Table III.

Coping Measures

Scale description					Reliability and validity		Treatment implications	Scale criteria
Authors and measure	Informant/population	Stressor	No. of items; subscales	Scales/factors	Internal consistency/test–retest	Convergent/predictive	Sensitive to treatment outcome? Leads to treatment implications?	Stress and coping criteria
Self-report general coping measures
A-Cope Patterson & McCubbin, 1987	Self-report 11 and up Healthy adolescents; cystic fibrosis; HIV; adolescent mothers	“When feeling tense or facing a problem or difficulty”	54 items; 12 subscales	aScales include: VF; SD; DR; DSS; SFP; AP; SSS; ICF; SPS; EDA; BH; R Factors derived from factor analysis by Chapman and Mullis (2000) were problem-focused coping, cognitive-focused coping, and emotion-focused coping	α =.50 to.75 (median =.72) Test-retest (r =.83) based on Young Adult COPE	Convergent: Not reported Predictive: High self-esteem correlated with more problem-focused coping and less emotion-focused coping; avoiding problems correlated with illicit substance use.	Sensitive: pre- and post-test measures for treatment (Carty, 1993; Harris & Franklin, 2003; Mason & Collison, 1995) Implications: No study currently demonstrates this. Typically used to describe most frequently used coping strategy.	Well-established assessment that broadens understand-ing
Coping Response Inventory – Youth Form (CRI-Y) Ebata & Moos, 1991	Self-report 12–18 Healthy children; depression; conduct disorder; rheumatic disease; siblings of children with a disability	Researcher (e.g., start college) or self-selected stressor	48 items; eight subscales Measure has Actual form and Ideal form. Ideal form asks preferred coping style.	bScales include four approach coping (LA, PR, SG, PS) and four avoidance coping (CA, AR, SAR, ED) No factor analytic studies have been conducted with this measure.	α =.55 to.79 Test–Retest (r =.29 to.34) 15 month	Convergent: Not reported Predictive: Approach coping correlated negatively with health problems and health risk behaviors; avoidance coping correlated positively with these domains. Approach coping related to fewer stressors with siblings and friends.	Sensitive: Some changes in coping behaviors following Teaching Kids to Cope program for depression and coping in rural children (Puskar, Sereika, & Tusaie-Mumford, 2003). Implications: No study currently shows this.	Approaching well-established
Coping Strategies Inventory (CSI) Tobin, 1991	Self-report 7 and up or parent report on child 3 and up Healthy children and young adults; sickle cell anemia, HIV; renal transplant; eating disorder; cancer; Inflammatory Bowel Disease	Researcher (e.g., sickle cell disease) or self-selected stressor	32 items; eight primary subscales, four secondary scales, two tertiary scales	cPrimary scales include: PS, CR, SS, EE, PA, WT, SC, SW; Secondary Scales include: PE, EG, PD, ED; Tertiary scales include: ENG, DIS factor analysis by Tobin, Holroyd, Reynolds, and Wigal (1989) are consistent with the hierarchical scales	α =.70 to.94 Test–retest (r =.67 to.83) for same stressor and (r =.39 to.61) with two different stressors	Convergent: Not reported Predictive: Individuals with greater self-efficacy report doing more problem-solving and less problem-avoidance than individuals with lower self-efficacy. Adolescents with IBD with poor coping report lower medication adherence (Mackner & Crandall, 2004)	Sensitive: No study found. Implications: No study currently demonstrates this.	Well-established assessment that broadens understanding
Kidcope Spirito, Stark, & Williams, 1988	Self-report 7–12 year old version Self-report 13–18 year old version Various contexts in which child is faced with an acute or chronic health related stressor (e.g., cancer and diabetes).	Researcher (e.g., being teased, hospital) or self-selected stressor	15 items; 10 subscales 10 items; 10 subscales	dScales include: PS, D, SS, SW, CR, SC, BO, ER, WT, R Factors derived from factor analysis by Cheng and Chan (2003) were control-oriented coping and escape-oriented coping	Internal consistency not reported Test-retest (r =.41 to.83) 3–7 days (r =.15 to.43) 10 weeks	Convergent: Scales related to Coping Strategies Inventory scales (r =.33 to.77) and ACOPE scales (r =.08 to.62) Predictive: Cognitive restructuring positively correlated with positive well-being and negatively correlated with depression (Well-Being Questionnaire 12); Avoidant/ emotion-focused strategies correlated with PTSD diagnosis	Sensitive: No study found. Implications: No study currently demonstrates this.	Approaching well-established
Role-Play Inventory of Situations and Coping Strategies (RISCS) Quittner, Tolbert, Regoli, 1996	Self-report adolescent version Self-report school-age children version Self-report parents of adolescents version Self-report parents of school-age children version Children and adolescents with CF and their parents	Vignette provided; “What would you say or do in this situation?” Also rate frequency and difficulty level of each situation	31 vignettes	11 domains: Medications and treatment, Routines, Spouse, Outside activities, Discipline, Peers, School, Medical care, Finances, Siblings, and Mealtimes	Inter-rater reliability: 81%	Convergent: Not reported. Predictive: For adolescents, RISCS correlated in the expected directions with CDI and the Harter Self-Perception Profile for Adolescents. For parents, RISCS correlated in the expected directions with the CES-D and certain domains from the Who Does What? Questionnaire, with some findings only significant for mothers or fathers.	Sensitive: CBT intervention showed that coping strategies generated by children and adolescents with CF improved, but no significant change occurred in their ratings of frequency or difficulty of situations (Davis, Quittner, Stark, & Tang, 2003). Implications: Not currently demonstrated; however, the RISCS identifies the frequency and severity of specific types of situations that are problematic for families, which could inform treatment.	Approaching well-established
