used to solve an existing problem by either changing the situation, one's behaviour, or both. Emotion-focused coping strategies are employed to regulate emotional reactions or to make one feel better without actually solving the problem. Other researchers have broadened the concept of coping strategies to encompass at least the following elements: problem solving or direct action strategies, cognitive strategies such as positive thinking, avoidance or resignation strategies, and strategies that draw on resources from others such as help-seeking strategies (Wong, Leung & On So, 2001).
Although every change, whether big or small, is stressful and placing demands on the individuals to cope, these changes are not bad or unpleasant at all times. In fact, it may be said that existence of psychological stressors and even severity of them is not per se dysfunctional and maladaptive; what is important is the way or ways used to cope with stressors. Therefore, the strategies that individuals choose are part of their vulnerability profile. Along with this idea, Anda et al., (1991) take the increasing number of adolescents that commit suicide or abuse drugs as evidence of the increasing stress of this group and insufficiency of their coping strategies.
Relationship between coping and mental health is a relatively well-researched topic in the literature; however the relationship between coping and behavioural problems in children and adolescents is less explored. This is particularly so in Middle East societies.
Some researchers indicated that the use of approach coping, that includes problem-focusing and emotion-focusing, is less related to negative emotions than avoidance strategies (Gomez, 1998; Halpern, 2004). Between approach coping, the relationship between application of emotion focusing strategies and less mental health has been a recurrent finding (Aldwin and Revenson, 1987) and in contrast with it, the relationship between use of problem focusing strategies and more mental health (Aldwin and Revenson, 1987; Herman-Stahl, Stemmler & Peterson, 1995; Kavsek & Seiffge-Krenke, 1996). In other words, within one range, problem-focusing coping has been observed to be related to mental health more than emotion-focusing coping which is itself in turn more than avoidance.
It is explored that there are positive links between active strategies such as problem-solving, rational analysis and information seeking with higher mental health (Herman-Stahl, Stemmler & Peterson, 1995; Kavsek & Seiffge-Krenke, 1996), and among passive coping strategies such as avoidance, denial and feeling repression with more life stress (Kavsek & Seiffge-Krenke, 1996; Simoni & Paterson, 1997; Strivastava, 1991).
In the study of Elgar, Arlett and Groves (2003) on high school adolescents, there was a positive relation between approach strategies and externalized behavioural problems (such as hyperactivity, aggressive and disruptive behaviors) but no relationship with internalized behavioural problems (such as depression and anxiety). Of course, it should be noted that in this research emotion-focusing and problem-focusing strategies were held under a general class entitled approach strategies. Thus separate relations among all of these strategies with behavioural problems were not assessed. In fact, as approach strategies, whether problem-focusing or emotion-focusing, demand more act and performance on environment than avoidance strategies; if the ways of approaching are maladaptive, such approach strategies can indicate themselves as externalized behavioural problems.
Compas, Maclcarne, and Fondacaro (1988) reported that older children and adolescents who used problem-focused coping in response to self-identified interpersonal stressors had more positive emotional and behavioural outcomes, whereas those who used emotion-focused coping strategies, such as behavioural self-soothing, emotion venting, and aggressive actions, had greater behavioural problems.
The work of Sandler, Tein, Mehta and Ayers (2000) showed that for chronic events, avoidant forms of coping may provide immediate relief, but if used exclusively, these strategies are likely to lead to greater internalizing problems. Similarly, Steele, Forehand, and Armistead (1997) reported that among children who are coping with parental chronic illness, active/approach coping was related to lower psychological problems, and avoidant coping with increased overall problems and internalizing problems.
Windle and Windle (1996) found a positive link between emotion focusing coping and depression in adolescents. In a research (Halpern, 2004) on preschool children, general coping efforts and problem approach coping were negatively related to behavioural problems, but general low score in coping scale was positively related.
Aldwin and Revenson (1987) concluded that problem-focusing coping acts were a psychological buffer against stress. They observed also, that strategies such as avoidance, fantasy and blaming were more related to psychological symptoms. It has also been found that maladaptive coping is related to serious problems such as drug abuse (Wills & Hirky, 1996).
Gender difference in coping has been a well-researched issue in the literature. Although some researchers have found that women use more emotion-focused strategies (e.g. Davila, Hammen, Burge, Paley, & Daley, 1995; Olah, 1995) and more avoidance coping (Gomez, 1998) than men, other studies have found no gender differences in coping (Compas, Maclcarne, and Fondacaro, 1988; Armistead et al., 1990; Gore, Aseltine, & Colton, 1992). Such inconsistencies between studies underscore the need for further research on whether males and females differ in how they experience and respond to stress.
The first aim of this research was to investigate the relationship between behavioural problems severity, coping styles and coping strategies, thus predicting the effect of coping in severity of behavioural problems. The secondary aim was to assess the role of gender differences in coping.

