Handbook of the Psychology of Coping: New Research : New Research [1 ed.] 9781620814659, 9781620814642

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Copyright © 2012. Nova Science Publishers, Incorporated. All rights reserved. Handbook of the Psychology of Coping: New Research : New Research, Nova Science Publishers, Incorporated, 2012. ProQuest Ebook Central,

Copyright © 2012. Nova Science Publishers, Incorporated. All rights reserved. Handbook of the Psychology of Coping: New Research : New Research, Nova Science Publishers, Incorporated, 2012. ProQuest Ebook Central,

PSYCHOLOGY OF EMOTIONS, MOTIVATIONS AND ACTIONS

HANDBOOK OF THE PSYCHOLOGY OF COPING

Copyright © 2012. Nova Science Publishers, Incorporated. All rights reserved.

NEW RESEARCH

No part of this digital document may be reproduced, stored in a retrieval system or transmitted in any form or by any means. The publisher has taken reasonable care in the preparation of this digital document, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is assumed for incidental or consequential damages in connection with or arising out of information contained herein. This digital document is sold with the clear understanding that the publisher is not engaged in rendering legal, medical or any other professional services.

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PSYCHOLOGY OF EMOTIONS, MOTIVATIONS AND ACTIONS

HANDBOOK OF THE PSYCHOLOGY OF COPING NEW RESEARCH

BERNANDO MOLINELLI Copyright © 2012. Nova Science Publishers, Incorporated. All rights reserved.

AND

VALENTINO GRIMALDO EDITORS

Nova Science Publishers, Inc. New York

Handbook of the Psychology of Coping: New Research : New Research, Nova Science Publishers, Incorporated, 2012. ProQuest Ebook Central,

Copyright © 2012 by Nova Science Publishers, Inc. All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted in any form or by any means: electronic, electrostatic, magnetic, tape, mechanical photocopying, recording or otherwise without the written permission of the Publisher. For permission to use material from this book please contact us: Telephone 631-231-7269; Fax 631-231-8175 Web Site: http://www.novapublishers.com NOTICE TO THE READER The Publisher has taken reasonable care in the preparation of this book, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is assumed for incidental or consequential damages in connection with or arising out of information contained in this book. The Publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers’ use of, or reliance upon, this material. Any parts of this book based on government reports are so indicated and copyright is claimed for those parts to the extent applicable to compilations of such works.

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Independent verification should be sought for any data, advice or recommendations contained in this book. In addition, no responsibility is assumed by the publisher for any injury and/or damage to persons or property arising from any methods, products, instructions, ideas or otherwise contained in this publication. This publication is designed to provide accurate and authoritative information with regard to the subject matter covered herein. It is sold with the clear understanding that the Publisher is not engaged in rendering legal or any other professional services. If legal or any other expert assistance is required, the services of a competent person should be sought. FROM A DECLARATION OF PARTICIPANTS JOINTLY ADOPTED BY A COMMITTEE OF THE AMERICAN BAR ASSOCIATION AND A COMMITTEE OF PUBLISHERS. Additional color graphics may be available in the e-book version of this book.

Library of Congress Cataloging-in-Publication Data Handbook of the psychology of coping : new research / editors, Bernando Molinelli and Valentino Grimaldo. p. cm. Includes index.

ISBN:  (eBook)

1. Adjustment (Psychology) I. Molinelli, Bernando. II. Grimaldo, Valentino. BF335.H263 2012 155.2'4--dc23 2012010675

Published by Nova Science Publishers, Inc. † New York

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CONTENTS Preface Chapter 1

Chapter 2

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Chapter 3

vii Coping with Climate Change: Bringing Psychological Adaptation in from the Cold Joseph P. Reser, Graham L. Bradle, and Michelle C. Ellul

1

The Search for Meaning: A Framework for How Individuals Cope with Bereavement and Other Existential Stressors Benjamin Lord, Sandra Gramling, and Stephen M. Auerbach

35

Parental Coping, Emotional Resources and Children's Adjustment: Theory, Empirical Evidence, and Interventional Implications Michal Al-Yagon and Malka Margalit

59

Chapter 4

Economic Coping and Heads of Households’ Perception of Health Kenya L. Covington, Luciana Lagana, Theresa R. White and Lisa Bratton

Chapter 5

Coping in a Relational Context: The Case of Dyadic Coping Iafrate Raffaella and Donato Silvia

Chapter 6

Flow as a Way of Coping – A Qualitative Study of the Metacognitions of Flow Edith E. Wilson and Giovanni B. Moneta

133

How to Cope with Work-Family Conflicts in an International Career Context? Liisa Mäkelä, Kati Saarenpää, Vesa Suutari, and Olivier Wurtz

151

Chapter 7

Chapter 8

Adolescence: Sequence of Coping Behaviours Donna-Maria B. Maynard

Chapter 9

How Differential Coping Styles in Rodents May Explain Differences in Disease Susceptibility in Humans Gretha J. Boersma

Chapter 10

Factors That Influence Coping Self-Efficacy after Trauma Christina L. Meads and Melanie D. Hetzel-Riggin

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85

111

169

189 207

vi Chapter 11

Chapter 12

Chapter 13

Chapter 14

Chapter 15

Chapter 16

Contents The Early Years Coping Project: Building a Shared Language of Coping Erica Frydenberg, Jan Deans, and Rachel Liang

225

Coping, Social Support and Psychosomatic Status of Health Professionals – A Hungarian Experience Mariann Kovács, Eszter Kovács, and Mária Kopp

243

The Role of Enacted and Perceived Dyadic Coping for Young Couples’ Satisfaction Donato Silvia and Parise Miriam

261

Anxiety and Severity of Illicit Substance Use in Adolescence: Evaluating the Mediating Role of Perceived Coping Styles Grégoire Zimmermann and Pablo Cascone

279

Coping and Emotional Responses to Surgery by Injured Professional Rugby Union Players F. Carson and R. C. J. Polman

293

Coping in Parents of Children with Congenital Heart Disease Karolijn Dulfer, Willem A. Helbing, and Elisabeth M. W. J. Utens

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Index

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307 321

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PREFACE Coping has been defined as constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that exceed the resources of the person. In this book, the authors present new research on the psychology of coping. Topics discussed include coping with climate change; coping with bereavement and other existential stressors; parental coping, emotional resources and children's adjustment; economic coping and heads of households' perception of health; coping in a relational context; how to cope with workfamily conflicts in an international career context; and sequence of coping behaviours in adolescents. Chapter 1 - The chapter addresses the neglect of psychological coping and adaptation and the psychological impacts of the threat of climate change in the context of climate change science approaches to adaptation and mitigation. Current theoretical approaches and research engagements utilizing stress and coping models, environmental stress formulations, and disaster preparedness and response frameworks are examined to assess their relevance to the issue and global threat status of climate change. Perspectives examined include recent work on future oriented thinking and proactive coping, as well as applications of psychological models such as protection motivation in the climate change science literature. Challenges for a stress and coping approach to the phenomenon and threat of climate change are not only the encompassing global and very complex nature of climate change, its geographic and temporal distance and horizons, and the profound implications of climate change for life support systems and human communities, but also inherent limitations with respect to effective problem-focused coping at individual or community levels in the face of such an ongoing global threat and changing climate systems. A further and related challenge for coping approaches addressing the threat of climate change is that we are dealing with largely indirect and virtual exposure and experience to ubiquitous media and popular culture representations and coverage of a global threat and emergency, and a polarized and highly charged information environment and risk domain, suffused with uncertainty and aggregated symbolic meanings. As well the nature and status of climate change is arguably that of an ongoing, background, environmental stressor of profound consequence, an environmental threat and condition not typically addressed by conventional coping frameworks. The considerations and conclusions offered are informed by a current cross-national research initiative examining public risk perceptions, understandings and responses to the intertwined threats of climate change and natural disasters in Australia and Britain, with cross-reference to North American research. These findings are particularly revealing with respect to the intersections and

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Bernando Molinelli and Valentino Grimaldo

relative importance of direct and indirect exposure and experience, the nature of psychological coping and adaptation processes, already current and extensive psychological impacts, and implications for policies and interventions. Chapter 2 - The idea that coping with stressful events involves a cognitive as well as a behavioral component has long been accepted in the stress-and-coping literature. However some major-life stressors, such as the death of a loved-one, may present challenges to individuals’ fundamental worldviews, and engender a spiritual, existential, or identity crisis. In these cases, it is theorized that one must successfully complete a journey wherein one makes sense of the stressful event in order for adjustment to occur. Park and Folkman have provided a framework for understanding this process by extending the Lazarus and Folkman transactional model of stress and coping to include meaning-making as a key component of the coping process. Meaning-making, or the reconciliation of one’s fundamental beliefs and life goals with the untenable situations which challenge them, may represent a relatively untapped theoretical framework for understanding how individuals cope with suffering that is unavoidable, and situations that are irreparable. Historically, meaning-making theory has been primarily applied to the study of loss and trauma. Indeed, meaning-making has been conceptualized as the core task of the grieving process. However, more recently researchers have begun to apply the meaning-making model to describe how individuals cope with numerous existentially threatening stressors, including cancer diagnosis, chronic pain diagnosis, and caregiving for a loved-one with dementia. Despite this growing interest in how individuals interpret and find meaning in stressful circumstances, issues with the operationalization and measurement of the meaning-making process have made it difficult to compare results across studies and come to a consensus regarding how best to assist individuals with their search for meaning. The authors review the theory and conceptualization of meaning-making using a detailed review of bereavement research to illustrate the weaknesses currently present in the literature. A model of meaningmaking in the grieving process is proposed, and suggestions are made for how to use qualitative and quantitative methods to further the study of meaning-making in the context of grief and other major-life stressors. Chapter 3 - The current chapter reviews and integrates new conceptual and empirical research regarding the role of parental coping resources in understanding children's and adolescents’ adjustment, resilience, and well-being. In particular, this chapter discusses findings regarding the conceptual and empirical progress seen in the study of four major parental coping resources, including two emotional coping resources – attachment and affect – as well as sense of coherence and coping strategies. Throughout the current discussion, this chapter considers parents’ coping resources among families of children with typical development as well as of children with disabilities such as learning disorders, attentiondeficit and hyperactivity disorders, autism, and mental retardation. Alongside scrutiny of this complex group of parental personal resources, the current discussion also focuses on the differential susceptibility of children with genetic, biological, and behavioral sensitivities to various childrearing experiences. The chapter's conclusions pinpoint attention at identifying resilient families and the factors that promote effective coping and well-being, suggesting future research directions and interventional implications. Chapter 4 - It is widely documented that various stressors can affect overall health, including mental health. Nevertheless, there is insufficient literature explicitly linking physical or mental health to specific forms of economic coping within the general population.

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ix

To address this gap in the literature, the authors explored the economic coping strategies employed by ethnically/racially diverse heads of households (2,200 in 1997 and 1,600 in 2007) using secondary data from the Institute for Social Research (Panel Study of Income Dynamics, 1997, 2007), which oversampled for ethnic/racial minorities as well as for lowincome status. The authors chose to focus on the decade between 1997 and 2007 to capture trends during: a) large changes in the welfare system (e.g., the implementation of the program “Temporary Assistance for Needy Families” in 1997); and b) times of economic slowdown in the United States. The authors focused their analyses on documenting the likelihood of use of various economic coping behaviors by income groups (reported in three categories) and specific economic coping strategies related to perceptions of head of household’s health, as well as on testing the authors’ preliminary financial coping-health model. This research represents a necessary step toward exploring the importance of the U.S. population’s economic coping as it relates to health. Results were obtained by utilizing SPSS in nonparametric analyses and multiple regressions. By comparing income categories in 1997 and 2007, the authors found that economic coping strategies were more likely to be used by low income individuals in both years, although use increased in the high income group over the decade. Economic coping was employed more frequently by people of all economic groups in 2007 than in 1997. Moreover, when wthe authors tested their financial coping-health model in weighted stepwise multiple regression analyses, they found that a variety of demographic as well as coping-related variables were significantly related to health. A total of six financial coping strategies were associated with health; only one of them was related to better health (i.e., postponing purchases). Concerning the financial coping-health link findings by income group, they found that self support financial coping in particular was significantly related to worse health. The authors’ findings speak to the health-related financial sacrifices made by many people living in the U.S. in times of economic crisis, yet they should be verified in future research. The authors believe that, although highly significant, the authors’ results offer a conservative estimate of the relationship between economic coping and health, because perceptions of one’s health status usually underestimate the magnitude of health problems. Chapter 5 - Since its origins most of the stress and coping literature has focused primarily on the individual’s efforts to manage stressful encounters, conceptualizing both stress and coping as individual phenomena in which the coper appraises and deals with stressors individually. The individualistic approach, however, fails to consider that individuals do not experience and cope with stress in isolation, but within an articulated interpersonal context, especially the one referring to intimate others. Recent advances in the stress and coping field have highlighted the limitations of such a self-focused conceptualization and called for a broader view of the phenomenon. The present chapter is going to present these advances in the stress and coping literature with respect to coping in couples, from the recognition of the importance of interpersonal aspects of coping to the conceptualization of novel notions such as the one of dyadic coping. Finally, the chapter will conclude with research findings on the role of dyadic coping and partner support in couple functioning, with regard to both benefits and costs of such processes, and with the evidence available on some of the antecedents of dyadic coping. Chapter 6 - Flow is a state of intense task absorption and cognitive efficiency. Flow has been reported to occur during various everyday activities such as sports and leisure, but also during work. Being in flow has been found to be associated with achievement in different domains and has also been linked to adaptive approaches to studying during academic

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examination preparation. More recently, the importance of investigating the “metacognitions of flow” -- i.e., self-regulatory aspects of the flow state -- has been raised. Metacognitions of flow encompass people’s awareness and beliefs about flow, including awareness of flow as a state that fosters performance and the measures taken to create and maintain flow when necessary. Flow theory posits that this state is more likely to occur during perceived high-demand situations. As identified by Lazarus and Folkman (1984), people can employ different cognitive or behavioural processes to deal or cope with stressful situations. Given the potential for flow to be self-regulated, being in flow could be theorised as an adaptive way of coping in demanding situations. Beer and Moneta (in press a) were the first to provide empirical evidence for the adaptive effects of wider, non-flow specific, positive metacognitions on coping. This study focuses on whether people actively use the flow state as a way of coping with demanding situations, and, in particular, explores flow specific metacognitions; i.e., people’s awareness of the flow-achievement link, the beliefs people hold about actively making the flow state happen and wider beliefs about flow. Chapter 7 - The aim of the present article is to discuss the coping strategies adopted by international managers when they face conflicts between work and family life due to the international nature of their work. The authors reflect the experiences of two different groups of international managers: Global careerists who work on long-term international assignment and have experience of several expatriate assignments (n=20), and those whose work involves frequent international business traveling (n=15). The findings are reported in four dimensions, combining on the one hand problem- and emotion-focused coping strategies and on the other individual- and family-level coping strategies. The results indicate that both groups of respondents actively use problem-focused coping strategies at both an individual and a family level, but that emotional coping strategies were also used on occasion. Chapter 8 – The authors propose that a sequence of coping behaviours is utilised by Caribbean students when faced with problems that arise in the school environment. The sequence involves a dynamic process of seven cognitive decision-making and behavioural steps that the adolescents engage in, in their quest to effectively cope with daily problems. How adolescents cope with problems is very important, for educators and psychologists wish to gain a better understanding of the psych-socio-cognitive functioning of young people at this stage of development, which serves as a foundation for young adulthood. In our quest to discover how adolescents were coping they employed a phenomenological approach and conducted a qualitative study using semi-structured interviews with a purposive sample to examine the coping strategies of ‘problem’ adolescents in the Caribbean, specifically in regard to their interactions with peers and teachers. Data were collected from twenty 14-16 year olds in Barbados. The overarching finding was that adolescents employ a sequence of coping behaviours in an attempt to actively seek to prevent problems from progressing to a maladaptive level, and avoid permanent damage of the relationship. Chapter 9 - For many disorders the origins of an increased susceptibility for development of the disorder is not clear. This is especially the case in disorders characterized by heterogeneity in symptoms, such as depression, anxiety, and the metabolic syndrome. Indicating a single risk factor that predicts disease onset and severity has proven difficult. Due to the polygenetic origin of such disorders, a prediction based on a risk profile rather than a single risk factor may be more accurate. Recent advances in animal research have

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Preface

xi

indicated the coping style, characterized by a behavioral and associate physiological profile in response to changes in the environment, may have high predictive value for the incidence of both psychiatric and somatic disorders. Rodents with a passive stress coping style, for example, are more prone for depression like behavior, and this stress coping style is also associated with an increased susceptibility for the metabolic syndrome. The proposed chapter will give an overview of recent studies investigating the role of the coping style in the vulnerability for both psychiatric and somatic disorder using animal models. The chapter will summarize the neuroendocrine mechanisms indicated to play a role in the interaction between coping style and disease susceptibility. Finally, in the chapter the translational value of animal models for coping style will be discussed. Chapter 10 - Past research has demonstrated that coping self-efficacy (CSE), the belief that one is capable of seeking out resources that help to adapt successfully to challenges, plays a role in the coping process. CSE is associated with psychological well-being and mental health outcomes following a traumatic event. However, relatively little research has investigated what factors may be related to positive or negative CSE. Since the field understands the positive impact of CSE, research investigating factors associated with positive or negative CSE is imperative. In order to investigate factors related to positive and negative CSE, 97 undergraduate students completed several online assessments measuring CSE, trauma history and previous counseling, perceived effectiveness of coping, coping style, psychological distress, perceived control, trauma attribution, and resiliency. CSE was significantly and positively associated with perceived coping effectiveness, present control, and resiliency; CSE was significantly and negatively associated with duration of previous counseling, greater trauma history, distraction and avoidant coping, behavioral and characterological self-blame, past control, and psychological distress. These variables were entered into a stepwise multiple regression equation predicting CSE. Five variables entered the equation: psychological distress (β = -.37***), resiliency (β = .41***), TLEQ total scores (β = -.20**), perceived coping effectiveness (β = .23**), and past control (β = -.13*), which was significant, R2 = .74, F(5, 73) = 42.40***. Prevention efforts may benefit from targeting variables related to coping effectiveness, past control, and resiliency. Primary and secondary prevention efforts could be developed to teach coping strategies that are usually successful, such as cognitive reappraisal mindfulness problem solving and emotional expression. Resilience imagery and skills training has been successful at improving mood and performance as well as the ability to handle stress. Interventions for attention-control, inhibitory-control, and affect regulation have increased self-regulation ability. Combined, these programs could help to improve CSE. Chapter 11 - Social and emotional competence underpins healthy development, educational achievement and the well-being of a community and coping skills are considered an important index of such competence. It is helpful to construe coping as a continuum that extends from the management of stress and adaptation to the achievement of success in the pursuit of goals and meeting the challenges of everyday life. It is clear that the earlier these skills are developed the better. This chapter provides an overview of four-phase research by Frydenberg and Deans at the University of Melbourne. The researchers have engaged with children, teachers and parents to learn more about coping skills and how they can be developed. One significant outcome of this work has been the development of the Early Years Coping Cards which is a

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visual resource suitable for use by parents, teachers and clinicians with children aged 4-8 years. The cards have been applied in a number of contexts including classrooms and the home and are used to stimulate conversations about situations that young children find challenging or stressful. Research findings highlight the importance of building a shared language of coping between teachers, parents, clinicians and children in order to effectively engage in deeper meaningful conversations around coping—an important step in building social and emotional competence. Chapter 12 - Background: There is increasing evidence form studies that health care professionals treating patients are overloaded emotionally as well as intellectually and physically. The far-reaching damage of cumulative stress and lack of stress-management influence the health status and well-being of health professionals, who face several stress factors frequently, thus they might suffer from psychosomatic problems. Coping is embedded in stress process. The contextual, cognitive model of coping elaborated by Lazarus suggests the role of cognitive appraisal in forming the response to a troubled person-environment relationship and in the ways of coping using the individual. Folkman and Lazarus distinguish two theory-based functions of coping namely, problem-focused coping and emotion-focused coping. The former focuses on the problem that causes distress while the latter helps managing negative emotions associated with the problem. Social support has been proved to contribute to physical and psychological health respectively. Objectives: The aim of the present chapter is to explore the psychosomatic status of Hungarian health personnel to reveal the coping mechanisms and the perceived social support. Further, to investigate their interrelations by comparing two different databases. Method: First, a cross-sectional survey (database 1) was conducted in 2007 among health care professionals (N=199) and secondly, from the latest Hungarostudy Epidemiological Panel (HEP) 2006 follow-up study (database 2), represented the Hungarian population classified according to age, sex, and 150 sub regions, the authors analyzed the data of health professionals (N=184). Coping was measured by Ways of Coping Questionnaire; Social support was measured by Caldwell Social Dimension Scale. The authors attempted to encompass the wide spectrum of demographical background factors, and they also included questions addressing health related factors (e.g. ‘Do you have any physical complaints, symptoms?’, ‘Do you take any medicine?’). Results: In the case of the total sample (N=383) 59,9% of the respondents have any physical complaints, while 42,1% of them take any medicine and 10% among the respected individuals were treated with psychiatric symptoms. Differences were found across databases in psychosomatic background of health professionals. The comparison revealed similarities regarding the positive relationship between problem-focused coping and emotion-focused coping and that of between perceived family support and perceived social support from others. Problem-focused coping was more characteristic for health personnel. Health professionals that have physical complaints and taking medicines achieve significantly higher scores in emotion-focused coping, further taking medicines might decrease the possibility of problem-focused coping in total sample. Differences were found in coping and in social support when comparing databases. Examining the total sample illness and not taking medicine predicted problem-focused coping.

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Conclusion: Improving the physical and psychological well-being of health professionals is mandatory. One explanation for the differences across databases may be the constitution of the sample. In database 1 those who work in psychiatric-psychotherapeutic profession and in oncology were overrepresented in the sample. Emotional burden among these workers is more characteristic than among those who work other fields of health care. In order to device effective intervention for stress reduction, the authors need to focus on coping, primarily on adaptive emotion-focused coping strategies elaborated profession specific points. Chapter 13 - Dyadic coping refers to the way partners manage their everyday stress as a couple and is an emergent topic within the research on stress and coping processes. The role of dyadic coping for partners’ well-being and couples’ functioning has been explored in numerous studies, proving that, when positive, dyadic coping has potential benefits for the well-being of the relationship as well as of the partners themselves. However, still little is known about how its beneficial effects are delivered. In particular, little research has been devoted to the examination of the interplay between one partner’s dyadic coping behaviors and the perceptions of such behaviors as they are received by the other partner. The link between enacted and perceived dyadic coping, as well as their influence on relationship satisfaction, has been theoretically formulated, but this mechanism has never been empirically tested. The purpose of this chapter is to present a study examining the role of enacted and perceived dyadic coping for the relationship satisfaction of young couples facing the transition to marriage. Results highlighted that partner enacted dyadic coping was moderately reflected in the other partner’s perceived dyadic coping, though men and women differed in how accurately they perceived positive vs. negative dyadic coping behaviors, with women being more accurate in detecting partner’s negative behaviors and men in perceiving partner’s positive ones. Moreover, perceived positive dyadic coping mediated the effect of women’s enacted positive dyadic coping on men’s relationship satisfaction, whereas perceived negative dyadic coping mediated the effect of men’s enacted negative dyadic coping on women’s relationship satisfaction. Chapter 14 - The purpose of this study was to examine whether coping styles (Active coping, Internal coping and Withdrawal coping) mediated the relationships between anxiety and severity of illicit substance use among a sample of 110 Swiss adolescents ages 12-19 (M=16.3, SD=1.66). The current study tested two competing models of anxiety on severity of illicit substance use. In the first model, the authors tested the direct effect of trait anxiety (STAI-Y anxiety score) on severity of illicit substance use (ADAD drug use severity rating), while in the second models they examined the mediating role of coping styles in the link between trait anxiety and severity of illicit substance use. Path models indicated that the associations between trait anxiety and severity of illicit substance use are partially mediated by active and withdrawal coping styles. Limitations of the findings and implications for prevention of substance use in adolescence are discussed. Chapter 15 - Coping with and emotional responses to sports injury have been increasingly researched within the scientific literature. However, few studies have examined the psychological effects of surgical intervention on professional athletes who have suffered serious injury. This chapter identifies the coping behavior and emotions experienced by professional rugby union players’ pre- and post-surgery. A mixed-methodological, qualitative dominant, approach was utilized with five professional rugby union players who required anterior cruciate ligament reconstruction. Each player was interviewed on three occasions (after initial injury; pre-surgery; and post-surgery). In addition each player completed a self-

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report diary, as well as three quantitative questionnaires: Emotional Responses of Athletes to Injury Questionnaire (ERAIQ; Smith, Scott, O’Fallon, and Young, 1990); Sports Inventory for Pain (SIP; Meyers, Bourgeois, LeUnes, and Middendorf, 2003); and the Coping with Health, Injuries, and Problems (CHIP) inventory (Endler and Parker, 2000). Content analysis was conducted on both pre (11 higher order themes) and post (10 higher order themes) surgery data, which were coalesced into the general dimensions Approach Coping, Avoidance Coping, Negative Emotions or Positive Emotions. Findings indicated instrumental coping strategies and social support were used consistently to manage emotional characteristics of surgical intervention, while negative emotions are replaced by positive following successful surgical intervention. Chapter 16 - Due to the huge medical advances in pediatric cardiology and pediatric cardiac surgery over the past 30 years, survival rates of children with congenital heart disease (ConHD) have increased enormously. Nowadays 90% of these children survive into adulthood. When parents learn that their infant has ConHD, they usually experience overwhelming distress. The normal transition process to parenthood is burdened by the extra stress of having to adapt to this overwhelming situation. This is accompanied by feelings of sadness, grief, anger, resentment, guilt, helplessness and hopelessness, the fear of an uncertain future for their child and the demands of having to learn how to take care of their infant. When parents need to prepare for one or more cardiac operation(s), the distress may become even more overwhelming. To deal with all these feelings and changes in levels of distress, parents have to use coping strategies. In this chapter, the authors start in the introduction by giving a brief review of empirical research findings of studies into stress in parents with children with ConHD (§1a and §1b). Subsequently a theoretical model regarding stress and coping will be presented (§1c) and finally empirical research findings of studies into coping in parents of children with ConHD will be presented (§1d). Secondly, they will focus on the relationship between the disease severity and parental stress and coping (§2) and changes in parental stress and coping over time (§2a), with the description of empirical studies into changes in parental stress and coping over time (§2b). Thirdly, individual differences in parental coping styles will be discussed (§3). Differences between maternal and paternal coping styles and the levels of parental psychopathology will be described. Fourthly, they will focus on the influence of social support on coping (§4). Finally the authors will discuss some clinical implications (§5).

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Chapter 1

COPING WITH CLIMATE CHANGE: BRINGING PSYCHOLOGICAL ADAPTATION IN FROM THE COLD Joseph P. Reser, Graham L. Bradley, and Michelle C. Ellul Griffith University and University of Queensland, Australia

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ABSTRACT The chapter addresses the neglect of psychological coping and adaptation and the psychological impacts of the threat of climate change in the context of climate change science approaches to adaptation and mitigation. Current theoretical approaches and research engagements utilizing stress and coping models, environmental stress formulations, and disaster preparedness and response frameworks are examined to assess their relevance to the issue and global threat status of climate change. Perspectives examined include recent work on future oriented thinking and proactive coping, as well as applications of psychological models such as protection motivation in the climate change science literature. Challenges for a stress and coping approach to the phenomenon and threat of climate change are not only the encompassing global and very complex nature of climate change, its geographic and temporal distance and horizons, and the profound implications of climate change for life support systems and human communities, but also inherent limitations with respect to effective problem-focused coping at individual or community levels in the face of such an ongoing global threat and changing climate systems. A further and related challenge for coping approaches addressing the threat of climate change is that we are dealing with largely indirect and virtual exposure and experience to ubiquitous media and popular culture representations and coverage of a global threat and emergency, and a polarized and highly charged information environment and risk domain, suffused with uncertainty and aggregated symbolic meanings. As well the nature and status of climate change is arguably that of an ongoing, background, environmental stressor of profound consequence, an environmental threat and condition not typically addressed by conventional coping frameworks. The considerations and conclusions offered are informed by a current crossnational research initiative examining public risk perceptions, understandings and responses to the intertwined threats of climate change and natural disasters in Australia and Britain, with cross-reference to North American research. These findings are

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Joseph P. Reser, Graham L. Bradley, and Michelle C. Ellul particularly revealing with respect to the intersections and relative importance of direct and indirect exposure and experience, the nature of psychological coping and adaptation processes, already current and extensive psychological impacts, and implications for policies and interventions. “Analyses of psychological phenomena are essential to understanding the ways in which individuals perceive, experience, and respond to global threats in the context of their local communities and behavior settings. … Psychological processes such as environmental cognition, information processing, stress, and coping play key roles in determining how global conditions impinge on individuals’ psyche and behavior in the context of their daily lives.” (Stokols et al., 2009)

INTRODUCTION

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In the chapter which follows we examine the interconnections between coping and adaptation within psychology, and the differing cultures of use and meaning with respect to coping, adaptation, and mitigation in the context of climate change science. The argument is made that stress and coping perspectives within psychology well address some crucial aspects of coping with and adapting to the threat of climate change, but in other respects have more limited applicability. Nonetheless developments within this field relating to proactive coping and future-oriented thinking, the bridging roles which transactional and environmental stress perspectives within environmental psychology provide, and a more encompassing psychological perspective on adaptation processes suggest that psychology can make an invaluable contribution in addressing climate change adaptation and mitigation.

THE PHENOMENON AND THREAT ‘Climate change’ is a very complex global and atmospheric system phenomenon, it is a profound global and local threat, it is a culturally constructed and represented risk domain and environmental problem, it is an ongoing and dynamic environmental condition which will likely be with us for the next millennium if not much longer, it is a contested and challenging set of environmental, political, and social issues, it is the implications and consequences of the physical phenomenon and corresponding social and geopolitical implications, it is the psychological and social impacts of the threat itself and of physical environmental changes, it is the explanation, account, and meta-narrative of all of the preceding. In these respects we are clearly discussing something which is far more than a case of conventional threat appraisal, risk perception, and human response. Nonetheless it is still very much the case that climate change is an anxiety-inducing and profoundly consequential environmental threat which implicates coping and adaptation responses and which constitutes a quintessentially psychological challenge. In the context of the Framework Convention on Climate Change, climate change “refers to a change of climate that is attributed directly or indirectly to human activity that alters the composition of the global atmosphere and that is in addition to natural climate variability observed over comparable time periods” (Intergovernmental Panel on Climate Change (IPCC), 2007, p. 6).

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COPING AND ADAPTATION IN THE CONTEXT OF CLIMATE CHANGE The discourse of climate change science is dominated by the constructs and terminology of climate change adaptation and mitigation, and related and familiar sounding notions and constructs, such as vulnerability, resilience, adaptive capacity, and behavior change. Occasionally there is reference to the question and challenge of coping with climate change, and more specifically its environmental and human consequences, particularly in more popular culture discussions and considerations of this seemingly profound phenomenon, threat, and set of issues (e.g., DiMento and Doughman, 2007; Moser and Dilling, 2007; Whitmarsh, O’Neill and Lorenzoni, 2011). But the language and constructs of psychology and social science, and indeed popular culture, are more often than not very different from climate change science language use and meanings. While one might think that coping and adaptation, for example, have much in common, which is indeed the case in everyday language and within the broader context of psychology (e.g., Coelho, Hamburg and Adams, 1974; Lazarus, 1991; Somerfield and McCrae, 2000; Zeidner and Endler, 1996), the reality is that neither coping, as a basic notion and process, nor a psychological perspective on adaptation, have been salient considerations for the IPCC or climate change science. There are a number of reasons for this, but a principal factor has been the very system-focused levels of analysis of climate change science (e.g., Nelson, 2011; Smit and Wandel, 2006; Yohe, 2000; Young, 2010). But there is little question that coping and adaptation with climate change is increasingly on the agenda of policy makers, communities, and individuals (e.g., Hamilton, 2010; Hamilton and Kasser, 2009; Hulme, 2009; McClanahan et al., 2008; Millenium Ecosystems Assessment, 2006), and there is now a concerted effort to redress what has been an anomalous gap in climate change research, along with the current focus on adaptation to a climate change reality which cannot, in the more immediate term, be mitigated (APA, 2009; Gifford, 2008; Gifford, Kormos and McIntyre, 2011; Kazdin, 2009; Swim et al., 2011). Coping perspectives have been increasingly referred to and invoked in the context of global climate change, and most particularly in the context of climate change adaptation (e.g., Hamilton and Kasser, 2009; Homburg and Stolberg, 2006; Reser and Swim, 2011). As climate change science and policy attention has shifted from mitigation of climate change (principally greenhouse gas emission reduction) to human adaptation to the threat and unfolding realities of climate change (human adjustments to the consequences of climate change already in train), a more serious consideration of just what such adaptation and adjustment processes encompass and imply has taken place. Available perspectives, discussions, and research have reflected and at times bridged many disciplines (e.g., geography, psychology, sociology, urban and rural planning, human ecology) and multi-disciplinary arenas (e.g., climate change science, global environmental change, human dimensions of natural resource management, disaster preparedness and response, food and energy security) (e.g., Lever-Tracy, 2010; Smit and Wandel, 2006; Wolf and Moser, 2011). The processes at issue are not always framed in coping terms, and typically reflect discipline-distinctive assumptive worlds and levels of analysis with respect to seemingly core processes and targeted changes (e.g., adaptation, adjustment, changed thinking and understandings, behavior change, enhanced adaptive capacity, resilience), but coping is

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nonetheless integral to these processes. Notably absent in these predominantly system and structure-based approaches is a psychological perspective which encompasses and addresses those coping and adaptation processes operating at intra-individual, individual behavioral, and within-situation levels of analysis (e.g., Wapner & Demick, 2000). Adaptation in the context of human dimensions of global change usually refers to a process, action or outcome in a system (household, community, group, sector, region, country) in order for the system to better cope with, manage or adjust to some changing condition, stress, hazard, risk, or opportunity. (Smit and Wandel, 2006, p. 282)

These missing levels of analysis and an informed psychological perspective are crucial omissions when considering not only effective risk communication, public engagement, and adaptive behavior change, but with respect to how individuals are making sense out of and coming to terms with this complex, confronting, and profoundly consequential phenomenon, risk domain, and global disaster (APA, 2009; Swim et al., 2011). Within the contemporary, multidisciplinary, climate change discourse there are numerous framings of coping and adaptation, with most of these taking this system based approach, and typically reflecting a natural science worldview. Governmental and policy making bodies adopt a more multidisciplinary approach and language, but this too arguably privileges particular disciplinary perspectives and system level analyses (e.g., engineering, socioeconomics, and regional planning).

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The United Nations Framework Convention on Climate Change treats adaptation in the narrowest sense – as actions taken in response to climate changes resulting from anthropogenic greenhouse gas emissions. By contrast, for decision-makers and researchers focused on sustainable development and disaster mitigation, adaptation describes a much broader range of actions that make societies more robust to changes, including but not limited to, those caused by climate change. (Pielke et al., 2007, p. 597)

For world bodies such as the United Nations, adaptation is, quite simply, about coping with climate change. Adaptation: Coping with Climate Change Scientific evidence of climate change, as contained in the fourth assessment report of the Intergovernmental Panel on Climate Change (IPCC), puts the reality of human-induced global warming beyond any doubt. The Earth’s surface temperature is rising, thereby changing the Earth’s climate. Adaptation is about finding and implementing ways of adjusting to climate change. (The United Nations Framework Convention on Climate Change, 2008).

A consideration of coping and adaptation in the context of climate change must initially address whether and how these constructs and terms differ within psychology and the social and health sciences generally, and then briefly examine the emergent use of adaptation in the discourse of the IPCC and climate change science. The consensus on the meaning of coping by the time of the third edition of Stress and Coping (Monat & Lazarus, 1991, p. 5) was that “coping refers to an individual’s efforts to master demands (conditions of harm threat, or challenge) that are appraised (or perceived) as exceeding or taxing his or her resources.” It is interesting to note that a parenthetical observation preceding this initial clarification of

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constructs and terminology for this further anthology volume was “More recently, however, there has been a rapid growth of curiosity and concern among researchers about coping and ‘adaptation’ (Monat & Lazarus, 1991, p. 5). While the intersection and at times synonymous use of coping and adaptation within psychology reflects a purposefully fluid and dynamic understanding of these person-insituation transactional processes there have been many attempts to achieve a more useful and operational conceptual clarity.