Ways of Coping (Revised version) Folkman & Lazarus, 1980	Self-report for children, adolescents, and adults Widely used; e.g., healthy children, adolescents, and adults; children and adults at risk for type 1 diabetes	Researcher or self-selected stressor	68 items; eight subscales	eSubscales include: CC, D, SC, SSS, AR, EA, PPS, PR Factor analysis reported for original version: Folkman and Lazarus (1980) found two factors: emotion- and problem-focused coping; using an adolescent sample, Halstead, Johson, & Cunningham, 1993, found four factors: problem-focused, seeks social support, wishful thinking, and avoidance.	α =.61 to.88 for subscales Test–retest not reported; however, Consistency scores for individuals reporting on different stressors ranged from.714 to 1.00	Convergent: Not reported Predictive: Israeli children's scores were positively correlated with global distress, measured via the Global Severity Index (Hallis & Slone, 1999). Older adolescents used a wider variety of coping strategies and methods that could more likely reduce the impact of a stressful situation compared to younger adolescents (Williams & McGillicuddy-De Lisi, 1999). Children at risk for Type 1 diabetes used more avoidance, wishful thinking, and self-blame than adults (Johnson & Carmichael, 2000).	Sensitive: No study found. Implications: No study currently demonstrates this. Typically used to describe coping strategies used in stressful situations.	Well-established assessment that broadens understanding
Self-report pain coping measures
Pain Coping Questionnaire (PCQ) Reid, Gilbert, & McGrath, 1998	Self-report 8 and up or parent report Healthy youth; youth with chronic, recurrent or postoperative pain and their parents	“When I am hurt or in pain for a few hours or days, I …”	39 items; eight subscales; three higher-order scales	fSubscales include: IS, PS, SSS, PSS, BD, CD, E, I/C; higher-order scales include: A, PFA, EFA Factors derived from factor analysis by Reid et al. (1998) are consistent with the hierarchical scales	α =.74–.86 for subscales α =.85 to.89 for higher-order scales Test–retest not reported	Convergent: Not reported Predictive: Approach and problem-focused avoidance were positively related to pain controllability and coping effectiveness. Problem-focused avoidance was negatively related to pain, distress, and functional disability. Emotion-focused avoidance was negatively related to pain controllability and coping effectiveness, and positively related to pain intensity, distress, depression, and functional disability.	Sensitive: CBT treatment showed significant reduction in catastrophizing (Eccleston, Malleson, Clinch, Connell & Sourbut, 2003) Implications: Typically used in correlational studies. Potential implications for treatment to coping style. Children with low distraction scores did better in attention focusing than distraction intervention in one study (Piira, Hayes, Goodenough, & von Baeyer (2006).	Well-established assessment that broadens understanding
Pain Response Inventory (PRI) Walker, Smith, Garber, & Van Slyke, 1997	Self-report for school-age children Children with recurrent abdominal pain (RAP)	“When you have a bad stomachache how often do you …?”	60 items; 13 subscales; three broad coping factors	gSubscales include: PS, SSS, R, M/G, CSS, SI, BD, C, A, MP, SE, D/I, S; broad coping factors include: ACT, PAS, ACC Covariance structure analysis by Walker et al. (1997) supports 13 first-order and three second-order factors, which include passive coping, active coping, and accommodative coping	RAP patients: α =.71–.78 for higher-order scales α =.68–.89 for subscales Test–retest (r =.46–.71) 1 week median =.59 (r =.34–.46) 6 months	Convergent: Episode-specific active, passive, and accommodative coping was associated with PRI dispositional scores, active (r =.28), passive (r =.53), and accommodative (r =.42) coping. (Walker, Smith, Garber & Claar, 2005) Predictive: PAS coping was associated with pain, somatization, functional disability, and depressive symptoms. Behavioral disengagement, lack of self-encouragement, lack of problem-solving predicted pain and somatization. Self-isolation and stoicism predicted somatization. Catastrophizing lack of distraction strategies predicted pain. Greater Catastrophizing and Massage/Guard, and less Problem-Solving and Condition-Specific Strategies predicted depressive symptoms.	Sensitive: 3-session CBT treatment showed significant reduction in catastrophizing (Levy et al., 2003). Implications: Walker et al. (2005) examined dispositional and episode specific coping strategies to extend our conceptual understanding of coping with pain with direct implications for the importance of reducing passive coping.	Well-established assessment that broadens understand-ing
