When a person experiences a stressful event, he or she has to handle the problem in some way. Some persons, for example, may take direct action to resolve the problem or may ask others for advice. Other persons might go to a movie to distract themselves from the problem or might ignore the problem and hope that it goes away. These are a small sampling of the numerous ways that people can respond to stress. Coping efforts or coping behaviors are therefore defined as those thoughts and behaviors that a person uses to manage a stressor.
One useful model for understanding coping behavior is the transactional model, developed in 1984 by Richard Lazarus and Susan Folkman. When an event occurs, a person evaluates the event to determine whether it is stressful (called primary appraisal)- Events that pose a threat (e.g., taking an exam that one is not prepared for) or that involve loss (e.g., being fired from a job) are appraised as stressful. Following this primary appraisal, the person reviews options of how to manage the problem (called secondary appraisal) and engages in one or more of those options. The result of those coping efforts is to produce either a positive mood state if the stressor is resolved or a negative mood state if the problem remains ongoing. Negative mood states produce physiological reactions that are detrimental to health, and positive moods produce physiological responses that relax the body and are more health protective. The final, crucial piece of the model is that it is a process. A person can continually reappraise the situation and adjust his or her coping efforts as needed. The remainder of this article discusses the different types of coping, how often they are used and by whom, and their effectiveness at reducing the health-related consequences of stress.
Types of Coping
There is no single way to view or to categorize coping efforts. Several ways of categorizing coping have been offered, and three commonly used models are described here.
One distinction is between active and passive coping. Active coping efforts include those intended to resolve a problem. Passive coping efforts are avoidant in nature and include such efforts as distraction (focusing one’s attention on something other than the stressor) and denial (acting as if the stressor never occurred). Other categorizations view coping efforts as being problem focused, emotion focused, or avoidant nature. Problem-focused strategies include those actions taken to resolve a stressor. Emotion-focused strategies include those efforts that make a person feel better about the situation. Avoidant strategies include those that essentially ignore the problem, such as denial.
A student who is struggling in a class, for example, may engage in problem-focused coping such as scheduling extra study time or hiring a tutor. An example of an emotion-focused strategy for the same situation is when the student talks to friends to relieve anxiety while waiting to hear about test results. Denial is an example of an avoidant strategy in which a person insists that things are fine even though she or he is in danger of failing the class.
Although these distinctions are useful, they obscure the variety of ways that people can cope, and efforts turned to identifying specific coping factors. These factors are often labeled differently across studies, but they have common underlying features such as planful problem solving, seeking social support, waiting for the right time to do something, denial or distancing oneself from the problem, reappraising the situation to view it more positively (e.g., “looking for the silver lining”), accepting responsibility, and escape/avoidance (e.g., drinking alcohol to forget a problem), among others. How a particular effort is categorized depends on the nature of the problem and the intent and result of the effort. For example, talking to a friend may be a problem-solving strategy if it results in a plan of action or it may be an attempt to seek social support if the goal is to help the person feel better. Thus, it is more the intent and outcome of the action that determines the type of coping rather than the action itself.
Thus far, coping efforts have been described as specific behaviors. Another way to conceptualize coping efforts is in terms of coping flexibility. When first developed, this concept generally referred to one’s variability in the use of coping efforts. In 2001, Cecilia Cheng provided a theoretical model of coping flexibility and tested her model in laboratory and real-life settings. Cheng identified five broad categorizations of flexibility: flexible (people who could perceive variability in their degree of control over a situation), active—inflexible (maintaining an appraisal of control across all situations), passive—inflexible (viewing all events as outside of their control such as in a learned-helplessness attitude), active-inconsistent(relying somewhat exclusively on active coping efforts even in situations that were outside of personal control), and passive—inconsistent (relying somewhat exclusively on emotion-focused coping efforts, even in instances when personal control existed). Compared to the other groups, the flexible group indeed reported greater variability in their perceptions of stress, selection of coping behaviors, and greater coping effectiveness. Consequently, the concept of coping flexibility is important to the understanding of the coping process.
Coping Strategies and Usage
When people have personal control over a stressor, they tend to utilize problem-focused coping strategies. When a stressor is outside a person’s control, he or she tends to rely more on emotion-focused or avoidant coping strategies. Otherwise, the usage of the different strategies depends on such factors as the person’s gender, personality, and cultural background.
Gender Differences in Coping
Many studies throughout the 1970s and 1980s found that men engaged in more problem-focused coping efforts and that women engaged in more emotion-focused coping efforts when managing a stressor. This information, combined with findings that women reported more psychological problems such as anxiety and depression and utilized the health care system more frequently, led people to believe that women were ineffective copers compared to men.
Research in the 1990s and early 2000s painted a more complex picture of the gender differences in coping. Shelley Taylor and her colleagues proposed that women have a greater tendency to “tend-and-befriend” others when stressed, rooted in women’s evolutionary investment in producing and protecting offspring (Taylor et al., 2000). According to Taylor, women are more likely to nurture and protect individual people and the larger social network when faced with stress. Taylor also posited that this response is related to an attachment-caregiving biological system that differs from the “fight-or-flight” system used to fight or run away from an adversary. Although some disagreed with Taylor’s assertions, the model suggested that gender differences in coping may, in part, be biologically rooted in different evolutionary needs of men and women.
