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COPING. Pittsburgh Mind-Body Center Summer Institute 2008. Overview of Talk. Conceptualizing the coping process Measuring coping Place of coping in Center model Development of coping Issues in coping Dispositional styles vs. situational responses

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Coping

COPING

Pittsburgh Mind-Body Center

Summer Institute

2008


Coping

Overview of Talk

  • Conceptualizing the coping process

  • Measuring coping

  • Place of coping in Center model

  • Development of coping

  • Issues in coping

    • Dispositional styles vs. situational responses

    • Adaptive vs. maladaptive ways of coping


Coping

Conceptualizing CopingLazarus and Folkman Model

Primary Appraisal

  • Significance of event for person

    • Threat

    • Challenge

    • Harm/Loss

      Secondary Appraisal

  • What can I do? How can I cope?


Coping

Dimensions of CopingLazarus and Folkman Model

Problem-focused coping

  • Action taken to counteract the source of the stress

    Emotion-focused coping

  • Responses designed to alter the emotions produced by the event


Coping

Dimensions of CopingSuls and Fletcher Model

Approach coping

  • Responses focused on source of stress and reactions to it

    Avoidant coping

  • Responses designed to place focus away from source of stress and reactions to it


Coping

Dimensions of CopingMoos Model

Differentiates responses along two independent dimensions

  • Active vs. avoidant

  • Behavioral vs. cognitive


Coping

Measuring Coping

Omnibus measures:

  • Ways of Coping Checklist (Folkman & Lazarus, 1980; revised 1985)

  • The COPE (Carver, Scheier, & Weintraub, 1989)

    Dimension-specific measures:

  • Impact of Events Scale (Horowitz et al., 1979)

  • Emotional Approach Coping Scale (Stanton et al., 2000)


Coping

The COPE

  • 60 item self-report questionnaire

    • Dispositional and Situational versions

  • 15 broad coping subscales

  • Broad range of strategies:

    • Behavioral

    • Affective

    • Cognitive

(Carver et al., 1989)


Coping

COPE Subscales

  • Active Coping:

    • Taking action, exerting efforts to remove or circumvent the stressor.

  • Planning:

    • Thinking about how to confront the stressor, planning one’s active coping efforts.

  • Seeking Instrumental Social Support:

    • Seeking assistance, information, or advise about what to do.


Coping

COPE Subscales

  • Seeking Emotional Social Support:

    • Getting sympathy or emotional support from someone.

  • Suppression of Competing Activities:

    • Suppressing one’s attention to activities in which one might engage, in order to concentrate more completely on dealing with the stressor.

  • Religion:

    • Increased engagement in religious activities.


Coping

COPE Subscales

  • Positive Reinterpretation and Growth:

    • Making the best of the situation by growing from it, or viewing it in a more favorable light.

  • Restraint Coping:

    • Coping passively by holding back one’s coping attempts until they can be of use.

  • Acceptance:

    • Accepting the fact that the stressful event has occurred and is real.


Coping

COPE Subscales

  • Focus on and Venting of Emotions:

    • An increased awareness of one’s emotional distress, and a concomitant tendency to ventilate or discharge those feelings.

  • Denial:

    • An attempt to reject the reality of the stressful event.

  • Use of Drugs or Alcohol:

    • Turning to the use of alcohol or other drugs as a way of disengaging from the stressor.


Coping

COPE Subscales

  • Behavioral Disengagement:

    • Giving up or withdrawing effort from the attempt to attain the goal with which the stressor is interfering.

  • Mental Disengagement:

    • Psychological disengagement from the goal with which the stressor is interfering, through daydreaming, sleep or self-distraction.

  • Humor:

    • Making jokes about the stressor.


Four main clusters

Four Main Clusters

Active.72Denial .80

Pos Rein & Growth.71Beh Disengage .76

Planning.67Mental Disengage .58

Supp Comp Activ.63

Restraint Coping.59

Acceptance.52

Emot Soc Supp.86Humor .67

Instru Soc Supp.79Religion-.59

Focus on/Vent Emot.76Use of drugs/alcoh .47


Coping

Place of Coping in Center Model

Chronic/Stable Burdens and Resources

Coping dispositions

Psychological Pathways

Affect,

Quality of life, Perceived stress, Depression,

Purpose

Emotion-focused coping

Biological Pathways

Disability

Disease

Acute

Precipitating

Event

Behavioral Pathways

Active coping


Coping

Development of Coping

How do coping tendencies develop?