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There is an important distinction that is not made in many traditional approaches to coping, namely, between automatised and effortful responses. … For example, experienced drivers are not ordinarily conscious of using the clutch and brake, stopping for traffic signals, and so on, nor is there much special effort involved. We do these things so automatically that we can think about a problem at work while engaging in all the complex acts needed to get us here. These acts are adaptive, but they should not be called coping. If they were, coping would consist of almost everything we do. When there is a nonroutine occurrence, however, such as a road closed for a repair that requires a decision as to an alternative route, or a flat tire that needs changing, effort is required. In these circumstances coping efforts are clearly distinguishable from the automatic adaptive behaviors that occur in routine driving situations. [But] the distinction between coping and automatised responses is not always clear. … Put differently, not all adaptive processes are coping. Coping is a subset of adaptational activities that involves effort and does not include everything that we do in the environment. From this point of view, the cognitive styles we discussed … may be adaptive processes but not coping. (Lazarus and Folkman, 1991, p. 198-199)

The adaptation construct, in psychology and the social sciences generally, acknowledges and frequently refers to adaptation as an integral evolutionary process, but also places particular and arguably greater emphasis on individual, community, and societal adaptation processes as involving contemporary and functionally similar psychological and social processes, operating both within individuals and within groups of people. Such reference to adaptation is not limited to behavioral or lifestyle changes, or adjustments at both individual and collective levels. Adaptation can and frequently does refer to changes in individuals’ perceptions, appraisals, attitudes, attributions, perceived locus of control, sense making, and emotional and cognitive responses to situations. Similarly, adaptation can refer to changes in collective or shared perceptions, understandings, attitudes, beliefs, and acceptance (e.g., Vaughan, 1993). Perhaps the most typical reference to adaptation in psychology today is found in the stress and coping literature, which follows from more biomedical perspectives and models such as those of Selye (e.g., 1946), but brings in cognitive and emotional mediation in significant ways, as in cognitive behavioral approaches (e.g., Antonovsky, 1987; Lazarus, 1991, 1999, 2000; Lazarus and Folkman, 1984; Sommerfield and McCrae, 2000). Such common reference to adaptation in the stress and coping literature is closely followed by frequent reference in developmental psychology, personality theory, cross-cultural psychology, and sensation and perception, for example. Another important psychological context for the use of adaptation is found in the risk literature, where the focus is often on an individual or community’s psychological or social response to risk communications or directly encountered or impending threat (e.g., Etkin and Ho, 2007; Sjoberg, 2006; O’Riordan, 1995). A serious threat is conceptualized as a challenging appraisal circumstance in which an individual must make sense of both the nature

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Joseph P. Reser, Graham L. Bradley, and Michelle C. Ellul

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and immediacy of the threat and available response resources. The contemporary conjunction of stress and coping models and risk communication and appraisal approaches has been characterized by a greater emphasis on the roles of emotional processes in the context of riskas-feeling, risk-as-analysis understandings of threat appraisal of particular relevance to risk communications and representations relating to ‘climate change’ (e.g., Loewenstein, Weber, Hsee, and Welch, 2001; Slovic, 2000, 2010; Slovic, Finucane, Peters, and MacGregor, 2004). Hence the use of adaptation in a more psychological context often refers to intra-individual responses, involving cognitive reframing, reappraisal, adjusting one’s appraisal of and expectations toward a situation – or oneself, adjusting one’s alarm/concern threshold, normalizing what was experienced as an abnormal response to a terrifying situation, changing one’s behavior and/or lifestyle, emotion-focused coping, protection motivation, and adjustment of expectations and aspirations to available opportunities and achievable objectives. Unfortunately much of the compass of adaptation as a pervasive and fundamental process in human behavior is effectively ignored in prevailing discussions and considerations of adaptation to climate change. An important part of the present argument is that the scope of ‘adaptation’, and certainly climate change adaptation, must encompass those psychological processes of adaptation that are an integral part of human functioning and adaptive capacity and behavior. We argue that there is wisdom in referring to these processes as psychological adaptation. In the context of our own research and writing we have adopted the following conceptual specification of psychological adaptation. Psychological adaptation in the context of climate change refers to those within individual adjustments and changes in risk perception, threat appraisal, and associated cognitive, emotional, and motivational responses to the threat and perceived physical environmental impacts of climate change, as well as to altered behavioural responses and engagements associated with such changed thinking, feeling, and motivational responses. Psychological adaptation also and necessarily refers to those underlying psychological processes mediating and moderating such individual change (e.g., emotion management, self perception, self-efficacy, protection motivation, coping strategies), as well as to the achieved state of relative balance with respect to own needs and environmental press and/or threat. Psychological adaptation in the context of climate change can also encompass community and societal changes in how the phenomenon and threat of climate change is perceived, understood, and responded to in terms of shared understandings and collective behaviour change and adjustment, and the respective sense-making social psychological processes involved such as social construction, social representation, and the social amplification of risk. (Reser et al., 2012)

This specification does oversimplify but does not overgeneralise matters. The reality is that adaptation has always been a core construct and perspective within psychology encompassing the biological organism, psychological functioning, the ecological contexts of behavior, and the nature of people-environment transactions. This construct and perspective within psychology, anthropology, and the health sciences generally does differ appreciably from the emergent use of adaptation in the IPCC context and discourse, notwithstanding some important common ground at biological organism and macrosystem levels. One need only think of the rich vocabulary and suite of related constructs and theoretical perspectives which exist in psychology relating to stress and coping, proactive coping, anticipatory coping,

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preventive coping, stress inoculation, psychological preparedness, protection motivation, future oriented thinking, anticipatory grief, decision making under stress, and heuristic biases, to appreciate that there is a highly relevant indeed crucial body of work – in addition to the widely acknowledged and recognized work addressing effective behavior change – that must be factored in and integrated with other collaborative, multi-level, perspectives and syntheses when addressing climate change adaptation.

QUESTIONS AND ISSUES

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The challenge of climate change, and indeed the nature of environmental stressors and human response more generally, have raised a number of important questions and unresolved issues with respect to just how applicable and effective psychology’s well-developed coping and adaptation frameworks are to the challenges of climate change. A sampling of these questions and issues would include the following: 1) What conceptual and operational adjustments might be necessary when moving from conventional stress and coping frameworks addressing acute and immediate life circumstance stressors to an ongoing environmental stressor such as global climate change? 2) Can approaches such as ‘cognitive adaptation’ in the face of longer term health threats approximate the individual adaptation challenges of climate change? 3) What conceptual and operational adjustments are necessary when moving from individual to collective or community levels of analysis? 4) How can adaptation and coping frameworks addressing the threat of climate change accommodate the reality of virtual exposure and experience through multi-media coverage and risk representation and communication? 5) What is the relationship between psychological adaptation and psychological impacts? Are not all adaptations and adjustments ‘impacts’? Are some impacts in many ways the psychological costs of adaptation? 6) How do problem-focused coping and emotion-focused coping play out in the context of climate change? 7) Are adaptation and mitigation distinct and independent processes and behavior change targets from a psychological perspective? 8) How can we best measure and monitor those psychological changes which we would regard as important psychological adaptations and/or psychological impacts? These questions have both motivated our writing of this chapter and have influenced the content and underlying arguments of the chapter. In the course of our own research on public risk perceptions, understandings, and responses to climate change and associated extreme weather events (e.g., Reser, Bradley, Glendon, and Ellul, 2012; Reser and Swim, 2011; Reser, Morrissey and Ellul, 2011)) we have had to seriously think our way through each of these.

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THE INTERTWINED HISTORIES OF STRESS AND COPING AND ENVIRONMENTAL STRESS The stress and coping paradigm which has become such a dominant and convergent set of perspectives and models in health psychology and personality theory, and indeed many other areas of psychology, was founded in the early stress research and writing of Cannon (1932), Selye (1946, 1956), Dubos (1965), and others (e.g., Bateson, 1972; Holmes and Rahe, 1967; Piaget, 1955; Pribram, 1969; White, 1974). This research focus quickly moved from phylogenetic adaptation, comparative psychology, and biophysiology to a human focus, and notably to a more in-depth consideration of the functioning, experiencing individual transacting with his or her often stressful physical and social environment (e.g., Goldberger and Breznitz, 1982). Following the seminal work of Lazarus and associated theorists and researchers (Lazarus, 1966; Lazarus and Cohen, 1977; Lazarus and Launier, 1978; Moos, 1976), the emergent stress and coping perspective became closely aligned with cognitive behavioral and emotion regulation approaches. These developments led to an increasing focus on stressful events and circumstances within the ambit of an individual’s life and circumstances, and perceived social and health threats (Lazarus and Folkman, 1984; Monat and Lazarus, 1991). At the same time a parallel environmental stress perspective was taking a decidedly more environmental direction and focus, with physical and social environments and contexts being given particular consideration (e.g., Baum, 1991; Cohen, Evans, Stokols, and Krantz, 1986; Evans, 1982; Evans and Cohen, 1987; Evans and Stecker, 2004; Glass and Singer, 1972). While a considerable and diverse ‘coping literature’ is available within psychology addressing acute and life circumstance threats, events, and circumstances (e.g., Folkman, 2011; Lazarus and Folkman, 1984; Monat and Lazarus, 1991; Siddiqui and Pandey, 2003; Zeidner and Endler, 1996), available models, conceptualizations, and research have tended to skirt the matter of ongoing threat and more chronic environmental conditions which are stress-inducing, with some exceptions (e.g., Adeola, 2000; Baum, Gatchel, and Schaeffer,1983; Edelstein, 2002; Trumbo, McComas and Besley, 2008). It is interesting to note that the approach of Lazarus and many stress theorists has strongly emphasized the transactional nature of stress and coping and individual-environment interaction, with the environment being more figure and dynamic context than ground (e.g., Lazarus and Folkman, 1984; Lazarus and Launier, 1978). This transactional - and at the same time situational and interactional - perspective has particular resonance with the equally important emphasis on adaptation which characterises the work of Lazarus and stress and coping theorists generally (e.g., Lazarus, 1991, 1999) and of course with the very nature of coping with environmental demands. The transactional perspective of stress and coping models has always had its equivalent in other areas of psychology, for example the situationism of Mischel (1976), and the interactional perspective of Magnusson and Endler, 1977, Pervin (1984a, b) and others, that is, behaviour is always a reflection of the interaction between the person and the situation. Pervin, for example, argues that the real import of the interactional approach is the conceptual emphasis it places on understanding the interdependence between person and situation or between internal and external determinants of behaviour (e.g., Pervin 1984a, Pervin and Lewis, 1978). Within environmental psychology the transactional perspective went beyond the interaction between individual and environment

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(e.g., Altman and Rogoff, 1987; Wapner, 1981; Wapner & Demick, 2000), and has become a core assumption and paradigm for many researchers and practitioners in the field. A transactional approach goes one step further than [mutual influence] and proposes that the system cannot be divided into separate elements or discrete relationships. Rather, the experienced environment is an event whose components are so intermeshed that no part is understandable without the simultaneous inclusion of the complex texture of all aspects of the instant, and it is the interaction among the components that is of interest for study. (Bell, Greene, Fisher, and Baum, 2001, p. 61)

While this transactional emphasis permeates both stress and coping and environmental stress perspectives generally, it arguably has particular currency, but also challenges, in the context of the threat of global climate change. Can individuals and communities ‘transact’ with an ongoing and dynamic environmental condition and stressor such as climate change? What is the nature of transactions with virtual and information environments representing and communicating a geographically and temporally distant phenomenon and threat such as climate change?

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CLIMATE CHANGE AS AN ENVIRONMENTAL STRESSOR The environmental stress approach which emerged in environmental psychology in the early 1970s (Glass and Singer, 1972; Milgram, 1970; Saegert, 1975) quickly developed as a foundational paradigm closely linked to other perspectives within psychology, public health, and disaster mental health on adaptation, stress, and stress and coping (e.g. Cohen et al., 1986; Evans, 1984; Holahan, 1982; McAndrew, 1993; Veitch and Arkellin, 1995). The environmental stress approach, while initially making an appreciable investment in the systematic experimental examination of particular stressors, such as noise, human crowding, and toxic waste, nonetheless framed these challenges and issues in terms of an encompassing environmental psychological perspective, which included and emphasized the reciprocal nature of people-environment transactions, and the ecological and experiential realities of multiple and interacting stressors, and net ‘environmental load’ as well as the ongoing and cumulative costs of coping (e.g., Evans and Cohen, 1987). What is very clear from that research literature which has addressed the adaptive consequences of coping with multiple stressors is that multiple stressors do not have simple additive effects on physical and psychological functioning, that cumulative and interactive effects can appreciably influence the physiological and psychological costs of coping, and that the effects of multiple stressors can be both moderated and mediated by coping processes (e.g., Evans, Allen, Tafalla and O’Meara, 1996; Lepore and Evans, 1996, 1997). An environmental stress perspective on the psychosocial impacts and adaptation demands of global climate change is particularly valuable as it brings environmental, human ecological, and phenomenological perspectives to the complex phenomenon of climate change, and the requisite multiple levels of analysis needed to adequately frame the adaptation challenges of dramatic climate change impacts and to strategically address planning considerations and interventions for enhancing individual and community adaptations. An area of psychological research and theory where the environmental stress

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approach and models of stress and coping have well-complemented each other is that of disaster preparedness, response, and recovery (e.g., Reyes and Jacobs, 2006). Given the substantial overlap between natural and technological disasters, on the one hand, and those multiple climate change impacts which will manifest as extreme weather events and natural disasters of increased intensity and frequency on the other, it makes considerable sense to examine the distilled wisdom and generalizability of disaster preparedness and response research findings and evidence-based practice (e.g., Morrissey and Reser, 2007; Reser and Morrissey, 2008). The most explicit and detailed examination and use of a stress and coping framework to examine human response to environmental threat (as distinct from climate change) is found in Bell, Greene, Fisher, and Baum’s five editions of their environmental psychology text (2001, 1978). These authors employ a modified and more encompassing environmental stress (and coping) perspective to address a spectrum of environmental psychology matters covered in their text. The stress and coping framework of Lazarus and others (e.g., Lazarus, 1966; 1991), and the specific notions of primary and secondary appraisals, and problem-focused and emotion-focused coping strategies, are integral aspects of the model, with such an integration of stress and coping and environmental stress characteristic of environmental psychology treatments (e.g., Bell et al, 2001; Bonnes and Secchiaroli, 1995; Evans and Cohen, 1987; Gifford, 2007; Holahan, 1982). The rather different nature of many environmental stressors is emphasized in the Bell et al. text, including ongoing chronic or ambient stressors (e.g., Campbell, 1983; Breslau, 1990), and ‘natural’ and ‘technological’ environmental stressors (e.g., Baum and Fleming, 1993; Peek and Mileti, 2002), but this overarching environmental stress perspective is seen as a very serviceable way to integrate disparate but convergent literatures addressing human response to environmental threat. While coping and adaptation processes are canvassed and discussed as a core part of this integrative stress framing, there is little specific consideration of the inter-relationships or essential similarity between adaptation and those coping strategies which are viewed as part of the stress response. As well, this frequently cited environmental psychology perspective predated more recent considerations of climate change per se, with the previous and broader social and behavioral science terminology being ‘Human Dimensions of Global Change’ and ‘Global Environmental Change’ (e.g., Matthies, 2008; National Research Council, 2010a; 2009, 1992). Paralleling and informing this environmental stress perspective as covered in most environmental psychology textbooks has been a valuable and distinct theoretical and research literature with a more specific focus on the nature of proximal and distant, acute and ongoing, environmental stressors (e.g., Aldwin and Stokols, 1988; Cohen et al., 1986; Evans, 1984; Evans and Cohen, 1987; Evans and Stecker, 2004). A related stress and disaster literature has also addressed the more specific nature of the stressors and stress responses implicated in natural and technological disasters (e.g., Baum and Fleming, 1993; Diamond, Lipsitz, Farerman, and Rozenblat, 2010; Neria, Galea and Norris, 2009; Reyes and Jacobs, 2006; VandenBos and Bryant, 1987). More recently very major and interlinked natural and technological disasters around the world, such as Hurricane Katrina and the Indian Ocean tsunami in 2004, the Japan earthquake, tsunami, and Fukushima nuclear plant disaster in 2011, and the ongoing stress of terrorism epitomized by the destruction of the World Trade Towers on 9/11, have brought home the complex nature of such world-changing and symbolically prognostic events. These dramatic occurrences against a backdrop of global

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degradation and escalating and seemingly irreversible environmental impacts have again focused considerable theoretical and research attention on the nature and impacts of ongoing environmental stressors (e.g., Heyman, Brennan and Colarossi, 2010; Marshall, Bryant, Amsel, Suh, Cook, and Neiria, 2007; Silver, 2011; Stokols, Misra, Runnerstrom, and Hipp, 2009). In many ways this encompassing environmental stress literature aligns closely with stress and coping perspectives. How distinct is the threat and phenomenon of climate change as an environmental stressor? The fact that climate change is an environmental threat and stressor makes this threat and phenomenon very different from other stress-inducing threats and circumstances typically addressed in the stress and coping literature. An immediate implication when the stressor relates to one’s extended environment is that secondary appraisal is less likely to lead to problem focused coping strategies. The fact that climate change is a global and ongoing threat and phenomenon arguably makes climate change rather different from other periodic or ongoing environmental stressors, though many of the extreme weather event manifestations of climate change do suggest that there may well be perceived inter-relationships and experiential analogies between climate change and such weather events and natural disasters, including ongoing disasters such as drought, in public risk perceptions and understandings. A further distinction relates to the magnitude and duration of this threat, and extent of influence. As a global phenomenon that may well persist for millennia, with profound consequences for most ecosystems as well as human societies, climate change does seem to constitute a truly global disaster which is understandably difficult to fully comprehend, imagine, or appraise. There are arguably a number of other quite distinct aspects of climate change as an environmental threat. Climate change appears to straddle the classic distinction made between ‘natural’ and ‘technological’ disasters as it is by definition an anthropogenic or human-forced phenomenon and condition. This would suggest that the ‘risk domain’ of climate change carries and evokes a mix of symbolic meanings, dread responses, and responsibility and efficacy connotations associated with both natural and technological disaster threats and events (e.g., Flynn, Slovic and Kunreuther, 2001; Pidgeon, Kasperson and Slovic, 2003). The salience of climate change, and arguably public ‘exposure’ around the world, has been, in part, a reflection of the unprecedented and ubiquitous media coverage of climate change in many regions of the world for well over a decade through international multi-media channels. Finally, as previously mentioned, climate change is not just the phenomenon and profound threat; it is also the perceived consequences and implications of such a phenomenon. Climate change also has been a contested and polarizing environmental, political, and social issue, ‘climate change’ is itself a popular explanation and account of multiple events and changes taking place in our contemporary physical and sociopolitical world, and in this latter respect has arguably achieved the status of a globalised metanarrative and encompassing explanatory framework and story of what is happening to our planet. All of this suggests that when we consider primary and secondary appraisals and coping and adaptation responses to ‘climate change’, it is understandable that current frameworks and conceptualizations require a critical and reflective examination, an assessment of what can and cannot be meaningfully addressed and encompassed by conventional stress and coping perspectives in this context of climate change, and what integration possibilities exist with respect to other convergent perspectives and models.

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THE NATURE AND STATUS OF CURRENT COPING APPROACHES TO CLIMATE CHANGE While a small number of recent psychology-based sources exist which have framed adaptation and mitigation to climate change, and other environmental threats and stressors, in stress and/or coping terms (e.g., Grothman and Patt, 2005; Homburg and Stolberg, 2006; Van Zomeren, Spears and Leach, 2011), these sources have tended to either ignore distinctions or interrelationships between ‘coping’ and ‘adaptation’ or assume they are essentially the same, without critically addressing this matter. The recent APA Taskforce on Psychology and Climate Change (APA, 2009) has arguably clarified but not resolved this situation, with its coverage and examination of what they have framed as ‘adapting to and coping with’ the threat and impacts of climate change (APA, 2009; Doherty and Clayton, 2011; Reser and Swim 2011). In addition there now exist a number of frequently cited sources by nonpsychologists in which the nature and challenges of coping with climate change is a very strong theme and focus. In many respects it has been these more popularised accounts and exhortations from geographers (Cutter, 1993; Hulme, 2009; Moser and Dilling, 2004, 2007), philosophers (Hamilton; 2010; Leslie, 1996), and scientific journalists (Kolbert, 2006; Kunstler, 2005; Linden, 2007) which have informed current popular culture views about the nature of psychological responses and the human impacts of, in addition to on, a dramatically changing climatic regime (e.g., Eckersley, 2008; Hamilton, 2010; Hamilton and Kasser, 2009; Hulme, 2009).

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A Dual Pathway Model Van Zomeren et al. (2011), for example, have applied a ‘dual pathway model’ of coping to climate change, developed in the context of coping with collective disadvantage (Van Zomeren, Spears, and Leach, 2008; Van Zomeren et al., 2011). They argue that conventional stress and coping models and applications in the context of individual problems such as health behaviors or conditions, which have well-evidenced success, do not generalize well to collective and global environmental problems that require collective action. They also argue for and provide supportive research evidence for a dual pathway model in which parallel but independent emotion-focused and problem-focused collective coping strategies would seem to evidence the strongest linkages to environmental action intentions. The authors also contend that while a conventional stress and coping approach works well in the context of an individual addressing a more immediate and personal problem or health condition, as in cognitive adaptation (e.g., Taylor, 1983), it would be necessary to move to a collective level of coping to meaningfully address the problem of climate change. While these authors provide an argument worth consideration, and one which resonates with pertinent issues of collective efficacy (e.g., Bandura, 1995; Benight, 2004), the research evidence to date consists of two very modest experimental studies using intentions as a proxy for behaviors. As well the extrapolation and application of Lazarus’s ‘emotion-focused’ and ‘problemfocused’ coping strategies to the global and very complex ‘problem’ and multiple issues of climate change require a more detailed and convincing argument and a more diverse and definitive body of evidence.

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A Socio-Cognitive Model

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Grothman and Patt (2005) have developed a socio-cognitive Model of Private Proactive Adaptation to Climate Change (MPPACC) which separates out and addresses the psychological steps to taking action in response to risk perception and appraisal in the context of climate change. While the language of these geography discipline authors is that of ‘adaptation’ rather than ‘coping’, the literature cited, the protection motivation framework they adopt, and the socio-cognitive model they have developed are all very psychological in many respects and looks very much like a stress and coping framework. These authors characterize their approach as addressing individual level motivational considerations and perceived adaptive capacity, while underscoring the importance of measurable and alterable psychological factors in influencing adaptation to climate change. Importantly the authors clearly acknowledge that climate change adaptation at an individual and community level is already ongoing, and able to be studied. It is noteworthy, however, that the argument and constructs used in this research, framed in terms of protection motivation theory and behavioral economics, coincide almost exactly with the primary and secondary appraisal, and emotion-focused and problem-focused framework of Lazarus and Folkman, but with a very strong emphasis on secondary appraisal, relabeled as perceived adaptive capacity, and with three subcomponents, perceived adaptation efficacy, perceived self efficacy, and perceived adaptation costs. While the arguments mounted and the model presented are interesting and highlight how psychological thinking and variables are beginning to permeate climate change thinking and considerations in other disciplines, it is clear that multiple risk perception, threat appraisal, and motivational considerations have not been as well-informed by the past four decades of convergent psychological perspectives addressing coping and adaptation processes as they would need to be. As well, the case studies involved were retrospective modeling comparisons of existing data sets with very few and arguably tenuous ‘psychological’ variables, and no actual examination of individual level psychological processes.

A Cognitive Theory of Stress Model A similar theoretical approach is that of Homburg and Stolberg (2006), though the emphasis is more generically focused on pro-environmental behavior and the authors are psychologists. Again the theoretical scaffolding is that of Lazarus (1966, 1991), characterized as ‘cognitive stress theory’, the environmental stress perspective of Baum (e.g., 1991) and Lepore and Evans, 1996), and the more general context of environmental psychology (e.g., Bell et al., 2001; Gardner and Stern, 1996). In this research the authors propose “an adapted theory of cognitive stress to analyse and explain when and why environmental stress actually leads to pro-environmental behavior” (Homburg & Stolberg, 2006, p. 1). While the challenge and complexity of climate change is mentioned a number of times, the distinctiveness of climate change as contrasted with other environmental stressors is not addressed. As well the focus of the research is arguably much more on the motivational implications of cognitive stress in terms of mitigation through pro-environmental behavior change than on psychological adaptation or psychological impacts per se, though the role of problem-focused coping is viewed as central in mediating “between the unspecific motivation to protect the environment (and oneself) and pro-environmental behavior” (p. 2). An interesting four study

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research program and emergent structural model is presented and reported upon by the authors. The researcher assumptions and the proposed model view pro-environmental behavior as the direct result of individual coping strategies and stress-management which is determined by threat appraisal (demand appraisal) and either individual or collective efficacy. A repeated argument in the article is that in the case of environmental stressors it is the belief in the coping abilities of a larger reference group (collective efficacy) that determines coping attempts and behavioral engagement. The reported research findings provide some evidence supporting the basic argument that threat appraisal processes activate problemfocused coping which mediates pro-environmental behavior. This research canvases an important mitigation avenue but remains somewhat opaque with respect to the nature and importance of emotional experiences and emotion-focused coping in the context of an environmental stressor such as climate change. The larger issue of coping and adaptation, particularly in the context of the ongoing stressor of climate change is not explored or discussed, nor are the multiple ‘internal environment’ and psychological coping benefits of ostensibly problem-focused behavioral engagement.

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A Coping with Global Environmental Problems Scale An important avenue for conceptualizing and researching the topic of coping and adapting to climate change is the development of a climate change specific or global environmental problem scale which could sensitively assess coping strategies and dynamics as well as effectiveness. An initial development and validation of such a scale was published in 2007 by Homburg, Stolberg and Wagner. The principal theoretical basis of this scale and development work was again Lazarus’s coping approach. And again global environmental problems were conceptualized and addressed as environmental stressors, defined, following Lepore and Evans (1996), as “environmental conditions that the average person would perceive as actually or potentially threatening, damaging, harmful or depriving” (p. 350). The rationale for drawing substantially on coping perspectives was that “coping processes play a decisive role as mediators and moderators between environmental impacts, appraisal of these impacts, and physical and psychological consequences” (p. 755), and “that individual ways of coping with global environmental problems might inhibit or foster … change in human lifestyles and behavior will be required to reach the goal of environmental sustainability” (p. 755). Research findings based on three studies supported an eight factor coping scale, but with reservations expressed about the sufficiency of coping acts and the structure and metastructure of coping. The respondent samples involved in this research were not large (n< 300) nor was the statistical power of the multi-group analysis, but this scale development reflects a very direct application of the mainstream stress and coping approach to global environmental problems, in this case with specific reference to climate change.

General Observations on Recent Work There are no doubt other empirical attempts underway to apply coping and adaptation approaches from psychology to the threat of climate change. A broader overview of this

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terrain, the challenges, and the urgency of such research was provided by the APA Taskforce and Psychology and Climate Change (2009; Swim et al., 2011). A parallel review and report was undertaken by the National Research Council’s Panel on Addressing the Challenges of Climate Change Through the Behavioral and Social Sciences (2010b). It is arguable that these preceding research examples and models do seem to effectively neglect individual level experience, distress, and more existential considerations relating to experienced angst in the context of climate change (e.g., Fritsche, Jomnas, Kayser, and Koranyi, 2010; Greenberg, Solomon and Pyszczynski, 1997; Langford, 2002) and both personal and cultural meaning systems (e.g., Miller, 1984; Shore, 1996). The profound implications of climate change pose very real challenges for the sustainability of our planet, its life support systems, and species and human survival. Hence this is not a simple threat or ‘problem’ that can be readily ‘solved’; the matter being addressed is arguably a very changed world, set of environmental conditions, and suite of rather fundamental adaptation and human ecological parameters and processes that have to do with species survival, including, quite possibly, our own. It is also remarkable that while climate change science has had a long term and genuine interest in social science and psychological theory and research on climate change mitigation and behavior change (Chen, Boulding and Schneider, 1983; Gardner and Stern, 1996; National Research Council, 1992), and more recently on public attitudes, beliefs, and engagement (e.g., Leiserowitz, Maibach, RoserRenouf, Smith and Hmielowski, 2011; National Research Council, 2009, 2010a,b; Steg and Vlek, 2009), so little collaborative work or research investment has focused on the nature and dynamics of individual level coping and adaptation processes and how these inevitably mediate and otherwise influence attitude and value change, understandings, and behavioral engagement.

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FURTHER APPROACHES AND CONSIDERATIONS Protection Motivation and Defense What characterizes a number of current approaches to the interwoven issues of human response to and the impacts of the threat of climate change is a framing and focus in terms of protection motivation and defense, with implicit and explicit reference to coping processes. This has been, historically, a very established psychoanalytic perspective (Baumeister, Dale and Sommer, 1998; Cramer, 2000; Epstein, 1994; Paulhus, Fridhandler and Hayes, 1997) and an encompassing and nuanced framework in the context of ‘protection motivation’ (Floyd, Prentice-Dunn and Rogers, 2000; Rogers, 1983; Weinstein, 1987). Protection motivation theory (PTM) as developed by Rogers was originally based on the work of Lazarus. It is noteworthy that a number of more contemporary and popular discussions of response to and coping with climate change draw heavily on one or the other of these functionally similar perspectives, i.e., psychodynamic and protection motivation perspectives (e.g., Hamilton and Kasser, 2009; Lertzman, 2009) and several of what have been deemed more existential approaches are also, and clearly, both protection motivation and psychoanalytic approaches, e.g., terror management theory (e.g., Greenberg et al.,1997; Greenberg, Koole and Pyszczynski, 2004). It is also important to note that more mature and often reflective defenses

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such as humor, altruism, and positive illusions are associated with adaptive functioning (e.g., Cramer, 2000; Taylor, 1989; Valliant, 1994). The ‘reality’ of often apocalyptic scenarios of climate changed futures (Eckersley, 2008: Kunstler, 2005; Lovelock, 2006) and nonstop media coverage of not only this dire threat, but associated uncertainty, and the continuous erosion of public faith and trust in climate change science and government resolve and capacity by lobbyists and journalists (e.g., Oreskes & Conway, 2010; Stocking, 2009; Washington and Cook, 2011), make the risk representations and communications associated with climate change very anxiety-inducing for many, with defensive and psychological ‘distancing’ coping strategies (e.g., Spence, Poortinga and Pidgeon, 2011; Uzzell, 2000) being both understandable and in many ways adaptive. Is it possible that our anxieties about ecological problems, and the existential dilemmas they raise regarding how we are to live, can be so great as to be unmanageable or unthinkable? Might we unconsciously deny what is staring us in the face because what is at stake is too painful to consider? (Lertzman, 2008, p. 5)

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Adaptation and Mitigation from a Coping Perspective It is important to appreciate that this dual focus within psychology on effective behavior change and the nature of the psychological response to and psychological and social impacts of these threats and unfolding biophysical environmental impacts reflects the fact that, from a multi-level psychological perspective on climate change, adaptation and mitigation are interrelated and reciprocal processes. How individuals understand and psychologically respond to the phenomenon of climate change (including in terms of cultural sense making and meaning systems) powerfully mediates the adjustments and adaptive actions they will make, both individually and collectively. This is an argument now increasingly being made by non-psychologist climate change researchers and writers (e.g., Etkin and Ho, 2007; Moser and Dilling, 2004) as well as psychologists (e.g., Homburg et al., 2007; Reser and Swim, 2011; Stokols, et al., (2009). It would appear that, from a psychological perspective and at an individual level of analysis, climate change science ‘adaptation’ and ‘mitigation’ do align in a reasonable way with threat appraisal, and with emotion and problem-focused coping, with aspects of such adaptation and mitigation also corresponding to differing coping strategies and pathways. These alignments are not really surprising, as, at this level, and through a psychological lens, this is very familiar territory for psychologists. But this conjunction of approaches in the context of climate change does present an excellent opportunity for presenting and explaining this crucially absent ‘psychological systems’ component to current climate change science thinking, research, and policy contributions. However this engagement with climate change science requires that psychologists are able to clearly and cogently communicate how coping processes are an integral part of adaptation and mitigation, and that somewhat independent but increasingly convergent perspectives within psychology over the past four decades well position psychologists to play an increasingly vital role in climate change science, along with other social and behavioral scientists (e.g., APA, 2009; Matthies, 2008; NRC, 2009, 2010b).

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Coping, Adaptation and Impacts For the sake of a discussion and analysis which is easier to follow we have treated coping and adaptation to climate change and the psychosocial impacts and consequences of climate change as separable and distinct aspects of human response to climate change. But the psychological reality is that appraisal of threat is always, at the same time, a response to perceived threat, with the complexities of risk-as-analysis and risk-as-feeling (Loewenstein et al., 2001; Slovic et al., 2004) underscoring the fact that sense-making itself is an important mode of coping, which in turn mediates ultimate behavioral responses. It is clear from the disaster literature that the psychosocial impacts of events such as Three Mile Island were largely a consequence of risk perceptions and appraisals, not objective risk factors in the environment (e.g., Baum et al., 1983; Dew, Bromet and Schulberg, 1987; Edelstein, 2002). We need to appreciate and understand that public understandings of and responses to the perceived threat of global climate change are undoubtedly having very consequential psychosocial impacts, as clearly evidenced by contemporary and ubiquitous media coverage and discussion of climate change, itself a complex social impact. These collective and ‘adaptive’ responses to the threat of climate change, as well as constituting first order ‘impacts’ in their own right, are also mediating subsequent psychological and behavioral responses to behavior change and decision opportunities which could contribute to mitigating the human causes of climate change in terms of greenhouse gas emissions. And, of course, a fundamental and very real set of environmental impacts of climate change are those changes to and disruptions of biophysical environments and human settings that will constitute further environmental stress factors, in turn requiring further adaptation responses. In brief, coping and adaptation processes both mediate and constitute important psychosocial impacts in the context of global climate change. Evidence-based principles from those research literatures relating to environmental stress, threat appraisal and coping, and the fundamental role of adaptation in mediating human-environment transactions, provide a very apposite and valuable body of knowledge for addressing the challenges of climate change (Doherty and Clayton, 2011; Reser and Swim, 2011). An important conceptual complexity is that the psychological impacts of climate change can be seen and understood at sequential stages of the risk communication, risk perception, risk response, adaptation process, similar to coping processes. There is little question but that media coverage and social representations of climate change can have immediate and longer term psychological impacts such as alarm and continuing distress or pessimism (e.g., Carvalho, 2007; Nabi and Wirth, 2008; Smith and Joffe, 2009). There are then the psychological impacts which are integral to and which follow from the sense making associated with threat appraisal and limited response options, such as elevated concern, distress, and pessimism. And coping responses also constitute psychological and behavioral impacts of climate change. These latter responses relate to a neglected and very important psychological impact and emotional and energy ‘cost’ of the ongoing threat of climate change, i.e., the impacts of coping and adaptation themselves (e.g., Cohen et al., 1986). A fundamental insight deriving from early stress research was that stress responses and the experience and physiological concomitants of the stress response tax an individual’s biological and psychological system, and this is particularly the case for chronic or unrelieved stress (Selye, 1956). The costs of coping have been an integral aspect of the environmental stress literature (e.g., Evans and Cohen, 1987; Evans and Stecker, 2004) and are an important

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focus of psychosocial impact assessment (e.g., Reser and Bentrupperbäumer, 2001) and disaster mental health (e.g., Neria, Galae, and Norris, 2009; Reyes and Jacobs, 2006). From an environmental impact assessment perspective, as well as from climate change adaptation perspectives, it is increasingly urgent that the full spectrum of psychological and social impacts of the threat and unfolding physical environmental impacts of climate are adequately measured, documented, and monitored, as these current impacts are crucial indicators and powerful mediators of not only health and well being in the context of climate change but of coping and adaptation capacities, limitations, and costs (e.g., Doherty and Clayton, 2011; Reser and Swim, 2011).

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Direct and Indirect Exposure and Experience A premise of both stress and coping and environmental stress perspectives is that we are dealing with real or at least perceived to be real threats and risks in our personal, social or biophysical environment, and that such circumstances require appraisal of the threat, appraisal of one’s capacity to respond, and a more general sense making and response framing with respect to what if anything needs to or can be done. In the case of stress and coping models there is arguably more latitude with respect the ‘objective reality’ leading to subjective exposure and vulnerability, but in the case of environmental stress there is more often than not an objectively real ‘environmental’ incident, condition, or source of stress which is being appraised and responded to, such as noise, air pollution, local environmental contamination (e.g., Bell et al., 2001; Evans, 1984). But exposure to and encounters with climate change for most people are a virtual and vicarious exposure and experience presented through media coverage and today’s multi-media information environment. This is not to dismiss in any way the grave and global risks which are being cogently communicated and often eloquently and powerfully presented in environmental documentaries, but this is arguably a very different context, framing, and experience than direct personal encounters with a perceived risk or danger in one’s own local and known social or proximate physical environment. And of course the temporal and geographic scale of this complex and global system disequilibrium is simply not in the same ‘ballpark’. This throws up further challenges for conventional stress and coping models. Can an individual realistically and meaningfully appraise such a threat and global phenomenon and their own adaptation capacity? Can individuals meaningfully address and attempt to counter or solve such a ‘problem’? Does the spectre of climate change immediately allocate this matter to professional risk assessment and collective response? Environmental stress perspectives and the environmental risk discourse generally seem to be better equipped than conventional stress and coping frameworks to handle the more encompassing ‘environmental’ character and attributes of an environmental condition and threat such as climate change (e.g., Evans and Cohen, 1987; Stokols et al., 2009). While the scale and ultimate magnitude and complexity of the ‘problem’ and phenomenon are still daunting and arguably unprecedented, there is common ground with respect to other global condition threats such as biodiversity loss, marine pollution, geopolitical conflict and instability, ecosystem unsustainability, etc. Even environmental threats that are more transparently technological and anthropogenic, such as genetic engineering, nanotechnology, and toxic waste are also complex, global, and planet and human society threatening (e.g.,

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Adam, 1998; Bauer and Gaskell, 2002). As well, the more tangible and salient impacts of climate change are manifesting in the form of extreme weather events, natural disasters, and altered landscapes and bioscapes, which are familiar, known, and often local environmental threats and hazards, though occurring more frequently and with greater intensity. But while environmental stress perspectives have been able to document the nature and psychological impacts of such stressors (e.g., Aldwin and Stokols, 1988; Evans and Stecker, 2004), models and intervention applications have been less clear with respect to individual risk perception and coping and adaptation responses. In the case of climate change this is arguably very new territory (e.g., Reser and Swim, 2011). But the ubiquitous ‘reality’ of climate change as a profound and looming global and local threat that individuals, communities, and nations must deal with and prepare for is no longer questioned in scientific and policy sectors around the world (e.g., IPCC, 2007; Hulme, 2009). There is a real need and increasing realization that psychological and social science input is urgently required if the stringent policy and governance changes envisioned are to be accepted and effective. There has also been more balanced and realistic consideration of the adaptation challenge to what will be a very changed world regardless of some still possible but modest mitigation successes. This in turn requires a very serious consideration of what is available by way of more transparent and proven models and interventions which can address the coping and adaptation challenges associated with climate change as current and very salient threat as well as unfolding global disaster (e.g., Spratt and Sutton, 2008; Swim et al., 2011).

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‘Adapting’ and Integrating Stress and Coping and Environmental Stress Approaches to Climate Change There are clearly a number of challenges in integrating stress and coping and environmental stress approaches to climate change. A summary statement of these would include:  







The existing research gap. The very different nature of this threat, risk, domain, and set of global impacts as compared and contrasted with other environmental and psychological threats and stress-inducing risks. The integration and synthesis of two very distinct theoretical perspectives and bodies of work which are nonetheless both of particular relevance to adapting to and coping with climate change. The need to measure, document and monitor the nature and extent of adaptation responses and the nature and extent of psychological impacts, including the psychological impacts and costs of adaptations themselves. The need for robust but sensitive and valid outcome measures of psychological adaptation and psychological impacts relating to the threat and physical environmental impacts of climate change.

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

The translation of very successful individual level intervention wisdom and best practice with respect to more immediate life circumstance threats and accompanying stress into a more generic psycho-educational set of strategies and interventions which can be delivered to a mass audience or tailored to particular segments of the public with particular needs, and which complements and enhances existing risk communications addressing climate change and extreme weather events.

A cogent argument can be made that psychological adaptation has been a core construct and terminology in psychology for the past century. But within this disciplinary and professional practice context the adjective ‘psychological’ was typically implicit and unnecessary, given the foundational status of adaptation models and processes within psychology and allied health domains. It was and remains the case however that this use of adaptation readily accommodates the multiple levels of analysis found within psychology and the biopsychosocial underpinnings of human cognitions, emotions, motivations, and behavior. An important and again convergent set of processes integral to adaptation at an individual level and reflecting a more phenomenological and mindful functioning are coping processes. Indeed these terms are often used synonymously in the literature and often in professional discourse, whereas ‘coping’ is the most widely used term in everyday conversation and by the media. A decision was made by the APA Taskforce on psychology and climate change (APA, 2009) to employ both terms in their addressing and consideration of ‘coping and adaptation’ to the threat and psychosocial impacts of climate change (Doherty and Clayton, 2011; Reser and Swim, 2011). An important rationale was that this language and use would resonate with climate change scientists’ discourse and the language of the IPCC, but also would enable psychologists and social scientists to address this crucial research gap in the context of climate change in a more strategic and informed way, while referencing the extensive body of very relevant work which exists in psychology and the social and health sciences. In reality a similar modification of language was already established in the stress and coping and health psychology literatures, though this took the form of cognitive adaptation and was principally applied in the context of a spectrum of health issues and ongoing and stressful conditions and diagnoses (e.g., Taylor, 2009, 1983; Taylor and Aspinwall, 1996). It is noteworthy that the term ‘adaptation’ was used to communicate that this type of coping intervention could have salutary effects on one’s biological system and biophysical as well as psychological health. A more recent emphasis in the stress and coping literature has been that of anticipatory coping, proactive coping, and future-oriented thinking (e.g., Aspinwall, 2011; Folkman, 2011) with this language and conceptual framing being seen as having much wider applications, including the coping challenges of climate change.