Other research found that men and women tended to select and report on different stressors. When allowed to select a stressor, men tended to select more task-oriented stressors and women tended to select more interpersonal stressors. Consequently, prior gender differences in coping may have been more an outcome of these different stressors than an indication of ineffective coping.
A meta-analysis compared findings across studies published from 1990 to 2000 and found that women were more likely than men to seek emotional support, constantly think about the problem (called rumination), and engage in positive self-talk designed to encourage or reassure oneself. However, gender differences in coping were more apparent when women appraised the stressor as being more stressful. When men and women appraised the stress equally, gender differences disappeared, with one exception: men were more likely to seek nonspecific social support. Furthermore, women reported using more coping strategies overall, including problem-solving strategies, than men did. These findings suggest that, if gender differences in coping exist, women may take a more flexible approach to their coping rather than have a preference for a given strategy.
Cultural Differences in Coping
When comparing coping efforts of people from Western versus Eastern cultures, research suggests that the more collectivist nature of Asian cultures results in a lesser valuation of personal control and a tendency to report less personal control over stressful events. Because appraisals of low control result in using fewer active behavioral coping strategies, one would predict—and research findings support the notion—that people from Western cultures use more active behavioral coping and that people from Asian culture used more emotional or cognitive coping strategies.
In the United States, similar differences in the use of coping efforts have been found between people from European-American versus other cultural backgrounds. In general, people from African-American and Latino backgrounds tend to report less usage of problem-focused strategies and rely more on emotional and spiritual-based coping as compared to Americans of European descent. Like Asian cultures, African-American and Latino cultures also tend to rely on and value community over individuality more so than do people of European descent. Consequently, the lesser reliance on individual action may be a direct result of this value. One should note, however, that members of African-American and Latino ethnic groups are disproportionately represented in the lower socioeconomic strata; therefore, it is unclear whether these differences are due to cultural preferences per se or to the relatively uncontrollable life circumstances that accompany lower socioeconomic status (e.g., crowding, poverty).
Personality Differences in Coping
Yet another way to conceptualize coping efforts is through a person’s general coping style, also known as trait coping. This approach assumes that different personalities interact with the world differently and have preferences for using certain strategies more than others. One example of a coping style is the characteristic of optimism, a general outlook on life that maintains the belief that positive things will happen. Optimists use more problem-focused coping, positive reappraisal, and seeking social support. Pessimists report using more denial, distancing, and disengagement in their coping efforts. A second example of a trait coping style is the monitoring versus blunting coping style, which is particularly relevant for people coping with medical problems. Whereas people with a monitoring coping style desire and seek out information about their medical conditions, people with a blunting coping style-avoid and distract themselves from such information. A third example of personality-influenced coping style is the construct of hardiness. People who are considered “hardy” exhibit a composite of three characteristics: high commitment (being fully engaged in what one encounters), high control (believing that one can influence the environment and the events in one’s life), and high challenge (being open to change and viewing events as opportunities for growth). People who are high in hardiness tend to use more problem-focused and less avoidant coping strategies than people low in hardiness.
Evaluation of Coping Efficacy
The term coping efficacy refers to the extent to which coping efforts are effective at helping a person to resolve a problem or feel better about a situation. A large body of research has accumulated on coping efficacy; in fact, it is perhaps the most prolific in psychology research. Several different methods exist for studying coping efficacy. One model asks them how they typically handle stressors and reflects the more trait-oriented type of coping style. A second model provides people with hypothetical examples of stressors and asks them how they would cope with it if they experienced it. A third model asks people to identify a stressor that they have experienced and how they coped with it. People may be asked to retrospectively recall a stressor that occurred in the past week or month. Diaries recorded at the end of a day are used to study coping efforts close in time to when they happened. In the 1990s the development of hand-held computerized diaries allowed researchers to study coping efforts as they occurred throughout a day. The end-of-day and momentary diaries provide the most promise for understanding the process component of coping.
For as many stressors as one can name—job stress, academic difficulties, illness and injury, marital difficulties, and so on—a separate literature has developed to understand how to cope effectively with these problems. Overall, these studies indicate that problem-focused strategies are more effective when the person has personal control over the situation but that avoidant strategies are most effective when personal control is lacking. A 1985 review by Jerry Suls and Barbara Fletcher found that avoidant strategies were more effective in the short term and strategies that focused one’s attention on a stressor were more effective in the long term. Thus, distracting oneself may be effective while waiting to hear the results of a medical test, but such avoidance behaviors are not effective for health matters in the long term.
In the late 1990s, interest developed in previously overlooked ways of coping, including spiritual-based coping and expressive writing (i.e., writing about stressful events in a journal). These strategies were found to be effective at helping people to accept stressful experiences in a positive way. Expressive writing in particular was found to help people to process emotional experiences, release emotions in an adaptive way, and improve health-related physical functioning. The effect of spiritual coping efforts on health remains controversial.