  • Influence of genes

    • Temperaments/IQ

  • Influence of learning

    • Idiosyncratic experience/trial and error

    • Parent/peer modeling


Coping

CMU Parent Study

Subjects:

44 college students,their parents (42 mothers, 41 fathers), and their roommates (43).

Measures:

COPE: 60 item inventory assessing 15 conceptually distinct coping strategies


Coping

Correlations between student’s coping responses and coping responses of parents and roommates

ActivePlanningSuppressionRestraintPositive

copingcompetingcopingreinterpret

activitiesand growth

Mother- .16- .06.00- .12 .01

Father- .26- .12.19- .15- .21

Roommate- .23- .08.22-.07- .15


Coping

Correlations between student’s coping responses and coping responses of parents and roommates

HumorInstrumental Religion Emotional Acceptance

soc support soc support

Mother.20- .16 .46 - .11 .11

Father.09 .00 .20 .14 .19

Roommate.50 .01 .23 .11 - .18

*

*

* p < .05


Coping

Correlations between student’s coping responses and coping responses of parents and roommates

Denial Focus on Mental BehavioralUse of

& ventingdisengage-disengage-drugs or

of emotionsmentment alcohol

Mother- .19 .02- .12 - .07 .29

Father .02.14.04.01.40

Roommate- .04 .00.27.06.16

*

* p < .05


Coping

Issues in Coping

  • Dispositional vs. situational assessment

  • Adaptive vs. maladaptive ways of coping

    • Importance of engagement vs. disengagement


Coping

Dispositional vs. Situational Assessment

Some questions:

  • Is the notion of coping styles useful?

  • How do these relate to coping responses in particular situations?

  • Which is better to assess?


Coping

College Adaptation Study (CAPS)

Sample:

  • 89 first-semester undergraduates

    COPE:

  • Dispositional — Start of the semester

  • Situational — 12 to 16 weeks later

    Outcomes:

  • Depression

  • Perceived stress

  • Subjective health


Coping

Correlations between Dispositional and Situational Coping (CAPS)

College Undergraduates:

Correlation Coefficient

(Scheier et al., 2000)


Coping

Correlations between Dispositional and Situational Coping (CAPS)

College Undergraduates:

Correlation Coefficient

(Scheier et al., 2000)


Coping

Correlations between Dispositional and Situational Coping (CAPS)

College Undergraduates:

Correlation Coefficient

(Scheier et al., 2000)


Coping

Dispositional and Situational Coping and Distress (CAPS)

Correlation Coefficient


Coping

Dispositional and Situational Coping and Distress (CAPS)

Correlation Coefficient


Coping

Dispositional and Situational Coping and Distress (CAPS)

Correlation Coefficient


Coping

Mediation

Coping

Dispositions

Distress

Situational

Responses


Coping

Mediation Analyses (CAPS)

DispositionalSituational

CopingCoping

Active coping- 0.13 - 0.36

Behavioral Disengagement0.140.54

Denial0.200.37

Use of drugs or alcohol0.100.29

Focus on/venting emotions0.130.15

Pos Reinterpretation & Growth- 0.25 - 0.34

Planning- 0.04 - 0.25

**

***

*

***

*

*

**

*

* p < .05* * p < .01* * * p < .001


Coping

Conclusions

  • Coping styles predict situational responses

  • Both predict adjustment (situational stronger)

  • Situational responses largely (but not entirely) mediate effects of dispositional coping styles

  • Which to use?

    • Base decision on conceptual issues and/or study needs


Coping

Functionality of Coping

Characterization of field:

  • Lots of work on psychological well-being

    • Adjustment to chronic/acute disease

    • Adjustment to medical problems

  • Less work on physical health/relationship to disease processes


Coping

Functionality of Coping: General Characterization

MentalPhysical

HealthHealth

Active Coping+++/-++

Avoidant Coping---/+--/+

Moderators:

Chronicity/Control

Emotion-focused Coping---/++-/+

Moderators:

Pos reint & growth, humor,

acceptance

(links to active coping)


Coping

Engagement vs. disengagement

The benefits of remaining engaged

Focus on Specifics


Coping

74 gay/bisexual men

Mean age: 38 years

95% white

Mean length of diagnosis: 12.2 months

Living with AIDS Study

(Data from Reed et al., 1994)


Coping

Realistic Acceptance

  • Try to accept what might happen.