INITIAL FINDINGS FROM AUSTRALIAN CLIMATE CHANGE RESEARCH WITH A STRONG FOCUS ON PSYCHOLOGICAL ADAPTATION AND IMPACTS The authors are conducting a cross-national program of research that addresses public risk perceptions, understandings, and responses to climate change and energy futures (Reser et al., 2011). As part of this research, in 2010, a nationally-representative sample of

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3,096 Australians completed a questionnaire containing multi-item scales measuring nine core variables: prior direct experience of climate change impacts, objective knowledge about climate change, climate change risk perceptions, concerns about climate change, distress associated with climate change, self-efficacy related to climate change action, felt personal responsibility to act, psychological adaptation to climate change, and extent of climate change mitigation behaviors. We found that 88% of respondents reported feeling at least some level of concern about climate change. Compared to those without direct experiences of the impact of climate change, those who reported direct experiences had significantly higher levels of knowledge, concern, perceptions of risk, distress, felt responsibility to act, self-efficacy, adaptation, and engagement in pro-environmental (climate change mitigating ) behaviors. Tendencies for Australians to engage in mitigating behaviors were correlated with all eight study variables. However, as predicted, behavioural engagement was directly predicted by just three of these variables: distress, self-efficacy, and (most strongly) psychological adaptation. These relationships are shown in Figure 1. Together the findings highlight two important phenomena: first, the nexus between direct experiences of climate change impacts and related cognitive, affective, and behavioral responses, and, second, the role played by adaptation in mediating the relationship between a range of internalized psychological variables and pro-environmental behaviours. This research is ongoing, with our most recent wave of data collection containing additional measures of coping with climate change-related stressors. These findings and interpretation are very consistent with the insight offered by Folkman and Moskowitz that “distinct kinds of coping seem to travel together [and] facilitate each other” (2004, p. 753). In our own findings taking action and behavioral engagement appeared to offer multiple benefits with respect to the two spheres of adaptation and mitigation. The actions and behavior change made a modest and environmentally significant and problemfocused contribution to reducing one’s carbon footprint, but importantly these actions, and this behavioral engagement more generally, were clearly very psychologically significant both in terms of emotion-focused coping and meaning-focused coping. This in turn says something about mediation and the reciprocal nature of the stress and coping dynamic that characterizes human transactions with their environments. An interesting aspect of our Australian findings is the strong perceived interrelationship between natural disaster and extreme weather events and climate change evidenced in public risk perceptions and understandings. While the authoritative meteorological view is that such associations in the context of specific events are by and large spurious, the psychological, social, and experienced ‘reality’ for the Australian public would appear to be that these phenomena are clearly linked, as is the underlying risk domain. This lay perspective and understanding is for all practical purposes also a media view, and an increasingly expressed professional and practical risk management perspective for those involved in disaster management, mitigation, and capacity building (e.g., Cullen, 2010; McBean and Rodgers, 2010; Stewart, 2009). This also reflects an important change in thinking and understanding on the part of the public with respect to the nature, threat, and implications of climate change, including a revised appraisal of human response options, and is therefore both an important and dynamic psychological adaptation to climate change as well as a psychological impact of climate change.

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Psychological Distress

Concern

Prior Direct Experience of Climate Change Impacts

Knowledge Psychological Adaptation

Risk Perception

Behavioural Engagement Resilience

Felt Responsibility to Act

Self-Efficacy

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Figure 1. Selective view of findings from a survey of 3096 Australians showing direct experiences as a likely antecedent to and psychological adaptation as a powerful mediator of, internal and behavioral responses to climate change.

CONCLUSION Where does this overview of relevant perspectives, considerations, and selective research findings take us? What aspects of the climate change adaptation and mitigation challenge can current stress and coping perspectives meaningfully address? Is an integrated model of stress and coping, environmental stress, and human adaptation perspectives possible? Can such synthesized theoretical scaffolding, with reference to convergent bodies of psychological and social science evidence, meaningfully address the collaborative needs of interdisciplinary and transdisciplinary environmental social science as well as the requirements of climate change science and government bodies? There are some promising signs. Many coping theorists might be surprised by how frequently the language of coping is being used to address, conceptualize, and effectively and experientially communicate the challenges of our contemporary local and global environments (e.g., Davies, 1993; Hamilton, 2010; Homburg et al, 2007; Hulme. 2009; Luginaah et al., 2002; Unger, Wandersman & Hallman, 1992; Weishaar, 2010). This itself is a powerful testament to the relevance and transactional character of such frameworks, the crucial status given to environments and their contexts (e.g., Wapner & Demick, 2002), and ideally the transformational capacity of such perspectives in changing how environmental threats and problems are viewed, appraised, and understood by individuals and communities as well as by researchers and policy makers. This

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also suggests that the language and constructs of coping might constitute a very meaningful and effective way in which to engage the public, a current and very high priority of climate change science as well as social scientists (e.g., Gifford, Kormos and McIntyre, 2011; Moser and Dilling, 2004; Whitmarsh et al., 2011; Wolf and Moser, 2011). It is also the case that a number of more recent developments in the convergent arenas of stress, health, and coping would appear to be particularly relevant to more psychological considerations of coping and adaptation in the context of climate change. Refined models of anticipatory coping, proactive coping, future oriented thinking, and psychological preparedness are providing real scope for addressing and conceptualizing the extended temporal frames in which ongoing environmental stressors operate and which environmental sustainability requires. Clearly distinctions between anticipatory coping, proactive or preventive coping, self-regulation, and future-oriented thinking are important considerations when addressing coping and preparedness, and adaptation and mitigation “as we think through, prepare for, and potentially act to alter what we believe to be in store for ourselves and our loved ones”(Aspinwall, 2011, p. 334). Arguably the spectre of climate change makes such considerations and the distinctive roles of anticipatory and proactive coping particularly compelling. As well, such areas of coping research and practice as meaning-focused coping strategies and psychologically significant behavioral engagement suggest worthwhile ways forward (Folkman & Mos kowitz, 2000; Gifford, Steg and Reser, 2011; Park, 2011). There is also a considerable push for such integrative and synthetic models from the multidisciplinary arenas in which so many applied social and natural scientists work. Research on social-ecological systems, in restoration ecology, in disaster preparedness and response, in terrorism, in urban planning, in community psychology, in psychosocial environmental impact assessment, and in public health, to name a few such interdisciplinary spaces, require frameworks and conceptual models from psychology which can address and inform the stresses and strains, the wear and tear, of contemporary people and – often challenging - environment transactions. While myriad models exist in the arena of climate change science, very few of these models incorporate psychological parameters or levels of analysis. Such frameworks from psychology are often better able to encompass the multiple levels of analysis required in moving from organismic system functioning, to experienced reality, to individual behavior, to psychological and societal sense making and responses. Human coping and adaptation are integral processes at many of these levels, and the interrelatedness between adaptation and mitigation becomes particularly apparent through such a reflective prism. An initial framework and set of considerations and constructs was recently formulated in the context of the American Psychological Association’s Taskforce Report on Psychology and Climate Change. See Figure 1. This was more by way of a compiling and organizing of parameters and processes than a satisfactory synthesis or model of stress and coping, environmental stress, and adaptation processes, but it did allow the authors of this report and a subsequent coping and adaptation article to at least consider and speak to many of the issues which an environmental threat and risk domain such as climate change poses (APA, 2009; Reser and Swim, 2011).

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Note: Copyright 2011 by the American Psychological Association. Reproduced with permission from: Reser, J. P., & Swim, J. (2011). Adapting to and coping with the threat and impacts of climate change. American Psychologist, 66(4), 277-289. No further reproduction or distribution is permitted without written permission from the American Psychological Association. Figure 1. Psychological processes that influence adaptation to and coping with climate change.

It would seem self-evident that both conceptual clarity and a measure of crossdisciplinary consensus are required with respect to the emergent construct of climate change adaptation and how and where such adaptation processes dovetail with more psychological formulations of coping and adaptation processes and dynamics. While this is a reasonably resolvable problem within psychology which has a very positive history of engagement across

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multiple applied areas (e.g., environmental psychology, health psychology, disaster psychology), it has proven to be a more challenging task in the context of multidisciplinary areas with strong natural and physical science roots, such as public health, social ecology, and climate change science. The complexity of ‘climate change’ as threat, environmental stressor, cultural risk domain, and impacting processes with dramatic environmental and human consequences requires a synthesis of perspectives and models from diverse areas of psychology in order to adequately conceptualize and communicate how a more psychological framing of the ‘human dimensions of global environmental change’ can best inform and enhance effective and collaborative climate change adaptation and mitigation policies, research, and action. In this chapter we present an overview and integrative perspective but not yet a satisfactory conceptual model which can identify and accommodate important mediating and moderating parameters and processes relating to climate change coping and adaptation, with particular emphasis given to environmental stress and stress and coping perspectives. The primary intention has been to highlight crucial but currently neglected aspects of adaptation in the climate change science arena. Of particular importance are intra-individual and social psychological adaptation processes which would appear to powerfully mediate effective coping responses and resilience, overt behavioral adjustment and change, and psychological and social impacts. The argument mounted is that this psychological window on climate change adaptation is arguably indispensable to genuinely multidisciplinary and interdisciplinary research and policy initiatives addressing the impacts of climate change. We have employed the expression psychological adaptation in this chapter, in conjunction with coping, as a terminology which is most likely to bridge existing disciplinary divides and cultures in the context of climate change and address current confusions and omissions. The adjective psychological flags a particular emphasis on individual level psychological considerations and processes, while including behavioral adjustments and engagement, as well as micro and macro social psychological processes, such as the social construction and social representation of environmental risk, the social amplification and attenuation of risk, social support, and collective and symbolic coping (e.g., Wagner and Hayes, 2005; Pidgeon et al., 2003). This language use acknowledges coping as an integral, psychological, and more mindful suite of cognitive, emotional, and motivational responses and engagements occurring in transactions with threatening and/or challenging situations and environments, while acknowledging the more encompassing nature of closely intertwined adaptation functions and processes, and an understanding of adaptation as the fluid objective and end state of coping processes.

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Stewart, A. E. (2009). Psychological perspectives on adaptation to weather and climate. In K. L. Ebi et al. (Eds.), Biometeorology for adaptation to climate change. New York, NY: Springer. Stocking, S. H. (2009). Manufacturing doubt: Journalists’ roles and the construction of ignorance in a scientific controversy. Public Understanding of Science, 18(1), 23-42. Stokols, D., Misra, S., Runnerstrom, M. G., & Hipp, J. A. (2009). Psychology in an age of ecological crisis: From personal angst to collective action. American Psychologist, 64, 181-193. Swim, J., Clayton, S., Doherty, T., Gifford, R., Howard, G., Reser, J., et al. (2011). Psychological Contributions to Understanding and Addressing Global Climate Change. American Psychologist, 66(4), 241-250. Taylor, S. E. (2009). Health psychology (7th ed.). New York: McGraw-Hill. Taylor, S. E. (1989). Positive Illusions: Creative self-deception and the healthy mind, New York: Basic Books. Taylor, S. E. (1983). Adjustment to threatening events: A theory of cognitive adaptation. American Psychologist, 38, 1161-1173. Taylor, S. E., & Aspinwall, L. G. (1996). Mediating and moderating processes in psychosocial stress: Arousal, coping, resilience, and vulnerability. In H.B. Kaplan (Ed.), Psychosocial stress: Perspectives on structure, theory, life-course and method (pp. 71109). New York: Academic Press. Trumbo, C. W., McComas, K. A., & Besley, J. C. (2008). Individual and community-level effects on risk perception in cancer cluster investigations. Risk Analysis, 28(1), 161-178. Unger, D.G., Wandersman., A. & Hallman, W. (1992). Living near a hazardous waste facility: Coping with individual and family distress. Journal of Orthopsychiatry, 62, 5570. Uzzell, D. (2000). The psycho-spatial dimension to global environmental problems. Journal of Environmental Psychology, 20(4), 307-318. Valliant, G. E. (1994). Ego mechanisms of defense and personality psychopathology. Journal of Abnormal Psychology, 141, 542-545. VandenBos, G. R., & Bryant, B. K. (1987). Toxins, technology and natural disasters. Washington, DC: American Psychological Association. Van Zomeren, M., Spears, R., & Leach, C. W. (2011). Experimental evidence for a dual pathway model analysis of coping with the climate crisis. Journal of Environmental Psychology, 30, 339-346. Van Zomeren, M., Spears, R., & Leach, C. W. (2008). Exploring psychological mechanisms of collective action: Does relevance of group identity influence how people cope with collective disadvantage? British Journal of Social Psychology, 47, 353-372. Vaughan, E. (1993). Individual and cultural differences in adaptation to environmental risks. American Psychologist, 48, 673-680. Veitch, R., & Arkkelin, D. (1995). Environmental psychology: An interdisciplinary perspective. Englewood Cliffs, NJ: PrenticeHall. Wagner, W., & Hayes, N. (2005). Everyday discourse and common sense: The theory of social representations. New York: Palgrave Macmillan. Wapner, S. (1981). Transactions of persons-in-environments: Some critical transitions. Journal of Environmental Psychology, 1, 223-239.

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Wapner, S. & Demick, J. (2002) Tne increasing contexts of context in the study of envoironment behavior relations. In R. B. Bechtel., & A. Churchman (Eds.), Handbook of environmental psychology (pp. 3-14). New York: Wiley. Wapner, S., & Demick, J. (2000). Person-in-environment psychology: A holistic, developmental, systems-oriented perspective. In W. B. Walsh., K. H. Craik., & R. H. Price. (Eds.), Person-environmental psychology: New directions and perspectives (2nd ed., pp. 25-60). Hillsdale, NJ: Lawrence Erlbaum Associates. Wapner, S., Demick, J., Yamamoto, T., & Minami, H. (2000). Theoretical perspectives in environment-behavior research: Underlying assumptions, research problems, and methodologies. New York: Kluwer Academic/Plenum Publishers. Washington. H., & Cook, J. (2011). Climate change denial: Heads in the sand. Taylor & Francis. Weber, E. U. (2006). Evidence-based and description-based perceptions of long-term risk: Why global warming does not scare us (yet). Climatic Change, 77, 103-120. Weinstein, N. (1987). Taking care: Understanding and encouraging self-protective behaviour. New York: Cambridge University Press. Weishaar, H. B. (2010). “You have to be flexible” – Coping among Polish migrant workers in Scotland. Health and Place, 16, 820-827. Wheaton, B. (1997). The nature of chronic stress. In B. Gottlieb (Ed.), Coping with chronic stress. New York: Plenum. White, R. W. (1974). Strategies of adaptation: An attempt at systematic description. In G. V. Coelho., D. A. Hamburg., & J. E. Adams (Eds.), Coping and adaptation (pp. 47-68). New York: Basic Books. Whitmarsh, L., O’Neill, S., & Lorenzoni, I. (2011). Climate change or social change? Debate within, amongst, and beyond disciplines. Environment and Planning, 43, 258-261. Wolf, J., & Moser, S. C. (2011). Individual understandings, perceptions, and engagement with climate change: insights from in-depth studies across the world. Climate Change, 2(4), 547-569. Yohe, G. (2000). Assessing the role of adaptation in evaluating vulnerability to climate change. Climatic Change, 46, 371-390. Young, O. R. (2010). Institutional dynamics: Resilience, vulnerability and adaptation in environmental and resource regimes. Global Environmental Change, 20, 378-385. Zeidner, M., & Endler, N. S. (1996). Handbook of coping: Theory, research, applications. New York: Wiley.

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Chapter 2

THE SEARCH FOR MEANING: A FRAMEWORK FOR HOW INDIVIDUALS COPE WITH BEREAVEMENT AND OTHER EXISTENTIAL STRESSORS Benjamin Lord, Sandra Gramling, and Stephen M. Auerbach Virginia Commonwealth University, Department of Psychology, Virginia, US

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ABSTRACT The idea that coping with stressful events involves a cognitive as well as a behavioral component has long been accepted in the stress-and-coping literature (e.g., Lazarus, & Folkman, 1984). However some major-life stressors, such as the death of a loved-one, may present challenges to individuals’ fundamental worldviews, and engender a spiritual, existential, or identity crisis. In these cases, it is theorized that one must successfully complete a journey wherein one makes sense of the stressful event in order for adjustment to occur (Park, 2010). Park and Folkman (1997) have provided a framework for understanding this process by extending the Lazarus and Folkman (1984) transactional model of stress and coping to include meaning-making as a key component of the coping process. Meaning-making, or the reconciliation of one’s fundamental beliefs and life goals with the untenable situations which challenge them, may represent a relatively untapped theoretical framework for understanding how individuals cope with suffering that is unavoidable, and situations that are irreparable (Frankl, 1962). Historically, meaning-making theory has been primarily applied to the study of loss (e.g., Janoff-Bulman, 1992) and trauma (e.g., Creamer et al., 1992). Indeed, meaningmaking has been conceptualized as the core task of the grieving process (Neimeyer et al., 2006). However, more recently researchers have begun to apply the meaning-making model to describe how individuals cope with numerous existentially threatening stressors, including cancer diagnosis (Boehmer et al., 2007; Christie et al., 2009), chronic pain diagnosis (Graham et al., 2008), and caregiving for a loved-one with dementia (Gignac, & Gottlieb, 1996). Despite this growing interest in how individuals interpret and find meaning in stressful circumstances, issues with the operationalization and measurement of the meaning-making process have made it difficult to compare results across studies and come to a consensus regarding how best to assist individuals with their search for meaning (Park, 2010). We review the theory and conceptualization of meaning-making

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Benjamin Lord, Sandra Gramling, and Stephen M. Auerbach using a detailed review of bereavement research to illustrate the weaknesses currently present in the literature. A model of meaning-making in the grieving process is proposed, and suggestions are made for how to use qualitative and quantitative methods to further the study of meaning-making in the context of grief and other major-life stressors.

INTRODUCTION

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“In some ways suffering ceases to be suffering at the moment it finds a meaning… (Frankl, 1962, p. 113).”

The idea that human beings have a drive to actively make sense of the world around them is not a new one, nor is it unique to the study of psychology. One of the first psychotherapists to emphasize this drive that we all have toward making meaning from stressful situations was Viktor Frankl (1962). In his best-selling book Man’s Search for Meaning, Frankl argued that human psychology is fueled by a need to understand the world around us, and that meaning and purpose can be derived from even the most terrible situations. His book brought the concept of meaning-making as a basic human need to the popular imagination, and since that time logotherapists and constructivist psychologists have argued for the primacy of meaning in promoting resilience in the face of mental health problems and existential challenges (e.g., Gillies & Neimeyer, 2006). However, it has only been relatively recently that meaningmaking has been conceptualized as a part of the stress-and-coping process (e.g., Park & Folkman, 1997), and the empirical study of meaning-making has continued to lag behind theoretical considerations. Park (2010) has suggested that the reason the empirical investigation of meaning-making has not progressed as rapidly as the development of theories and models is due to issues with the measurement of the meaning-making construct. Indeed, there has yet to be a strong consensus on exactly what meaning-making means. This viewpoint is echoed in the general stress-and-coping literature (Lazarus & Folkman, 1984), where it has been suggested that the use of general coping checklists is ineffective unless they are validated for use with specific populations suffering from specific stressors. Lessons from the field of stress-and-coping suggest that a shift to more intensive or process-oriented methodologies, studying fewer participants in more detail as they change over time, may be required in order to more accurately capture the coping process (Coyne & Raccioppo, 2000). This suggestion may be of particular importance to meaning-making researchers because few comprehensive measurement tools currently exist which have been constructed specifically to quantify the meaning-making process. In addition to being difficult to measure, the search for meaning may also appear to some to have limited utility in describing how individuals cope with commonly encountered stressors. After all, not every individual experiences a religious conversion, identity crisis, or existential catastrophe in their lifetime. However, it should be noted that some of the most extensive research into the meaning-making process has been conducted with individuals experiencing the loss of a loved one, which is among the most common (Allumbaugh & Hoyt, 1999) and distressing (Holmes & Rahe, 1967) life events. Indeed, a growing number of authors have implicated meaning-making, or “the restoration of meaning in the context of highly stressful situations” (Park, 2010, p. 257), as both an important theoretical framework for describing the unique ways that individuals grieve over time, and as a way to distinguish

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those individuals who require clinical intervention from those who do not (Neimeyer, Baldwin, & Gillies, 2006). Different meaning-making pathways suggested in the bereavement literature (Davis & Noelen-Hoeksema, 2001) and predicted by modern meaning-making models (Park, 2010) appear to be related to the process of grieving that has been observed empirically through longitudinal studies. There is some evidence to support the idea that individuals who are unable to make meaning out of a loss are more likely to experience a prolonged and problematic period of distress which may require therapeutic intervention (Prolonged Grief Disorder; Bonanno, 2004; Coleman & Neimeyer, 2010). This use of the meaning-making model for the study of the grieving process has encouraged researchers to move away from stage models of grief and challenge previously held assumptions about the grieving process itself (e.g. Bonanno, 2004; Wortman & Boerner, 2007). After describing the meaning-making model below, a detailed review of the changes present in the grief literature and how they relate to advances in the study of meaning-making is provided. The example of bereavement will be used as a context to briefly review the research currently available regarding the role of meaning-making in coping with other major life stressors.

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MEANING-MAKING: WHAT DOES IT MEAN? The concept of meaning-making draws from a variety of theoretical perspectives, including: Janoff-Bulman’s assumptive world theory (1989, 1992), autobiographical memory research (Bluck, & Habermas, 2001; Neimeyer, 2006), cognitive theory, stress-and-coping theory (Lazarus & Folkman, 1984), and narrative/constructivist theories (Gilbert, 2002). Indeed Park (2010) has suggested that one of the greatest challenges in conducting research into the meaning-making process may be defining it. However, Park and Folkman (1997) and Park (2010) have provided a comprehensive model of meaning-making based on the agreedupon “essential tenets” from the various meaning-making theories (p. 257). Put simply, they define meaning-making as the process of reconciling interpretations of major life events (e.g., the death of a loved one) with foundational beliefs about the world (e.g., bad things only happen to bad people). Stated another way, meaning-making is a type of coping aimed specifically at preserving psychological homeostasis by creating or maintaining a unified system of beliefs and expectations.

The Meaning-Making Model The meaning-making model suggested by Park and Folkman (1997) and refined by Park (2010) is essentially an extension of the transactional model of stress and coping developed by Lazarus and Folkman (1984) as part of their cognitive stress theory. According to cognitive stress theory, the ways in which an individual deals with (or copes with) stress and the emotions that accompany it can either ameliorate or exacerbate the effects of the event (Hansson & Stroebe, 2007). The transactional stress and coping model proposed by Lazarus and Folkman (1984) describes a process through which people identify stressors, evaluate the threat that they pose, and identify and implement procedures to reduce the stress response

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either by changing the stressful situation (i.e. problem-focused coping) or by regulating the internal stress response (i.e. emotion-focused coping). The first step in this model is one's appraisal of the stressful situation, including how threatening the event is, and whether it is controllable or not (this is termed primary appraisal). Secondary appraisal occurs when one decides what coping strategies might be effective in the situation (i.e. what can be done). The appraisal process, in turn, determines what coping strategies will be deployed by the individual, and reappraisal can occur at any point during the process. This model clearly emphasizes the importance of cognitive processes such as appraisal in determining both the perceived stressfulness of an event, and which coping options an individual chooses to draw from. Park and Folkman’s (1997) meaning-making model is based on the premise that the appraisal of an event also includes an evaluation of the significance of the event, or the reasons why the event is happening, and the implications that the event has for the future. This appraisal of meaning is influenced by one’s expectations, previous experiences, beliefs, and life goals, which form a framework through which an event can be processed. Situations that contradict past experience, threaten one’s sense of self, or frustrate progress on goals may threaten this framework of belief, therefore causing or contributing to distress. Meaningmaking therefore involves the individual’s attempts to reduce the dissonance between these two meaning-systems, and when successful results in a reduction in emotional distress and the maintenance of a sense of coherence, purpose, and stability.

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Global Meaning The framework of belief against which one compares life experiences is labeled global meaning. According to Park and Folkman (1997), global meaning consists of the beliefs, goals, and feelings that make up our general schema or orienting system about the world. This can include core beliefs regarding the randomness of events, intentions of others, and the role and basic evaluation of the self (Janoff-Bulman, 1989), as well as long-term goals or current states that one wishes to maintain (e.g., planning to be a husband for the rest of one’s life). Park (2010) extended the definition of global meaning to include subjective feelings of meaningfulness or having a purpose in life. This system of global meanings is hypothesized to develop early in life, and continues to change slowly over time as it accumulates or is modified by life experiences. It is generally thought that the global meaning system is robust and capable of assimilating most daily stressors, and that only more traumatic stressors such as witnessing a disaster, the death of a loved one, or having one’s identity challenged by a chronic illness necessitate the rebuilding of global meanings. In fact, some recent research has suggested that even the loss of a loved one does not necessarily impact global beliefs (Currier, Holland, & Neimeyer, 2009). Global meanings are also assumed to play a large role in how people actively construct their subjective experiences (Janoff-Bulman & Frantz, 1997). In short, global meaning refers to the building blocks of one’s unique worldview. The global meaning construct can be further broken down into two related dimensions: order and purpose (Park, & Folkman, 1997). Order, sometimes referred to as global belief, includes one’s core beliefs about how the world is organized, how it functions, and how positive and negative outcomes are distributed in a predictable manner. Theorists commonly

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include beliefs about justice, perceived control, the predictability of events, and one’s selfworth (e.g., Janoff-Bulman, 1989) as a part of the order dimension of global meaning. For example, an individual may hold a belief that bad things only happen to bad people, and that one’s hard work will result in positive outcomes. Purpose, sometimes referred to as global goals, consists of the framework of long- and short-term goals that motivate a person’s actions. These may be desired states that one hopes to achieve sometime in the future (e.g., to have a child one day), or may refer to current circumstances that one wishes to maintain (e.g., a harmonious marriage). A third domain that is also considered an aspect of global meaning is the subjective feeling that one is living in a world that makes sense, and that one has a purpose in life. This aspect of the global meaning system will be described in more detail later in the chapter.

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Situational Meaning Situational meaning, in contrast to global meaning, refers to the appraised meaning and significance of a particular stressful life event, including the degree of threat, the implications, and the perception of control that one has over it (Park, 2010). This appraisal is closely related to the processes of primary and secondary appraisal described by Lazarus and Folkman (1984), but expands upon them to include the perceived significance and implications of the event (i.e. does it call a global belief into question or disrupt a global goal?). These appraisals are, by definition, situational in nature and therefore more malleable than global meanings. According to the meaning-making model, when a stressful event occurs an individual will explicitly or implicitly compare the situational meaning to his or her global meaning system. A discrepancy results in the distress associated with the event, with the implication being that more significant discrepancies between global and situational meanings result in a correspondingly greater amount of distress. Although there are some extant measures that are designed to evaluate one’s global belief systems (Janoff-Bulman, 1989), or one’s subjective sense of meaning and purpose (e.g., Holland, Currier, & Neimeyer, 2006), no attempt has yet been made to quantify the amount of discrepancy between a situational meaning and one’s global beliefs.

Meaning-Making as a Coping Process If a discrepancy exists between the appraised meaning of an event and the global meaning system through which the individual interprets the world, the individual will attempt to reduce this distress through various strategies. The coping strategies used specifically to reduce this dissonance make up the process that we call meaning-making (Park, 2010). Researchers have suggested that these coping attempts may consist of unconscious processes (Horowitz, 1986) as well as effortful ones (e.g., Folkman, 1997). The effortful processes, which we will focus on here, can include some strategies assessed by popular coping checklists and inventories, as well as unique strategies (Park, & Folkman, 1997). What distinguishes them as meaning-making coping is their purpose: the recreation or maintenance of congruent meaning systems. Therefore, any coping strategy which modifies one’s core beliefs and life goals or one’s interpretation of a situation may be

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considered a part of the meaning-making process. Folkman (1997) used a qualitative research design to elicit meaning-making strategies from individuals who lost a loved-one to AIDS. She organized the resulting meaning-making coping strategies into three categories: 1) positive reappraisal, 2) revising or working toward goals, and 3) drawing from spiritual beliefs or experiences. Park (2010), in a review of the meaning-making literature, discussed other proposed coping strategies such as focusing on the benefits of a situation, using downward comparisons, imagining a worse scenario that has been avoided, revising the perceived reason for an event, and honoring a continued bond with the deceased. Constructivist therapists such as Neimeyer (2009) suggest other methods that can be applied by individuals themselves, or in the context of psychotherapy, such as writing and reexamining life narratives, revising one’s life story, and eliciting core values. Notably, no measure currently exists which aims to capture the full spectrum of coping strategies that may be useful in reducing discrepancies between the two meaning systems.

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Alternative Models of Meaning-Making Other researchers have provided a variety of different definitions of meaning-making, each of which may tap into a portion of the Park and Folkman (1997) meaning-making model. For example, some researchers have divided meaning-making into the individual’s subjective impression of their ability to make sense of a loss by finding an explanation for it, and the ability to find benefit from it (Davis, Nolen-Hoeksema, & Larson, 1998; Davis, & Nolen-Hoeksema, 2001; Holland, Currier, & Neimeyer, 2006). Other researchers in the field of trauma define meaning-making as the reconstruction of formerly violated assumptions about the safety and goodness of the world, the predictability of events, and the role of the self (Janoff-Bulman, 1989; Park & Ai, 2006). Still another perspective emphasizes the role of significance of the event (its value or worth) as well as attempts to make the event fit into existing rules (Janoff-Bulman, & Frantz, 1997; Taylor, 1983). Below, we review the details of Janoff-Bulman’s (1989) world assumptions theory (WAT) because it has come into increased use in the bereavement literature and is the most popular method for conceptualizing global beliefs.

World Assumptions Theory One method for conceptualizing the meaning-making process which predates the meaning-making model proposed by Park and Folkman (1997) is world assumptions theory (Janoff-Bulman, 1989; Parkes, 1972). World Assumptions Theory (WAT) was originally developed in order to explain how individuals react to a trauma or loss, and it has been applied most recently to bereavement research. Summarizing the utility of WAT, Holland, Currie, and Neimeyer (2006) have stated that: …bereavement often challenges people’s cherished beliefs about themselves and their worlds, thereby rocking the very foundation that sustains and supports them. Healing from loss can therefore by seen as a reconstructive process that involves weaving together the remaining fragments of one’s assumptive world (p. 176).

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C.M. Parkes (1972) first coined the term assumptive world to refer to the way that people organize their immediate environment within the world at large. According to Parkes, the assumptive world represents “our interpretations of the past and our expectation of the future, our plans and our prejudices” (p.102). Janoff-Bulman (1989) built upon this idea and proposed a pattern of beliefs that serve to reduce one’s feelings of insignificance and vulnerability in the world. WAT assumes that there are three primary categories of assumptions which people use to orient themselves in the world, and which can become challenged and possibly destroyed in the face of a traumatic event: benevolence of the world, meaningfulness of the world, and worthiness of self. These three primary assumptions break down further into eight subcategories. Benevolence of the world includes both the assumption that the impersonal world is safe, and also that people are generally good. Meaningfulness includes justice (the idea that people get what they deserve), controllability (the idea that one’s actions determine what happens), and randomness (the idea that positive and negative outcomes are distributed without regard for one’s morals or preparation and work). Worthiness of self contains the assumptions of self-worth (am I a good person?), selfcontrollability (do I take appropriate steps to keep myself safe?), and luck (am I better off than other people?). For Janoff-Bulman (1989) and Kaufmann (2002) these basic world assumptions are internal schemas or “constant internal constructs” which allow us to feel that our lives are orderly and that we are safe and able to function (p. 2). Since the introduction of this theory it has been used widely in research in the field of trauma (for a review see Kaufmann, 2002) serving as a model for the way that meaning can be challenged and rebuilt in the face of extremely stressful experiences.

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THE MEASUREMENT OF MEANING-MAKING: THE STATE OF THE SCIENCE Each of the alternative theories mentioned previously can be encompassed by the Park and Folkman (1997) model, and may be considered as unique attempts at measuring the meaning-making process, rather than as competing theories. For example, from the cognitive stress theory perspective, Park (2005) operationalized meaning-making as a process of positive reappraisal using a subscale of the COPE. Researchers such as Janoff-Bulman (1992) have attempted to measure changes in core beliefs about the world by comparing groups on a measure of World Assumptions. Currier, Holland, and Neimeyer (2006), using single survey items, have operationalized meaning-making as a subjective feeling of both making sense of, and finding benefit in, the loss. Each of these operationalizations of meaning-making actually select out and measure a distinct part of the larger meaning-making process, with Park (2005) focusing on situational meaning, Janoff-Bulman (1989) focuses on global beliefs, and Currier, Holland, and Neimeyer (2006) focus on the subjective feeling of having sense and purpose. Other researchers such as Folkman (1997) have attempted to use qualitative methods, coding interviews for causal attributions, insight statements, and expressions of understanding (e.g., Graham et al., 2008). Qualitative research is particularly important for the meaningmaking literature, because open-ended questions and intensive interviews can both provide insight into the types of meaning-making coping that people report as being helpful to them, and provide a foundation for the empirical derivation of quantitative scales and checklists to

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be used in future research. Gillies & Neimeyer (2006) reviewed the qualitative research that has been conducted on meaning-making in the process of grief. They noted that qualitative studies have added to our understanding of how people, both as individuals and family units, attempt to make meaning of difficult events and can effectively cope with the loss of a loved one. However, many approaches, including qualitative ones have failed to distinguish between meaning-making as a process and as an outcome (Park, 2010). A recent development in the measurement of meaning-making outcomes (often referred to as meaning made or having made sense of a stressor) has been the development of the Integration of Stressful Life Experiences Scale (ISLES; Holland, Currier, Coleman, & Neimeyer, 2010). The ISLES is a 16-item self-report measure which evaluates the extent to which an individual has made meaning out of a major life-event. In other words, the ISLES is a measure of how successful the outcome of a meaning-making attempt is. The scale was developed and validated for use with samples of young adults, some of whom had experienced the death of a loved-one, and some of whom had not. This allowed Holland et al. (2010) to compare the two samples, as well as provided support for the use of the measure with bereaved and non-bereaved populations. Although the measure demonstrated promising psychometric properties and will contribute to future meaning-making research, it is relatively new and has yet to come into wide use in the literature.

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MEANING-MAKING AND BEREAVEMENT An area that has been developing contemporaneously with the meaning-making literature is the study of how individuals react to the loss of a loved one. The study of bereavement as a distinct discipline in psychology is in its early stages. Beginning as a subject of interest in the realms of counseling psychology and psychoanalytic theory (e.g. Deutsch, 1937; Freud, 1917), it has only been in the second half of the twentieth century that there has been strong interest in the empirical study of bereavement-related phenomena (Archer, 2008). It could be stated that the field has come to the forefront of the health psychology movement since the publication of the Institute of Medicine Report on the state of bereavement research in 1984 (Osterweis, Solomon, & Green, 1984). However the field of grief research is still working to transition from a model couched in clinical practice (i.e. the use of case descriptions and clinical judgment) to one with an empirical basis (i.e. based on the collection of data with an emphasis on the reliability and validity of results). Although the bereavement literature continues to expand (a PsycNet search for empirical journal publications using the term “bereavement” for 2010 alone produced 141 results, as compared to 62 for 2000) studies of grief continues to suffer from methodological flaws that prevent this literature from progressing to the level of sophistication evident in the literature on other forms of psychopathology. Progress has been retarded by an attempt to move into the realm of rigorous empirical science without laying the necessary groundwork. Specifically, there is a need for the development of precise measurement tools designed specifically for bereaved populations, as well as a theoretical model for explaining the different courses that the grieving process can take over time.

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According the “Report on Grief and Bereavement Research” published by the Center for the Advancement of Health (2004), an overarching framework is needed to help synthesize research finding which at this point only capture a cross-section of the grief experience. A movement toward conducting more phenomenological research on the grieving process has suggested that meaning-making may play a key role in providing this framework. In fact, it is the opinion of at least one prominent author that “meaning reconstruction in response to a loss is the central process of grieving” (Neimeyer, 2001, p. 4). This meaning reconstruction model assumes that any major loss has the potential to cause a “fundamental revision of assumptive worldviews, meaning systems, or life narratives” (Stroebe & Schut, 2001, p. 69). Meaningmaking, or “the restoration of meaning in the context of highly stressful situations” (Park, 2010, p. 257), may potentially be used to describe the unique ways that individuals grieve over time, as well as a way to distinguish those individuals who require clinical intervention from those who do not (Neimeyer, Baldwin, & Gillies, 2006). Although thorough measurement tools for the evaluation of meaning-making processes have yet to be developed, the examination of meaning may be central to the future of grief research. The loss of a loved one (specifically a spouse) has been consistently appraised as one of the most stressful events that can occur in an individual’s life (e.g., Holmes, & Rahe, 1967). The stress-and-coping approach, also known as the transactional model of stress and coping, was developed by Lazarus and Folkman (1984) to account for the ways that both cognition and behavior can have an impact on how individuals respond to a stressful event. Factor analyses of general coping checklists have yielded different categories of coping which are theorized to be adaptive or maladaptive. Large inventories of coping strategies such as the empirically derived Ways of Coping Checklist (Lazarus, & Folkman, 1984) and the theoretically constructed COPE (Carver, Scheier, & Weintraub, 1989) were developed to measure the effects that different coping strategies would have on outcomes for different stressors. While these measures are meant to be wide-spectrum and useful for application with any stressor or population, more specifically targeted coping checklists have been developed as well. For example, the RCOPE (Pargament, Koenig, & Perez, 2000) is a measure of the different ways that individuals may use religious beliefs and practices to cope with stressful life events. All of these checklists include items or subscales of items that could be considered part of the meaning-making process. However, despite the clear importance of coping in the study of bereavement, relatively few empirical studies have been conducted to ascertain what coping strategies or styles are beneficial or detrimental in the context of grief (Folkman, 2001). One possible reason for this lack of research is the absence of a well-validated coping measure designed specifically for bereavement. Van Heck and De Ridder (2001) note that most bereavement studies that include coping strategies as a variable use the wide-spectrum coping checklists mentioned above, and that they may not represent the full range of coping strategies employed by the bereaved. Indeed, the use of wide-spectrum coping checklists in coping research in general has come under attack in recent decades, and has been pointed out as one reason for the slow progress in that field (Coyne & Gottlieb, 1996; Coyne & Raccioppo, 2000; Somerfield, & McCrae, 2000). A further issue is the idea that the appropriateness of different coping strategies may change throughout the grieving process, which requires a more intensive longitudinal approach to research that is often anathema to large-scale survey studies (Stroebe, Stroebe, &Schut, 2003).

