Coping: pitfalls and promise - Folkman - 2004 - Article

Summary of the article: Coping: pitfalls and promise - Folkman - 2004.

Most research on coping has been couched in the framework of ego-psychology and the concept of defense and a large proportion of contemporary coping research can be traced back to the publication of Lazarus's (1966) book Psychological Stress and the Coping Process. Around 1970 coping became a distinct field in psychology. Lazarus and Folkman defined coping as thoughts and behaviors that people use to manage the internal and external demands of situations that are appraised as stressful. Coping is a process that unfolds in the context of a situation or condition that is appraised as personally significant and as taxing or exceeding the individual's resources for coping.

How can you measure coping?

The first generation of the coping measures took the form of a checklist of thoughts and behaviors that people use to manage stressful events. These inventories are helpful in that they allow multidimensional descriptions of situation-specific coping thoughts and behaviors that people can self-report. But there are also limitations:

• Potentially burdensome length
• Inadequate sampling of coping inherent in checklist approaches and response keys that are difficult to interpret
• Variations in the recall period
• Changes in meaning of a given coping strategy depending on when it occurs
• Unreliability of recall
• Confounding of items with their outcomes

The most prominent of all the criticisms of the checklist approach concerns the problem of retrospective report and the accuracy of recall about specific thoughts and behaviors that were used one week or month earlier during the coping measurements. Narrative approaches provide an interesting alternative to checklist approaches. A great deal can be learned by asking people to provide narratives about stressful events, including what happened, emotion they experienced, and what they thought and did as the situation unfolded. Narrative approaches are also useful for uncovering for ways of coping that are not included on inventories. Research has also shown that narrative and quantitative approaches overlap, but are not equivalent.

There is no golden standard for the measurement of coping, and you also have to think about possible biases that can be an influence. Retrospective accounts may be telling what the person is doing now to cope with what has happened, as well as what the person did then to cope with what happened then. Some might call this 'error' or 'noise'. The theoretical distinction between problem-focused and emotion-focused coping provides a useful way of talking about many kinds of coping in broad brushstrokes and it is used in the coping literature. Several researchers found that the problem-focused and emotion-focused distinction was a good starting point, but they identified meaning-focused coping as a different type of coping in which cognitive strategies are used to manage the meaning of a situation.

Empirically derived categories of coping usually include the three theoretically derived factors mentioned above - problem-focused, emotion-focused and meaning-focused coping. Sometimes this kind of distinction is important to retain, if sample size allows, statistical techniques such as structural equation modeling can be used to examine unique effects of individual coping responses even though they are grouped into larger latent factors. A second set of issues related to the grouping of coping responses concerns the evaluation of the psychometric qualities of coping scales based on the groupings. Also another psychometric issue has to do with the expectation that a multifactorial scale should have factors that are independent of one another.

What is coping effectiveness?

An important motivation for studying coping is the belief that within a given culture certain ways of coping are more and less effective in promoting emotional well-being and addressing problems causing distress, and that such information can be used to design interventions to help people cope more effectively with the stress in their lives. The outcomes are about certain goals the individual wants to accomplish, and so, are personally significant to the individual. First, some outcomes tend to be proximal and are probably influenced by momentary coping. Second, coping responses that are effective with respect to one outcome may have a negative impact on another. A third point has to do with an assumption that a successful goal outcome involves mastery or resolution. A fourth issue has to do with who evaluates the status of the goal. 

A full account of coping effectiveness must consider characteristics of the context and the fit between those characteristics and various types of coping. One is to classify stressful situations in terms of what they are about in objective terms, such as illness, death, or children. This approach ignores the psychological dimensions that are theoretically relevant to a contextual approach to coping. People's ability to modify their coping according to the situational demands is sometimes referred to as coping flexibility, which involves the systematic use of a variety of strategies across different situations rather than the more rigid application of a few coping strategies. Flexibility has been measured in three ways: through a card sorting procedure in which the individual places card containing descriptions of coping into categories that range from 'most like me' to 'least like me'. 

What is future-oriented proactive coping?