  • Prepare myself for the worst.

  • Refuse to believe that this problem has happened.


Realistic acceptance and survival

Realistic Acceptance and Survival

Percentage surviving

(Data from Reed et al., 1994)


Coping

Further Manifestations of Process

  • Active coping

  • Fighting spirit

  • Vital exhaustion

  • Stoic acceptance


Coping

Disengagement and Successful Living

  • Much research suggests giving-up is bad

  • Questions

    • Is disengagement always bad?

    • Is persistence always good?

    • Might disengagement produce positive effects if goals are unattainable?


Coping

Components of Disengagement

  • Withdrawal of effort

  • Relinquishment of commitment


Coping

Give up effortbut

remain committed to goal

Distress,

despondency,

futility

Give up goal

commitment,

disengage

from goal

Absence

of distress

1

Obstacles

seem too great to

overcome

2


Coping

Scale back to more limited goal in

same domain

Potential

for positive

outcomes

Potential

for positive

outcomes

Pick alternate

path to high

order goal

Potential

for positive

outcomes

Form new goal

or new path to

high order goal

Aimlessness,

emptiness,

loneliness

Give up goal

commitment,

no new goal

Give up effort but

remain committed to goal

1

Distress,

despondency,

futility

Obstacles

seem too great to

overcome

2

a

Give up goal

commitment,

disengage

from goal

b

c

d


Coping

Components of Re-engagement

  • Identify new goals

  • Commit to those goals

  • Pursue those new goals


Coping

Goal Disengagement Items from GAS

If I have to stop pursuing an important goal in my life:

  • It’s easy for me to reduce my effort toward

    the goal.

  • I stay committed to the goal for a long time,

    I can’t let it go.


Coping

Goal Re-engagement Items from GAS

If I have to stop pursuing an important goal in my life:

  • I seek other meaningful goals.

  • I convince myself that I have other meaningful

    goals to pursue.

  • I start working on other new goals.


Coping

Phenomenon

Parents might have to restructure life goals (e.g., career goals, daily activities, being with child)

Children with Cancer Study

(Wrosch et. al. , 2003)

  • Sample (cross-sectional)

  • 20 parents whose children were diagnosed with cancer

  • 25 parents with healthy children (matched control group)

  • Main Measures

  • Disengagement (a = .79), Re-Engagement (a = .86)

  • Depression (CES-D, a = .94)


Coping

30

30

20

20

10

10

0

0

-1 SD

+1 SD

-1 SD

+1 SD

Disengagement

Re-Engagement

Effects of Disengagement and Re-Engagement on Depression

Cancer Parents

Cancer Parents

r = -.53*

r = -.64**

Depression (CES-D)

Contol Parents

Contol Parents


Coping

Goal Adjustment and Cortisol Levels

  • Examined goal adjustment and objective

    measure of health -- cortisol secretion

    • Normally, cortisol peaks in the early morning hours & declines steadily throughout the day

    • Those experiencing stress have a flattened cortisol rhythm, with low morning output or no drop in secretion during the day

      Wrosch, C., Miller, G.E., Scheier, M.F., de Pontet, S.B. (under review), Giving up on unattainable goals: Benefits for health?


Coping

Goal Adjustment and Cortisol Levels

  • Sample…

    • 54 participants

      • Recruited via newspaper ad

      • 38 female; 24 Caucasian; 85% of non-Caucasians were African-American

      • Average age = 30.3


Coping

Goal Adjustment and Cortisol Levels

  • Measures include…

    • Goal disengagement

    • Goal reengagement

    • Diurnal cortisol rhythm - collected on 4 separate days


Salivary cortisol levels

Goal Disengagement and Cortisol Levels

Salivary Cortisol Levels

Wrosch, C., et al., Study 3.


Coping

Life Truth

You have to know when to hold ‘em,

know when to fold ‘em.

Don Schlitz, The Gambler


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