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Despite these theoretical issues, a small number of important studies have been conducted examining coping strategies and bereavement. Schnider, Elhai, and Gray (2007) conducted a study of coping strategies among college students reporting a traumatic loss. Participants completed self-report measures to assess their levels of PTSD and grief symptoms. The Brief COPE, a commonly used coping checklist, was used to assess the use of three types of coping strategies: problem focused coping (e.g., planning how to overcome a problem), emotion-focused coping (e.g., reinterpreting the stressor in a positive way), and avoidant coping (e.g., using denial or self-distraction). Grief severity and PTSD symptoms were found to be positively associated with all three forms of coping. However, after controlling for years since loss, frequency of trauma, and the overlapping variance between the coping subscales, only avoidant coping was significantly related to complicated grief and post-traumatic stress syndrome. These results lead to several important conclusions that have implications for the use of stress-and-coping theory in conceptualizing bereavement. First, there is significant overlap in the usage of all three of these coping strategies among sufferers of traumatic loss. Also, avoidant coping strategies such as denial, which are reported by many individuals, may not be effective in the face of sudden or unexpected bereavement. A study by Rogers, Hansen, Levy, Tate, and Sikkema (2005) on coping strategies and optimism in the face of AIDS-related bereavement found that active coping strategies (taking action to change or remove the stressor) were positively associated with optimism and negatively associated with hopelessness. Conversely, avoidant coping strategies (distracting oneself from or ignoring the stressor) had the opposite relationships with those two variables. However, as with Schnider et al. (2007), both active coping and avoidant coping were positively related to grief symptoms. Hansen et al. (2006) evaluated the relationship between coping skills and outcomes among HIV positive participants who had recently lost a loved one to AIDS. They found that avoidant coping strategies were significantly associated with increased grief symptoms over time, whereas active coping was not associated with grief symptoms. These results highlight the problems associated with performing research on coping in the context of bereavement. A weakness lies in the use of general coping checklists which have not been validated on bereaved samples, rather than investigating the specific coping strategies the bereaved themselves report using. This reveals a further weakness in bereavement research which has yet to be illustrated: the need for more qualitative or mixedmethod designs in order to supplement the lack of validated measurements. One of the major problems that has yet to be successfully addressed is the lack of a comprehensive framework for describing the grieving process and predicting outcomes. The Center for the Advancement of Health (2004) summarized the current state of the literature on grief by noting that “it is difficult to organize, make sense of, and apply research findings that cannot be situated within a larger framework of some kind,” and that field may require a “formal theory” to tie together disparate research findings, and to tie research findings to clinical practice (p. 569). Although no attempt has yet been made to measure the Park and Folkman (1997) model in its entirety, a variety of research has examined the role that meaning-making plays with bereaved individuals using other methods. Focusing on the subjective portion of the global meaning system, Davis et al. (1998) demonstrated that participants’ self-reported ability to make sense of, and find benefit in their loss, were both associated with reduced grief symptoms as measured by a semi-structured interview. In a similar study, Holland, Currier, and Neimeyer (2006) examined the subjective sense of meaning among a sample of bereaved

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college students. Their results partially replicated those reported by Davis et al. (1998) while further indicating that sense-making was a stronger predictor of low grief scores than benefit finding. Another study in this vein evaluated the importance of meaning-making by testing the mediational role that it plays in the relationship between the circumstances of a loss and the intensity of grief symptoms following the loss (Currier, Holland, & Neimeyer, 2006). A sample of bereaved college students was administered a grief severity questionnaire, a single item assessing the ability to make sense of a loss, and a questionnaire regarding the circumstances of the loss. The researchers compared the grief reactions of those who had suffered a traumatic loss (homicide, suicide, or accident) to those who had suffered a natural loss due to an expected illness and found that the higher levels of grief severity in the traumatic loss group were partially explained by the self-reported ability of the participants to make sense of their loss. This research, although not longitudinal in nature, hints at the possibility that the success of the meaning-making process may be related to the trajectory that grief takes following a loss. If situational factors impact bereavement outcomes primarily based on how they affect one’s subjective sense of meaning, then meaning-making can be considered central to the grieving process. Further research has been conducted examining the meaning-making model from the standpoint of world assumptions theory. Janoff-Bulman (1989; 1992) proposed three primary categories of assumptions which people use to orient themselves in the world, and which can become challenged and possibly destroyed in the face of a traumatic event: benevolence of the world, meaningfulness of the world, and worthiness of self. Schwartzberg and JanoffBulman (1991) explored the impact of bereavement on these three facets of global meaning in a sample of college students who had recently lost their parents. Twenty-one bereaved undergraduate students and a matched sample of controls were administered the Symptom Checklist-90, a self-esteem scale, and a locus of control scale, along with a semi-structured interview assessing participants’ beliefs in the benevolence of the world, the meaningfulness of the world, and their self-worth. The results of the study indicated that meaningfulness of the world was an important variable in the grieving process given that it was significantly reduced among the bereaved students as compared to the non-bereaved controls. Two related studies have examined the world assumptions variable with samples of bereaved parents. Wickie and Marwit (2000) administered the World Assumptions Scale, the Revised Grief Experience Inventory, and a packet of demographic information to a sample of parents of murdered children and a sample of parents of children who had died in accidents. They found that parents bereaved by homicide had significantly more negative opinions of the benevolence of the world than those bereaved by an accident. The second study examined the predictive power of the world assumptions theory among a sample of parents bereaved by a variety of circumstances: homicide, accident, and illness as well as nonbereaved controls (Matthews, &Marwit, 2003). It was found that bereaved parents, regardless of type of loss, reported lower benevolence of the world and self-worth scores than controls. Although these studies offer only a cross-section of participants’ global meanings, and do not measure situational meanings, or how they change over time, they do demonstrate that a loss can indeed impact an individual’s global meaning system. At least two studies have attempted to improve on the designs of those described above by analyzing data from the Changing Lives of Older Couples Study (CLOC). This study, initiated in the 1980s, recruited and followed 1,532 older adult couples. Couples completed interviews, and those who lost a spouse during the duration of the study (N = 205) were

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identified using state records and recruited to complete further measures at 6, 18, and 48 months following the loss. Variables assessed in the study included pre-loss measures of social support, marital quality, mood and wellbeing, personality, and worldviews. Post-loss assessments also included questions regarding grief, continued attachments, and attempts to work through the loss. This allowed the researchers to look at the relationship between meaning-making and grief over time. Kim et al. (2011) analyzed data from three time-points to measure the impact that meaning-making had on feelings of personal strength among participants in the study. Meaning-making was measured using a single item (“Have you made sense or found any meaning in your [husbands/wives] death”) that was responded to on a four-point scale. The researchers found that finding a sense of meaning was the strongest predictor of feelings of personal strength, and that it mediated the relationship between social support and personal strength. Coleman and Neimeyer (2010) conducted an additional reanalysis of data from the CLOC study in order to measure the impact of both searching for and finding meaning on adjustment to loss. Measuring sense of meaning the same way as in the previous study, and evaluating the extent to which the individual engaged in a search for meaning with a similarly coded single-item, the researchers found that searching for sense of meaning was associated with higher grief and depression scores while having made sense of the loss predicted positive affect. Notably, the majority of individuals in the sample (60%) did not report searching for meaning during the study. There is some evidence to suggest that different pathways of meaning-making may be related to the trajectories of grief developed by Bonanno et al. (2002). For example, the meaning-making model is open to the possibility that a stressful life event, such as a loss, may not necessarily cause a discrepancy between individuals’ situational and global meaning systems. If an individual’s global meaning system is already congruent with the meaning that they derive from the situation, distress is diminished or absent and no search for meaning will occur. Bonanno et al. (2008) reported an analysis of the CLOC data, where it was found that individuals in the resilient group (those who would be expected to have not had their meaning systems challenged) did not report engaging in a search for meaning. Chronic grievers, on the other hand, were less likely to report not searching for meaning. Therefore, there is some evidence to suspect that: 1) bereaved individuals whose meaning systems are not challenged tend to be resilient to loss and 2) those who engage in a search for meaning are more likely to report distress over the course of grieving. Future studies will need to evaluate this hypothesis in more detail, using measurement more appropriate to the Park and Folkman (1997) model because the measures used in the CLOC study did not explicitly assess global and situational meanings.

Meaning-Making and the Dual Process Model In place of the general transactional model of stress and coping, Stroebe, and Schut (1999) have suggested an alternative known as the dual-process model of coping with bereavement (DPM). The DPM was developed specifically to provide a framework for examining how bereaved individuals cope with the challenges that are unique to the loss of a loved-one, and was developed with some of the previously reviewed longitudinal research on the grieving process in mind. Rather than setting forth a specific set of stages through which bereaved individuals should pass, the DPM suggests two general types of coping which

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individuals are expected to oscillate between at an idiosyncratic rate: loss-oriented coping and restoration-oriented coping. Loss-oriented coping refers to directly dealing with the emotional consequences of the loss itself, including the bereaved person's need to focus on, process, and integrate the loss. This concept is most closely related to the concept of emotion-focused coping in that the individual is focusing on and coping with the emotional reality of the loss. Restoration-oriented coping, on the other hand, refers to the bereaved individual’s need to cope with stressors that arise from, but are secondary to the loss itself, such as forging a new identity, developing new relationships, and creating new life goals. These coping efforts might be considered active, or problem-focused. However, exploring the feelings associated with experimenting with new identities and relationships may not be strictly “problemfocused.” There is no set pattern for attending to each of these two orientations that is considered normative. Instead, each bereaved person is expected to cope with each aspect of the model in a unique way. Notably, the DPM is not a reaction against Lazarus and Folkman’s (1984) transactional model, but rather represents a model of coping that focuses on the specific needs of the bereaved rather than being generalizable to all stressful situations. Meaning-making can also be used to interpret the DPM, and the DPM may serve as a good way to examine how individuals go about attempting to make meaning when meaning needs to be made. Stroebe and Schut (2001), two of the original developers of the DPM, have indicated that meaning-making processes are central to the model. For example, those engaged in loss-oriented coping may positively reinterpret the event, shift their beliefs about the justice of the world (e.g. change from “good things happen to good people” to “higher powers work in mysterious ways"), or seek out a subjective sense that the loss fits into their life story. Those engaged in restoration-oriented coping, on the other hand may need to reevaluate their relationship goals, set new priorities, or reevaluate their identity and how it fits into society at large. We view loss- and restoration-oriented coping as being representtative of attempts to adapt respectively global beliefs and life goals (the two primary components of the global meaning system) in the face of a challenging loss. Considered this way, the DPM enriches the Park and Folkman (1997) model both by suggesting a number of methods that individuals may use to make meaning and by suggesting an oscillating trajectory for the meaning-making process. The Park and Folkman model, in turn, provides a larger context for the DPM, and provides a theoretical basis for predicting the oscillating coping pattern based on which meaning systems have been challenged and need to be adjusted.

Meaning-Making and the Cognitive-Behavioral Conceptualization of Grief Meaning-making has also been implicated during the development of the cognitivebehavioral conceptualization of grieving, such that Neimeyer (2006) has suggested that it be renamed the cognitive-constructivist model. The central tenet of the cognitive-behavioral model of grief is that in adaptive cases a loss is conceptually processed and integrated into autobiographical memory, while in cases of grief that do not resolve, the loss is never integrated in this way (Boelen et al., 2006). According to Neiemeyer (2006), this integration is itself indicative of a meaning-making process, and the idea of integrating a loss into existing autobiographical memory is simply another way of saying that the loss must be incorporated into the individual’s life story. Indeed Boelen et al. (2006) themselves state that this “conceptual processing” can also be interpreted as “meaning-based” processing (p. 112).

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Stated in terms of the Park and Folkman (1997) model, integration of the information surrounding the loss into memory by linking it with other facts, beliefs, and memories about one’s life is accomplished by reconciling differences between the meaning of the situation and the preexisting global beliefs and goals that the individual has. The avoidance processes described by Boelenet et al. (2006) serve to retard this integration by preventing the individual from considering the meaning of loss and how it fits in with previous knowledge and from exploring new life goals and relationships.

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Toward an Integrated Model of Meaning-Making and Grief Although the empirical basis for the integration of models provided above is in its infancy at best, we believe that the conceptual rationale is sound. We now present an integrated model of the grief process, based on the three contemporary theories described above with meaning-making as the central variable. When a loss occurs, an individual begins the grieving process. Factors such as the type of loss, the quality and kinship type of the relationship to the deceased, and the developmental and psychological characteristics of the bereaved determine the likelihood that the meaning-systems of the individual become incongruent, and thus determine the grief trajectory that the bereaved will take. Those whose meaning-systems are not challenged will be resilient to the loss, and exhibit little distress. Those whose meaning systems are challenged engage in a meaning-making process during which they may find meaning (common grief) or they may be unable to find meaning (chronic grief). Additionally, some individuals may be in a crisis of meaning prior to the loss (chronic depression, depression followed by improvement) which may or may not resolve following the loss itself. Those who must engage in a search for meaning may also be described as attempting to integrate their loss into autobiographical memory. In order to do this they oscillate between engaging in loss-focused coping in order to reconcile situational meanings with their global beliefs, or restoration-focused coping in order to reconcile the realities of the situation with their long-term life goals. During this process, catastrophic attributions regarding the feelings of grief that the individual has (e.g., “no one will ever love me again; I cannot handle these feelings of grief”) may contribute to their engagement in anxious-avoidance and therefore the refusal to engage in loss-oriented coping, or in depressive avoidance and therefore the refusal to engage in restoration-oriented coping. Intervention strategies may attempt to assist the individual directly in integrating the loss and resolving their crisis of meaning (e.g., through narrative techniques; Neimeyer, 2006) or indirectly by reducing catastrophic cognitions and preventing avoidance. In theory, once the discrepancy between meaning systems is ameliorated, the symptoms of the grief reaction will abate. The research reviewed above has several implications. There is a strong case for meaning-making acting as the theoretical framework through which grief experiences can be interpreted, and it is possible that the grieving process largely consists of a search for meaning. Second, meaning-making has the potential to synthesize disparate models of grieving. Methodologically, both meaning-making and grief research have benefited from the application of longitudinal designs which aim to examine changes over relatively long periods of time. However, the longitudinal studies available have lacked thorough measurement tools for examining the process. Finally, there appears to be a need for further qualitative research,

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as suggested by Gillies, and Neimeyer (2006), in order to both describe the meaning-making and grieving processes further and to form the beginning stages of the scale development process.

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FINDING MEANING IN SPECIFIC STRESSFUL EVENTS While meaning-making has been discussed primarily as a way in which individuals cope with grief, it is important to keep in mind that the model can be applied to any stressor which causes a discrepancy between an individual’s global and situational meaning systems. Some models of meaning (e.g., WAT; Janoff-Bulman, 1989) were designed specifically with loss in mind, but have also been applied to other stressors such as trauma. Park (2010), in her review of the meaning-making literature noted several situations where meaning-making has been applied to research with problems as diverse as cancer, dementia, and depression. However, it should be noted that this list is not exhaustive. The possibility that challenges to meaning contribute to an individual’s distress should be considered in the context of any stressor, and it should be noted that some stressors which might challenge the global meaning systems for one person may not for another. Traumatic events, by definition, are capable of disrupting our core beliefs and derailing our fundamental goals in life. It makes sense, therefore, that a fairly strong focus on meaningmaking has been a part of recent efforts to understand individuals’ responses to traumatic events. Traumatic experiences that have been examined include mass shootings (Creamer et al., 1992), rape and sexual assault (Drauker, 1989; Harvey et al., 1991; Koss &Figueredo, 2004), and surviving a fire (Thompson, 1985). However, the methods for measuring meaningmaking varied widely in these studies, and none took the approach of measuring all of the components of the Park and Folkman (1997) model. For example, Koss & Figueredo (2004) conducted a longitudinal study of 59 survivors of sexual assault. They measured participants’ global beliefs and attributions of self-blame for the event at four different time-points, and demonstrated that a positive change in global beliefs and a positive change in attributions for the event (i.e. lower self-blame scores) were associated with decreases in psychopathology. By measuring both situational and global meanings and how they change over time, this study comes as close as any to fully evaluating the meaning-making model. Going beyond loss and trauma, Stanton & Revenson (2007) include meaning-making as one of the components of successful adjustment to chronic illness. They note that the attributions that one makes regarding the causes and prognosis of one’s disease not only impact psychological distress, but also can contribute to the decisions one makes regarding self-care and treatment options. They give the example of a man with a diagnosis of prostate cancer who believes his disease to be a death sentence. Aside from threatening his view of himself, his place in the world, and frustrating his life goals (e.g., seeing his children grow up), this attribution may also make him less likely to seek treatments that could cure his disease. Specific diseases for which meaning-making research has been conducted include cancer (e.g., Boehrmer et al., 2007), multiple sclerosis (e.g., Pakenham, & Cox, 2009), HIV/AIDS (e.g., Folkman, 1997), and chronic pain (e.g., Graham et al., 2008).

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CONCLUSION Researchers in the field of stress and coping have long advocated the microanalysis of processes that individuals use to cope with specific stressors (Lazarus, & Folkman, 1984). There has been a call to “move away from global assessments toward specifics” in order to pinpoint “what it is that is being coped with,” (p. 317). This echoes a need in the grief literature to expand research to encompass specific bereaved populations (e.g., military casualties, young adults who have lost friends) rather than using convenient samples of older adults, as well as a need for further research into the meaning-making processes associated with specific stressors. Recently it has been suggested that coping researchers move away from use of large nomothetic methods and general coping checklists and toward a more process-oriented, idiographic approach (Tennen, Affleck, Armeli, & Carney, 2000). The process-oriented approach is defined by Lazarus and Folkman (1984) as the measurement of mediational variables at various time-points throughout the research process, as well as examining both the immediate and long-term outcomes associated with those variables. In the case of bereavement, they suggested that the understanding of how individuals cope with grief necessitates both “microanalysis of grieving by giving attention to the daily encounters of living” as well as “macroanalyses of the total pattern throughout the total course of bereavement.” (p. 298). A focus on evaluating the processes and outcomes of coping-skills interventions has also been suggested in order to close the gap between research and practice (Coyne, & Racioppo, 2000). Although much has been learned from the survey studies conducted to date, critical questions, such as how coping processes work, and to what extent they impact stress have remained unanswered (Somerfield, & McCrae, 2000). This problem is mirrored in both the bereavement and meaning-making literatures, where a reliance on coping checklists that have not been validated on the populations of interest has left the field with little empirical evidence regarding how individuals cope adaptively with grief, or how they make meaning in stressful situations. However, the grief and meaningmaking literature are even more unsuited to the use of survey methods, as few empirically derived, well-validated measures exist designed specifically for the study of those two constructs. Indeed, despite its utility in enriching the conceptualization of the grieving process, and uniting disparate theories with a common framework, meaning-making suffers from its own methodological shortcomings. Park (2005) stated that future research in the field of meaning-making “must continue to increase in methodological sophistication.” This includes a need to measure “meaning” more precisely in order to distinguish between “different meaning-making constructs such as meaning-making, searching for meaning, and finding meaning,” (p. 724). With a lack of any comprehensive measurement available, qualitative methods are not only preferable, but necessary. Despite these weaknesses, there is a growing case for the examination of meaningmaking and its related components both in grief research and the study of other life-changing stressors. The skillful use of longitudinal designs (e.g., Bonanno, Boerner, &Wortman, 2008; Koss, & Figueredo, 2004) has shed further light on the role of meaning-making processes in both grief and trauma, and the development of new measurement tools for measuring specific parts of the Park and Folkman (1997) model (e.g. ISLES; Holland, Currier, Coleman, & Neimeyer, 2010) has made the comprehensive assessment of the validity of the model a real possibility. It is our hope that future research into meaning-making will result not only in a

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greater understanding of how our beliefs and appraisals affect the ways that we react to stressors, but that they will also serve to strengthen the evidence-based treatment of grief and other existentially challenging stressors.

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REFERENCES Allumbaugh, D., and, Hoyt, W. (1999). Effectiveness of grief therapy: A meta-analysis. Journal of Counseling Psychology, 46, 370-380. Archer, J. (2008). Theories of grief: Past, present, and future perspectives. In M. Stroebe, R. Hansson, H. Schut, and W. Stroebe (Eds.) The Handbook of Bereavement Research and Practice (p. 45-65). Washington D.C.: American Psychological Association. Balk, D., and Corr, C. (1996). Handbook of Adolescent Bereavement. Washington DC: American Psychological Association. Balk, D., Walker, A., and Baker, A. (2010). Prevalence and severity of college student bereavement examined in a randomly selected sample. Death Studies, 34, 459-468. Bluck, S., and Habermas, T. (2001). Extending the study of autobiographical memory: Thinking back about life across the life-span. Review of General Psychology, 5, 135-147. Boehmer, S., Luszczynska, A., and Schwarzer, R. (2007). Coping and quality of life after tumor surgery: Personal and social resources promote different domains of quality of life. Anxiety, Stress & Coping, 20, 61–75. Boelen, A., and Prigerson, H. (2007). The influence of symptoms of prolonged grief disorder, depression, and anxiety on quality of life among bereaved adults: A prospective study. European Archives of Psychiatry and Clinical Neuroscience, 257, 444-452. Boelen, P., de Keijser, J., van den Hout, M., and van den Bout, J. (2007). Treatment of complicated grief: A comparison between cognitive-behavioral therapy and supportive counseling. Journal of Consulting and Clinical Psychology, 75, 277-284. Boelen, P., van den Hout, M., and van den Bout, J. (2006). A cognitive-behavioral conceptualization of complicated grief.Clinical Psychology: Science and Practice, 13, 109-128. Boelen, P., van den Bout, J., and van den Hout, M. (2010). A prospective examination of catastrophic misinterpretations and experiential avoidance in emotional distress following a loss.Journal of Nervous and Mental Disorders, 198, 252-257. Bonanno, G. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? The American Psychologist, 59, 20-28. Bonanno, G., Boerner, K., and Wortman, C. (2008).Trajectories of grieving. In M. Stroebe, R. Hansson, H. Schut, and W. Stroebe (Eds.) The Handbook of Bereavement Research and Practice (p. 3-25). Washington D.C.: American Psychological Association. Bonanno, G., and Kaltman, S. (2001). The varieties of grief experience. Clinical Psychology Review, 21, 705-734. Bonanno, G., Keltner, D., Holen, A., and Horowitz, M. (1995).When avoiding unpleasant emotions might not be such a bad thing: Verbal-autonomic response dissociation and mid-life conjugal bereavement.Journal of Personality and Social Psychology, 69, 975989.

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Bonanno, G., Wortman, C., Lehman, D., Tweed, R., Haring M., Sonnega, J. et al. (2002). Resilience to loss and chronic grief: A prospective study from pre-loss to 18 months postloss. Journal of Personality and Social Psychology, 83, 115-1164. Bournstein, P., Clayton, P., Halikas, J., Maurice, W., and Robins, E. (1973).The depression of widowhood after thirteen months.British Journal of Psychiatry, 122, 561-566. Bowlby, J. (1969). Attachment: Attachment and LossVolume 1. New York: Basic Books. Bowlby, J. (1980). Attachment and loss: Volume 3. Loss: Sadness and depression. Harmondsworth, England: Penguin Books. Calhoun, L., and Tedeschi, R. (2001). Posttraumatic growth: The positive lessons of loss. In R. Neimeyer (Ed.) Meaning Reconstruction and the Experience of Loss, (p. 191-211). Washington D.C.: American Psychological Association. Carver, C., Scheier, M., and Weintraub, J. (1989).Assessing coping strategies: A theoretically based approach.Journal of Personality and Social Psychology, 56, 267-283. Center for the Advancement of Health (2004). Chapter 8: Summary and conclusions. Death Studies, 28, 568-575. Center for the Advancement of Health.(2004). Themes in research on bereavement and grief.Death Studies, 28, 498-505. Coleman, R., and Neimeyer, R. (2010). Measuring meaning: Searching for and making sense of spousal loss in late life. Death Studies, 34, 804-834. Coyne, J., and Gottlieb, B. (1996).The mismeasure of coping by checklist.Journal of Personality, 64, 959-991. Coyne, J., and Racioppo, M. (2000). Never the twain shall meet? Closing the gap between coping research and clinical intervention research.American Psychologist, 55, 655-664. Creamer, M., Burgess, P., & Pattison, P. (1992). Reaction to trauma: A cognitive processing model. Journal of Abnormal Psychology, 101, 452–459. Creswell, J., Lam, S., Stanton, A., Taylor, S., Bower, J., and Sherman, D. (2007). Does Selfaffirmation, cognitive processing, or discovery of meaning explain cancer-related health benefits of expressive writing? Personality and Social Psychology Bulletin, 33, 238-250. Currier, J., Holland, J., and Neimeyer, R. (2006). Sense-making, grief, and the experience of violent loss: Toward a mediational model. Death Studies, 30, 403-428. Currier, J., Holland, J., and Neimeyer, R. (2009).Assumptive worldviews and problematic reactions to bereavement.Journal of Loss and Trauma, 14, 181-195. Currier, J., Neimeyer, R., and Berman, J. (2008) The effectiveness of psychotherapeutic interventions for bereaved persons: A comprehensive quantitative review. Psychological Bulletin, 134, 648-661. Davis, C., and Nolen-Hoeksema, S. (2001) Loss and meaning: How do people make sense of loss? American Behavioral Scientist, 44, 726-741. Davis, C., Nolen-Hoeksema, S., and Larson, J. (1998). Making sense of loss and benefitting from the experience: Two construals of meaning. Journal of Personality and Social Psychology, 75, 561-574. Deutsch, H. (1937). Absence of grief. Psychoanalytic Quarterly, 6, 12-22. Draucker, C. (1989). Cognitive adaptation of female incest survivors.Journal of Consulting and Clinical Psychology, 57, 668–670.

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Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science and Medicine, 45, 1207-1221. Folkman, S. (2001).Revised coping theory and the process of bereavement.In M. Stroebe,R. Hansson, W. Stroebe, and, H. Schut, (Eds.) Handbook of Bereavement Research: Consequences, Coping, and Care (pp. 563-584). Washington, D.C.: American Psychological Association. Frankl, V. (1962).Man’s Search for Meaning. New York: Touchstone Books. Freud, S. (1917/1957). Mourning and Melancholia. In J. Strachey (Ed.), The Standard Edition of the Complete Psychological Works of Sigmund Freud. London: Hogarth Press. Friedman, H., and Silver, R. (2003).Foundations of Health Psychology. Oxford: Oxford University Press. Gilbert, K. (2002). Taking a narrative approach to grief research: Finding meaning in stories.Death Studies, 26, 223-239. Graham, J., Lobel, M., Glass, P., and Lokshina, I. (2008). Effects of written anger expression in chronic pain patients: Making meaning from pain. Journal of Behavioral Medicine, 31, 201-212 Granek, L. (2010). Grief as pathology: The evolution of grief theory in psychology from Freud to the present. History of Psychology, 13, 46-73. Hagman, G. (2001). Beyond decathexis: Toward a new psychoanalytic understanding and treatment of mourning. In R. Neimeyer (Ed.) Meaning Reconstruction and the Experience of Loss, (p. 13-32). Washington D.C.: American Psychological Association. Hansen, N., Tarakeshwar, N., Ghebremichael, M., Zhang, H., Kochman, A., and Sikkema, K. (2006).Longitudinal effects of coping on outcome in a randomized controlled trial of a group intervention for HIV-positive adults with AIDS-related bereavement.Death Studies, 30, 609-636. Hansson, R., and Stroebe, M. (2007).Bereavement in Late Life: Coping, Adaptation, and Developmental Influences. Washington, D.C.: American Psychological Association. Harvey, J., Orbuch, T., Chwalisz, K., andGarwood, G. (1991).Coping with sexual assault: The roles of account-making and confiding.Journal of Traumatic Stress, 4, 515–531. Hogan, N., and Desantis, L. (1996) Adolescent sibling bereavement: Toward a new theory. In A. Corr, & D. Balk (eds.) Handbook of Adolescent Death and Bereavement. New York: New York: Springer Publishing Complany. Hogan, N., Greenfield, D., and Schmidt, L. (2001).Development and validation of the Hogan Grief Reaction Checklist.Death Studies, 25, 1-32. Hogan, N., and Schmidt, L. (2002).Testing the grief to personal growth model using structural equation modeling.Death Studies, 26, 615-632. Holland, J., Currier, J., and Neimeyer, R. (2006).Meaning reconstruction in the first two years of bereavement: The role of sense-making and benefit-finding.Omega: Journal of Death and Dying, 53, 175-191 Holland, J., Currier, J., Coleman, R., and Neimeyer, R. (2010). The integration of stressful life experiences scale (ISLES): Development and initial validation of a new measure. International Journal of Stress Management, 17, 325-352. Holland, J., and Neimeyer, R. (2010). An examination of the stage theory of grief among individuals bereaved by natural and violent causes: A meaning oriented contribution. Omega: Journal of Death and Dying, 61, 103-120.

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Maciejewski, P., Zhang, B., Block, S., and Prigerson,H. (2007). An empirical examination of the stage theory of grief.Journal of the American Medical Association, 297, 716-723. Maddison, D., and Viola, A. (1968).The health of widows in the year following bereavement.Journal of Psychosomatic Research, 12, 297-306. Matthews, L., and Marwit, S. (2003). Examining the assumptive worldviews of parents bereaved by accident, murder, and illness.Omega: Journal of Death and Dying, 48, 115136. Murphy, S., Johnson, C., and Lohan, J. (2003). Finding meaning in a child’s violent death: A five-year prospective analysis of parents’ personal narratives and empirical data. Death Studies, 27, 381-404. Murphy, S., Lohan, J., Braun, T., Johnson, L., and Cain, K., et al. (1999). Parents’ health, healthcare utilization, and health behaviors following the violent deaths of their 12- to 28year-old children: A prospective longitudinal analysis. Death Studies, 23, 589-616. Neimeyer, R. (2000). Searching for the meaning of meaning: Grief therapy and the process of reconstruction.Death Studies, 24, 541-558. Neimeyer, R. (2001). Meaning Reconstruction and the Experience of Loss. Washington DC: American Psychological Association. Neimeyer, R. (2006). Complicated grief and the reconstruction of meaning: Conceptual and empirical contributions to a cognitive-constructivist model. Clinical Psychology Science and Practice, 13, 141-145. Neimeyer, R. (2009). Constructivist Psychotherapy. London: Routledge. Neimeyer, R., Baldwin, S., and Gillies, J. (2006). Continuing bonds and reconstructing meaning: Mitigating complications in bereavement. Death Studies, 30, 715-738. Neimeyer, R., Hogan, N., and Laurie, A.(2008). The measurement of grief: Psychometric considerations in the assessment of reactions to bereavement. In M. Stroebe, R. Hansson, H. Schut, and W. Stroebe(Eds.) The Handbook of Bereavement Research and Practice (p. 223-240). Washington D.C.: American Psychological Association. Osterweis, M., Solomon, F., and Green, F. (1984). Bereavement: Reactions, Consequences and Care. Washington DC: National Academy Press. Pakenham, K., and Cox, S. (2009). The dimensional structure of benefit finding in multiple sclerosis and relations with positive and negative adjustment: a longitudinal study. Psychology & Health, 24, 373-393. Pargament, K., Koenig, H., and Perez, L. (2000). The many methods of religious coping: Development and initial validation of the RCOPE. Journal of Clinical Psychology, 56, 519-543. Park, C. (2005). Religion as a meaning-making framework in coping with life stress.Journal of Social Issues, 61, 707-729. Park, C. (2010). Making sense of the meaning literature: An integrative review of meaningmaking and its effects on adjustment to stressful life events.Psychological Bulletin, 136, 257-301. Park, C., and Ai, A. (2006). Meaning making and growth: New directions for research on survivors of trauma. Journal of Loss & Trauma,11, 389-407. Park, C., and Folkman, S. (1997). Meaning in the context of stress and coping. Review of General Psychology, 1, 115-144.

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Chapter 3

PARENTAL COPING, EMOTIONAL RESOURCES AND CHILDREN'S ADJUSTMENT: THEORY, EMPIRICAL EVIDENCE, AND INTERVENTIONAL IMPLICATIONS Michal Al-Yagon1,* and Malka Margalit1,2 1

2

School of Education, Tel Aviv University, Tel Aviv, Israel School of Social Sciences, Peres Academic Center, Rehovot, Israel

ABSTRACT Copyright © 2012. Nova Science Publishers, Incorporated. All rights reserved.

The current chapter reviews and integrates new conceptual and empirical research regarding the role of parental coping resources in understanding children's and adolescents’ adjustment, resilience, and well-being. In particular, this chapter discusses findings regarding the conceptual and empirical progress seen in the study of four major parental coping resources, including two emotional coping resources – attachment and affect – as well as sense of coherence and coping strategies. Throughout the current discussion, this chapter considers parents’ coping resources among families of children with typical development as well as of children with disabilities such as learning disorders, attention-deficit and hyperactivity disorders, autism, and mental retardation. Alongside scrutiny of this complex group of parental personal resources, the current discussion also focuses on the differential susceptibility of children with genetic, biological, and behavioral sensitivities to various childrearing experiences. The chapter's conclusions pinpoint attention at identifying resilient families and the factors that promote effective coping and well-being, suggesting future research directions and interventional implications.

*

Correspondence regarding this manuscript should be addressed to Dr. Michal Al-Yagon, Head, Special Education Program, Constantiner School of Education, Tel-Aviv University, Tel-Aviv 69978, Israel. E-mail: [email protected]

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INTRODUCTION Over recent decades, much research has supported the prediction that parents' psychological resources as well as their developmental histories directly influence childrearing quality and, through parenting, child development (Arteche & Murray, 2011; Belsky, Conger, & Capaldi, 2008; Belsky, & Pluess, 2012; Parke, 2004; Rholes, Simpson, & Friedman, 2006; van Bakel & Riksen-Walraven, 2002). As suggested by Belsky (1984), although parenting is shaped by three general sources – the parent’s personality or psychological resources, the child’s individual characteristics, and contextual sources – parental psychological resources comprise the most important determinant. Data from these studies suggested that in order to provide optimal care, parents must possess sufficient psychological and coping resources, manifested in abilities such as taking others’ perspectives and regulating impulses (Rholes, Simpson, & Friedman, 2006; ZahnWaxler, Duggal, & Gruber, 2002). Such studies examined diverse parental personal resources assumed to wield considerable influence on child development like parents' psychopathology and well-being (Campbell, 2003; Goodman & Gotlib, 2002), personality (Belsky & Barends, 2002), attachment style (Mikulincer & Shaver, 2007; Shaver & Mikulincer, 2010), and coping strategies (Al-Yagon, 2011a). Alongside scrutiny of this complex group of parental personal resources, a recent direction of empirical study has begun to attempt to unravel the differential susceptibility of children with different genetic, biological, and behavioral sensitivities to various childrearing experiences (e.g., Boyce & Ellis, 2005; Pluess & Belsky, 2011), as we discuss toward the end of this chapter. The current chapter aims to review and integrate conceptual and empirical research regarding the role of parental coping resources in understanding children's and adolescents’ adjustment, resilience, and well-being. In particular, this chapter discusses findings regarding the conceptual and empirical progress seen in the study of four major parental coping resources, including two emotional coping resources – attachment and affect – as well as sense of coherence and coping strategies. Throughout the current discussion, we consider parents’ coping resources not only among families of children with typical development but also of children with disabilities such as learning disorders, attention-deficit and hyperactivity disorders, and mental retardation (Lin et al., 2011; Margalit, 2010; Trivette, Dunst, & Hamby, 2010). Identifying resilient families and the factors that promote effective coping and wellbeing will conclude the chapter. We end with discussions of future research directions and intervention planning. Of particular importance, based on the recent upsurge of interest in fathers' important role for children’s development and later adjustment (Marsiglio, Amato, Day, & Lamb, 2000; Parke, 2004), the current chapter attempts to maintain equal focus on mothers and fathers. However, it should be noted that the majority of the research literature on parents’ resources has primarily investigated mothers rather than fathers (see Campbell, 2003, for a review). Several reasons may account for this gender trend, including the assumption that mothers’ caregiving and relationships with their children are more central and proximal than those of fathers, or the higher proportions of mothers who agreed to participate in research studies compared to fathers (Campbell, 2003; Zahn-Waxler et al., 2002).

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PARENTAL EMOTIONAL RESOURCES This section discusses findings regarding the conceptual and empirical progress seen in the study of two parental emotional resources: attachment style and affect.

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A) Attachment Styles Generally, studies on the parental caregiving system have emphasized the association between parents’ attachment style and their ability to provide appropriate and optimal care to their offspring (e.g. Bernier & Matte-Gagne, 2011; Lyons-Ruth, Yellin, Melnick, & Atwood, 2005; Mikulincer & Shaver, 2007; Rholes et al., 2006). We begin our discussion of this parental emotional resource with a brief review of the conceptual framework of attachment theory, followed by conceptual and empirical data regarding the association between attachment styles and parental caregiving behaviors and representations. Overall, Bowlby’s attachment theory (1973, 1982/1969) highlighted the role that early interactions with significant others play in explaining individual variations in adjustment (Cassidy & Shaver, 2008; Grossmann, Grossmann, & Waters, 2006). Although this theory focused on early interactions with significant others, studies have highlighted that attachment theory is a lifespan developmental theory and have widely explored adults’ attachment representations (see Mikulincer & Shaver, 2007 for a review). Researchers have underscored how adults’ attachment representations (Bowlby, 1973, 1982/1969) contribute to a variety of psychological resources such as affect regulation and coping with distress, as well as to parental caregiving behaviors (e.g., Bernier & Matte-Gagne, 2011; Collins & Ford, 2010; Mikulincer & Shaver, 2004, 2007; Rholes et al., 2006; van IJendoorn, 1995). Briefly, attachment theory emphasizes that over the course of the first year of life, infants develop a specific and enduring relationship with their primary caretakers (Ainsworth & Wittig, 1969). Infants’ strong tendency to seek proximity to caregivers is the overt manifestation of the inborn attachment behavioral system, which is designed to restore or maintain proximity to supportive others in times of need. Proximity to an available, supportive, and responsive caregiver (“attachment figure”) provides the infant with a sense of “secure base,” which refers to a set of expectations about others’ availability and responsiveness in times of stress. As emphasized by this theory, attachment figures play a central role in the infant’s cognitive, social, and emotional development as well as in the development of a sense of self (Bowlby, 1982/1969; Waters & Cummings, 2000). Children’s experiences with attachment figures are internalized into “working models of attachment” – mental representations of significant others and of the self. These result in unique attachment styles, that is, stable patterns of cognitions and behaviors that are manifested in other close relationships and social interactions, across the lifespan. Notably, studies reported on diverse assessment approaches of adults' attachment relationships, including interviews (i.e., the Adult Attachment Interview, George, Kaplan, & Main, 1985) and questionnaires (e.g., the Experiences in Close Relationships Scale, Brennan et al., 1998). Studies utilizing questionnaire measures have focused on the role of two orthogonal attachment dimensions: anxiety and avoidance (Brennan, Clark, & Shaver, 1998;

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Mikulincer & Shaver, 2007; Rholes, Simpson, Campbell, & Grich, 2001). Attachment anxiety refers to a strong desire for closeness and protection, intense worries about significant others' availability and one’s own value for these significant others, and the tendency to use hyperactivating strategies to deal with insecurity and distress. Attachment avoidance refers to an individual’s discomfort with the closeness of significant others, preference for emotional distance, and high tendency for self-reliance, as well as using deactivating strategies to cope with insecurity and distress (Shaver & Mikulincer, 2010). Both questionnaires and interviews have demonstrated similar links between attachment anxiety and avoidance classifications on the one hand, and a variety of parental psychological resources and caregiving behaviors on the other (e.g., Brennan et al., 1998; Collins, Guichard, Ford, & Feeney, 2006; Mikulincer & Shaver, 2007).