Coping research is dynamic and new directions are emerging that are helping the field move forward. Although the concept of threat is central to cognitive theories of stress, most studies of coping focus on how people cope with events that occurred in the past or that are occurring in the present. The responses on potential stressors are referred to as 'proactive coping'. The model defines five interrelated components of the proactive coping process: (a) the importance of building a reserve of resources that can be used to prevent or offset future net losses, (b) recognition of potential stressors, (c) initial appraisals of potential stressors, (d) preliminary coping efforts, (e) and the elicitation and use of feedback about the success of one's efforts. 

What is the dual process model of coping?

The Dual Process Model of coping (DPM) is a theoretically based cognitive model of coping designed for a the social, behavioral, and health sciences. The DPM specifies a dynamic process of coping whereby the individual changes between two orientations: loss and restoration. Loss-oriented coping has to do with grief, breaking bonds and thinking of the deceased person. The restoration-oriented coping includes attending secondary stressors that come about as a consequence of the loss. The DPM defines adaptive coping as involving oscillation between loss- and future-orientations. 

What is religious coping?

Religious coping received little attention until relatively recently. The interest in religious coping is spurred in part by evidence that religion plays an important role in the entire stress process, ranging from its influence on the ways in which people appraise events to its influence on the ways in which they respond psychologically and physically to those events over the long time. Most measures of religious coping relied on just one or two items that asked about religious involvement, religiosity or prayer. In the late 1990s the RCOPE is designed to assess five religious coping functions; (a) finding a meaning in the face of suffering a baffling life experiences, (b) providing an avenue to achieve a sense of mastery and control, (c) finding comfort and reducing apprehension by connecting with a force that goes beyond the individual, (d) fostering social solidarity and identity, and (e) assisting people in giving up old objects and value and finding new sources of significance. 

Negative religious coping is an expression of 'a less secure relationship with God, a tenuous and ominous view of the world, and a religious struggle in the search for significance'. 

What is emotional approach coping?

Emotion-focused coping has been associated with higher levels of distress. Emotion-focused coping can include many different types of coping depending on the study. Second, emotion-focused items that indicate approach and items that reflect avoidance of emotions are often combined into a single scale when, in fact, their effect may be very different and they may actually be inversely correlated. Third, many of the emotion-focused items on the most commonly used coping scales are confounded with distress and therefore the correlations with distress outcomes are likely to be inflated. Coping through emotional approach involves actively processing and expressing emotion. 

How does emotion regulation work?

Emotion regulation is the process 'by which individuals influence which emotions they have, when they have them, and how they experience and express these emotions. Emotion regulatory processes may be automatic or controlled, conscious or unconscious, and may have their effect at one or more points in the emotion generative process'. 

Emotion regulation also includes non conscious processes. Eisenberg (1997) identified two types of emotion regulation: one that involves regulating the internal feeling states and associated physiological processes and the second that involves regulating the behavioral concomitants of emotion. Researchers came to the conclusion that reappraisal and suppression have different affective, cognitive, social and physiological consequences. Gross & John (2003) developed the Emotion Regulation Questionnaire, a measure of individual differences in the tendency to reappraise or suppress. The work on emotion regulation adds to the coping literature by providing an in-depth look at the effects of some forms of emotion-focused types of coping. 

What is the relation between coping and positive emotion?

A new development in the field of coping has to do with the growing awareness of the presence of positive emotion in the stress process. This awareness has been fueled by growing interest in positive emotion more generally among emotion researchers. Positive emotion can occur with relatively high frequency, even in the most dire stressful context, and can occur during period when depression and distress are significantly elevated.

The co-occurrence of positive and negative emotion has important implications for coping. On the one hand, if positive and negative emotions are simply bipolar opposites, then coping that reduces distress should simultaneously increase positive emotion, and vice versa. On the other hand, the co-occurrence phenomenon suggests there may be a degree of independence, in which case different kinds of coping may be associated with the regulation of positive and negative affect. One of the central tasks in coping with severe stress is to integrate the occurrence of the stressor with one's beliefs about the world and the self. A common theme in the coping processes related to positive emotion is their link to the individual's important values, beliefs, and goals that comprise the individual's sense of meaning.

Also, people who have experienced a severe stressful event such as a tornado, hurricane, cancer diagnosis or losing a loved one, often report that something positive has come out of the experience, such as closer relationships with family and friends, reprioritizing of goals, and greater appreciation of life. These benefits and personal changes have been called stress-related growth.&