METHODS

Participants. The population of this research was a secondary school in Iran. The secondary school included grades 6 to 9, and ages almost 11-12 until 14-15 years old- students in Tehran city (Capital of Iran). For sampling three areas (areas 1, 6, 16) formed the research sample, each of which three girls and three boy schools were chosen. From each school three classes were chosen and from every class 25 students were selected (all stages in random). In this way, the sample was really comprehensive. Data was gathered from 450 students and questionnaires of 30 students were excluded because of faults in completion. Ultimately data from 420 were analyzed. The sample included 225 (53/6%) females and 195 males (46/4%) and respectively 37/4, 29/3 and 33/3 percent from areas 1, 6, 16 of Tehran.
Tools. An anonymous pencil and paper questionnaire was administered to participants which contained two separate scales for the measurement of behavioural problems and coping:
1) Strength and Difficulties Questionnaire (SDQ): SDQ is a relatively new questionnaire about behavioural problems that was made in 1997 by Goodman according to ICD-10. It has five subscales including emotional symptoms, conduct problems, hyperactivity-attention deficit, peer problems and pro-social behaviours. It has three forms; teacher, parent and self-report that are used for 3 to 16-year-old children and adolescents. Although it has a shorter life than other recognized questionnaires such as CBCL or YSR, it has the same psychometric characteristics and some advantages such as: fewer items (25), yet holds the same sensitivity (Becker et al., 2004), good correlation with YSR (Koskelainen, Sourander, & Kaljonen, 2000), good reliability (Becker et al., 2004: Goodman, Meltzer & Bailey, 1998) and according to ICD-10.
In this research a self-report form was used. Severity of every adolescent's behavioural problems was calculated by adding the psychological signs and/or symptoms that a student affirmed about him/her self. Participants were asked to answer the items about their states during the last six month on a Likert-type scale ranging from zero to two, with zero being "not true", one being "somewhat true" and two being "certainly true".
2) Adolescent Coping Inventory (ACI): ACI was made by Frydenberg and Lewis (1993) to assess 12 to 18-year-old adolescents' coping styles and strategies. Rarely is there a coping scale comparable to ACI in comprehensiveness. The form of ACI used in the present research assesses 18 strategies in 3 general styles. The first style, that is called solving the problem, includes eight strategies: seek social support, focus on solving the problem, physical recreation, seek relaxing diversions, invest in close friends, seek to belong, work hard and achieve and focus on the positive. This style of coping indicates an active and adoptive approach to problems. The second style is Reference to Others that includes four strategies; seek social support, seek professional help, seek spiritual support and social action. Use of these strategies shows that a person asks for help from friends, professionals or spiritual powers to overcome his/her problems. The third style is Non-productive Coping that involves eight strategies: seek to belong, worry, wishful thinking, tension reduction, ignore the problem, self-blame, keep to self and not cope. These strategies are those that may be called maladaptive avoidance strategies and are empirically related to inability in adjustment. Frydenberg and Lewis have found 0.44 to 0.84 correlations for test-retest reliability of this test after two weeks. In the present research, Cronbach's alpha of total scale was calculated 0.87 and for three subscales; Solving the Problem, Non-productive Coping and Reference to Others were respectively 0.80, 0.77 and 0.78.
Participants were asked to express how much they used these strategies. They should express their opinion about items on a five Likert-type scale ranging from one "I do not do it" to five "I always do it".

RESULTS

In order to assess the relations among severity of behavioural problems with coping strategies and styles, Pearson correlation was used, and results are shown in Table 1.

p<0.01*, p<0.001**

As shown in Table 1 there are negative relationships between Solving the Problem coping style and severity of behavioural problems (r = -0.49, p<0.001) and also between Reference to Others coping style with severity of behavioural problems (r = -0.32, p<0.001). There are also negative relationships among strategies of these two styles and severity of behavioural problems. Among Non-productive Coping strategies wishful thinking and not cope strategies have negative relationships with severity of behavioural problems. There is also a positive link (r = 0.21, p<0.001) between tension reduction (a Non-productive Coping strategy) and severity of behavioural problems, but there is no relation between Non-productive Coping style and severity of behavioural problems. In other words, the more use of Solving the Problem and Reference to Others coping styles, and consequently strategies of these two styles, the fewer symptoms of behavioural problems reported by participants.
Multiple Regression Analysis (stepwise method) was conducted to test predicting effect of coping styles on the severity of behavioural problems.
The results are shown in Table 2.

p<0.000**

The regressions testing coping styles as predictors (Table 2) are statistically significant for severity of behavioural problems (R= 0.53, F= 83/618, p< 0.000). Selected coping styles are Non-productive Coping and Solving the Problem. Together these predictors contributed 28 % of the variance to the prediction of behavioural problems that, in case of generalization, will be 0.28 (R2Adj = 0.283). From these styles, Beta Coefficient of Non-productive Coping is positive (Beta = 0.223, p<0.000) and that of Solving the Problem is negative (Beta = -0.591, p<0.000). In summary, the more use of Solving the Problem, the fewer behavioural problems, symptoms, and the greater application of Non-productive Coping, the more behavioural problems symptoms reported by students.
To answer more concisely, that exactly which coping strategies can predict severity of behavioural problems, coping strategies and behavioural problems were analyzed by Multiple Regression Analysis (stepwise method was used) the results of which are shown in Table 3.