Attachment Theory Regarding the Caregiving System As suggested by Bowlby (1982/1969), humans are born with a capacity to develop caregiving behaviors aimed to provide protection and care to others in need. According to this theory, the caregiving system serves two major functions: (a) to meet others’ needs for protection and support in times of distress or potential threat, and (b) to support others’ exploration and autonomy growth when not distressed. Although attachment theory assumed that caregiving behaviors are an inborn system, they may be affected by various intrapersonal and interpersonal factors like the caregiver's emotional regulation and the care-seekers’ failure to express their needs (Bernier & Matte-Gagne, 2011; Collins & Ford, 2010), which may have specific implications in the case of parenting. For example, Collins et al. (2006) suggested the possible role of four intrapersonal and interpersonal factors that may impair the optimal functioning of the caregiving system: (a) social skills deficits that may affect individual caregivers' abilities to accurately decode the needy person's signals; (b) reductions in individual caregivers' psychological resources that may affect their abilities to provide appropriate sensitive care; (c) caregivers' lack of motivation to help; and (d) acting on egoistic motives when providing the help. Together, such studies highlighted that optimal functioning of the caregiving system requires adaptive emotion-regulation strategies that enable effective coping with others’ distress and a temporary suspension of the caregivers' own goals (for a review, see Mikulincer & Shaver, 2007; Shaver, Mikulincer, & Shemesh-Iron, in press). Conversely, deficits in individual caregivers' emotional regulation may associate with high levels of anxiety or distress as well as ineffective means of coping with care-seekers' distress such as creating physical, cognitive, or emotional distance from care-seekers to soothe the caregivers' own feelings (Mikulincer & Shaver, 2007). Consequently, although anxiously attached adults may possess some of the skills and qualities needed for effective caregiving such as feeling comfortable with closeness and intimacy, they demonstrate deficits in intrapersonal and interpersonal regulatory skills that increase their vulnerability to personal distress, which in turn interferes with sensitive and responsive care (Mikulincer & Shaver, 2007). Studies also revealed that avoidant attachment (i.e., deactivating attachment strategies) may lead to unresponsiveness to others' suffering and discomfort with others’ expressions of need and vulnerability (Collins & Ford, 2010; Collins et al., 2006).

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Individual Differences in Caregiving Behaviors Similarly to other internal working models of self and others, parents’ mental representations of themselves as caregivers influence their caregiving behaviors, expectations, and feelings (Bernier & Matte-Gagne, 2011; George & Solomon, 1999). Based on these assumptions, research studies have examined individual differences in the parental caregiving system in two major directions: (a) differences in parental caregiving behaviors, and (b) differences in mental representations of themselves as caregivers and of their parent-child relationships. In exploring differences in parental caregiving behaviors, empirical data highlighted that mothers classified as securely attached were more supportive, provided more help, and communicated in warmer ways with their children than mothers classified as insecurely attached – anxious or avoidant (Crowell & Feldman, 1988; Rholes et al., 2006; Scher & Dror, 2003; van IJendoorn, 1995). Securely attached mothers also revealed more attunement to their babies' positive and negative emotions than insecurely attached mothers (Haft & Slade, 1989). Furthermore, whereas anxious mothers attuned inconsistently to both positive and negative emotions, mothers with avoidant attachment tended to ignore their babies' negative emotions. Research findings also demonstrated group differences in maternal sensitivity and level of responsiveness, between mothers with secure versus insecure attachment styles (e.g., Raval et al., 2001; Tarabulsy et al., 2005). These studies showed that insecurely attached mothers were less responsive and attentive to their infants’ needs compared to securely attached mothers and also exhibited more distress and intrusive behaviors through their interactions with their infants. Furthermore, data also indicated that whereas secure mothers sang less playfully to distressed than to non-distressed infants, the emotional tone of avoidant mothers did not vary as a function of their infants’ level of distress (Milligan, Atkinson, Trehub, Benoit, & Poulton, 2003). They seemed not to acknowledge their infants’ negative emotions and displayed high levels of playfulness that seemed more designed to keep their own spirits up than to respond appropriately to their infants’ distress. A similar direction of results also emerged for mothers of adolescents. For instance, Kobak, Ferenz-Gillies, Everhart, and Seabrook (1994) examined conversations between mothers and their children regarding the adolescents’ leaving home for work or college. Utilizing the Adult Attachment Interview (George et al., 1985), Kobak et al. showed that anxiously attached mothers manifested the greatest difficulty in maintaining a calm state of mind during the conversation and providing a secure base for their adolescents' exploration. In addition, these mothers with anxious attachment displayed more verbal and nonverbal signs of anxiety compared to securely attached mothers regarding their adolescents’ imminent departure. These mothers also demonstrated more verbal intrusions in response to the adolescents’ attempts at autonomy, which in turn hindered the adolescents’ ability to discuss future goals and plans. Although less examined among fathers, research has also indicated an association between attachment styles and individual differences in paternal caregiving behaviors. As yielded by Cohn, Cowan, Cowan, and Pearson's (1992) study, securely attached fathers were warmer and more supportive, and they provided better task organization and structure in interactions with their offspring, compared to insecurely attached fathers. Similarly, fathers with insecure avoidant or anxious attachment manifested either fewer interactions with their children or greater over-involvement in their lives, respectively (e.g., Edelstein et al., 2004).

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Correspondingly, among fathers with posttraumatic stress disorder, those with a secure attachment style showed a higher level of parental involvement than those with an insecure style (Cohen, Zerach, & Solomon, 2011). Also, low level of attachment avoidance of fathers was reported as moderating the relations between fathers’ posttraumatic symptoms and their paternal functioning such as involvement and expressions of physical and verbal violence (Cohen et al., 2011).

Individual Differences in Parental Mental Representations As mentioned above, empirical data have underscored individual differences in the parental caregiving system, both regarding caregiving behaviors and differences in parents' mental representations of themselves as caregivers and of their parent-child relationships. Thus, in examining individual differences in parents’ mental representations, prior studies revealed that securely attached parents reported experiencing more joy and pleasure in their relationships with their children than insecurely attached parents (e.g., Rholes et al., 2006; Scher & Dror, 2003). Conversely, research also indicated that insecurely attached parents described themselves as less competent parents, as worrying more about separation from their children, and as less competent at coping with their children’s distress (e.g., DeOliveira, Moran, & Pederson, 2005; Mayseless & Scher, 2000). Anxious parents’ high need for closeness and recognition may also interfere with their ability to provide their children with a secure base for exploration and to encourage their children’s growth and autonomy (Mikulincer & Shaver, 2007). For instance, Mayseless and Scher (2000) reported that anxiously attached mothers attributed less importance to the development of their children’ social skills and independence than securely attached mothers. Studies also emphasized that avoidant attachment may lead parents to feel discomfort with others’ expressions of need and vulnerability. For example, parents with avoidant attachment reported feeling less close to their children than parents with secure attachment (Rholes, Simpson & Blakely, 1995). Research outcomes also underscored the vulnerability of attachment avoidant mothers and their children (Al-Yagon, 2007; Berant, Mikulincer, & Shaver, 2008). Furthermore, insecurely attached mothers assessed their infants as more prone to distress and less sociable, compared to securely attached mothers (Pesonen, Raikkonen, KeltikangasJarvinen, Strandberg, & Jarvenpaa, 2003; Pesonen, Raikkonen, Strandberg, KeltikangasJarvinen, & Jarvenpaa, 2004; Priel & Besser, 2000). Similar findings emerged for fathers (Pesonen et al. 2003, 2004) and when extending these studies to the adolescent developmental period (Kobak et al., 1994). Thus, insecurely attached mothers of adolescent females perceived them as less able to regulate impulses and distress as compared to securely attached mothers of adolescent females. Taken together, the current literature review highlighted that attachment styles provide an important emotional resource for parental caregiving, both in terms of parenting coping behaviors (i.e., providing responsive care to their offspring) and in terms of parents' mental representations (i.e., expectations and feelings regarding themselves as caregivers). Notably, although most of these studies investigated mothers’ caregiving behaviors and representations, the few existing studies that examined these dimensions among fathers have yielded similar outcomes. Despite growing awareness about the impact of parents' attachment styles, relatively few studies have examined this important parental resource among parents of children with

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atypical development as well as the possible reciprocal relations between parents and children at risk. The few available studies on high-risk children have underscored the vulnerability of both insecurely attached mothers and their children for a variety of maladjustment symptoms compared to children of securely attached mothers (Al-Yagon, 2007; Berant et al., 2008), but only seldom have researchers examined the role of attachment styles in parental caregiving behaviors and mental representations, calling for additional exploration. For example, a longitudinal study on mothers of children with congenital heart disease focused on maternal factors, not caregiving behaviors, revealing that maternal avoidant attachment was the best predictor of deterioration in maternal mental health and marital satisfaction (Berant et al., 2008). Only rarely have research studies pinpointed the role of both mothers’ and fathers’ attachment styles in explaining the socioemotional and behavioral functioning of their offspring with LD (e.g. Al-Yagon, 2010, 2011b).

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B) Parental Affect An extensive body of literature has shown that a deficit in this second parental emotional resource – namely, parents' high levels of negative affect – is a major risk factor for children’s maladjusted behaviors, from prenatal development through childhood and into adolescence (e.g., Campbell, 2003; Elgar et al., 2007; Goodman & Gotlib, 2002; Radke-Yarrow, 1998; White & King, 2011; Zahn-Waxler et al., 2002). Children of clinically depressed parents demonstrate a higher risk for maladjustment problems such as social, academic, and clinical difficulties. In general, the focus has been on maternal depression, although several studies also explored mothers with other psychopathological diagnoses (e.g., Zahn-Waxler et al., 2002). These studies also highlighted that even in the absence of clinical psychopathology, parental affect such as high levels of anxiety, negative affect, or depression can significantly influence parents’ quality of care as well as their interpretation and tolerance of their offspring's behaviors (Cummings, Keller, & Davies, 2005). To be noted, inasmuch as most of the research literature on parental affect investigated mothers' psychopathology (e.g., Campbell, 2003; Zahn-Waxler et al., 2002), mothers rather than fathers, and depression rather than positive affect, comprise the focus in the majority of studies currently reviewed. Major depressive disorder is an affective disorder characterized by one or more major depressive episodes (i.e., at least 2 weeks of depressed mood) accompanied by at least four additional symptoms of depression; DSM-IV-TR; American Psychiatric Association, 2000). The additional symptoms must occur during the same 2-week period and represent a change from previous functioning and can include any combination of the following: (a) depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or by others' observations (e.g., appears tearful); (b) markedly diminished interest or pleasure; (c) significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or a decrease or increase in appetite nearly every day; (d) insomnia or hypersomnia; (e) psychomotor agitation or retardation; (f) fatigue or loss of energy; (g) feelings of worthlessness or excessive or inappropriate guilt; (h) diminished ability to think or concentrate, or indecisiveness; and (i) recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or specific plan for committing suicide.

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Numerous studies have indicated a link between mothers' depression symptoms and their offspring's maladjustment difficulties. From the prenatal period through adolescence, children of parents with depression are at risk for a variety of emotional, social, academic, and clinical difficulties (Arteche & Murray, 2011; Copper et al., 2006; Elgar et al., 2007; Goodman & Gotlib, 2002; Radke-Yarrow, 1998; White & King, 2011; Zahn-Waxler et al., 2002). As pinpointed by Pluess and Belsky (2011), research evidence indicated that maternal prenatal distress (e.g. depression, stress, anxiety, level of cortisol) predicts problematic health and behavioral difficulties in their offspring as well as dysfunctional cortisol levels and negative emotionality. Similarly, infants of depressed mothers more often exhibit difficult temperament, dysregulated emotion, atypical frontal lobe activity, lower motor and mental development, as well as less secure attachments compared to infants of non-depressed mothers (e.g., RadkeYarrow, 1998). By toddlerhood and preschool age, children of depressed mothers demonstrate a higher incidence of cognitive and emotional difficulties such as disturbances in the development of functional autonomy, more negative reactions to stress, less effective selfregulation strategies, and fewer interpersonal skills in interactions with playmates than children of non-depressed mothers (e.g., Aeteche & Murray, 2011; Zahn-Waxler et al., 2002). By middle childhood, children of depressed mothers reveal higher levels of behavior problems with peers, poorer academic performance, as well as increasing evidence of clinical expressions such as anxiety, mood disorders, and disruptive behavior disorders (e.g., Cooper et al., 2006; White & King, 2011). Data from these studies revealed that such difficulties continue through adolescence (e.g., Ellis & Garber, 2000; Radke-Yarrow, 1998; Zahn-Waxler et al., 2002). In addition, research also suggested the possible role of maternal depression in explaining adolescents’ hormonal functioning (Ellis & Garber, 2000). Early puberty in adolescent females was associated with a history of their mothers' affect disorder. In general, studies described multifaceted transmission and transaction mechanisms and processes linking maternal depression to children’s difficulties (e.g., Campbell, 2003; Cummings, Davies, & Campbell, 2000; Goodman & Gotlib, 1999), through their coping style. The inheritability of maternal depression may be the first mechanism underlying these children's possible genetic vulnerabilities (e.g., White & King, 2011). As with other psychopathological disorders, evidence from adoption, twin, and family-study designs suggests some degree of inheritance in the etiology of depression (Copper et al., 2006; Goodman & Gotlib, 1999; Zahn-Waxler et al., 2002). For example, the lifetime risk of depression for children with a depressed parent has been estimated as 40-45% (Copper et al., 2006; Timko, Cronkite, & Moos, 2010). However, as suggested by these previous studies, additional exploration is required to examine whether the disorder is inherited directly or indirectly due to other associated factors. The second mechanism regarding the intergenerational transmission of risk has emphasized the role of the maternal dysfunctional neuroregulatory system. As argued by several studies (e.g., Goodman & Gotlib, 1999; Zahn-Waxler et al., 2002), depressed mothers show higher levels of abnormal neuroendocrine functioning during pregnancy than nondepressed mothers. Consequently, the fetus may experience higher cortisol levels and reduced blood flow, which may restrict its growth and movement, alter the infant’s physiological arousal, and hence contribute to the development of regulatory problems. A third transmission mechanism focuses on children’s exposure to negative or maladaptive maternal coping, expressed in their cognitions, behaviors, and affects, associated

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with their depression. For example, depressed mothers are less involved, responsive, or sensitive with their children (e.g., Campbell, 2003; Cummings et al., 2000). Thus, research reported a higher incidence of insecure attachment patterns among children of depressed mothers than non-depressed mothers (e.g., see Osofsky & Thompson, 2000, for a review). Furthermore, studies also suggested that children may learn parental depressive attributional styles through imitation processes, as well as through direct internalization of parental criticism (e.g., Goodman & Gotlib, 1999). These mothers’ impairments in childrearing skills and coping were expressed in various behaviors such as negative discipline and control practices; low nurturance and sensitivity; high levels of angry and negative feelings; intrusiveness; ineffective conflict resolution processes; harsh, hostile, retaliatory and coercive parenting styles (e.g., Campbell, 2003; Goodman & Gotlib; 1999; Osofsky & Thompson, 2000; Zahn-Waxler, Klimes-Dougan, & Slattery 2000). Finally, the fourth transmission mechanism emphasized the role of children’s exposure to stressful environments. Maternal depression often co-occurs with other contextual risk factors such as marital distress, low social support, and financial difficulties (e.g., Osofsky & Thompson, 2000). Findings have demonstrated that more chronically depressed mothers may cope with accumulated psychosocial stressors and are less likely to respond sensitively to their children and provide optimal care (e.g., Campbell, 2003; Goodman & Gotlib, 1999; White & King, 2011). Notwithstanding the rise of interest in the role of parental negative affect as a risk factor for children's development outcomes, relatively few studies have examined families of children with disabilities. The few studies available on affective resources among parents of children with disabilities reported higher negative affect and lower positive affect than among parents of non-disabled children (Al-Yagon, 2007; Margalit, Raviv, & Ankonina, 1992; Olsson & Hwang, 2002). Such studies also emphasized that children with learning disabilities might be more vulnerable to variations in parents' affective resources (Al-Yagon, 2010). Altogether, these studies indicated multifaceted transmission and transaction mechanisms between parental negative affect, especially depressed mood, and children’s socioemotional and behavioral development. As emphasized above, general agreement exists that the development of children’s maladjustment problems derives from a transactional process by which children with vulnerabilities to genetic disorders may be raised by parents who face many challenges and in disturbed environments. Most studies on parental affect examined the coping of mothers; however, several studies yielded similar findings regarding the role of fathers’ negative affect in predicting their coping and children’s maladjustment (e.g., Bernnan, Hammen, Katz, & Le Brocque, 2002; Weinfield, Ingerski, & Moreau, 2009). Importantly, several studies also found adequate parenting practices among mothers with depressive symptoms (e.g., Campbell, 2003), suggesting that the severity and chronicity of maternal disturbance may be more important than specific diagnosis. The latter finding also highlights the importance of identifying these parents' intrapersonal and interpersonal characteristics that may contribute to their relatively good caregiving abilities, such as positive self-esteem, help-seeking skills, parental role attributions, social support and socioeconomic status.

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PARENTAL COPING RESOURCES This section discusses findings regarding the conceptual and empirical progress seen in the study of two parental coping resources: sense of coherence and coping strategies.

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A) Sense of Coherence Studies have highlighted the role of this third parental coping resource – sense of coherence – in understanding parents' coping with stressors (Mak, Ho, & Law, 2007; Margalit, 1994; Oelofsen & Richardson, 2006; Olsson & Hwang, 2002). The term "sense of coherence" (SOC) was coined by Antonovsky (1979, 1987) and comprises the core variable within his health promotion model, which he termed salutogenesis in contrast to pathogenesis. This approach derives from the assumption that the human environment produces stressors that emerge from various sources such as genetic, microbiological, personal, economic, social, cultural, or geopolitical. The salutogenic model suggests a complementary approach to the pathological model of human functioning and examines individuals’ strategies and coping resources in coping with these stressors (Antonovsky & Sagy, 1986). This dynamic model proposed that individuals are constantly moving along a continuum characterized by the endpoints of health ease and health disease (Antonovsky, 1987). The salutogenic model also underscored the role of generalized resistance resources such as ego strength and social support, in enhancing individuals’ movement toward the health-ease endpoint. Antonovsky (1987) defined SOC as a global orientation that expresses the extent to which an individual has a pervasive, enduring, though dynamic feeling of confidence that: (1) the stimuli deriving from one’s internal and external environments are structured, predictable, and explicable; (2) resources are available to meet the demands posed by these stimuli; and (3) these demands are challenges worthy of investment and engagement. According to research investigating the salutogenic model, individuals’ SOC holds implications for their responses to various types of stressful situations (e.g., Antonovsky & Sagy, 1986; Hart, Wilson, & Hittner, 2006; Marsh, Clinkinbeard, Thomas, & Evans, 2007). These studies have indicated that persons with a high SOC level are less likely to perceive stressful situations as threatening and are more likely to appraise such situations as manageable. In addition, individuals with a high SOC level are also less likely to perceive stressful situations as provoking anxiety and anger as compared to individuals with a low SOC level. Furthermore, these studies underscored that individuals’ SOC may be considered an indicator of resilience and personal strength, with unique value at times of crisis and distress (Greeff & Van Der Merwe, 2004; Lindstrom & Eriksson, 2005; Marsh et al., 2007). Such studies also emphasized the possible role of this concept in explaining individuals’ mental health and coping with stressors (Hart et al., 2006; Lundman, 2010). As mentioned above, studies have also suggested that parents' SOC may hold unique importance for understanding their coping with stressors (Margalit, 2010; Oelofsen & Richardson, 2006). For example, Cohen and Dekel (2000) reported that mothers with a high level of SOC used less avoidant coping strategies and were more engaged in social activities compared to mothers with a low SOC level. Moreover, in examining mothers of typically

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developing school-age children, Al-Yagon (2008) underscored the unique role of maternal SOC in explaining differences in children’s socioemotional and behavioral adjustment such as their feelings of loneliness, SOC, level of behavior problems, and secure attachment relationships with their mothers. Presumably, mothers with high SOC levels, who tend to perceive stressful situations as challenges, less threatening and worth investing involvement and effort, may provide their children with a more secure, consistent, and calm environment and may also model effective strategies for coping with stressors. To be noted, most studies on parental SOC have focused on parents of children with disabilities (Al-Yagon, 2003; Mak et al., 2007; Oelofsen & Richardson, 2006; Olsson & Hwang, 2002). Data from these studies emphasized three major aspects. First, these studies indicated that, as a group, parents of children with disabilities such as developmental disabilities, intellectual disabilities, and autism reported a low level of SOC compared to parents of non-disabled children (Al-Yagon, 2003; Mak et al., 2007; Margalit, 2006; Oelofsen & Richardson, 2006; Olsson & Hwang, 2002). As suggested by these studies, having a child with disabilities may affect parents' lives in pervasive ways, beyond the impact of the child’s development (Oelofsen & Richardson, 2006; Olsson & Hwang, 2002). Interestingly, several of these studies showed that such group differences emerged only for mothers but not for fathers (Al-Yagon, 2011a; Olsson & Hwang, 2002). As suggested by prior research, mothers and fathers tend to respond differently to their child with a disability (Katz, 2002). It may also be assumed that such sex differences in parents’ global orientation to life (i.e., SOC level) may associate with the overall differences between mothers and fathers in both their quantity and quality of involvement (McBride, Schoppe, & Rane, 2002; Parke, 2004). Second, these studies pinpointed the associations between parents’ low SOC level and various measures of mental health and coping with stressors. For example, such studies yielded the significant association between parents' low SOC levels and high depression levels (Olsson & Hwang, 2002) as well as high stress levels (Margalit, Al-Yagon, & Kleitman, 2006). In addition, Al-Yagon (2003) found a link between mothers’ low SOC levels and low levels of family cohesion. Furthermore, Mak et al. (2007) reported that parental level of SOC moderated the effect of children’s autism severity on parental stress. Third, these studies also highlighted the unique role of parental SOC in explaining differences in children’s socioemotional functioning. For example, low levels of SOC among mothers of high-risk children were associated with the children’s low levels of secure attachment (Al-Yagon, 2003). Similarly, low SOC in fathers of children with learning disabilities contributed to children’s high levels of internalizing and externalizing behavior problems as well as children’s low levels of hope (Al-Yagon, 2011a).

B) Parental Coping Strategies The fourth parental coping resource – coping strategies – refers to a complex set of mechanisms by which parents adapt to stress (Folkman & Moskowitz, 2004; Lyons, Leon, Roecker, & Dunleavy, 2010). The transactional model of stress and coping (Folkman & Moskowitz, 2004; Lazarus, 1999, 2006) defined coping as the process of managing external and/or internal demands that may exceed the person's resources. Thus, coping strategies refer to both cognitive and behavioral efforts used to manage specific external and internal demands that tax an individual's resources (Folkman & Moskowitz, 2004; Lazarus, 2006).

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Traditionally, studies have underscored four major types of coping strategies: (a) taskoriented or active coping methods that attempt to solve a problem, to reconceptualize the problem, or to minimize the effect of a problem such as information seeking and problem solving; (b) emotion-oriented coping such as emotional responses, self-preoccupation, and fantasizing reactions; (c) avoidant-oriented coping strategies including social diversion such as efforts to deny or escape the stressful situation; and (d) distraction such as engaging in a substitute task. Whereas task-oriented and social diversion and distraction coping were related to adaptation, inconsistent results were found regarding the relations of emotion-oriented coping and psychopathology (e.g., Abery, 2006; Folkman & Moskowitz, 2004; Richardson, 2002). Recently, two additional coping strategies were proposed: (a) Future oriented coping (proactive) versus past oriented coping (reactive coping): Proactive coping is directed at an upcoming stressor, trying to prevent its occurrence or to reduce its impact, while a reactive coping is directed at an ongoing stressor (Sohl, & Moyer, 2009). (b) Voluntary (controlled) versus involuntary (automatic) coping: Voluntary coping responses to stress reflect volition and conscious effort by the individual to change the distressful circumstances whereas responses that are automatized and not under conscious control are considered involuntary coping (Compas, et al., 2011). Studies have emphasized the role of coping strategies as central mediators of potential stress-related responses that affect well-being, behavior, and adjustment (Abery, 2006; AlYagon & Margalit, 2009; Folkman & Moskowitz, 2004; Lazarus, 1999). Research studies examining parental coping strategies have primarily focused on parents of children with disabilities or other high-risk conditions. Importantly, the parents who participated in these studies were predominantly mothers. In general, over the last decades, research studies examining parents and families of children with disabilities and chronic conditions have shifted from a focus on the expressions of crisis and pathology (Blacher, Neece, & Paczkowski, 2005) to the dynamic approach within the stress-and-coping paradigm (Abery, 2006; Al-Yagon & Margalit, 2011; Margalit et al., 2006; Van Riper, 2003). This change may reflect the shift from a reductionistic, problem-oriented approach to a perspective accentuating nurturing and strengths (Richardson, 2002). Coping strategies provide a protective role in moderating caregiving stress among parents of children with a variety of difficulties and chronic conditions. For example, several studies showed that high levels of problem-focused coping and low levels of emotion-focused coping buffered the impact of high stress levels on maternal well-being among mothers of children with mental retardation (Margalit et al., 2006; Wang, Michaels, & Day, 2010). Similarly, AlYagon and Margalit (2009) reported that mothers of children with developmental disabilities who frequently used avoidant coping strategies (such as keeping feelings to oneself, avoiding other people's company, and decreasing tension by eating or substance use) manifested high levels of negative affect. In contrast, mothers who frequently used active coping strategies (such as information seeking and problem solving) reported high positive affect. Research on the family adjustment to childhood disability (Trute et al, 2010) provides a unique perspective associated with elements of strength in mothers' psychological coping. This study focused attention on mothers' abilities to perceive positive family consequences of childhood disability and to maintain higher proportions of positive emotion in their daily activities. The findings of this study provide support to the important role of positivity in mothers' coping and adjustment to childhood disabilities.

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Several additional studies among parents of children with autism pinpointed the direct and moderating effects of coping strategies. Higher levels of problem-solving coping predicted less psychopathological distress such as depressive symptoms and spousal conflict (Benson, 2010; Dunn, Burbine, Boweres, & Tantleff-Dunn, 2001; Smith, Seltzer, TagerFlusberg, Greenberg, & Carte, 2008). Distancing strategies such as going on as if nothing has happened also corresponded with increased depression symptoms (Dunn et al., 2001). Furthermore, Smith et al. (2008) reported on the role of coping resources as a moderator variable in explaining the effects of stressors on caregivers' distress, among these parents of children with autism. In their study, for mothers of preschoolers with autism, lower emotionfocused coping and higher problem-focused coping were associated with improved maternal well-being, regardless of children's symptom severity. However, for mothers of adolescents with autism, coping was often related to maternal well-being only when child symptoms were severe. Research on parents of children with learning disabilities have also investigated the stressful impact of children's disabilities on parental coping resources and affect (Al-Yagon, 2007). Mothers and fathers of children with learning disabilities reported higher levels of avoidant coping compared to parents of typically developing children (Al-Yagon, 2011). Finally, the current review highlighted that the majority of the studies on parental coping strategies mainly focused on parental well-being or adjustment and less often examined offspring's adjustment. However, several recent studies have attempted to narrow this gap in the literature. For instance, Al-Yagon (2007) suggested that mothers’ low use of avoidant coping strategies moderated the effect of their children's learning disabilities on the children’s level of loneliness. Similarly, in exploring the role of fathers’ coping strategies, Al-Yagon (2011a) reported that among the group of children with learning disabilities, fathers’ higher level of active coping (e.g., more information seeking and problem solving) and lower level of avoidant coping (e.g., less denial or escape through food, drugs, etc.) contributed to these children's more secure attachment (e.g., children's belief that the father was responsive and available and could be relied on in times of stress), which, in turn, played a mediating role for children’s socioemotional adjustment. Similarly, in the group of children with typical development, fathers’ lower level of avoidant coping contributed to children's more secure attachment, and fathers’ high level of active coping contributed to children's lower feelings of loneliness (Al-Yagon, 2011a). Parental avoidant coping was the main explanatory mechanism in exploring the association between parental depression and their offspring's risk for depression and maladaptive coping, among parents with depression symptoms (Timko et al., 2010). Findings from this study indicated that parents’ reliance on avoidant coping predicted adult offspring’s depression and avoidant coping 23 years later. As suggested by this study, parents with a high tendency to utilize avoidant coping strategies may model and coach this coping style. Up to this point, the current chapter has reviewed this complex group of parental personal resources. As noted earlier, a recent parallel direction of empirical study has begun to explore the differential susceptibility of children with different genetic, biological, and behavioral sensitivities to various childrearing experiences (e.g., Boyce & Ellis, 2005; Pluess & Belsky, 2011). The next section reviews and integrates this recent conceptual and empirical research.

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OFFSPRINGS' DIFFERENTIAL SUSCEPTABILITY TO ENVIRONMENTAL EFFECTS Wide consensus exists that children and adolescents may vary in their responsivity to the qualities of their environments, including their childrearing experiences (see Pluess & Belsky, 2011 for a review). Such ideas are generally framed in diathesis-stress or "dual risk" terms, suggesting that some individuals are more vulnerable due to their biological/neurological and or behavioral characteristics (i.e., “stress” or “risk 1”) to the adverse effects of negative experiences and environmental qualities (i.e., “diathesis“ or “risk 2”) (e.g., Belsky, Bakermans-Kranenburg, & van Ijzendoorn, 2007; Belsky & Pluess, 2009; Trentacosta et al., 2008), whereas others may be relatively resilient to these negative factors. Additionally, studies have also emphasized that individuals may vary not only in the degree to which they are vulnerable to the negative effects of adverse experiences but also, more generally, in their "developmental plasticity" (e.g., Boyce & Ellis, 2005). This hypothesis, termed the "differential susceptibility hypothesis" (Belsky, 2005) or "biological sensitivity to context" (Boyce & Ellis, 2005), refers to the idea that children may vary in their susceptibility to both adverse and beneficial effects of childrearing influences. Thus, more "plastic" or malleable children may be more susceptible than others to environmental effects in a “for better and for worse” manner (Belsky et al., 2007). In contrast, less "plastic" children may be less susceptible to childrearing conditions, whether they are presumptively supportive or undermining of well-being. In analyzing the susceptibility factors that may contribute to individual children's differential susceptibility, studies emphasized the possible role of three categories of variables (see Pluess & Belsky, 2011 for a review). The first category consists of genetic factors such as short allele of the serotonin transporter linked polymorphic region (5-HITTLPR). For example, in examining the moderating effect of 5-HITTLPR on the association between retrospectively reported childhood environment and current depression symptoms among young adults, Taylor et al. (2006) reported that participants who were homozygous for the short allele manifested the most depressive symptoms if they had experienced an adverse childrearing history, but the least depression if they had experienced a supportive history. This pattern of "for better and for worse" findings did not emerge for individuals with other genetic variants of the same gene. Similar findings emerged in Bakermans-Kranenburg and van Ijzendoorn's (2011) study, demonstrating the role of dopamine-related genes (dopamine receptor D2, DRD4, dopamine transporter) on the association between childrearing environment and children’s developmental outcomes such as externalizing behaviors, prosocial behaviors, and irritability. The second category consists of physiological factors such as cortisol reactivity. For example, children with high cortisol levels were rated by their teachers as least prosocial when living under adverse conditions, but as most prosocial when living under more benign conditions (Pluess & Belsky, 2011). Such "for better and for worse" patterns did not emerge for children scoring low on cortisol reactivity. Finally, the third category includes behavioral factors like negative emotionality. For instance, Pluess and Belsky (2009) found that those children who had been classified as infants with difficult temperaments demonstrated the most and the least behavior problems,

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depending on whether they experienced poor or good quality care, respectively. This "for better and for worse" pattern did not emerge for children with easier temperaments. Notwithstanding this recent upsurge of interest regarding children’s differential susceptibility to environmental effects, most of these studies focused on parental style such as negative control, and parental sensitivity (e.g., Belsky & Pluess, 2009; BakermansKranenburg & van Ijzendoorn, 2011), whereas the possible role of parental psychological and coping resources was rarely examined. As discussed above, parental resources are assumed to wield a considerable influence on children’s development because in order to behave in sensitive and responsive ways, parents need to possess sufficient psychological maturity to be able to take the perspective of others, control impulses, feel secure in their own lives, and be able to find ways to meet their needs. Thus, there remains a paucity of knowledge regarding the role of parental resources in children’s differential susceptibility, calling for comprehensive additional exploration.

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CONCLUSION The current chapter reviewed and integrated conceptual and empirical research regarding the role of parental coping resources in understanding children's and adolescents’ adjustment and well-being. Specifically, this chapter discussed empirical findings regarding the study of four major parental coping resources including two emotional coping resources – attachment and affect – as well as SOC and coping strategies. Throughout, the current discussion reviewed coping resources in parents of children with typical development as well as children with disabilities. Along with this complex group of parental resources, we also discussed the recent direction of investigating the differential susceptibility of children with different genetic, biological, and behavioral sensitivities to various childrearing experiences. Overall, research highlighted the important role of these four parental resources for children's adjustment. At the same time, several studies failed to find support for these associations. For example, whereas the majority of research reported a significant link between maternal depression and parenting impairment, few studies documented adequate parenting practices among mothers with depressive symptoms (see Campbell, 2003 for a review). In addition, non-significant findings emerged in several studies scrutinizing the links between parents' attachment style and their caregiving behaviors (see Mikuliner & Shaver, 2007 for a review).

FUTURE DIRECTIONS AND INTERVENTIONAL IMPLICATIONS Altogether, the surveyed body of research suggests the need to continue in-depth search for resilient parents and families and to identify factors that promote parents' effective coping and well-being, in order to influence childrearing practices and, in turn, child development. Based on the research literature, it may be conjectured that the severity and chronicity of maternal disturbance may be more influential than a specific diagnosis (e.g., Cummings et al., 2005). Moreover, when examining the impact of parental resources on children's adjustment, it seems crucial to reconsider the children's biological sensitivity to contextual conditions

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(Boyce & Ellis, 2005) and children's variations in genetic, biological, and behavioral sensitivities, which may predict their susceptibility not only to the adverse effects of childrearing influences but also to beneficial effects (Belsky, 2005; Pluess & Belsky, 2011). Furthermore, notwithstanding these interesting findings accentuating that parental abilities to provide appropriate care to their children may emerge from their personal resources, other contextual and child-related factors may play an important moderating role such as social supports, life stressors, and, notably, children's unique characteristics (Rholes et al., 2006; Seiffge-Krenke & Pakalniskiene, 2011). Future studies that will examine such moderating factors and the possible reciprocal relationships between these parents, children, and environmental variables may provide comprehensive and in-depth understanding. For example, one may speculate that depressive symptoms in mothers and in their offspring may contribute to reciprocal negative interactions within these families. Parental affect or coping strategies may also be influenced by children’s characteristics such as developmental disabilities, temperament classification, and maladjusted behaviors. Conceptual matters merit words of caution, regarding the role of parental resources in understanding children's adjustment. First, inasmuch as these four selected parental resources are only few of the possible parental psychological and coping resources, additional resources should be considered. Such resources may include parental monitoring levels, parental anxiety, family climate, as well as parents' level of hope (Snyder, 2002). The "hope" construct (Snyder, 2002, 2006) extend the parental experience by providing a future perspective to their coping. It refers to a cognitive set that involves both pathway thinking and agency thinking. Pathway thinking concerns the perceived capacity to generate strategies for attaining future goals, whereas agency thinking concerns perceptions involving one’s capacity to initiate and sustain movement along the chosen pathways. Prior studies indicated that feelings of hope were associated with a variety of adjustment measures including the ability to cope with stressful situations (e.g., Bernardo, 2010; Snyder, 2002). Future studies may examine the interrelations between coping and hopeful thinking and to find if effective coping predicts hopeful thing or maybe maternal hope mediates between personal characteristics and effective coping with parental stress. Second, despite the recent upsurge of interest in fathers' important role for children’s development and later adjustment (Marsiglio et al., 2000; Parke, 2004), as seen in the current review of available literature on parents’ resources, the focus of inquiry thus far has been directed mainly at mothers rather than fathers. Importantly, the few existing studies examining these parental resources among fathers have demonstrated partially similar outcomes to those reported for mothers, calling for additional exploration.

Clinical and Interventional Implications Whereas continued research is necessary to explore the possible reciprocal relations between parental resources and children’s susceptibility to both adverse and beneficial effects of childrearing, there is already sufficient basis to experiment intervention planning. Common to all four of the parental resources reviewed here is the need to empower parental awareness of their own needs, to recognize and meet their offspring's needs, and to cope with the possible conflicts between parents’ and children's needs in an appropriate manner that promotes children’s well-adjusted functioning and well-being.

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Interventions may be designed to address each of the reviewed parental resources, separately or in combination, following careful assessment of the particular parents' attachment styles, affect, SOC, and coping strategies in order to develop an optimal intervention to empower parental strengths, to extend their proactive coping abilities, hopeful thinking and their skills for controlled coping. In addition, regarding parental attachment, based on the surveyed research outcomes indicating the contribution of parents' own attachment style to their caregiving system and to their children’s socioemotional adjustment, interventions may aim to decrease the parental tendency to adopt attachment-activated strategies. In particular, such interventions could foster specific skills related to parental caregiving behaviors such as increasing parental sensitivity, providing support in times of distress, and furnishing a secure base for children's exploration, autonomy, and growth (Diamond, Siqueland, & Diamond, 2003; Lucassen et al., 2011). To address negative parental affect, such interventions may also increase the emphasis on ways in which emotions are implicated in parenting, and considering the importance of positive affect (Gerdes et al., 2005; Trute et al., 2010; Zahn-Waxler et al., 2002). Specifically, such interventions may teach parents to become more attuned to their own emotional functioning, learn how their emotions influence parenting, and learn strategies to regulate emotions. Moreover, systematic efforts are also needed to identify parents with depressive tendencies who could benefit from parent training, along with individual therapy. Further research may explore the possible role of positive affect such as the ability to enjoy moments of happiness and exhilaration, elevate mood and energy, and enhance well-being, which may influence these parents' caregiving behaviors as well (Magyar-Moe, 2009). Additionally, the adaptation of the SOC construct for parental interventions' planning may also promoting personal strengths and coping strategies. Such interventions may attempt to teach more effective task-oriented, active, and social diversion coping strategies as well to enhance parents’ levels of comprehensibility, manageability, and meaningfulness in stressful situations. These interventions could also sensitized parents’ awareness concerning the possible potential risks of their own avoidant or emotion-oriented coping strategies for their children’s adjustment. Altogether, these future trends may extend current public policy for mental health services that offer prevention via identification of high-risk populations and appropriate treatments (Zimmer-Gembeck, & Skinner, 2011). Future studies attempting to develop such intervention programs should examine their effectiveness in enhancing both parents' and their offspring's well-being and adjustment.