Waldron/Varni Pediatric Pain Coping Inventory (PPCI) Varni et al., 1996	Self-report 5–12 year old version Self-report 13–18 year old version Parent version (5–18 years) Children with musculoskeletal pain secondary to rheumatologic disease; leukemia; their parents	“When I feel pain or hurt, I:”	41 items; five theoretically-derived subscales OR 5 empirically-derived subscales	hTheoretically-derived Subscales include: CSI, PS, D, SSS, C/H; Empirically-derived include: CS, SSS, SRBA, CR, PSSE. Factor analysis supports five subscale model	α =.85 for total PCCI;.57 to.74 for subscales Test-retest not reported	Convergent: Not reported Predictive: Strive to Rest and Be Alone subscale were positively associated with pain intensity, anxiety, depressive symptoms, and inversely associated with self-esteem. These relationships were opposite for the Cognitive Refocusing subscale. Scores on the Problem Solving Self-Efficacy subscale were positively associated with self-esteem and inversely associated with depressive symptoms. Scores on the Seeking Social Support subscale were associated with higher depressive symptoms, trait anxiety, externalizing problems, and lower emotional and social functioning.	Sensitive: No study found. Implications: No study currently demonstrates this.	Promising
Observational pain coping measures
Behavioral Approach–Avoidance and Distress Scale (BAADS) Hubert et al., 1988	Observational rating scale of ages 3–13 years Preschoolers undergoing immunizations; pediatric patients with leukemia undergoing their first BMA	Children's behavioral responses to an acute painful medical procedure	10 items; two scales	Scales include: Approach–Avoidance; Distress Each subscale includes 5-point behaviorally anchored ratings taken at five points during medical procedures.	α =.82 approach α =.95 distress Inter-rater reliability was κ =.65–.78 for approach-avoidance and κ =.77–.89 for distress	Convergent: Correlates in expected directions with the CAMPIS-R & CAMPIS-SF (Bachanas & Blount, 1996) Predictive: BAADS scores during medical preparation correlated with behavior during subsequent bone marrow aspirations. (Hubert et al., 1988)	Sensitive: Significant differences found between treatment and control groups in coping skills training intervention (Blount et al., 1992). Implications: No study currently demonstrates this.	Promising
Child Adult Medical Procedure Interaction Scale (CAMPIS) and (CAMPIS-R) Blount et al., 1989; Blount et al., 1997	Observational rating scale of ages 6 months to 13 years Immunizations; pediatric patients with leukemia undergoing BMAs and LPs; voiding cystourethograms; physical therapy regimens; cold pressor exposure	Acute painful or stressful procedure	35 codes in CAMPIS; grouped into six codes in CAMPIS-R	Scales include: child coping, child distress, child neutral, adult coping promoting, adult distress promoting, and adult neutral behaviors Each person's behavior is typically coded at three phases (up to 3 min before the injection, during the injection, and from the needle removal until 2 min later)	Inter-rater reliability was κ =.65–.92 for all scales	Convergent: The Child Coping scales correlated in the expected directions with the Observational Scale of Behavioral Distress (OSBD), and the BAADS distress scores. Child Coping and Child Distress scales have been correlated in the expected directions with BAADS Approach scores. Predictive: Child Coping scales correlated with parent, child, and staff reports of child fear and pain. Child Coping and Child Distress scales correlated in the expected directions with parents’ ratings of their ability to help their children and with staffs’ ratings of child cooperation.	Sensitive: Therapeutic effects have been demonstrated by changes in CAMPIS-R distress, coping, distress promoting, and coping promoting scales following intervention (Blount et al., 1992; Cohen, Blount, Cohen, Schaen, & Zaff, 1999; Cohen, Blount & Panopoulus, 1997). Implications: Assessment studies lead directly to the design of therapeutic interventions to help children cope prior to and during medical treatments (Blount, Bunke, & Zaff, 2000)	Well-established assessment that guides treatment
Child Adult Medical Procedure Interaction Scale- Short Form (CAMPIS-SF) Blount et al., 2001	5-point rating scale version of CAMPIS-R. Could be used with the same populations.	Acute painful or stressful procedure	Includes four of the six codes of the CAMPIS-R.	Scales include: child coping and child distress, as well as parent and staff coping promoting and distress promoting behaviors.	Inter-rater reliability was α =.74–1.0 for all scales	Convergent: During immunization procedures, ratings for the different CAMPIS-SF factors correlated in the expected directions with CAMPIS-R and BAADS measures, and with nurse report, parent report child self-report measures. Predictive: Nurse behavior was correlated with child coping and parent behavior with child distress during an intervention study with 3 to 7-year-old children (Cohen et al., 2002)	Sensitive: Did not show change in child behavior in one intervention study (Cohen et al., 2002). Implications: No study currently demonstrates this.	Promising

