Gender Differences in Coping among Spousal Caregivers of Persons with Multiple Sclerosis

Multiple sclerosis (MS) is a progressive central nervous system disease resulting in motor, cognitive, and neuropsychiatric symptoms (Chiaravalloti & DeLuca, 2010). According to the National Multiple Sclerosis Society (2011), MS affects approximately 400,000 adults in the United States. Due to the progressive nature of MS, an individual's need for personal assistance and care is likely to increase over the course of the disease, and nearly 30% of individuals with MS rely on support from informal caregivers to assist them in performing activities of daily living (Akkus, 2011; Buchanan, Radin, Chakravorty & Tyry, 2010; Kersten et al., 2000). Elliott, Shewchuk, and Richards (1999) described that caregiving for individuals with disabling conditions who have considerable life expectancies can create immediate and sometimes extreme changes in personal, vocational, and family roles and functions. These changes have been found in caregivers caring for a family member with MS as well. Caring for people with chronic illness and disability (CID) is generally viewed as a stressful situation. Researchers have found that caregivers providing care for an individual with MS experience a significant amount of stress, which in turn can affect their psychological well-being (McKeown, Porter-Armstrong, & Baxter, 2003; Roth, Perkins, Wadley, Temple, & Haley, 2009). Several factors associated with caregiving for individuals with MS have been found to increase strain, including the feeling of caring for an individual, financial strain, physical burden of caregiving, and the need to change personal plans due to caregiving (Chipchase & Lincoln, 2001; Khan, Pallant, & Brand, 2007). Additionally, caring for an individual with MS can have a negative impact on the caregiver's social life. Caregivers for individuals with MS have been found to have relatively low levels of social support in comparison with the general population (McKeown et al., 2003). Coping Coping is defined as a person's cognitive and behavioral efforts to manage the demands of a stressful situation (Pakenham, 2001). According to Lazarus and Folkman (1984), the manner in which people cope with stressful situations can affect the impact of stress on adjustment and health. Coping strategies are thought to mediate the relationship between stress and adjustment, with some coping strategies aiding the individual to overcome a stressor, resulting in better psychological adjustment (Liang et al., 2009). In the coping literature, two general conceptual frameworks are widely used: problem-focused versus emotion-focused coping (Lazarus & Folkman, 1984) and approach versus avoidance coping (Krohne, 1993; Roth & Cohen, 1986). Problem-focused and approach coping involve direct strategies to alter the stressful situation. Emotion-focused and avoidance coping refer to more indirect efforts to adjust to the stressor by palliating feelings or avoiding the stressor (Kelly, Sereika, Battista, & Brown, 2007). Coping strategies may vary in their effectiveness from situation to situation and as the coping context evolves (Folkman & Moskowitz, 2004). In general, studies have shown that active, directive, problem-focused, information-seeking, and social support-seeking coping strategies are more likely to lead to positive psychosocial adaptation, while passive, nondirective, emotion-focused, self-blame, and avoidance coping strategies are more likely to lead to negative adaptation (Smedema, Bakken-Gillen, & Dalton, 2009). Coping and Gender Gender is an important marker for individual differences in psychosocial variables, which may affect choice of coping strategy, psychosocial adaptation, and the relationship between these. Gender differences in the modes of coping and the level of stress experienced in response to a given situation are consistently reported in the coping literature (Carver, Scheier, & Weintraub, 1989; Folkman & Moskowitz, 2004; Kim, Loscalzo, Wellisch, & Spillers, 2006; Lutzky & Knight, 1994; Tamres, Janicki, & Helgeson, 2002). …