ACKNOWLEDGMENT The authors would like to express their appreciation to Dee B. Ankonina for her editorial contribution.

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Weinfield, N. S., Ingerski, L., & Moreau, S. C. (2009). Maternal and paternal depressive symptoms as predictors of toddler adjustment. Journal of Child and Family Studies, 18, 39-47. White, C. P. & King, K. (2011). Is maternal fatigue mediating the relationships between maternal depression and child outcomes? Journal of Child and Family Studies, 20, 844853. Zahn-Waxler, C., Duggal, S., & Gruber, R. (2002). Parental psychopathology. In M. H. Bornstein (Ed.), Handbook of parenting (2nd ed., vol. 4, pp. 295-327). Mahwah, NJ: Lawrence Erlbaum. Zahn-Waxler, C., Klimes-Dougan, B., & Slattery, M. J. (2000). Internalizing problems of childhood and adolescence: Prospects, pitfalls and progress in understanding the development of anxiety and depression. Development and Psychopathology, 12, 443– 466. Zimmer-Gembeck, M. J., & Skinner, E. A. (2011). Review: The development of coping across childhood and adolescence. International Journal of Behavioral Development, 35(1), 1-17.

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Reviewed by Dr. Adi Sharabi, Ph.D, Kibbutzim College of Education and Tel Aviv University, Israel.

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In: Handbook of the Psychology of Coping Editors: Bernando Molinelli and Valentino Grimaldo

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Chapter 4

ECONOMIC COPING AND HEADS OF HOUSEHOLDS’ PERCEPTION OF HEALTH Kenya L. Covington1, Luciana Lagana2,*, Theresa R. White3, and Lisa Bratton1 1

Department of Urban Studies and Planning 2 Department of Psychology 3 Department of Pan African Studies California State University Northridge, California, US

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ABSTRACT It is widely documented that various stressors can affect overall health, including mental health. Nevertheless, there is insufficient literature explicitly linking physical or mental health to specific forms of economic coping within the general population. To address this gap in the literature, we explored the economic coping strategies employed by ethnically/racially diverse heads of households (2,200 in 1997 and 1,600 in 2007) using secondary data from the Institute for Social Research (Panel Study of Income Dynamics, 1997, 2007), which oversampled for ethnic/racial minorities as well as for low-income status. We chose to focus on the decade between 1997 and 2007 to capture trends during: a) large changes in the welfare system (e.g., the implementation of the program “Temporary Assistance for Needy Families” in 1997); and b) times of economic slowdown in the United States. We focused our analyses on documenting the likelihood of use of various economic coping behaviors by income groups (reported in three categories) and specific economic coping strategies related to perceptions of head of household’s health, as well as on testing our preliminary financial coping-health model. This research represents a necessary step toward exploring the importance of the U.S. population’s economic coping as it relates to health. Results were obtained by utilizing SPSS in non-parametric analyses and multiple regressions. By comparing income categories in 1997 and 2007, we found that economic coping strategies were more likely to be used by low income individuals in both years, although use increased in the high income group over the decade. Economic coping was employed more frequently by people of all economic groups in 2007 than in 1997. Moreover, when we tested our * Corresponding author: Luciana Lagana`, Full Professor, Department of Psychology, California State University Northridge, 18111 Nordhoff St., Northridge, CA, 91330-8255. Email: [email protected]. Handbook of the Psychology of Coping: New Research : New Research, Nova Science Publishers, Incorporated, 2012. ProQuest Ebook Central,

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Kenya L. Covington, Luciana Lagana, and Theresa R. White et al. financial coping-health model in weighted stepwise multiple regression analyses, we found that a variety of demographic as well as coping-related variables were significantly related to health. A total of six financial coping strategies were associated with health; only one of them was related to better health (i.e., postponing purchases). Concerning the financial coping-health link findings by income group, we found that self support financial coping in particular was significantly related to worse health. Our findings speak to the health-related financial sacrifices made by many people living in the U.S. in times of economic crisis, yet they should be verified in future research. We believe that, although highly significant, our results offer a conservative estimate of the relationship between economic coping and health, because perceptions of one’s health status usually underestimate the magnitude of health problems.

Keywords: Economic coping, financial coping, health, income, ethnic minority status

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INTRODUCTION Economic coping for survival is a common reality for the poor, but the strategies employed by U.S. families in general to make ends meet are not well documented. The current economic quagmire makes this a particularly appropriate time to explore questions about coping, whether significant differences exist in coping strategies, and the prevalence of specific coping behaviors employed by different socioeconomic groups. The health effects of income inequalities are also well-established (e.g., Lynch, Smith, Kaplan, & House, 2000). Many researchers have targeted the negative effects created by challenging economic conditions, such as unemployment, on both mental and physical health (e.g., see McKeeRyan, Song, Wanberg, & Kinicki, 2005 for a meta-analysis on this topic). Caplovitz (1981) reported that the consequences of economic calamities include problems in areas such as mental health, marriages, as well as basic value orientations and attitudes; thus, financial problems can have very broad negative consequences, and should be the focus of more research efforts.

Conceptualizing Financial Coping First, we should point out that there are several conceptualizations and definitions of coping in general; many scholars find that the Lazarus and Folkman’s broad definition of coping best captures coping responses (Sorkin & Rook, 2006). According to Lazarus and Folkman (1984), coping behaviors are either problem-focused (when the problem causing distress is considered amenable to change) or emotion-focused (when the person in question believes that it is impossible to alter the stressor), and work-related stressors are typically associated with increased problem-focused coping. The classic approach to coping by Lazarus and Folkman is situational: their conceptualization of coping is very dependent upon specific stressful situations. Importantly, as stated by the authors in question, due to the fact that both problem- and emotion-focused coping could be adaptive, researchers need to examine the context of a stressor to assess whether the coping strategies used are truly effective. Several researchers (e.g., Caplan & Schooler, 2007; Pearlin, Leonard, & Schooler, 1978) have pointed

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out the substantial difference between coping strategies aimed at eliminating or modifying problematic situations and those that involve managing emotions. In this chapter, the term coping is used to express how families or individuals make adjustments in their lives for purposes of survival. Often, coping as an action or strategy is a phenomenon that is investigated by social psychologists or other social scientists. In their view, coping strategies are typically seen as behavioral or psychological reactions to feelings of poor coping, “purposefully instigated in an attempt to regain control of a situation” (Walker, 1996, p. 791). Hence, overall coping responses represent some of the actions that individuals take, i.e., their concrete efforts, to deal with the life-strains they experience in their different roles (Pearlin & Schooler, 1978; Ray, Lindop, & Gibson, 1982). These actions can be identified as active or inactive attempts to adjust to stress. Active-cognitive coping includes efforts to manage one's appraisal of the stressfulness of the event. For example, a head of household who is presented with financial hardships might actively respond by utilizing his/her own resources and ingenuity or look to others for assistance. Activebehavioral coping includes overt behavioral attempts to deal directly with the problem and its effects (Billings & Moos, 1981). When compared to avoidance or emotional coping, it may be best to think about most acts of economic coping as a direct active response to adjust to financial hardships. Generally, financial coping behaviors of families attached to government assistance programs have been best documented. Typically, in these studies, researchers have explored how welfare recipients meet their financial obligations, for instance, on a month of welfare assistance. Edin and Lein’s (1997) work prior to the full implementation of welfare reform over the late 1990s showed evidence that families were not quite able to make ends meet on welfare alone, as many of them coped by not paying all their bills or by getting favors from friends, dating partners, and family members. They also experienced inadequate medical care, substandard housing, unreliable child care, food insecurity, and lack of transportation. Nevertheless, U.S. government welfare (otherwise known as Aid to Families with Dependent Children prior to 1996) declined from $22.6 billion in 1995 (a year before the 1996 welfare reform) to $19.7 billion in 2002 (Yoon, 2008), with many poor families attempting to survive by utilizing their resources and ingenuity. Many related issues still remain to be clarified via research, such as trends in and frequency of financial coping behaviors, as well as, most importantly, the health risks associated with economic coping and the degree to which heads of households and their families rely on certain financial coping strategies to make ends meet. The kind of coping discussed herein entails the application of coping responses to economic hardships for the poor and non-poor alike. Most individuals make adjustments to the various situations that they face in their attempts to survive. Pressures within the neighborhood or home, as well as financial shortcomings as a result of a job loss, represent just a few examples of strains that require adjustment by heads of households and their immediate families whenever applicable. Coping for survival is a common reality for the poor and has become more of a reality for the non-poor during recent economic downturns, but the relationship between financial coping strategies and health for both populations has not yet been thoroughly substantiated by empirical research. Unfortunately, within the context of economic coping, the current economic conditions have pushed many families to the brink. As of October 2011, the unemployment rate in the U.S. was 9.1 percent and had remained around 9 percent since 2008 (National Employment Law Project, 2011). Under these dramatic economic circumstances, heads of households are forced to make difficult decisions that

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impact their families, including downsizing living quarters, moving in with friends or family members to share housing costs, rationing food, and even sending young children to live elsewhere in order to survive. Although economic opportunity or lack thereof may be a catalyst for engaging in extensive financial coping, other aspects of life also impact these coping decisions, and particular financial coping strategies emerge from socio-economic situations and environments. Economic coping behaviors have the potential to be influenced by a whole host of circumstances, including age, gender, and ethnic minority status, but very little research is available on this topic. In the present research, we sought to gain an understanding of the relationship between specific economic coping strategies and financial circumstances (e.g., income bracket) experienced by heads of households in both poor and non-poor families. Specifically, we first explored whether economic coping was significantly related to health and then concluded with a more focused investigation of our conceptual framework regarding the relationship between prevalence of various financial adjustments and health status.

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A Brief Literature Review on Financial Coping By definition, low socio-economic status (SES) individuals are more likely to experience financial disadvantage, as they possess fewer material resources, and also typically possess a reduced perceived sense of control over their own lives, which could cause them to implement financial coping strategies that can further exacerbate their problems (Caplan & Schooler, 2007). According to scholars such as Pearlin and Schooler (1978), there is an unequal distribution of effective coping modalities in society: men, the educated, and the affluent often make greater use of efficacious coping mechanisms. The literature in this area is scarce and often dated. Several interesting studies address financial coping topics, which are somewhat related to the present investigation. For instance, Zekeri (2007) produced original data on livelihood strategies among African American single mothers in rural Alabama. This subject group has rarely been previously studied regarding food-insecurity and hunger; sub-groups such as women without access to food stamps have been left out of other studies altogether. Zekeri’s findings showed that most of the participating mothers used numerous strategies beyond government programs, and yet many experienced consequent psychological effects such as depression, sadness, loneliness, as well as difficulties sleeping or concentrating. The author recommended combining efforts to increase food security with psychological counseling to introduce ways of coping with such a difficult time in these women’s lives. To provide some examples of more suitable existing evidence on our topic of investigation, in surveying the research that explores or touches on financial coping strategies, we examined the classic work of David Caplovitz, author of Making Ends Meet: How Families Cope with Inflation and Recession (1981). Caplovitz conducted a survey across four metropolitan cities to identify a) individuals who were most negatively affected by the high inflation and recession of the late 1970s, and b) whether these people were able or unable to cope. Caplovitz discovered that an array of coping strategies were utilized, from “incomeraising strategies such as taking second jobs, having additional family members go to work, and working more overtime, to lowering consumption (i.e. number of meals from three to two or one and a half), greater self-reliance, bargain hunting, and sharing with others” (p. 88). Particularly relevant to our topic, a number of families in his survey cut back on medical and

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dental care to make ends meet. Additionally, he considered other difficult choices faced by these families, including the decision to keep some children in school while sending others out into the workplace. These coping mechanisms were a reflection of strategies utilized primarily by poor families. Middle-class families that were surveyed faced much different circumstances during this economic downturn (e.g., reduced savings and delayed purchases of larger items such as cars and homes). Many middle class individuals found themselves in a position to borrow against home equity to meet their financial obligations. Caplovitz concluded that, with the exception of increasing income, the poor were more likely than the affluent to depend on coping strategies to make ends meet. To clarify the meaning of the technical terms used next, according to Moffit et al. (2003, p.2), “non-entrants are composed of families who have never thought about applying for TANF and are self-sufficient without welfare, but also families who have thought about applying but have not for some reason, and families who have applied and have not come onto the welfare rolls either because they were rejected, diverted, or withdrew from the application process. This is an understudied group in the research on welfare reform, which has mostly concentrated on families who have left welfare (‘leavers’) and, to a lesser extent, those who have remained on the rolls (‘stayers’).” The aforementioned U.S. federal assistance program “Temporary Assistance for Needy Families (TANF)” was implemented in 1997. In an ethnographic analysis of welfare non-entrants from 1999 to 2001, the aforementioned authors found that these families created “packages of resources to make ends meet” (p. 107). These included a variety of strategies such as relying on help from family, engaging in doubled-up housing, and generating income from sources such as the informal and/or underground economy, among others. Moffitt et al. also discovered that non-entrant attitudes and perceptions about welfare, as well as experiences at the welfare office, often deterred several eligible families from applying for TANF benefits. Building on the theme of “combining” different coping strategies, an additional coping study on poor families that were not on welfare was conducted by Zedlewski et al. (2003). These researchers described how poor families crafted “complex supports” to survive, relying on several combinations of family and government support in order to survive. It is particularly unfortunate that attempts at poverty reduction are often unsuccessful. Previous research has shown that the welfare reform started in 1996 did not significantly reduce poverty (Li & Upadhyay, 2008). Based on this information, we grew particularly interested in using 1997 and 2007 data in order to investigate income as it related to health during those two distinct times. The findings of a study conducted on former and current welfare recipients by Henly, Danziger, and Offer (2005) showed that, although receiving financial support from friends and family is very important, it is a limited practice in terms of producing any real changes in overall economic status. Typically, shared housing, small financial loans, or child care assistance represents the extent of the help that these people’s social networks can provide. As Edin and Lein (1997) pointed out, those who are poor get more of their income by resorting to the utilization of irregular sources. Henly et al. determined that “extranetwork coping activities is an indicator of the respondent’s participation in survival activities beyond the supports offered by family and friends” (p. 127). These activities were identified in the study as comprising giving blood or plasma for money, trading or selling food stamps, and relying on charities for sustenance. Furthermore, Danziger, Corcoran, Danziger, and Heflin (2000) conducted a study in 1997 and 1998 (just after TANF was initiated) by recruiting single mothers who both left welfare and those who

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remained on welfare to determine employment patterns and the overall impact of welfare reform on participants’ well-being. Coping activities to make ends meet included, among others, pawning or selling personal items, searching in trash cans, as well as begging, stealing, or engaging in illegal activities. Even though the aforementioned financial coping strategies are self-preserving for poor families, the long-term stress associated with such acts may be connected to poor health. As reported by Danziger et al. (2000), a main goal of welfare reform is to allow its recipients to establish stable, long-term work patterns, assuming that their regular involvement in work will eventually enhance their well-being. However, according to Loprest (1999), the hourly wages and monthly earnings of former welfare recipients show that these individuals often end up working in similar circumstances as other near-poor or low-income mothers. Although there is much less information about specific acts of self-preservation by middle- and highincome families, it is possible, based on our brief literature overview, that a variety of economic coping strategies are related to poor health outcomes in these populations. For decades, it has been clearly documented in the literature that coping is, by definition, integral in dealing with stress, and is significantly related to health (e.g., Antonovsky, 1979). Indeed, there is plenty of evidence, gathered within the past decades, that dealing with distressing life events (such as dire financial circumstances) is related to worse health, both physical and mental (e.g., Andrews & Tennant, 1978; Andrews, Tennant, Hewson, & Vaillant, 1978). For instance, as people experience decreased income following adverse circumstances such as job loss, the corresponding financial stress and loss of personal control can often lead to a host of health problems such as depression, lower functioning in general, and worse health (Price, Choi, & Vinokur, 2002). Long-term coping with chronic psychosocial stressors such as low income has been related to higher risk for poor health among individuals without sufficient financial resources, including many low-income African-Americans (Bennett et al., 2004). Moreover, as more recently pointed out by Brinkman, de Pee, Sanogo, Subran, and Bloem (2010), health is negatively affected by many factors, such as the increasingly high price of food and the global financial crisis, which in turn have reduced access to nutritious food, especially for those with limited financial means.

The Present Study Although it is widely accepted that various stressors can affect health overall, including mental health, the empirical evidence explicitly linking physical and mental health to specific forms of economic coping is very limited. Most of the available literature targets job loss and its consequences on health (usually mental health) and fails to focus on the financial copinghealth link among low-income, middle-income, and high-income families. Indeed, it appears that much of the research has been conducted mostly on single mothers with children to evaluate the effects of welfare reform on those who have remained on welfare rolls and those who have left, i.e., the “leavers”. The literature is particularly scant on the financial coping of diverse economic groups of U.S. residents in relation to overall health. Recently, poverty has increased in the U.S.: in 2010, as previously pointed out, over 15 percent of the U.S. population was below poverty and at risk for financial shortfalls (U.S. Census Bureau, 2011). The question is, how do people with financial challenges (from all income backgrounds) make ends meet, i.e., how do they respond to financial hardship, and how many simultaneous

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ways of coping do they employ? Also, do economic responses to financial constraints relate to health status, and in what ways? There is empirical evidence showing that, when faced with a financial crisis, members of low-income households, in an attempt to deal with high food prices, for example, systematically forego meals, which increases levels of malnutrition (Ruel, Garrett, Hawkes, & Cohen, 2010). This could negatively affect health, but studies must be conducted on specific financial coping strategies as they relate to health in the overall U.S. population, not just in low-income populations. Yet, to our knowledge, there has been no prior research conducted on a large range of financial coping strategies and their relation to health (accounting for important demographics and other factors). An interesting study on financial problems and health was conducted by Waters and Moore (2001), but it was focused on psychological health in particular and targeted problems related to unemployment. Economic deprivation as it relates to fewer material necessities and fewer leisure activities predicted (among other psychological variables) depressive symptomatology. The present study offers a significant complement to the aforementioned research.

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Conceptual Framework of Our Model Conceptually, poor health can be related to a number of problems. These problems could be internal to an individual, i.e. genetic makeup or some others kinds of predispositions, and/or could be ecological, i.e., specifically related to the geographic location and the pollutants present. Moreover, economic social realities may strain individuals to the extent that emotional, mental, as well as physical health are impacted. Figure 1 depicts a proposed theoretical model, not necessarily a statistical one given that, technically, the double arrows should be single-headed to indicate prediction. In our model, we considered primarily the economic and social reality that may influence health outcomes. The conceptual model of the present research takes into consideration economic stress factors and coping responses, as well as both “self support” and “external support” financial coping (fully defined in the Assessment Tool sub-section). In our analyses, as specified later, we included potentially important demographic characteristics of the sample, a process that allowed for the testing of a preliminary conceptual picture covering both economic stress and variables such as gender, age, and ethnic minority status in relation to health. Given the lack of studies on specific types of economic coping, intensity of financial coping responses during periods of widespread economic change, and shifts in the social policy environment, our work, although preliminary, fills a critical gap in knowledge. Not only did we study financial coping descriptively, we also sought to understand the financial coping-health link for three income groups. Specifically, in the research described herein, we had five main aims: 1) investigate economic strains and coping responses exhibited by families within the U.S. by income group, 2) identify financial coping strategies significantly associated with the health status of heads of households, 3) explore changes in economic coping by income from 1997 to 2007, 4) test our proposed model of financial coping to predict heads of households’ health, and 5) assess intensity of coping strategies in relation to health within each income group. Our analyses included several factors such as age, gender, race/ethnicity (Whites versus Black and Latino respondents), number of children living at

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home, and income; these variables have been found to be related to health status in aforementioned studies.

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Figure 1. Conceptual Model of Economic Coping and Health.

We also made an effort to include coping intensity/count (i.e., number of financial coping strategies used), which held potential for being significant. The reason for including all the aforementioned variables was that health disparities have been observed regarding gender, age, income, and financial-stress-related factors such as having a high number of children, as well as having an ethnic minority status in classic as well as very current research (e.g., Whitfield, Bogart, Revenson, & France, 2012). Given the scarcity of evidence on specific financial coping strategies related to health, for our model, we did not formulate specific hypotheses on the economic coping strategies, yet tested them while taking into account the other variables likely to predict health as mentioned above (see Figure 1). Our variables are further defined below.

METHODS Sample We used the archival dataset of the Panel Study of Income Dynamics (PSID) — a longitudinal study with a representative sample of U.S. individuals and their households (PSID; Panel Study of Income Dynamics, 1997, 2007) — to address the study’s research questions. The PSID is considered one of the best sources for national data on economic

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behavior and a plethora of social conditions. At the conclusion of 2009, the PSID included information on more than 69,000 individuals, spanning as much as 38 years of their lives. Data includes detailed information on income sources and amounts, employment, family composition changes, borrowing practices, economic stressors, and self report as well as medical health measures. Specifically, we examined data on 2,200 heads of households in 1997 and 1,600 in 2007 from several ethnic/racial backgrounds. This dataset oversampled for ethnic/racial minorities as well as for low-income groups; such oversampling is critical for robust analyses of the relationship between economic coping and health of the poor. We chose to focus on the decade between 1997 and 2007 to capture trends during large changes in the welfare system, i.e., the implementation of TANF in 1997, and 2007, which corresponds to about 10 years after the full implementation of the Personal Responsibility and Work Opportunity Act (PRWORA), the 1996 legislation that dramatically changed the social safety net within the U.S.

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Table 1. Descriptive Statistics on the Study’s Variables. Variable Name Head of household Health Status %Excellent (value =1) %Very Good (value =2) %Good (value=3) %Fair (value=4) %Poor (value=5) Age Total Family Income % Male Years of Education % Sold Possessions % Postponed Purchase % Postponed Medical Care % Borrowed Money from Friends % Sought Govt. Assistance % Filed Bankruptcy % Paid Bills Late % Took Loan(s) to Pay Bills % Move to Cheaper Place % Acquired a Roommate % Sent kids away % Received Creditor Call(s) % Had Garnished wages % Had Lien Put on Property % Had Property Repossessed Coping Count Self Support Coping External Support Coping

Mean 2.28 26.70 35.10 26.20 9.20 2.40 40.97 70,757.51 79.78 7.36 5.60 35.93 10.80 26.47 12.40 1.79 31.17 12.68 4.89 3.06 .32 14.25 1.39 .83 2.13 1.64 .88 .57

Standard Deviation 1.10

10.66 84,341.73 .40 6.63 .23 .48 .31 .44 .33 .13 .46 .33 .22 .17 .06 .35 .12 .09 .14 1.90 1.05 .82

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Although the PSID is a prospective survey, it includes components that are retrospective, as many questions refer to the previous year. The chosen years are critical because they span periods of economic downturn and prosperity in the U.S. and they also allow for empirical analysis of the data before and after implementation of PRWORA, which represented an important social policy shift in the late 1990s. The year 2007 also represents proximity to the great recession and an economic climate that had not been witnessed in the U.S. since 1943, which signaled the end of the great depression. We made use of the main family data, individual data files, and primary caregiver household files. Variables included in our analyses were demographics, economic coping strategies, and perception of head of household’s health. Tables 1 succinctly describe the descriptive statistics on the variables used in the analyses, specifically, demographic and coping predictors, as well as heads of households’ health. The latter is the dependent variable that captured heads of households’ self report on the state of their health in the last year. A number of other predictors (in addition to financial coping strategies) were essential to the analyses in order to understand whether our financial coping and health model was sensitive to shifts in demographic makeup of the population, such as ethnic minority status, gender, and age.

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Assessment Tool The instrument used to gather this archival dataset was an extensive interview protocol of the Institute for Social Research (Panel Study of Income Dynamics, 1997, 2007) that covered a vast variety of variables. For the present study, we used demographic, financial coping, and health variables. The outcome variable, health of head of household, was self-reported from “excellent”/1 to “poor”/5 on a 1 to 5 scale. To investigate intensity of coping, we created two count variables of coping responses that comprised self support and external support financial coping. Self support financial coping was conceptualized as including those responses wherein heads of households used their own ingenuity and resources to make ends meet, e.g., selling possessions, postponement of purchases and of medical care, paying bills later, and moving to a cheaper place. External support financial coping, on the other hand, was conceptualized as comprising those responses wherein heads of households had to contact resources outside of the immediate family unit to make ends meet, including borrowing from friends, seeking government assistance, moving in with someone, securing a loan to pay off debt, filing for bankruptcy, and sending children away to live elsewhere.

Study Design The PSID is known to be a rich and well-gathered longitudinal dataset; we included the same set of families at two different points in time without strict adherence to a longitudinal design, examining data for 1997 and 2007 on the same sample in each of those two years.

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Analytic Strategy We focused on studying the relationship between economic coping and overall health status. The analytic approach for this chapter included conducting descriptive analyses with bivariate Pearson correlation analyses. This choice allowed for a presentation of the bivariate relationship of heads of households’ self reports on health status and an array of economic coping variables, along with select demographic variables such as age, minority ethnic status, and gender. Overall, we geared our analyses towards documenting the likelihood of use of various economic coping behaviors by income groups and specific economic coping strategies related to self-reports of head of household’s health. Because there is extensive aforementioned evidence indicating that many factors significantly contribute to health outcomes, including demographic characteristics such as age, gender, race and income, we included these variables in weighted stepwise multiple regression analyses to test our proposed model, i.e., whether scores on several economic coping strategies (as well as heads of households’ demographic characteristics and overall coping count) were associated with health. This allowed us to preliminarily test potential financial coping predictors of health in our model, as we were able to hold constant factors known to influence health more generally, while isolating the relationship that financial coping and economic strain may have with health status. Moreover, we planned to conduct income-varying ordinary least square regressions: dichotomous variables of three income groups (representing low, middle and high as defined by the trecile distribution of total family income) were used in the tested models. In each model, each group was compared to the other. Specifically, in Model 1, the low income group was compared to the middle income one; in Model 2, the middle and high income groups were compared; and, in Model 3, the low income group was compared to the high income one. This selection of strategies allowed for an in-depth reflection on each research question and testing of related hypotheses whenever applicable. Concerning the power to conduct our analyses, the sample size was more than sufficient, as we needed our sample size to be larger than 50 + 8m, with m being the number of predictors (Tabachnick & Fidell, 2007). The dataset contained much more than the minimum amount of participants needed to complete our analytic tasks.

RESULTS Descriptive Findings Overall, after applying sample weights, the study’s results can be generalized to 306,368 heads of households living in the U.S. Table 1 displays descriptive information about the sample used in our analyses (i.e., the original sample of the study) relative to demographic, health, and coping variables. Moreover, this table contains the percentages of coping strategies used by heads of households and the ratings of their perceived health. On average, about 11 percent of the sample reported that their health status was worse than “good”. According to responses that ranged from 1 to 5 (with 5 being the least favorable poor health status), the mean was 2.28. The average age of the sample was 40.97; heads of households in

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this sample were more likely to be male, and average family income was $70,757.00. Generally, there was a mixture of economic coping strategies employed by the research participants. Postponing purchases and paying bills late to make ends meet were the more commonly utilized strategies. As we were concerned about the number of simultaneous coping responses that sample respondents were using, we also investigated intensity of financial coping. The total count of responses averaged over the sample, on average, indicated that participants employed .88 self support financial coping responses and .57 external support responses. Figures 2 and 3 further summarize descriptive results, providing a basic understanding of the extent to which the study’s sample experienced various economic stressors. In a similar vein, Figure 4 (showing economic coping by income group) and Figure 5 further describe the between-income-groups economic coping response patterns.

Figure 2. Select Types of Economic Stress by Income Group, 1997.

In particular, Figure 2 shows that using financial coping, conceptualized from here on as “economic stress” to simplify the report of the findings, existed across income groups, with our findings indicating that the most frequent form of stress corresponded to a creditor calling. The low income group had more experience with getting calls from creditors. Additionally, almost across the board, both the low income and middle income group reported experiencing wage garnishments, property liens and repossessions at similar rates in 1997. Over the decade from 1997 to 2007, many changes in this trend were observed, as seen in Figure 3. Nearly10 percentage-point more creditors called low-income households, and there was approximately a 5-percentage-point increase in property repossessions in the low income group. For the middle income group, property repossession increased yet the number of creditors calling decreased. However, creditor calls increased for high income households at a similar rate of decline for middle income households. Hence, particularly for the low income group, overall economic stress (again, inferred from the reported utilization of

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financial coping) seems to be marginally worse in 2007 than in 1997, as to be expected, given the 2008 global financial crisis. What kinds of responses to financial stress were observed? Overwhelmingly, heads of households within the low income group responded to economic stress by actively coping with greater frequency than did both the middle and high income groups. As displayed in Figure 4, without exception, financial coping responses requiring means such as postponement of purchases, selling of possessions, filing bankruptcy, getting a loan to pay off debts that can protect assets, and access to credit lines were used more frequently by middle and high income groups. Other responses wherein participants requested help from other relatives/friends, sought help from government sources, or postponement of own medical care were overwhelmingly more often exhibited by individuals in the low income group. Additionally, this group used the aforementioned strategies much more frequently than the middle or high income group from 1997 to 2007.

Figure 3. Percentage Point Change in Select Types of Economic Stress by Income Group, 1997-2007.

Interestingly, Figure 5 shows that the middle and high income groups increased the use of certain types of economic coping strategies over the decade from 1997 to 2007. For instance, in the high income group, selling possessions as an active coping response increased by nearly 10 percentage-points. This indicates that, from 1997 to 2007, the proportion of high income respondents who sold possessions increased. Likewise, the proportion of high income research participants who postponed medical care as a result of economic stress increased by 7 percentage-points over this period (yet decreased by about 4 percentage-points for heads of households within the middle income group). The largest increases are observed among middle income individuals responding to economic stress by moving in with other people, as there was an over 10 percentage-point increase in this response. Moreover, as detailed in Figure 6, systematically, heads of households within the low income group, on average, exhibited more intense dependence on multiple coping responses than did those within

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medium or high income groups. In 1997, on average, the low income group utilized 2.91 strategies and, in 2007, 2.28 strategies were used. In comparison, the middle income group in 1997 used 2.03 strategies on average, while the high income group only used .91 strategies. In 2007, the intensity of use of economic coping strategies lessened only slightly for every group except the high income.

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Figure 4. Economic Coping by Income Group, 1997.

Figure 5. Percentage Point Change in Economic Coping by Income Group 1997-2007.

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Figure 6. Average Number of Economic Coping by Income Group.

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Results of the Testing of Our Model A major question to address in this chapter was whether economic coping was related to health of heads of households in the U.S. First, correlational analyses allowed us to begin answering this question. In particular, correlations of the relationship of individual variables to health were examined. Pearson correlation results (displayed in Table 2) showed slight univariate relationships between respondents’ health status and most of the variables included in the analyses. More generally, the directions of the hypothesized correlations between variables of importance were confirmed. We expected that factors proxying economic strain (such as creditor call, garnishment of wages, liens, and property repossessions) would have had a positive relationship with health status (with the latter variable being coded herein from 1 to 5, with 5 being the worse possible health status, poor). Pearson correlations indicated that, in general, health status seems to worsen with an increase in economic strain. Likewise, coping responses appeared to be even more important than economic strain in their relationship to health status. Generally, the magnitude of the correlation on coping responses and health outweighed that of economic stress and health. Moreover, in regard to the two categories of coping, external support coping responses appeared to be the coping activity most critical to health status. As expected, income-related coping variables were most important, with the greatest correlation observed between income-related financial coping (i.e., paid bills late) and health was .164. This result suggests that, as income increased, there were associated improvements in health, with scores leaning towards 1 (with 1=excellent health). Other variables that showed an inverse relationship with health scores (thus being protective health factors) were being male, White, and more highly educated. On the other hand, there were a number of risk factors for worse health, i.e., ethnic minority status and older age. The aforementioned

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analyses revealed a number of relationships between demographics and health. The main variables of concern, i.e., economic strain and coping responses, clearly mattered in bivariate analyses. Yet, would the importance of these economic coping variables remain in more sophisticated data analyses in which we would simultaneously consider other important characteristics of heads of households? This simultaneous introduction of demographics and other factors (i.e., coping count) likely to capture the financial coping-health link among heads of households was essential. A series of ordinary least square regression analyses was implemented for this task, as described below.

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Table 2. Pearson Correlations of the Study’s Variables and Health Status of Head of Household (weighted by data year via cross-sectional weight) Variables Self Support Coping Response Count External Support Coping Response Count Total Coping Count Family Income Year 2007 (compared to 1997) Male (compared to female) White Black Latino Number of Children in the Family Unit Education Age Sold Possessions Postponed Purchases Postponed Medical Care Paid Bills Late Moved to Cheaper Quarters Borrowed Money from Friends Sought Government Assistance Filed Bankruptcy Moved in With Someone Sent Kids to Live Elsewhere Took Loan(s) to Pay Bills Received Creditor Call(s) Had Garnished Wages Had Lien Put on Property Had Property Repossessed

Pearson Correlation .119*** .156*** .165*** -.164*** .076*** -.151*** -.144*** .145*** -.007*** .032*** -.049*** .144*** .061*** -.021*** .101*** .163*** .064*** .143*** .136*** .112*** .064*** .034*** -.021*** .108*** .057*** .055*** .075***

N 56,156 56,134 56,115 306,232 306,368 306,368 306,368 306,368 306,368 306,368 299,810 306,368 56,156 56,176 56,176 56,176 56,176 56,176 56,134 56,176 56,176 56,176 56,176 56,176 56,176 56,176 56,176

Our expectation was that coping responses categorized as self and external support responses were going to be positively associated with poor health status. That is, any marginal increase in active coping utilization was expected to be associated with respondents’ lower health status ratings. Moreover, we also expected some significant variation in the association of financial coping and health by income, year, age, and gender. Table 3 displays the model fit summary results for a weighted stepwise OLS multiple regression model (showing each

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model, from Model 1 to Model 10 and corresponding predictors). The main variables of concern were the economic coping responses: although all eleven of these variables were included in stepwise regressions, not all were retained. Iterative improvements up to Model 10 are worthy of consideration, as detailed by the improvement in the F-test. In the final Model (number 10), depicted in Table 4, which displays the weighted multiple stepwise regression findings, we obtained an adjusted R square of .084 and an F change of 3.996; six financial coping responses were significant. Overwhelmingly (with one exception), as indicated in the bivariate correlations, in Model 10 the coping responses and the economic correlates that remained in the model had a positive relationship to health status (thus indicating worse health). There was economic stress exhibited as a garnishment in wages (.042), which was associated with a poorer health status. Likewise, the postponement of medical care (.064), selling of possessions (.041), paying bills late (.121), and filing bankruptcy (.078) were also positively related to poorer health. The only coping response related to better health was the postponement of purchases (-.069). Generally, these results suggest that utilizing economic coping is related to worse health status. As documented in prior literature, having higher income, being White, and being younger were associated with better health status.

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Table 3. Weighted Stepwise Multiple Regression – Model Fit Summary Change Statistics MoAdjusted Std. Error of R Square Sig. F R R Square del R Square the Estimate Change F Change df1 df2 Change 1 .174a .030 .030 4.294 .030 85.295 1 2745 .000 2 .219b .048 .047 4.254 .018 51.660 1 2744 .000 3 .240c .058 .057 4.234 .009 27.626 1 2743 .000 4 .259d .067 .066 4.213 .010 28.332 1 2742 .000 5 .273e .075 .073 4.197 .007 21.758 1 2741 .000 6 .279f .078 .076 4.191 .003 9.614 1 2740 .002 7 .287g .082 .080 4.181 .005 13.910 1 2739 .000 8 .290h .084 .081 4.178 .002 5.147 1 2738 .023 9 .293i .086 .083 4.175 .002 4.619 1 2737 .032 10 .295j .087 .084 4.173 .001 3.996 1 2736 .046 Model 1. Predictors: (Constant), billslate Model 2. Predictors: (Constant), billslate, White Model 3. Predictors: (Constant), billslate, White, total family income Model 4. Predictors: (Constant), billslate, White, total family income, year2007 Model 5. Predictors: (Constant), billslate, White, total family income, year2007, f_bankrupt Model 6. Predictors: (Constant), billslate, White, total family income, year2007, f_bankrupt, postp_pur Model 7. Predictors: (Constant), billslate, White, total family income, year2007, f_bankrupt, postp_pur, postp_med Model 8. Predictors: (Constant), billslate, White, total family income, year2007, f_bankrupt, postp_pur, postp_med, garnish_w Model 9. Predictors: (Constant), billslate, White, total family income, year2007, f_bankrupt, postp_pur, postp_med, garnish_w, male Model 10. Predictors: (Constant), billslate, White, total family income, year2007, f_bankrupt, postp_pur, postp_med, garnish_w, male, soldpos

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Table 4. Weighted Multiple Stepwise Regression Results - Health Status Model 10 Independent Variables Postponed Purchases Postponed Medical Care Sold Possessions Paid Bills Late Filed Bankruptcy Had Garnished Wages Total Family Income White (compared to Black and Latino) Age Constant

B -0.153 0.216 0.184 0.276 0.604 0.392 -1.89E-06 -0.245 0.022 2.299

SE B 0.044 0.067 0.084 0.047 0.143 0.173 0.000 0.047 0.004 0.057

Β -0.069*** 0.064*** 0.041** 0.121*** 0.078*** 0.042** -0.129*** -0.098*** 0.108***

Note: ***, **, and * indicate statistical significance at the .01, 05, and .10 percent level, respectively.