p<0.000**

As the above table shows, the regressions testing coping strategies as predictors are statistically significant for severity of behavioural problems (R= 0.55, F= 26/117, p< 0.000). Selected coping strategies are physical recreation, work hard and achieve, seek social support, seek relaxing diversions, not cope, focus on the positive and finally tension reduction. Together, these predictors contributed 30 % of the variance to the prediction of severity of behavioural problems that, in the case of generalization, it will be 0.29 (R2Adj = 0.296). From these strategies, Beta Coefficients of not cope and tension reduction strategies are positive and for others are negative. In summary, the higher use of physical recreation, work hard and achieve, seek social support, seek relaxing diversions and focus on the positive strategies, the fewer behavioural problems symptoms reported and the greater application of not cope and tension reduction strategies, the more behavioural problems symptoms. To examine gender differences in coping styles, Independent Sample t-test was used the results of which are shown in Table 4.

As it is shown, there is not any difference between genders in every coping styles or general coping attempts (sum of numbers in all of coping styles).

DISCUSSION

The relationship between coping and behavioural problems found in this research is congruent with the results of many other researchers conducted in children and adolescents (e.g., Compas, Malcarne & Fondacaro, 1988; Gomez, 1998; Halpern, 2004; Windle & Windle, 1996), and also congruent with research that was conducted about the relations between mental health and coping in adults (e.g., Aldwin & Revenson, 1987; Herman-Stahl, Stemmler & Peterson, 1995; Chang et. al., 2006; Law, 2003; Wong, Leung, & On So, 2001). Similar to some of the studies that have assessed gender differences in coping responses to stressful or negative situations (e.g., Altshuler & Ruble, 1989; Bernzweig, Eisenberg, & Fabes, 1993; Iskandar et al., 1995), this study indicates that boys and girls did not differ in their coping responses.
Almost in every way that we want to see coping, we can say that it has two components: a cognitive and a behavioural component. The cognitive component encompasses an interpretative part that includes a person's beliefs system about identity of stress, his/her ability to expose, and the way he/she should apply. Lazarus and Folkman (1984) emphasise the role of appraisal and reappraisal [cognitive component] in the face of stressing situations. They believe that our emotions are results of our receiving information. It is obvious that a person's beliefs about stress and their ability can widely change the way the person responds, that is, his/her behavioural component of their coping responses. According to the above, we can say coping in the first place can moderate between environmental stressors and responses by a cognitive process, although it includes behavioural components as well. As individual's responses to situations can be defined partly as a persons' mental health, and also, as they can result in some consequences related to mental health, we can thus replace our inference by: coping can moderate between environmental stressors and mental health. It is not a new inference and in fact there are findings that support its empirical base (e.g., Halpern, 2004; Wang & Scott, 2002). For example Halpern (2004) found that coping acts as a moderating effect between family conflicts and externalized behavioural problems in children. In other words, it is assumed that the relation between mental health and coping is due to moderation effect of coping on the perception and reaction to environmental stressors. While adoptive coping can cause more adoptive perception and response, maladaptive coping can reverse it.
However coping's effects on mental health, the results of research such as this research implies, that adoptive or maladaptive coping are among important factors concerning child and adolescent mental health. The results of research such as the present research implies to us that the child's inability to generate constructive coping strategies may provide an early risk factor for behavioural problems.
Parents and families should review their duties regarding their children. Parenting duties not only include providing food and clothing, but also includes teaching more efficient strategies to cope better with situations in an increasingly more complex and challenging society. Without opportunities to practice coping skills, children and adolescents may be less equiped to manage the challenges that await them later in life.
These results emphasise also on the role of educational systems, not only as entities that teach reading and writing skills to children, but also help foster a child's aptitudes to grow up with more healthy coping styles and, consequently a more healthy personality.
Results of this research about gender differences in coping replicates results of other studies that have found no gender differences in coping (Compas, Maclcarne, and Fondacaro, 1988; Armistead et al., 1990; Gore, Aseltine, & Colton, 1992). Although no gender difference was found in adolescent's reports of coping in response to stressful events, girls and boys may utilize the same strategies differently in real world in stressing situations. Loss of gender difference in coping in this research can also be related to the age range of the sample of present research. Differential reinforcements have been one of the assumed causes for observing gender differences in coping (Matheny, Ashby, and Cupp, 2005). Adolescent males and females in this research may not have differential reinforcements for using specific coping as much as adults do, because of their lower ages. Therefore, results about gender differences in coping such as in this study may be more age-related rather than generalized. Considering inconsistent results about gender differences in coping, it is possible that, there was more complex relation between coping and gender.

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