Health Benefits of Successful Coping
When considering the health-related benefits of coping, it is important to consider the impact of coping efforts on both physical and mental health outcomes. Also, one can consider how coping efforts help to prevent illness from occurring and how coping efforts help people with medical problems during and after the diagnostic process.
Overall, there are two main ways by which coping efforts can help keep people healthy. The first is through health-related behaviors. When people cope effectively with stress, they are more likely to take care of themselves by eating regular and healthy meals and by getting adequate sleep. People who cope ineffectively with stress are more likely to turn to unhealthy habits such as smoking and eating poorly. Consequently, one path by which coping efforts influence health is by altering the person’s health behaviors.
The second way in which coping efforts contribute to health has been more difficult to establish in research findings. This route pertains to how coping efforts ameliorate the physiological effects of stress. When a stressor occurs, the human body engages in a fight-or-flight response, which prepares the body to either fight the threat or run away from it. This response includes, for example, increased heart rate and blood pressure to provide more oxygen to those parts of the body needed to respond to the threat. Although these physiological responses are adaptive for handling acute, time-limited stressors (e.g., escaping a predator), they are less adaptive when dealing with the longer term, chronic stressors encountered in our modern lives (e.g., the constant stress that accompanies attending college over several years). Although our stressors have evolved over time, the body’s response to those stressors have not and it is believed that our bodies remain in a heightened state of arousal as we go about our daily activities.
The body’s physiological responses are set off by such emotional reactions as fear and anger that accompany threatening situations. Coping theory posits that effective coping reduces the emotional reaction and short-circuits the physiological response. Although some research supports this notion, it has by no means been resolved in the literature and problems in these studies exist. Namely, early research relied on retrospective reports of coping with events that had already passed, the memory of which could have been influenced by the passage of time. In the 1990s, the development of computerized diaries allowed researchers to study coping efforts as they occurred during the day. One study found that coping efforts measured on this momentary basis were unrelated to mood measured at the same time. Although contrary to prior findings, the authors suggested that people might view the coping process differently at the momentary level compared to when they retrospectively recall a stressor. Consequently, many researchers in the early 21st century called for a more process-oriented approach to understand the dynamics of coping.
A 2002 paper by Julie Penley and her colleagues reviewed research on the relationship between coping and health. Although the review included a limited number of studies, it nevertheless produced some interesting summations of this relationship. Overall, the use of self-control and problem-focused coping strategies was associated with some improved physical health outcomes, whereas the use of distancing and seeking social support was associated with poorer physical health outcomes. The use of problem-focused coping was associated with improved psychological health and the use of confrontive coping, distancing, self-control, accepting responsibility, escape-avoidance coping, and wishful thinking were associated with poorer psychological health. Planful problem solving and positive reappraisal were unrelated to either physical or mental health outcomes. Although some of these findings are contrary to prior research, the results may be biased by the selection of only a small sample of studies that may not be representative of the larger body of research on coping and health. Furthermore, a cautionary note about the causal nature of these findings needs to be made. Because most of the articles in the meta-analysis focused on how people coped with medical stressors, it is unclear whether the use of certain coping strategies “caused” certain health outcomes or the experience of chronic health problems “caused” people to rely less on problem-focused and more on emotion-focused coping strategies.
Effectiveness of Coping Skills Intervention
Given that some people cope more effectively with stress than others, it seems reasonable to presume that ineffective copers may be trained to improve their coping skills. Research in this area typically has selected a problem (e.g., substance abuse) and trained people in techniques that helped them to adapt more successfully to the situation. Examples of skills taught in these interventions are problem-solving skills, time management skills, communication skills, managing emotions, and cognitive restructuring in which negative thought patterns (e.g., “This pain I’m in is absolutely unbearable!”) are replaced with positive ones (e.g., “This hurts, but I can ride it out and will be okay”), among others.
Although a wealth of research on this topic exists, James Coyne and Melissa Racioppo (2000) criticized it for not identifying the “crucial ingredients” that make such interventions successful and for not understanding how changes in behavior occurred. Furthermore, changes in behavior are difficult to maintain, and Coyne and Racioppo indicated a need to understand how such behavioral changes are maintained. They recommended that future research work to further our understanding of these issues.
Coping efforts refer to those thoughts and behaviors used to manage a stressor. Different ways of categorizing coping efforts have been suggested, and individual differences in the use of coping efforts exist based on gender, culture, and personality. Whether a particular strategy is effective depends on the nature of the stressor. In general, those stressors that are under a person’s immediate control tend to be coped with more effectively using problem-focused strategies and those stressors that are outside a person’s immediate control tend to be coped with more effectively using emotion-focused strategies. Effectively coping with stress can have health-protective effects by helping a person to maintain healthy lifestyles and reducing deleterious physiological responses to stress, although people can learn more effective coping responses via stress management or coping skills training. Finally, research on coping efforts would benefit greatly from a focus on the process of coping and how it can change over time rather than a focus on individual strategies at a single point in time.
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