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Intensity of Financial Coping in Relation to Health in Each Income Group We also wanted to explore whether the simultaneous use of an array of strategies to make ends meet further placed the health of the head of household at risk. The final set of analyses targeted whether increased prevalence of coping responses/higher coping count was further associated with poor health status. To address this question, we returned to our categories of financial coping responses, self support and external support. Each category was comprised of several coping responses. As already mentioned, the self support category included financial responses whereas the individual household member exercised agency and resourcefulness, using personal and household resources to make ends meet. As previously described, there were a total of five financial coping strategies for the self support category and, on average, each participant implemented a total of .88 coping responses. Although this list is not exhaustive, it captures important adjustments that households make, including postponed purchases, postponed medical care and late bill payment, as well as relocation to a more affordable place and sale of possessions. The second category is external support, which comprises coping responses that rely on help from outside of the immediate family unit. People may attempt to borrow money from friends, seek government assistance, file bankruptcy, seek loans to pay off bills, move in with someone else, and send their children elsewhere to live. Within the external support category, a total of six economic coping strategies were included. The basic model conceptualized in Figure 1 (which, again, is a theoretical and not strictly statistical depiction, given that we did not test the double-headed arrows, only the singleheaded predictions) was followed here, with one exception. Specifically, we changed each model slightly to take income variations into consideration. Model 1 included a dummy variable that captured the low income group compared to the middle income group. Model 2 included a dummy variable for income that captured the middle income group compared to the high income group, and Model 3 included a dummy for low income group compared to the high income group. Table 5 shows that, on the variables of concern, only self support (not external support) financial coping was significantly related to poor health across all three models. These results suggest that intense reliance on self supports at time of financial strain is associated with heads of households’ worse health. A focus on the standardized beta

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coefficients provides a better understanding of the comparative magnitude of each factor. Generally, we witnessed the greatest magnitude of impact on the self support financial response prevalence variable in the model when we compared the low income group to the high income group. Furthermore, on average, the low income group, compared to the high income group, had a .174 poorer health status. Alone, this finding is not a surprise, but what is most alarming is that sensitivity to this income difference in the model suggests that the members of the low income group are also worse off when they attempt to maximize economic self support as opposed to economic external support in their time of financial strain. Table 5. Weighted Multiple Regression Results on the Association of Coping Count Categories and Health (with Sensitivity Analyses) by Income Group

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Independent Variables

B

SE B β

B

SE B β

B

SE B β

Model 1 Model 2 Model 3 Self Support Coping .058 .027 .062** .048 .027 .049* .084 .028 .081*** Response External Support .013 .035 .011 .062 .039 .045 .020 .035 .016 Coping Response Creditor Call -.091 .074 -.033 .035 .083 .011 .094 .081 .030 Garnish Wages .368 .236 .037 .503 .221 .054** .597 .200 .067** Lien on Property .426 .278 .038 .647 .301 .050** .547 .287 .043* Property .262 .153 .045* .012 .186 .002 -.280 .181 -.036 Repossessed White (compared to -.159 .061 -.067*** -.146 .064 -.053** -.287 .059 -.118*** Black and Latino) Male (compared to -.031 .063 -.013 .167 .078 .051** -.140 .069 -.056** female) Year 2007 -.005 .101 -.002 -.069 .088 -.034 -.087 .085 -.042 (compared to 1997) Total Years of -.030 .011 -.076*** -.011 .009 -.036 -.017 .008 -.054** Education Exceed Two .033 .059 .014 -.041 .055 -.018 -.100 .052 -.043* Children in Family Unit Low income .250 .060 .110*** (compared to middle income group) Middle income .260 .051 .125*** (compared to high income group) Low income .382 .064 .174*** (compared to high income group) Age .029 .010 .134*** .028 .009 .142*** .036 .009 .176*** Constant 2.158*** .096 1.729*** .114 2.092*** .101 Adj R Square .043 .041 .118 F-Test 6.921*** 7.155*** 20.364*** Note: ***, **, and * indicate statistical significance at the .01, 05, and .10 percent level, respectively

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A few of our proxies for financial strain were statistically significant within the model. In Model 1, only property repossession was important, while garnish wages and lien on property surfaced in Models 2 and 3. Each standardized coefficient indicated that, when institutions acted to put pressure on households to honor financial obligations, health status was poorer for heads of households. Systematically across all three models, compared to Blacks and Latinos, Whites’ health status was much better on average (about .118 points better on a scale from 1 to 5). As expected, age and education matters. In every instance, one additional year of age was highly correlated with poorer health status. On average, as heads of households aged, their health status worsened. Overall, more years invested in education were related to better health status; in Model 1, for every year of additional education there was an associated .076 points improvement in health status. Likewise, in Model 3, there was an associated .054 improvement in health status. Notwithstanding the onset of an economic recession in 2007 and into 2008, respondents’ health status was not significantly different from 1997 to 2007. The OLS regression Model 3 was the most robust, as the income variation to the health status model deepened the explanatory power of the model to .118.

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DISCUSSION To reiterate, in this chapter we set out to: 1) investigate economic strains and coping responses exhibited by families within the U.S. by income group, 2) identify financial coping strategies significantly associated with the health status of heads of households, 3) explore changes in economic coping by income from 1997 to 2007, 4) test our proposed model of financial coping to predict heads of households’ health, and 5) assess intensity of coping strategies in relation to health within each income group. These are noteworthy tasks, since economic coping and health have seldom been explored with this analytic strategy. Moreover, finding new ways to improve the health of various sub-groups, particularly poor households, is important to facilitate advancement in further diminishing existing health disparities. Economic coping responses tend to be active responses to a lack of financial resources. As already mentioned, active-behavioral coping refers to overt behavioral attempts to deal directly with the problem and its effects, such as actions whereas an individual tried to find out more about the situation or took other action (Billings & Moos, 1981). To further reiterate, we chose to conceptualize active economic coping into two categories: those acts that seek to eliminate or modify the economic hardship through self support financial coping (e.g., postponed purchases or sold possessions to make ends meet) and coping that involved engaging external support (e.g., borrowed money from friends or sought government assistance). Our descriptive findings show that economic coping was mostly utilized by low-income individuals, but also those in other income brackets. Were there differences in exposure to economic strain by income group? Our results show that this was indeed the case, as it was expected. It is difficult to clearly identify in what kinds of ways and to what extent families are strained financially, as this is often such a private experience. Identifying a specific act and moment of the stress onset is an unrealistic endeavor. However, one may be able to capture generally and by proxy what is reasonably associated with economic stress. In this study, we considered acts by banks and legal authorities as evidence that a household and the

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head of this household in particular were under stress. Moreover, creditor calls, wage garnishment by an external authority, property lien or repossession (as well as all the other coping variables studied herein) were all interpreted as being indicative of the presence of financial stress. Being male, White, and having achieved higher educational levels were all associated with better health, as hypothesized, corroborating several aforementioned available findings. Our findings suggest that, when financial responsibilities are inordinate, families employ multiple strategies to make ends meet that may over time have an emotional, physical, or mental strain effect. A heightened reliance on the simultaneous use of multiple coping strategies provided some preliminary insight into the potential for an increase in intensity of stress that one may be under (although this should be tested more specifically in future studies). Moreover, the health status of heads of households was not significantly different from 1997 to 2007. Although there was an expectation that an economy requiring more financial adjustment might have shown a significant association with poorer health, we are not surprised that this relationship was not evident. There is possibly a lagged effect of the negative economy on health status, which would require additional years of data to be tested (2009 data was not available at the time of submission of this chapter). Our financial coping-health model was significant, as hypothesized; additionally, self support (not external support) financial coping was significantly associated with poor health across all three income groups. The latter finding suggests that financial coping that burdens the head of household with the responsibility to utilize personal and household resources to make ends meet is a risk factor for health. No prior research, to the authors’ knowledge, is currently available to explain this finding; certainly more studies should be conducted to clarify such an interesting result. We could speculate that the latter could be due to the fact that, without external financial support, heads of households who face financial problems are particularly vulnerable to feelings of failure and related psychological and physical health symptoms. It is also possible that the availability of external sources of financial support typically provides greater financial aid and/or major reduction in expenses. Once external financial coping is in place, it is reasonable to assume that some of the stress due to having to make ends meet would decrease. For instance, in the case of bankruptcy, this coping strategy eventually leads to creditor’s calls stopping, as the individual in question is no longer deemed responsible for the accumulated bills; it also could lead to the rental of a smaller residence with usually lower monthly bills and possibly decreased pressure on the head of the household. All these conjectures should be tested empirically. How do the lessons learned from the research described above influence discourse on ways to improve health in view of financial coping needs overall, and for the poor in particular? The 1996 passage of PRWORA ushered in a new era in social policy; one that is less sensitive to the number or age of child dependents and, most of all, to business cycle fluctuations (even if they represent extreme economic downturns). Given that many more poor families are unattached to major government support programs than ever before, it is critical that, ten years after welfare reform, we evaluate how families are coping over major shifts in the economy and the social policy environment. Regarding the limitations of this somewhat preliminary study, they include the fact that given our research design and analytic strategies, the findings reported herein are not causal; it is possible that worse health affected how people coped financially, and not vice versa. Replication of this study is needed to shed light on this topic. Moreover, in some of our

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analyses, we focused on Whites versus Latinos and Blacks; in future investigations on this topic targeting a variety of ethnic backgrounds, researchers should clarify whether our findings still apply. Additionally, important information on potentially relevant variables was not collected; for instance, health was not assessed using standardized health measures. Consequently, we were unable to verify whether respondents referred strictly to physical health and/or to mental health when they provided answers although, when asked about health, most people may assume that the question pertains to physical health. Either way, their perceived health was related to a variety of hypothesized factors and specific financial coping strategies. In this regard, however, although the coping variables tested herein were numerous, we did not have information on all possible economic coping strategies, such as reducing exercise to take on two jobs or sacrificing food quality. Furthermore, we could not capture underground economy, as the dataset does not reflect private assistance (i.e. food banks, non-profits). Also, the variables covered herein were all based on self-report, which can be highly biased, and our use of stepwise regression is by definition exploratory (yet, our best model, with all 10 predictors, accounted for roughly 9% of the variability in health, a notable finding). Future research in this area could test an improved version of our model using more sophisticated and standardized data collection tools and analytic procedures. Also, ideally through mixed method research, investigators could conduct in-depth inquiry into what is perceived as most financially stressful in each income group, as well as expenses priorities in each group and whether/how they change overtime. More extensive work in this research area is needed to clarify some of our findings, including the fact that, over the time period in question, the proportion of high income participants who postponed medical care as a result of economic stress increased by 7 percentage-points over this period yet decreased by about 4 percentage-points for heads of households within the middle income group. We also believe that the absence of additional financial coping strategies such as the use of soup kitchens and shelters, for example, renders our results conservative at best, as any associations revealed are most likely underestimates of the association of economic coping and health. Additionally, we did not explore potentially critical factors such as acculturation, locus of control, family composition, the presence of dual (or more) incomes within a family, religious connections related to financial aid possibilities, coping through employment of other strategies such as substance abuse, as well as the health status of family members other than heads of households. Wadsworth and Santiago (2008) stated that it is problematic that children – especially school-age children – are not addressed in the literature in this area, as the psychological problems created by economic stress among parents can interfere with educational attainment, social functioning, and optimal physiological development of children. If parents and children both increase their coping skills, the resilience of families under financial stress could increase. Applying this model to intervention research, especially to evaluations of coping-based family-focused preventive interventions, has the potential to buffer the effects of poverty and increase the resiliency of all members of financially challenged families. Overall, our results speak to the sacrifices made in the U.S. to survive, and how the attempts at surviving through financial coping are related to health in a variety of income groups. It appears as though only certain attempts to cope financially are related to worse health; more research is needed to investigate reasons for those findings. The results of the present research calls for social, health, and other psychologists, as well as interested scholars from a variety of disciplines, to conduct more research on financial coping, as we located a

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limited amount of literature linking income, age, ethnic minority status, gender, and financial coping strategies to heads of households’ health. It is also critical that, as done preliminarily herein, in the future more researchers focus on the coping strategies of the poor, middle-class, and relatively affluent, as the major differences in these strategies have yet to be highlighted and discussed, especially between low-income and middle class. Over the recent economic recession, middle income families have also been impacted significantly. The fallout of the housing market and subsequent foreclosures has overwhelmingly impacted middle income heads of households and their families, possibly affecting health in many ways. These families must also identify modes of economic coping, which is particularly difficult in dire circumstances. Generally, the poor receive more attention and more scrutiny about the financial coping behaviors they exhibit within their households. However, more recently, media attention and the recent “Occupy Wall Street” and related movements have emphasized that the average/middle class families are having a lot of financial problems as well. Therefore, their credit and saving habits should become the focus of investigation. Interested researchers should engage in empirical assessments of whether the intensity of use across a combination of financial coping strategies might compromise well-being (be it physical or psychological) in families within different income brackets. Fortunately, interventions in which people are trained in ways of coping with povertyrelated stress and the consequent social degradation and humiliation of being very economically disadvantaged (and, possibly, financial stress of those not qualifying as poor yet financially distressed) show great promise at mitigating the debilitating effects. Patterns of resilience emerge when reviewing the corresponding literature, showing in limited but significant portions of the population that coping skills can be taught. Although beyond the scope of this chapter, Wadsworth et al. (2011)’s preliminary results of an extensive study focused on strengthening couples’ relationships and teaching coping skills are pertinent to this discussion. The authors’ findings showed improved coping and reduced stress in a sample of low income parents. There were noteworthy reductions in financial stress, disengagement coping, and involuntary disengagement responses, as well as improvements in problem solving. Intervention with highly stressed families produced positive change, an important corollary to previous research that showed a lack of intervention leads to mental illness. Differences in success were found regarding the gender of the participant in the intervention group –men’s groups led to lower success rates than did women’s groups and combined groups. The combined couples group is likely optimal for many outcomes; focusing only on women or only on men is less effective. It is important to focus more research efforts on interventions targeting the reduction of financial stress and related negative health consequences. In conclusion, our model has potential, yet it needs to be confirmed in research on other samples and refined to include more financial coping strategies, potential predictors, and a specific assessment of health, both mental and physical. This preliminary investigation of a model of financial coping and health has, overall, yielded noteworthy results and demonstrated the need for more research in this area. Additional studies should also be conducted on effectively separating economic effects from policy effects of welfare reforms (as suggested by Blank, 2002), a task beyond the scope of this chapter. Regarding ways to help those in financial distress, considering the varied locations and sample sizes of the aforementioned studies, a striking pattern emerges: interventions aimed at enhancing both

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primary and secondary coping skills are remarkably effective. They are even more effective if they focus on the entire household under stress, as individuals and families show greater resiliency when interventions involve all members of a family rather than just the adult or adults in charge. In addition, attention to gender dynamics must take place for householdlevel interventions to succeed. While ending the predations of poverty is best accomplished by ending poverty, people under financial stress can nonetheless learn ways to mitigate or endure its effects. The rhetoric of the late 1990s, largely espoused while the debates on social policy were focusing particularly around welfare reform, might have led many people to believe that reliance on self is much more honorable and, ultimately, better for the household’s quality of life than any government support could be. Today these ideas are still espoused by many people, but the results presented here suggest that there could be circumstances/conditions that place heads of households at risk for worse health, particularly when our social policy climate requires that the poorest among us depend heavily on self support financial coping options when navigating hard times. More research is highly needed in this important yet neglected research area.

ACKNOWLEDGMENT

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This research was supported by two grants from the National Institutes of Health and National Institute of General Medical Sciences, award numbers 5SC3GM094075 and GM 48680, Luciana Lagana`, Principal Investigator. The content of this chapter is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of General Medical Sciences or the National Institutes of Health.

REFERENCES Andrews, G., & Tennant, C. (1978). Being upset and becoming ill: An appraisal of the relationship between life events and physical illness. Medical Journal of Australia, 8, 324-327. Andrews, G., Tennant, C., Hewson, D., & Vaillant, G. (1978). Life event stress, social support, coping style, and risk of psychological impairment. Journal of Nervous and Mental Disease, 116, 307-316. Antonovsky, A. (1979). Health, Stress, and Coping. San Francisco, CA: Jossey-Bass. Bennett, G.G., Merritt, M.M., Sollers III, J.J., Edwards, C.L., Whitfield, K.E., Brandon, D.T., & Tucker, R.D. (2004). Stress, coping, and health outcomes among African-Americans: a review of the John Henryism hypothesis. Psychology & Health, 19(3), 369-383. doi: 10.1080/0887044042000193505. Billings, A., & Moos, R. (1981). The role of coping responses and social resources in attenuating the stress of life events. Journal of Behavioral Medicine, 4(2), 139-157. Blank, R.M. (2002). Evaluating welfare reform in the United States. Journal of Economic Literature, American Economic Association, 40(4), 1105-1166. Brinkman, H., de Pee, S., Sanogo, I., Subran, L., & Bloem, M.W. (2010). High food prices and the global financial crisis have reduced access to nutritious food and worsened

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In: Handbook of the Psychology of Coping Editors: Bernando Molinelli and Valentino Grimaldo

ISBN: 978-1-62081-464-2 © 2012 Nova Science Publishers, Inc.

Chapter 5

COPING IN A RELATIONAL CONTEXT: THE CASE OF DYADIC COPING Iafrate Raffaella and Donato Silvia Catholic University of Milan, Italy

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ABSTRACT Since its origins most of the stress and coping literature has focused primarily on the individual’s efforts to manage stressful encounters, conceptualizing both stress and coping as individual phenomena in which the coper appraises and deals with stressors individually. The individualistic approach, however, fails to consider that individuals do not experience and cope with stress in isolation, but within an articulated interpersonal context, especially the one referring to intimate others. Recent advances in the stress and coping field have highlighted the limitations of such a self-focused conceptualization and called for a broader view of the phenomenon. The present chapter is going to present these advances in the stress and coping literature with respect to coping in couples, from the recognition of the importance of interpersonal aspects of coping to the conceptualization of novel notions such as the one of dyadic coping. Finally, the chapter will conclude with research findings on the role of dyadic coping and partner support in couple functioning, with regard to both benefits and costs of such processes, and with the evidence available on some of the antecedents of dyadic coping.

Keywords: Interpersonal aspects of coping; dyadic coping; couples

INTRODUCTION Since its origins most of the stress and coping literature has focused primarily on the individual’s efforts to manage stressful encounters, conceptualizing both stress and coping as individual phenomena in which the coper appraises and deals with stressors individually. The individualistic approach, however, fails to consider that individuals do not experience and cope with stress in isolation, but within an articulated interpersonal context (Eckenrode, 1991; Lyons, Sullivan, Ritvo, & Coyne, 1995; Revenson, Kayser, & Bodenmann, 2005; Zani,

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1999), especially the one referring to intimate others. Even when the interpersonal context is integrated in stress and coping models (e.g., Cohen & Wills, 1985; Dohrenwend, 1978; Eckenrode & Gore, 1981; Pearlin, Lieberman, Menaghan, & Mullan, 1981) the role of close others is generally considered merely as a further source of assistance or additional distress (e.g., Cohen & Wills, 1985), but not as an active involvement in the coping process. Recent advances in the stress and coping field have highlighted the limitations of such a conceptualization, defined by Mickelson, Lyons, Sullivan, and Coyne (2001) as self-focused, and called for a broader view of the phenomenon. The present chapter is going to present these advances in the stress and coping literature with respect to coping in couples, from the recognition of the importance of interpersonal aspects of coping to the conceptualization of novel notions such as the one of dyadic coping. Finally, the chapter will conclude with research findings on the role of dyadic coping and partner support in couple functioning, with regard to both benefits and costs of such processes, and with the evidence available on some of the antecedents of dyadic coping.

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BEYOND THE INDIVIDUAL FRAMEWORK OF STRESS AND COPING IN COUPLES When individuals face a stressful situation, close others, and especially their partners, are not only a source of social support or additional strain, but also active participants influencing the individual’s stress and coping process from the appraisal of the situation to the resources he/she can activate in order to deal with the problem. In particular, when people are involved in a couple relationship, their partners often share stressors, appraising them as “our” problem instead of “my” or “your” problem (Acitelli & Badr, 2005), activate shared resources or actually cope together as a couple (Revenson, Kayser, & Bodenmann, 2005). Since the early nineties the new attention devoted to the interpersonal context of coping has set the conditions for two theoretical and empirical traditions, the one on close relationships and the one on stress and coping, to converge and look for an integrative view of the stress and coping process as it unfolds within the couple relationship. Theoretical and empirical contributions on the social aspects of coping have focused on the following issues concerning the role of interpersonal relationships in people’s stress and coping.

Cross-Over Effects of Partners’ Stress and Coping A consistent finding that suggests the importance of the interpersonal context of stress and coping, refers to the effects of individuals’ stress on their intimates, and particularly on their partners (Bolger, DeLongis, Kessler, & Wethington, 1989; Hagendoorn, Sanderman, Bolks, Tuinstra, & Coyne, 2008; Repetti, 1989; Thompson & Bolger, 1999). When facing a stressful event, “family members labor not only with their own distress, but also with the distress of their loved ones” (O’Brien & DeLongis, 1997; p. 161). For example, in a study of couples in which one partner was about to take the New York State Bar Exam, Thompson and Bolger (1999) found that the distress experienced by the individual preparing for the exam influenced their partners’ level of distress as well. Similarly, the stress that medical students

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experienced during training showed to crossover and cause distress also in their partners (Katz, Monnier, Libet, Shaw, & Beach, 2000). In a recent meta-analysis of role and gender effects on distress among couples coping with cancer, Hagendoorn and colleagues (2008) found a significant, though moderate, association between patient and partner’s distress within couples, suggesting that the two partners may react as an “emotional system” (p.19) rather than as individuals when facing a stressful event. Research has shown, in fact, that in couple relationships emotions are transmitted from one partner to another (e.g., Schoebi, 2008). Cross-over effects, moreover, are not limited to the phenomenon of stress spillover or emotional transmission, but refer also to the impact of the individual’ s coping efforts on his/her intimates as well. Research supports the notion that the individual’s way of managing his/her stress exerts an impact on the others’ psychological functioning. Stanton (1991), examining couples coping with infertility, reported that when wives used a support-seeking strategy in managing their stress (i.e., looking for the support of others), their husbands reported to be less psychologically distressed. Moreover, wives engaging in more selfcontrolling coping strategies (i.e., controlling one’s reactions to the stressful situation) have husbands that experience higher levels of distress (Stanton, Tennen, Affleck, & Mendola, 1992). Overall these studies suggest that the individual’s stress and coping have an impact that goes beyond the individual’s own well-being and involves his/her close relationships, particularly the partner.

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Influences of the Other’s Responses on Partners’ Coping Another research finding that has contributed to the growing attention on the social context of coping is represented by the influence that the other’s responses exert on the individual’s coping efforts (e.g., Griffin, Friend, Kaell, & Bennett, 2001; Manne & Zautra, 1989; Marin, Holtzman, DeLongis, & Robinson, 2007). For example, in a longitudinal study of parents coping with the loss of a child (DeLongis, Silver, & Wortman, 1986, cited in DeLongis & Holtzman, 2005) negative responses (e.g., lacking empathy and minimizing the loss) of close friends and family members to the parents’ coping efforts predicted three aspects of parents’ coping: a) reduced desire to cope over time; b) reduced effort put into coping over time; and c) reduced effectiveness of the coping strategy when it was used. On the other hand, coping efforts that encountered the support of others were successful in helping parents to recover from their grief. In a study on couples coping with one partner’s rheumatoid arthritis Griffin and colleagues (2001) observed that patients whose partners responded to their pain expression by getting irritated or angry were more likely to use maladaptive coping strategies, such as venting of negative emotions, and behavioral disengagement. The influence of the other’s responses on the individual’s coping emerged also in terms of their moderating effect on the link between the individual’s coping and his/her well-being. For example, in a study of parents coping with their children disabilities (Marin et al., 2007) spouses’ responses to the parents’ coping efforts moderated the association between coping and distress. In particular, when parents reported positive responses to their coping efforts from their spouses, the benefits (in terms of reduced psychological distress) of their positive

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coping strategies (e.g., cognitive restructuring) were amplified and the negative effects of their maladaptive coping strategies (e.g., reproach coping) were attenuated. In contrast, in the context of negative responses parents’ cognitive restructuring was associated with greater distress. Research has shown that even anticipating close others’ criticism or negative responses may influence the individual’s coping efforts. Pearlin & McCall (1990), in fact, found that participants who expected criticism or negative responses from family members did not seek support within the family. Overall these studies suggest that the individual’s coping strategies are not only a function of the individual’s appraisal of the situation and his/her resources, but they are highly influenced by the (actual or anticipated) responses of close others, and especially the partner. Others may play a crucial role in influencing which strategies the individual eventually adopts to deal with a stressful event as well as which effects these strategies will have on the individual’s well-being. A focus on the other (the partner and the relationships with him/her) as not merely influencing the individual’s coping, but also as representing one of the individual’s concerns when dealing with stressors required specific new forms of coping to be conceptualized.

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Novel Notions: Communal Coping and Dyadic Coping In line with the previous findings, it seemed necessary to expand traditional stress and coping concepts. To this aim novel notions and models begun to emerge as an attempt to reframe coping processes within a more relational approach. This would allow not only to reconceptualize partners’ individual coping strategies within their interpersonal context, but also to target those partners’ coping efforts that could not be considered as mere individual responses, but rather as a potential emerging dimension of the relationship. New constructs such as communal coping (Hobfoll, 1998; Hobfoll, Dunahoo, Ben-Porath, & Monnier, 1994; Lyons, Mickelson, Sullivan, & Coyne, 1998; Mickelson et al., 2001; Wells, Hobfoll, & Lavin, 1997) and dyadic coping (Berg et al., 2008; Bodenmann, 1995a, 1997; Coyne & Smith, 1991; DeLongis & O’Brien, 1990; Revenson, 1994) were formulated to these aims. Lyons and colleagues (Lyons et al., 1998; Mickelson et al., 2001) defined communal coping as involving a) a “social appraisal” of the stressor, that is the understanding of a stressor as a problem of the whole group and not only of a single member of it, and b) the cooperative actions of the group members in order to cope with it. The authors proposed a two-dimensional framework of coping, in which one dimension refers to the type of stress appraisal (communal vs. individual; that is the degree to which one problem is appraised as “mine/yours” vs. “ours”) and the second dimension refers to the action (communal vs. individual; that is the degree to which coping strategies involve all partners or only the individual). Within this framework, communal coping is characterized by a shared appraisal and a shared action to manage the stressor. Communal coping is not enacted merely for collective interests, but serves both relational and individual functions. From the relationships point of view, engaging in communal coping is regarded as a) a long-term investment for future times of need, through the activation of a reciprocity system; b) a mean of relationship maintenance and development; c) a way to promote significant others’ well-being; and d) an activity aimed at the continuation and well-

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being of a social unit (i.e., the couple, the family or the community). From the point of view of the individual’s well-being, instead, communal coping serves as a) a mean for social validation and integration, since involvement in communal coping communicates to others their in-group and out-group membership; b) a way to elicit social support; and c) an activity that, in itself, elicits positive social experiences and emotions. Somehow similar to communal coping, but referring specifically to the couple relationship, dyadic coping is broadly defined as an interpersonal process involving both partners and as “the interplay between the stress signals of one partner and the coping reactions of the other, a genuine act of shared coping” (Revenson, Kayser, & Bodenmann, 2005; p. 4). In the past decades different conceptualizations of such a construct have been proposed and several distinguishable, yet overlapping, definitions have been elaborated (cfr. Barbarin, Hughes, & Chesler, 1985; Berg, Meegan, & Deviney, 1998, Berg & Upchurch, 2007, Berg et al., 2008; Bodemann, 1995a, 1997, 2005; Coyne & Smith, 1991, 1994; DeLongis & O’Brien, 1990; O’Brien & DeLongis, 1997; Revenson, 1994, 2003). All definitions share the same broad conceptualization of dyadic coping as a process through which partners cope with the stress they encounter in their life as a couple, though giving different connotations to the idea of what coping as a couple means.

DYADIC COPING: DIFFERENT PERSPECTIVES

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Within the various approaches to dyadic coping that can be traced in the stress and coping literature (see Bodenmann, 2005; Revenson, 2003; Revenson, Abraido-Lanza, Majerovitz, & Jordan, 2005) dyadic coping has been defined: a) as an interaction between each partner’s individual coping; b) as each partner’s coping efforts focused on the other partner’s well-being and on the maintenance of the relationship; and c) as a dyadic process in which both partners deal with stress as a couple.

Interaction between Partners’ Coping: Mutual Influence and Coping Congruence This perspective conceptualizes dyadic coping in terms of the relations between partner’s individual coping strategies and it has been declined into two approaches: mutual influence and coping congruence (see Revenson, Abraido-Lanza, Majerovitz, & Jordan, 2005; Bodenmann, Meuwly, & Kayser, 2011). The mutual influence approach analyzes each partner’s coping efforts with regard to the other person’s coping and outcomes (Barnoy, Bartal, & Zisser, 2006; Berghuis & Stanton, 2002; Levin, Sher, & Theodos, 1997; Wijngaards-de Meij et al., 2008), whereas the coping congruence approach emphasizes the congruence or fit between partners’ coping responses (Barbarin et al., 1985; Pakenham, 1998; Revenson, 1994; 2003). The two approaches have adopted different operationalizations of couples’ coping: whereas mutual influence models operationalize dyadic coping as the interaction between partners’ individual coping efforts in regression analyses, examining the association of one partner’s coping and his/her adjustment in the context of what the other partner does (or does not) to cope with the stressor; congruence models, instead, use measures of intracouple

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concordance (e.g., mean difference between partners’ coping scores; identification of patterns of couples’ coping through cluster analysis; etc.) to examine how the fit between both partners’ coping is related to their adjustment. An interesting example of the mutual influence approach is provided by Berghuis and Stanton (2002). In a study on couples adjusting to infertility, the authors tested three different mechanisms through which partners’ coping was hypothesized to influence each other’s adjustment. The first one was a mechanism of additive or independent influence: Each person’s adjustment was supposed to be independently affected by both their own coping and their partner’s coping. The second and third mechanisms, instead, were interaction models in which the relation between one partner’s coping and his/her adjustment was moderated by the other partner’s coping. In one version of this interaction model it was hypothesized that partners’ adjustment may be greater when partners use symmetric coping strategies, whereas in the other version partners’ use of an effective coping strategy may function as a compensatory mechanism and lead to better adjustment when the other partner uses little of the same strategy. In their short-term longitudinal study (Berghuis & Stanton, 2002) the authors found support for all three models, but the strongest evidence was in favor of the third, compensatory model, especially when considering partners’ coping through emotional approach: Women with high emotional-approach coping at Time 1 were low on distress at Time 2 regardless of their partners’ coping; on the contrary, women initially low on emotional approach coping benefited from their partners’ emotional-approach coping. The coping congruence approach is well represented by Revenson’s (1994, 2003) work. Revenson and her colleagues (Revenson, Abraido-Lanza, Majerovitz, & Jordan, 2005) argued that "the goal of couples’ coping is to maximize the congruence or fit between the partners’ coping styles in order to cope most effectively as a couple" (p. 141). According to these authors congruence can involve either symmetry or complementarity of coping styles as long as partners’ efforts work in concert to reach a desired goal: Symmetrical coping styles may help partners to reach their goals because they are coordinated and mutually reinforcing, whereas complementary coping styles may be useful because they broaden partners’ options and coping repertoire. On the contrary, incongruent strategies are the ones that work in direct opposition, canceling each other out or undermining the other’s coping efforts. In a study of couples coping with one partner’s rheumatic disease Revenson and colleagues (Revenson, Abraido-Lanza, Majerovitz, & Jordan, 2005) used cluster analysis to identify patterns of couples’ coping. Four clusters were identified: cluster 1 (described as effortful partnerships) grouped those highly congruent couples in which both partners used more problem-focused strategies; cluster 2 (defined problem-solvers with emotion-coping spouses) was composed of couples with a moderate degree of congruence, in which both partners used high levels of positive problem-solving, but spouses (compared to patients) used more emotion-focused strategies; cluster 3 (named minimalist copers) comprises congruent couples in which both partners used very little of all strategies; and cluster 4 (called and the patient copes alone) grouped those couples in which patients used several coping strategies, whereas the spouse used very few coping strategies. Results showed that couples in the first cluster were significantly more distressed than the ones in the other clusters; those couples, however, scored higher than the others on a measure of personal growth. Revenson interpreted this pattern of findings highlighting the importance of viewing coping patterns at a dyadic level: If an individual-level interpretation (derived from correlating individual-level coping with individual-level outcomes) could be that those partners’ problem-solving efforts

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were insufficient to manage their burdens, from a dyadic point of view an alternative explanation could be that those partners, despite their distress, were able to reappraise the illness in a more positive light, probably because they felt they were actively doing something as a team.

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Coping Efforts Focused on Partner’s Well-Being and Relationship Maintenance: Relationship-Focused and Empathic Coping This perspective conceptualizes dyadic coping as a third possible function of coping in addition to the two basic functions identified in classic research on individual coping (Endler & Parker, 1990; Lazarus & Folkman, 1984): when facing a stressful encounter partners’ coping can be directed not only to solve their own problem (problem-focused coping) or to manage their own distress (emotion-focused coping), but also to the regulation and preservation of their relationship during stressful periods (relationship-focused coping). Coyne and colleagues (Coyne, Ellard, & Smith, 1990; Coyne & Smith, 1991) identified two forms of relationship-focused coping: a) active engagement, which refers to the attempt of one partner to involve the other in discussing the problem, ask how the partner feels, engage in constructive problem-solving; and b) protective buffering, which refers to one partner’s attempt to protect the other and the relationship by hiding his/her concerns and worries and by giving in to the partner in order to avoid conflict. According to Coyne and colleagues the fact that people’s coping in close relationships is driven both from individual and relational motives points to a potential source of conflict, whenever individual and relational goals do not converge. In their studies on couples coping with myocardial infarction, for example, Coyne and Smith (1991) found that wives’ use of protective buffering was associated with their husbands’ increased self-efficacy, but with their own greater distress. Adding this third relational function (relationship-focused) to the individual ones gave impetus to consider a whole different set of competences in dealing with stress: Within the context of the couple relationship, the question is not only how individuals manage their stress and solve their problems, but also how they manage to do so while preserving their relationship and attending to the other’s well-being as well. A specific mode of relationship-focused coping was conceptualized by DeLongis and colleagues (DeLongis & O’Brien, 1990; O’Brien & DeLongis, 1996, 1997) and called empathic coping. Empathic coping refers to the attempts to understand the other’s feelings and emotions in the stressful situation and comprises the following dimensions: 1) efforts to engage in perspective taking and appraising the situation from the other’s point of view; 2) efforts to vicariously experience the other person’s emotions and to evoke one’s own emotional and cognitive associations to that experience; 3) efforts to interpret the psychological states underlying the other’s verbal and non-verbal communication; and 4) efforts to respond sensitively to the other person or to express caring and understanding in a nonjudgmental, validating manner.

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A Dyadic Process in which Both Partners Deal with Stress as a Couple: Bodenmann’s Systemic-Transactional Theory and Collaborative Coping In the early nineties Bodenmann developed his systemic-transactional theory of dyadic coping on the basis of the transactional model of Lazarus and Folkman (1984). Bodenmann applied a dyadic approach to extend this classic model of stress, appraisal and coping in all three components of it. According to Bodenmann, in fact, stress can be conceptualized not only as an individual phenomenon, but also as a dyadic event: Dyadic stress is defined as a circumstance that affects (directly or indirectly, through the other partner’s stress) both members of the couple and elicits joint appraisal and common coping efforts (Bodenmann, 1995a; Lyons et al., 1998). Differently from the other conceptualizations of dyadic coping, that were elaborated mostly within the context of chronic illness, Bodenmann’s theory was first developed to define coping with daily hassles (minor stressors), that couples can encounter in their everyday lives, and only later it was extended to critical life events (major stressors) as well as to chronic stress in everyday life (e.g., chronic stress at work). Once a dyadic stress is present and partners have made a dyadic appraisal of the situation, their coping efforts can become properly dyadic. Dyadic coping process is regarded as a circular sequence in which partner A’s communication of stress is perceived, decoded and evaluated by partner B, who then responds with his/her coping reactions. Partner A’s communication of stress, whether it is verbal or non-verbal, is considered in this model as a necessary, yet not sufficient, condition for the process of dyadic coping to initiate and proceed. Through stress communication the partners’ stress becomes a relational entity. Partner B’s coping responses are in turn perceived, decoded and evaluated by partner A in a circular process. Within Bodenmann’s theory the general aim of dyadic coping is twofold: It is intended to restore or maintain both partners’ individual well-being (not only the one of the stressed partner), by reducing the partners’ levels of stress, and to promote couple functioning, by strengthening partners’ sense of we-ness and reciprocal trust (Bodenmann, 2005; Cutrona, 1996). Dyadic coping, however, is not functional per se, but partners can engage in positive as well as negative forms of it. According to Bodenmann’s conceptualization, in fact, dyadic coping is a multidimensional construct. Depending on the profile of the situation, on the individual and dyadic appraisals and goals, and on partners’ own competences, different types of dyadic coping can be distinguished. In particular, Bodenmann distinguished between positive and negative forms of dyadic coping, where partners’ positive dyadic coping may include one partner showing understanding and being supportive (i.e., what Bodenmann called supportive dyadic coping), or both partners engaging in a problem-solving discussion (i.e., what Bodenmann called common dyadic coping). Negative responses include hostile, ambivalent, or superficial behaviors such as open disinterest, sarcasm, or minimizing the seriousness of the partner’s stress. These different forms of dyadic coping responses were also analyzed in different countries and language groups (Donato, Iafrate, Barni, Bertoni, Bodenmann, & Gagliardi, 2009; Ledermann et al., 2007). Dyadic coping shows analogies with other constructs relevant for relationship functioning, such as partner support, capitalization, and relationship awareness.

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Although dyadic coping requires both partners to be concerned with each other’s wellbeing and cannot be seen as a one-way flow of support provision to a single identified stress victim, thereby being conceptually distinct from partner support, recent developments of partner support theories have focused particular attention on the dynamic and dyadic nature of support and much research on dyadic coping and partner support has been highly intertwined.

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Also capitalization (i.e., the process of communicating the occurrence of positive events to intimate others, who can respond with supportive acts that maximize the benefits of the event; see Gable, Gonzaga, & Strachman, 2006) shares numerous features with the process of dyadic coping, but translated into the contest of positive events. The different individual and relationship goals of the two processes, however, argue for the distinction between capitalization and the construct of dyadic coping. Indeed, the relation between this two constructs deserves to be deeper investigated. Relationship awareness is defined as “a person’s focusing attention on a relationship or on interaction patterns, comparisons, or contrasts between partners in a relationship, including attending to the couple or relationship as an entity” (Acitelli & Badr, 2005, pp. 121-122). Dyadic coping relates to relationship awareness in that its expression requires a relational orientation, with partners understanding the stressful situation as our problem and “attending to the couple or relationship as an entity” (Acitelli & Badr, 2005; p. 122). Relationship awareness, however, can be considered both a prerequisite and a consequence of dyadic coping, since the capacity of partners to adopt a relational perspective can actually emerge from their interactions when facing a problem together. A recent attempt was made in order to integrate the different typologies of dyadic coping currently in use in the literature (e.g., supportive dyadic coping, common dyadic coping, active engagement, protective buffering) by positioning them along a continuum defined by the degree of involvement of the spouses in the coping process (Berg et al., 2008). Within this continuum Berg and colleagues introduced their concept of collaborative coping: Drawing from their study of collaborative problem-solving (Meegan & Berg, 2002) and within their socio-contextual approach to coping (Berg et al., 1998), they defined the construct of collaborative coping as “the active engagement of spouses in pooling resources and in joint problem-solving and coping” (Berg et al., 2008, p. 506). Collaborative strategies are the ones in which partners are both involved and share equal responsibility in actions and decision-making (Meegan & Berg, 2002) and are considered in contrast to uninvolved strategies (individual coping strategies in which partners act on their own), supportive strategies (instrumental or emotional supportive responses of the partner), and control strategies (overinvolvement of partner by dominating and telling the other what to do). Collaborative coping serves two major functions: a resource-enhancement function, through which partners activate shared resources that, especially in late adulthood, may function as a compensatory mechanism for partners’ reduced cognitive resources; and a relational function, by promoting relationship satisfaction. Moreover, the authors argued that the dyadic approach inherent in collaborative coping can be applied to any stressful event and also to other social units (e.g., parent-child relationship; Berg et al., 2007). This approach represents a useful effort toward the desirable integration of dyadic coping research (Revenson, Kayser, & Bodenmman 2005). Further work, however, is needed to take

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into account and integrate similarities as well as differences among the currently used conceptualizations of dyadic coping in order to reach consensus on its definition and operationalization.