^aVF, ventilating feelings; SD, seeking diversions; DR, developing self-reliance and optimism; DSS, developing social support; SFP, solving family problems; AP, avoiding problems; SSS, seeking spiritual support; ICF, investing in close friends; SPS, seeking professional support; EDA, engaging in demanding activity; BH, being humorous; R, relaxing.

^bLA, logical analysis; PR, positive reappraisal; SG, seeking guidance and support; PS, problem solving; CA, cognitive avoidance; AR, acceptance or resignation; SAR, seeking alternative rewards; ED, emotional discharge.

^cPS, problem solving; CR, cognitive restructuring; SS, social support; EE, express emotions; PA, problem avoidance; WT, wishful thinking; SC, self-criticism; SW, social withdrawal; PE, problem engagement; EG, emotion engagement; PD, problem disengagement; ED, emotion disengagement; ENG, engagement; DIS, disengagement; SPP-ATF, Society of pediatric psychology assessment task force.

^dPS, problem solving; D, distraction; SS, social support; SW, social withdrawal; CR, cognitive restructuring; SC, self-criticism; BO, blaming others; ER, emotion regulation; WT, wishful thinking; R, resignation.

^eCC, confrontive coping; D, distancing; SC, self-controlling; SSS, seeking social support; AR, accepting responsibility; EA, escape-avoidance; PPS, planful problem-solving; PR, positive reappraisal.

^fIS, information seeking; PS, problem solving; SSS, seeking social support; PSS, positive self-statements; BD, behavioral distraction; CD, cognitive distraction; E, externalizing; I/C, internalizing/catastrophizing; A, approach; PFA, problem-focused avoidance; EFA, emotion-focused avoidance.

^gPS, problem-solving; SSS, seeking social support; R, rest; M/G, massage/guard; CSS, condition-specific strategies; SI, self-isolation; BD, behavioral disengagement; C, catastrophizing; A, acceptance; MP, minimizing pain; SE, self-encouragement; D/I, distract/ignore; S, stoicism; ACT, active; PAS, passive; ACC, accommodative.

^hCSI, cognitive self-instruction; PS, problem solving; D, distraction; SSS, seeks social support; C/H, catastrophizing/helplessness; CS, cognitive self-instruction; SSS, seek social support; SRBA, strive to rest and be alone; CR, cognitive refocusing; PSSE, problem-solving self-efficacy.