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DYADIC COPING AND RELATIONSHIP FUNCTIONING The role of dyadic coping, in its different conceptualizations, for the couple’s functioning has been explored in numerous studies, proving that, when positive, dyadic coping has potential benefits for the well-being of the relationship as well as of the partners themselves. In particular, there is evidence that engaging in positive dyadic coping and support to the partner in times of stress significantly reduces partners’ experience of stress, enhances marital quality and partners’ psychological and physical well being, both in community couples (Badr, 2004; Bertoni et al., 2007; Bodenmann, 2000, 2005; Bodenmann, Atkins, Schar, & Poffet, 2010; Dehle, Larsen, & Larsen, 2001; Papp & Witt, 2010; Sullivan, Pasch, Johnson, & Bradbury, 2010; Vilchinsky et al., 2010) and in couples coping with a chronic illness (e.g., Acitelli & Badr, 2005; Badr, Carmack, Kashy, Cristofanilli, & Revenson, 2010; Berg et al., 2008; Hinnen, Hagedoorn, Ranchor, & Sandermann, 2008; Kayser, 2005; Rohrbaugh, Cranford, Shoham, Nicklas, Sonnega, & Coyne, 2002; Schokker et al., 2010; Zimmermann, Scott, & Heinrichs, 2010). For examples, in a study on couples coping with chronic illness, Berg and colleagues (Berg et al., 2008) assessed the association of dyadic coping with partners and couples’ wellbeing. They found that the ill spouse’s collaborative coping was positively associated with the healthy spouse’s well-being (in terms of positive mood). Perceptions of collaborative coping were associated with more same-day positive emotion for both husbands and wives and less same-day negative emotion for wives, these associations were in part mediated by perceptions of effectiveness in managing the stressor, especially for husbands. Bodenmann (1995b; 2000), in particular, found evidence for the relationship between dyadic coping, as defined within his theoretical framework, and marital satisfaction, whereby more positive forms of dyadic coping were associated with higher marital satisfaction whereas the inverse association was found for negative dyadic coping. A meta-analysis conducted across 13 studies (Bodenmann, 2005) provided evidence for this relationship (overall effect-size, d = 1.3). The association between Bodenmann’s dyadic coping and relationship quality and stability was also explored longitudinally over a 2 to 5-year period (Bodenmann & Cina, 1999, 2000, 2005; Bodenmann, Pihet, & Kayser, 2006). In particular, a 5-year longitudinal study (Bodenmann & Cina, 2000) was designed to investigate the effects of dyadic stress and dyadic coping on relationship quality and stability. Results highlighted that positive dyadic coping measured at Time 1 was a significant predictor of relationship quality 5 years later. Moreover, Time 1 dyadic coping (positive and negative) and dyadic stress, entered together in a discriminant function analysis, discriminated with 73% of accuracy between couples that remained stable in the 5 years and the ones that separated or divorced. The role of dyadic coping for relationship functioning was also recently tested in terms of its stress buffering effects on individuals’ experience and expression of negative emotions: Positive forms of dyadic coping were found to attenuate the impact of stress on individuals’

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anger and verbal aggression, especially when the level of stress they reported was low (Bodenmann, Meuwly, Bradbury, Gmelch, & Ledermann, 2010). Overall these findings suggest that when partners cope effectively as a unit against stressors and are prone to support each other in times of stress both their personal and couple well-being would increase. However, not always the use of dyadic coping can be beneficial to the relationship.

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THE NEGATIVE SIDE OF DYADIC COPING Sometimes, in fact, dyadic coping may benefit one partner more than the other or it may be enacted at the expenses of the individual’s well-being. Research on relationship-focused coping (Coyne & Smith, 1991) has shown that the use of protective buffering by wives was associated with enhanced self-efficacy for the husbands who suffered from myocardial infarction, whereas the same strategy used by husbands produced the opposite effect in their wives: The impact of both their own and their husbands protective buffering increased the wives’ distress. Dyadic coping efforts may have some costs for the individuals. Nevertheless, partners may choose to shoulder these costs if the other or the relationship is at stake. Coyne and Smith (1991), moreover, showed that the detrimental effects of husbands’ protective buffering on wives’ distress was limited to those couples that were less satisfied with their relationship and argued that in such couples men’s protective buffering was a kind of “antagonistic cooperation” (p. 410), in which this coping strategy was characterized by the overall negative tone of partners’ communication. More recently, in a sample of diabetes patients and their partners, protective buffering was found to be negatively associated with relationship satisfaction in both patients and partners, but only when levels of active engagement were relatively low (Schokker et al., 2010). Moreover, in a study of couples facing woman’s breast cancer, Badr and colleagues (Badr et al., 2010) found that common positive dyadic coping was associated with lower levels of distress in partners, but higher levels of distress in patients. In addition, the combination of positive common dyadic coping and common negative dyadic coping was predictive of both patients and partners’ dyadic adjustment. Beyond the negative side-effects of balancing individual and relational goals, Bodenmann’s theory distinguished among several forms of dyadic coping that are enacted with a negative, invalidating attitude. He also consistently found that negative dyadic coping was associated with lower marital satisfaction (Bodenmann, 1995b; 2000). Similarly, Manne and colleagues (Manne, Ostroff, Winkel, Grana, & Fox, 2005), in a study on couples coping with breast cancer, found that men’s ratings of unsupportive behaviors in response to the partner’s stress (a form of response that is similar to Bodenmann’s negative dyadic coping, including criticism for partner’s coping efforts and avoidance) predicted women’s distress through the mediation of women’s perceptions of partner’s behaviors as unsupportive.

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INTERPERSONAL PERCEPTIONS OF DYADIC COPING A fruitful line of research on dyadic coping has also recently started to investigate how dyadic coping interpersonal perceptions (i.e., the degree of congruence between partners’ perceptions) were linked to relationship functioning. This line of inquiry, quite new in dyadic coping research, relies on the abundant literature on partners’ interpersonal perceptions in other contexts (e.g., Acitelli, Kenny, & Weiner, 2001) as well as on studies specifically focused on partners’ support transactions investigating the role of the accuracy of partner’s perceptions, for example in terms of empathic accuracy (e.g., Verhofstad, Ickes, & Buysse, 2011) or appraisal detection bias (e.g., Kienle, Luszczynska, Pfüller, & Knoll, 2009). With regard to dyadic coping, Iafrate and colleagues (Iafrate, Bertoni, Margola, Cigoli, & Acitelli, 2010) investigated the role of several congruence measures about dyadic coping for couples’ satisfaction. In particular they analyzed each partner’s perceived similarity (i.e., how each partner perceives himself/herself similar to the other in dyadic coping), actual similarity (i.e., how partners actually report similar dyadic coping responses), and the couple bond, that is, the recognition of each partner’s coping efforts as measured at a couple level. Congruence measures were computed through an idiographic approach and two component of dyadic congruence were computed: Unique and stereotypical. The stereotypical component reflects partners’ stereotypical responding that may result from shared environmental influences (shared cultural background and social environment). The unique component, instead, reflects partners’ specific, idiosyncratic similarity. Stereotype was not considered as an error to be eliminated, but as a meaningful source of similarity in itself, in that dyadic congruence may comprise idiosyncratic as well as culturally shared aspects. Results showed that both partners’ relationship satisfaction was predicted by perceived similarity and couple bond, while neither women’s nor men’s actual similarity predicted relationship satisfaction. For both partners, couple bond had the strongest predictive power. Considering the unique component of partners’ congruence after stereotype adjustment, at least for women, the effect of perceived similarity remained significant and the one of couple bond resulted marginally significant. Another recent study examined perceived similarity and understanding (i.e., how partners report the other partner’s dyadic coping responses as compared to the other’s self-report), both unique and stereotypical, in young and mature couples (Iafrate, Bertoni, Donato, & Finkenauer, 2011). The authors found that perceived stereotypical similarity was higher in young couples than in mature couples and stereotypical and unique understanding were higher in mature couple relationships. Stereotypical understanding was positively associated with relationship quality, but only among mature couples. Unique understanding was not associated with relationship quality in mature couples, but it was negatively associated with relationship quality in young couples, probably because for young, less committed couples understanding of partner-specific ways of dyadic coping may contrast their need for idealization and therefore be experienced as relationship threatening. Overall these findings suggest the importance of interpersonal perceptions of dyadic coping, both in their stereotypical and unique components, for partners’ relationship satisfaction and the different role interpersonal perceptions play in couples facing different phases of their relationship.

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DETERMINANTS OF DYADIC COPING Despite the growing evidence that positive dyadic coping enhances marital quality and that negative forms of dyadic coping may undermine partner’s coping efforts and relationship functioning, still little research has been devoted to explore the potential determinants of dyadic coping and to isolate those factors that can foster or, on the contrary, impede the use of positive dyadic coping strategies. Available research, in particular, has focused primarily on individual and situational factors, such as personality traits and levels of distress or available resources.

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Personality O’Brien and DeLongis (1996) found evidence that both personality and situational factors were associated with empathic coping. However, on the whole the Big Five personality traits accounted for only 2% of the variance in empathic coping, whereas the social context of the stressor (in terms of stressors involving work problems vs. interpersonal problems with close others vs. interpersonal problems with distant others) accounted for 48% of the variance, and personality by context interaction accounted for an additional 4% of the variance. In particular, with regard to the association between empathic coping and neuroticism, a personality by context interaction emerged: People high in neuroticism were less likely to engage in empathic coping with close others than those low in neuroticism. Instead, those high in neuroticism, compared to those low in it, were more likely to use empathic coping when dealing with interpersonal stressors that involved distant others. The authors concluded that people high in neuroticism did not lack the ability to show empathy, but they did find it more difficult to engage in it when dealing with someone close, thereby responding in a way that is inappropriate to the demands of the situation. In a study on the situational and personality antecedents of empathic coping in stepfamilies Lee-Baggley and colleagues (Lee-Baggley, Preece, & DeLongis, 2005) found that partners were more likely to engage in relationship-focused coping when coping with marital conflict than when dealing with their children’s misbehavior. However, those high in extraversion were less likely than those low in extraversion to use relationship-focused coping with marital conflict, whereas the opposite was true for coping with child misbehavior. The authors interpreted these results in light of the dominant aspect of the extraverted people, which are more likely to emerge in egalitarian relationships, such as the couple relationship, than in more inherently hierarchical relationships, such as the parent-child one.

Stress Severity and Emotions Kramer and colleagues (Kramer, Ceschi, Van der Linden, & Bodenmann, 2005) found that people who experienced a trauma (e. g., a physical assault or a car accident), compared to controls, reported a general lack of dyadic coping with everyday stress. In particular, individuals who experienced a trauma reported to engage in less positive dyadic coping and more negative dyadic coping on a daily basis. Another study showed that high levels of

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distress or anxiety made people less prone to use empathic coping (Batson, Fultz, & Schoenrade, 1987). Similarly, Kramer (1993) found that low levels of distress and high levels of resources (e.g., income, network support) were associated with the use of positive relationship-focused strategies, whereas high levels of distress and low level of resources were linked to negative relationship-focused coping. However, O’Brien and colleagues (O’Brien, DeLongis, Pomaki, Puterman, & Zwicker, 2009) examined the meaning partners’ in stepfamilies attached to the stressors they encountered and found that when family stressors were considered of greater personal significance both husbands and wives in stepfamilies used more empathic responding. Moreover, negative emotions, like anger, have also proven to be detrimental to the use of positive dyadic coping: in a study on couples coping with one partner’s chronic obstructive pulmonary disease, Lane and Hobfoll (1992) found that patients’ anger and irritability predicted heightened spouses’ anger and less support from them over time. Julkunen and colleagues (Julkunen, Gustavsson-lillus, & Hietanen, 2009) found that, in couples coping with cancer, habitual inhibition of anger by both patients and partners had a negative impact on perceived partner’s support. Moreover, patient’s anger control (i.e., a constructive way of dealing with anger) was positively related to perceived partner’s support.

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Depression Partners’ level of depression has also shown to be associated with deficits in dyadic coping (Bodenmann, Charvoz, Widmer, & Bradbury, 2004): Depressed women, compared to controls, reported to communicate their stress less often than their partner and to engage in less positive dyadic coping; whereas depressed men, compared to their nondepressed counterparts, reported marginally more negative dyadic coping toward the partner. Furthermore, depressed people were found to rate their partner’s dyadic coping as more negative and less effective and satisfying (Bodenmann, Cina, & Schwerzmann, 2001). In contrast with these findings, however, a study on couples’ dealing with rheumatoid arthritis found a positive correlation between the patient’s level of depression and the amount of received spousal support (Revenson & Majerovitz, 1990). The authors argued that in this case the patient’s distress may have been interpreted by the partner as an understandable response to the disease. Only a few recent studies have focused on more distal precursors of dyadic coping, such us culture and partners’ families of origin.

Cultural Context Some studies have begun to explore cross-cultural differences in dyadic coping use and expression (Bertoni et al., 2007; Ledermann et al., 2007). For example, in a study comparing Italian and Swiss couples, Bertoni and colleagues (2007) found that Swiss couples used more common dyadic coping than Italian partners. Moreover, the cultural context moderated the relationship between relationship duration and dyadic coping: Only among Italian couples, older couples (with a relationship duration > 20 years) tended to use more negative dyadic coping than younger couples.

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Family of Origin A recent study (Donato, Iafrate, Bradbury, & Scabini, 2011) examined how the internalization of parental models of dyadic coping and reciprocity between partners influenced partners’ dyadic coping responses. In particular, the study investigated similarities in positive and negative dyadic coping responses between parents and their young-adult children as well as between partners. It was also examined whether parent–child similarities in dyadic coping varied as a function of child’s gender and of the type of dyadic coping model parents represented for their children (positive vs. negative). The study used an idiographic approach and distinguished between unique and stereotypical components of dyadic similarity. Findings showed evidence for both internalization of parental models and partner’s reciprocation. Differences were found for positive and negative dyadic coping: In positive dyadic coping only stereotypical parent–child similarities, but both unique and stereotypical partners’ similarities were significant. With negative dyadic coping, however, children internalized and reciprocated their parents’ and partners’ specific responses; stereotypical and unique similarities were in fact significant. Furthermore, similarities in negative dyadic coping were higher than those on positive dyadic coping, and daughters in particular were more similar to their parents in negative dyadic coping than were sons. In addition, children’s ability to discriminate between parental models influenced these processes. Daughters, in fact, were more similar to their parents the less parents engaged in negative dyadic coping. Sons, instead, did not show the same association with unique similarities. The authors argued that daughters may be more sensitive to the parental models than sons and more prone to reproduce them as long as they are less negative and more socially acceptable.

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CONCLUSION We would like to conclude this chapter by discussing some of the issues within this line of research that may deserve further theoretical and empirical attention. First of all, the theoretical model of dyadic coping, with its process involving both partners’ behaviors and perceptions, should be further analyzed. For example, in light of the research on partner support showing that enacted and perceived support only partially overlap (Coriell & Cohen, 1995) and the controversy about their specific role for the couple relationship (Hobfoll, 2009), the connection between enacted dyadic coping and perceived dyadic coping needs to be examined. Is perceived dyadic coping of one partner related to what the other partner actually does or does not in times of stress? And if so, how does this relate to relationship satisfaction? An attempt in this direction is represented by Donato and Parise’s work described in this book. Secondly, the process of dyadic coping has been fruitfully examined in the contest of critical life events as well as daily hassles, both concurrently and longitudinally. However, still little research has given a closer look on how this process is experienced in couples’ daily life and how daily dyadic coping exchanges affect partners’ individual and relational outcomes (for examples see Berg et al., 2008; O’Brien et al., 2009).

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Finally, the relationship between dyadic coping and other related constructs should be deeper investigated. Relationship scholars have recently called for the study of both positive and negative relationship processes to capture the role of close relationships for human functioning more broadly (Fincham and Beach, 2010). In the context of dyadic coping literature, we argue that couple relationship research could benefit from the investigation of those processes that couples activate when confronting both positive and negative events and even more so from the investigation of the connection between those processes. At this regard, the link between dyadic coping and capitalization deserves particular attention in that it would allow a more comprehensive account of couple’s exchanges in front of both positive and negative events. Dyadic coping represents a development in the stress and coping literature aimed at defining how coping occurs within the context of the couple relationship. Great attention has been devoted to the link between dyadic coping and partners and couples’ well-being as well as to some factors that could facilitate or inhibit partner’s dyadic coping, while other relevant issues remain to be examined in this expanding line of investigation.

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REFERENCES Acitelli, L. K., & Badr, H. (2005). My illness or our illness? Attending to the relationship when one partner is ill. In T. Revenson, K. Kayser, & G. Bodenmann (Eds.), Couples coping with stress: Emerging perspectives on dyadic coping (pp. 121-136). Washington, DC: American Psychological Association. Acitelli, L. K., Kenny, D. A., & Weiner, D. (2001). The importance of similarity and understanding of partners’ marital ideals to relationship satisfaction. Personal Relationships, 8, 167-185. Badr, H. (2004). Coping in marital dyads: A contextual perspective on the role of gender and health. Personal Relationships, 11, 197-211. Badr, H., Carmack, C. L., Kashy, D. A., Cristofanilli, M., & Revenson, T. A. (2010). Dyadic coping in metastatic breast cancer. Health Psychology, 29, 169-180. Barbarin, O. A., Hughes, D., & Chesler, M. A. (1985). Stress, coping, and marital functioning among partners of children with cancer. Journal of Marriage and the Family, 47, 473480. Barnoy, S., Bar-tal, Y., & Zisser, B. (2006). Correspondence in informational coping styles: How important is it for cancer patients and their spouses? Personality and Individual Differences, 41, 105–115. Batson, C. D., Fultz, J., & Schoenrade, J. (1987). Adults’ emotional reactions to the distress of others. In N. Eisenberg & J. Strayer (Eds.), Empathy and its development (pp. 163184). New York: Cambridge University Press. Berg, C. A., Meegan, S. P., & Deviney, F. P. (1998). A social contextual model of coping with everyday problems across the life span. International Journal of Behavioral Development, 22, 239-261. Berg, C. A., & Upchurch, R. (2007). A social contextual model of couples coping with chronic illness across the adult life span. Psychological Bullettin, 133, 920-954.

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In: Handbook of the Psychology of Coping Editors: Bernando Molinelli and Valentino Grimaldo

ISBN: 978-1-62081-464-2 © 2012 Nova Science Publishers, Inc.

Chapter 6

FLOW AS A WAY OF COPING – A QUALITATIVE STUDY OF THE METACOGNITIONS OF FLOW Edith E. Wilson and Giovanni B. Moneta School of Psychology, London Metropolitan University, UK

ABSTRACT

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Background Flow is a state of intense task absorption and cognitive efficiency. Flow has been reported to occur during various everyday activities such as sports and leisure, but also during work. Being in flow has been found to be associated with achievement in different domains (e.g., Bakker et al., 2011; Jackson & Roberts, 1992; Schüler & Brunner, 2009) and has also been linked to adaptive approaches to studying during academic examination preparation (Cermakova, Moneta, & Spada, 2010). More recently, the importance of investigating the “metacognitions of flow” -- i.e., self-regulatory aspects of the flow state -- has been raised (Moneta, in press a). Metacognitions of flow encompass people’s awareness and beliefs about flow, including awareness of flow as a state that fosters performance and the measures taken to create and maintain flow when necessary. Flow theory posits that this state is more likely to occur during perceived highdemand situations. As identified by Lazarus and Folkman (1984), people can employ different cognitive or behavioural processes to deal or cope with stressful situations. Given the potential for flow to be self-regulated, being in flow could be theorised as an adaptive way of coping in demanding situations. Beer and Moneta (in press a) were the first to provide empirical evidence for the adaptive effects of wider, non-flow specific, positive metacognitions on coping. This study focuses on whether people actively use the flow state as a way of coping with demanding situations, and, in particular, explores flow specific metacognitions; i.e., people’s awareness of the flow-achievement link, the beliefs people hold about actively making the flow state happen and wider beliefs about flow.

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Method Flow Questionnaires of a sample of 371 workers from various UK organisations were analysed for their qualitative content on questions relating to the activity they were engaged in when experiencing flow, how the flow state started, how it felt during the activity, and how they kept the flow state going. In addition, semi-structured interviews were held with 13 highly educated workers.

Results and Conclusion Although the majority of activities during which flow occurred were not situations of extreme demands, and hence did not give rise to coping efforts, a select number of respondents, particularly those with high job responsibility such as surgeons and other medical staff, reported flow during stressful and demanding work related activities. Their accounts provided initial evidence that being in flow helped them to cope with difficult situations and made them perform at their best. Given that participants were not specifically prompted to reflect on flow as a way of coping, this finding is particularly interesting. In addition, flow specific metacognitions, including people’s awareness of the flow-achievement link, were found. The potential for practical application -- i.e., interventions to foster adaptive coping with demanding situations, especially in high performance work environments -- is outlined. The need for further research in this area, in particular the development of a measure for flow specific metacognitions, is discussed.

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1. INTRODUCTION This chapter is divided into three broad sections. In the first, we give a succinct overview of the background and advancements in flow research, the flow concept, its origins, recent developments in terms of its measurement, and selected empirical evidence. This is followed by a brief overview of theories on metacognition and introduction of a new construct - flow specific metacognitions which are characterised by an awareness of the self-regulation of flow experiences. Based on the qualitative Flow Questionnaire and interview data, initial evidence is provided. The final section discusses flow as a way of coping during stressful encounters.

2. FLOW When he reads a book he does not merely see the words, the characters come alive. He is completely absorbed by the story which captures his full attention. He is devouring the book 1 page by page. Hours pass without him noticing. He is in flow.

Flow is a state of deep cognitive absorption in an activity accompanied by intrinsic enjoyment. It is a state which has often been described as one in which “nothing else seems to matter” (Csikszentmihalyi, 1990, p.4). The origins of flow theory are well documented and 1

This example was developed by the authors.

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lead back to Mihaly Csikszentmihalyi’s seminal studies published in the mid-1970s, when his interviews with composers, chess players, rock climbers and others led to the discovery of flow (Csikszentmihalyi, 1975; Getzels & Csikszentmihalyi, 1976). Csikszentmihalyi recognised that external rewards meant little to his interviewees. It was the experience of losing themselves in their chosen activity, enjoying their skills, and striving for higher levels of mastery that made them continue with the activity, without feeling hunger or tiredness. Later, Csikszentmihalyi (1996) conducted further interviews with individuals who had all produced remarkable achievements in their lives. Although their areas of expertise where very different, they appeared to have had one feature in common – experiencing flow was at the core of their utmost breakthroughs. From the initial discovery of flow, a broad theory of the flow construct emerged. Flow was initially operationalised as an optimal state during an activity, which required a balance between the challenges or demands of the activity and the individual’s skills. This balance made the person focus all his or her mental energy on the activity, losing any selfconsciousness otherwise experienced. Over the years, the flow model was based on increasing research evidence built upon and refined. The most recent model identified nine key characteristics of the experience which included focused attention/concentration, merging of action and awareness, loss of self-consciousness, sense of control, unambiguous feedback, autotelic experience, balance between challenges and skills, clarity of goals, and loss of time awareness (Csikszentmihalyi, 1975/2000; Jackson & Csikszentmihalyi, 1999). Although these components provided a more comprehensive definition of flow, operationalising and measuring the flow experience has not been straightforward. In addition to conducting interviews, alternative methods were sought to quantify the flow experience, such as the Flow Questionnaire (Csikszentmihalyi & Csikszentmihalyi, 1988), which measures the occurrence of flow and the activities during which flow happens. It also asks open ended questions about the flow state (e.g., how does flow start, what keeps it going, etc.) and numerical measures about how one feels in the flow state. More recently, other scales for measuring flow have been developed; e.g., the flow state and dispositional flow scales (Jackson & Eklund, 2002, 2004); Work Related Flow inventory (Bakker, 2008); the Flow Short Scale – a succinct measure comprising 10 items by Engeser and Rheinberg (2008); and a scale, measuring flow proneness (Ullén et al., 2012). An innovative way of measuring flow as it occurs in everyday life activities, the Experience Sampling Method, was developed by Csikszentmihalyi and Larson (1987). Here, participants are required to complete a short measure describing the characteristics of their current activity and their subjective experience prompted by electronic signals throughout the day; e.g., generated by a pager or watch. For a comprehensive discussion of these tools and their strengths and weaknesses, see Moneta (in press a). Many of us may have been so engrossed in an activity, perhaps whilst studying, playing sports, or engaging in other actives, that we were completely oblivious to what was going on around us. Therefore, it is not surprising that flow is universally recognised across people from different cultures, gender, and all ages (e.g., Delle Fave & Massimini, 1988, 2003, Moneta, 2004a). Yet not everyone experiences flow, nor do we all experience flow during the same activities. Among a recent sample of Japanese students, it was found that just over 27% never experienced flow (Asakawa, 2010). This is commensurate with findings presented later in this chapter, where approximately 30% of a worker sample did not recall having ever experienced flow. Earlier studies are somewhat more optimistic, reporting findings of

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between 12% and 15% of people who do not recognize the flow state (Noelle-Neumann, 1995; Csikszentmihalyi, 1997). There could be a number of reasons as to why some people experience flow to a lesser extent than others, or do not experience flow at all. For example, individual differences can go some way in explaining this. Csikszentmihalyi postulated that some people are more prone to experience flow than others because they have an “autotelic personality” (Csikszentmihalyi, 1975/2000), which was described as encompassing the following competencies: “a general curiosity in life, persistence, low self-centeredness, which results in the ability to be motivated by intrinsic rewards” (Nakamura & Csikszentmihalyi, 2005, p. 93). As suggested by Rathunde (1988), the development of an autotelic personality is fostered by a “complex” family environment of challenge and support. A recent study which investigated the propensity to experience flow in relation to personality and intelligence found that neuroticism was negatively related to flow proneness whilst conscientiousness showed a positive relationship. Intelligence, however, was not found to be linked to flow proneness (Ullén et al., 2012). Teng (2011) found empirical support for explaining differences in the likelihood of experiencing flow with regard to character and temperament. In addition to individual differences, the characteristics of the task can also alleviate the flow experience. Particularly, structured tasks that provide two of the key characteristics of the flow experience; i.e., “unambiguous feedback” and “clear proximal goals”, can facilitate getting into flow (Jackson & Csikszentmihalyi, 1999). Although flow research has seen a steady interest, not just due to the advent of the positive psychology movement (e.g., Seligman & Csikszentmihalyi, 2000), people’s beliefs and awareness of the flow state -- i.e., flow specific metacognitions, which could add to our understanding of individual differences -- to date have not been researched. In particular, we were interested to understand if flow is something that “just happens to you” or if people feel that they are the origin of their flow experiences, in the sense of personal causation as described by deCharms (1968). A sense of “ownership” of one’s flow experiences may have important implications for motivation and performance, particularly in work environments. Flow specific metacognitions are being introduced in the next part of this chapter.

3. METACOGNITION “Metacognition refers to the psychological structures, knowledge, events and processes that are involved in the control, modification and interpretation of thinking itself.” (Wells & Cartwright-Hatton, 2004, p.386). The study of metacognitions is traditionally more associated with the areas of cognitive psychology and developmental psychology (e.g., Nelson & Narens, 1990; Flavell, 1979; for an overview see Perfect & Schwartz, 2002). It has also found applications in educational (Maki & McGuire, 2002), clinical (e.g., Wells & Matthews, 1994, 1996), and most recently, positive psychology (Beer & Moneta, 2010).

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3.1. Maladaptive Metacognitions

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In the clinical context, Wells and Matthews (1994) produced a theoretical framework of the function of maladaptive metacognitions in the persistence of mental disorder. The model describes metacognitive factors as “components of information processing involved in the development and persistence of psychological disturbance. A basic tenet of this approach is that beliefs in psychological disorder consist of a metacognitive component that guides the activity of thinking and coping.” (Wells & Cartwright-Hatton, 2004, p. 386). Wells and coworkers found metacognitions to be associated with a number of disorders including obsessive-compulsive disorder, generalised anxiety disorder, and problem drinking (e.g., Wells, 2000; Solem et al., 2009, Spada & Wells, 2010). Maladaptive metacognitions are measured via the Meta-Cognitions Questionnaire (MCQ; Cartwright-Hatton & Wells, 1997) or its brief version, the MCQ-30 (Wells & CartwrightHatton, 2004). This self-report questionnaire measures maladaptive metacognitions along five factors: cognitive confidence (e.g., “I do not trust my memory”); positive beliefs about worry (e.g., “Worrying helps me cope”); cognitive self-consciousness (e.g., “I think a lot about my thoughts”); negative beliefs about worry concerning uncontrollability and danger (e.g., “I cannot ignore my worrying thoughts”); and beliefs about the need to control thoughts (e.g., “I should be in control of my thoughts all of the time”). Although the model was initially clinically oriented, it has since been tested on a number of non-clinical worker and student samples. Meaningful associations were found between maladaptive metacognitions, perceived stress, and negative emotions (Spada, Nikčević, Moneta, & Wells, 2008); problematic internet use (Spada, Langston, Nikčević, & Moneta, 2008); and negative emotions and alcohol dependence among college-students (Moneta, 2011). It was also found that maladaptive metacognitions fostered depression and anxiety in a non-clinical sample (Spada, Mohiyeddini, & Wells, 2008).

3.2. Adaptive Metacognitions The positive psychology movement (Seligman & Csikszentmihalyi, 2000) has taught us to shift the focus from the negative to the positive aspects of human life and to investigate what makes people flourish. So perhaps maladaptive metacognitions do not provide the full story. Indeed, preliminary research has shown that this seems to be the case. Beer and Moneta (2010) were the first to provide empirical evidence for so-called adaptive metacognitions. Their “kernel theory” of positive metacognitions and meta-emotions (see also Beer & Moneta, in press a, in press b) postulates that adaptive metacognitions can be simultaneously activated alongside maladaptive metacognitions during challenging situations. Beer and Moneta developed a new measure of positive metacognitions and emotions. This was based on a set of interviews with highly self-regulated people who were asked to describe how they had overcome challenging situations (Beer & Moneta, 2010, in press b). The Positive Metacognitions and Emotions Questionnaire (PMCEQ) measures adaptive metacognitions along three dimensions: (1) confidence in extinguishing perseverative thoughts and emotions; (2) confidence in interpreting own emotions as cues, restraining from immediate reaction, and mind setting for problem solving; and (3) confidence in setting flexible and feasible hierarchies of goals. The scale was shown to have good construct

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validity and correlated meaningfully with intrinsic motivation and with Wells and CartwrightHatton’s (2004) maladaptive metacognitive traits. Given that the concept of adaptive metacognitions is still very recent, it is not unexpected that evidence on a potential link between (adaptive) coping and positive metacognitions is scarce. However, an initial study on a mixed worker and student sample provided promising results. Beer and Moneta (in press a) hypothesised that adaptive metacognitions, specifically “confidence in extinguishing perseverative thoughts”, which was described as the antithesis to Well’s maladaptive metacognitions, would correlate negatively with maladaptive coping (i.e., denial, substance use, behavioural disengagement, and self-distraction) and perceived stress. The data supported this assumption. In addition, their second broad factor of positive metacognitions, which includes “confidence in interpreting own emotions as cues”, “restraining from immediate action”, and “mind setting for problem solving” was found to correlate positively with adaptive coping strategies, whereas none of the maladaptive metacognitive factors correlated with adaptive coping strategies. Overall, their study confirmed that the absence of maladaptive metacognitions was not sufficient to explain adaptive coping strategies, and that adaptive metacognitions played an important role in adaptive coping, independent of maladaptive metacognitions.

3.3. Flow Specific Metacognitions

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In its essence, flow is a cognitive state of deep absorption. However, to date, the metacognitions of flow, which encompass the beliefs people hold about the flow state, cognitive monitoring, and strategies to achieve flow have not been researched. That cognitive self-regulation is an intrinsic part of flow theory is evident when reading the following excerpts by Nakamura and Csikszentmihalyi (2005). These highlight the process of monitoring and control of cognition while being in flow. “Being ‘in flow’ is the way that some interviewees described the subjective experience of engaging just-manageable challenges by tackling a series of goals, continuously processing feedback about progress, and adjusting action based on this feedback.” (…) “Experiencing anxiety or boredom presses a person to adjust his or her level of skill and/or challenge in order to escape the aversive state and reenter flow” (p.90)

Moneta (in press a) stressed the importance of investigating both positive metacognitions, in particular the correct interpretation of emotions as cues, and flexible goal restructuring during challenging situations, as identified by Beer and Moneta (2010), and flow specific metacognitions. To date, these have neither been conceptualised nor measured. Also, given that a number of studies have provided evidence for a link between flow and achievement in a variety of areas, it is not clear if people are aware of this link and also, if they actively employ flow as a strategy to further their performance. At this initial stage, we define flow specific metacognitions as people’s awareness of and beliefs on the flow state, its consequences, and strategies for achieving and maintaining flow.

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4. A QUALITATIVE STUDY OF FLOW SPECIFIC METACOGNITIONS Do people possess flow specific metacognitions? In order to shed light on this potentially important area, we set out to investigate the following questions: 

 

Do people possess flow specific metacognitions? In particular, do people show an awareness of the potential usefulness of flow in certain situations (flow-achievement link)? Is flow an experience that happens “randomly” or do people believe that they can make flow happen when required? Do people hold any other beliefs about the conditions in which they can experience flow?

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4.1. Methodology The data used for the analysis was comprised of a convenience sample of 371 highly educated British workers who completed the Flow Questionnaire (Csikszentmihalyi & Csikszentmihalyi, 1988). The distribution of male (46%) and female (50%) workers was approximately equal (4% of this information was missing). The large majority was white (81%); just over 5% were Indian; and the remainder was made up of black, Chinese, mixed, and other ethnic origins. Approximately 93% held a postgraduate degree and all had an undergraduate degree. The sample included a wide variety of job types, the largest being managers (23%). 84% worked full-time, the remainder part-time. The Flow Questionnaire queried participants if they recognised two distinct quotes which describe the flow state. These quotes were adapted by Moneta (2010) to represent qualitatively different nuances of flow, labelled shallow (Flow 1), where the flow state is less intense, and deep flow (Flow 2) respectively, where the person is in a state of more complete absorption. “My mind isn’t wandering. I am totally involved in what I am doing and I am not thinking of anything else. My body feels good … the world seems to be cut off from me … I am less aware of myself and my problems.” (Flow 1) “I am really quite oblivious to my surroundings after I really get going in this activity. I think that the phone could ring, and the doorbell could ring, or the house burn (sic) down or something like that… . Once I stop I can let it back again.” (Flow 2)

The following open-ended questions, asked by the Flow Questionnaire for both deep and shallow flow, were deemed most likely to provide evidence for flow specific metacognitions: “When does it happen during the activity?”; “How does it feel?”; “How does this feeling get started?”; “What do you do to get it started?”; “Can it happen anywhere, anytime?”; and “What keeps it going once it starts?”. These questions were asked for both definitions of flow separately. Respondents were free to describe flow experiences during everyday activities, including, but not restricted to, work. We used the Flow Questionnaire because its questions are opened-ended, broad, and are not leading with regards to people’s reflections on cognitive processes involved in flow

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experiences. This is both a strength and a weakness of this methodology, albeit justified by its exploratory character. Participants were not specifically prompted to reflect on their flow specific metacognitions and were, therefore, able to describe a wide range of flow experiences including metacognitive insights. The data was coded into broader themes based on thematic analysis (e.g., Braun & Clarke, 2006). The approach to coding was not guided by identifying the themes most commonly mentioned, but rather by coding those themes that would, informed by the literature on metacognition and flow theory, shed light on flow specific metacognitions. In addition, qualitative interviews were conducted with a sample of 13 highly educated workers of various ages, employed by a UK organisation, providing management and leadership training. Participants volunteered to be part of a wider study on well-being at the workplace. The semi-structured interviews focused on the interviewees’ flow experiences at work which were prompted by the above detailed quotes (Flow 1 and Flow 2). Additional questions were asked about the strategies they employed to achieve and maintain flow (“Do you do anything to get into this state, to stay in this state, to end this state?”); their feelings prior to and during flow (“Before you get into flow, how do you feel?”; “When you are in flow, how does it feel?”); and more general, beliefs about the possible adaptive and maladaptive functions of being in flow (“Is there anything ‘good’/’bad’ about flow?”). Based on these two data sources, we will describe the identified flow specific metacognitions; i.e.:  

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

Belief that one is being able to create flow and awareness of its conditions; Awareness of the link between flow and achievement; i.e., the usefulness of being in flow; Other beliefs about the flow process; i.e., positive emotions and pressure as a flow conducive condition.

4.2. Findings on Flow Specific Metacognitions The majority of people (just over 70%), who completed the Flow Questionnaires, reported having flow, either during work or leisure. Therefore, they recognised the cognitive process that is flow, and which we argue, can be interpreted as an elementary level of awareness of the flow state. Although some of these people were able to give vivid accounts of their flow experiences, a considerable number of respondents (approximately 30% of the total) stated that they did not recognise either of the two definitions of flow. As mentioned previously, this is slightly higher compared to earlier studies but is similar to Asakawa (2010). All of the 13 interviewed workers recognised the flow state and most had experienced it at work. However, the analysis also revealed a qualitative difference in terms of the self-regulation of the experience for those who do recognise flow. A number of participants appear to actively seek and “create” flow for themselves, such as choosing or creating a flow conducive environment (e.g., “I order the things I need around me, prepare my computer and start looking at my notes and do not do anything else. I even ignore desk or mobile phone. I put on headphones and play music.” Manager – flow at work; “This can happen only in particular

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places and especially when I'm not very tired.” Editor – flow at work). A similar finding had been reported by Massimini, Csikszentmihalyi, and Delle Fave (1988) who had recognised the importance of the environment for facilitating flow experiences: “A favourable environment seems important, especially for activities that could be easily interrupted by outside distractions, such as intellectual endeavours like reading or studying.” (p. 69). Also, some of the interviewees recognised that a particular environment, not necessarily their workplace, was conducive to experiencing flow. Others describe how they engaged in cognitive self-regulation (How does it get started? “need to make a conscious decision to concentrate on something”; What keeps it going? “not sure, but occasionally I'll consciously realise I'm in danger of losing it so I focus on concentrating harder”, administrator – flow at work; “my own drive and determination” keeps flow going, “I motivate myself too by setting targets within the work I am doing …”, manager – flow at work). It appears that some people are aware of the conditions of flow and can make flow happen. For others, flow appeared to be more “random” (e.g., “just happens without any specific action”, manager – flow at work; “I am not aware at the time, it's more a feeling of having been focused enough to have achieved what I needed to, but really this is more of a reflection after the event”, manager – flow at work; “I don't consciously notice it, but am aware of a 'high' and afterwards I am buzzing”, teacher – flow at work). We were particularly interested to determine if people showed an awareness (metacognition) of the potential usefulness of being flow in special situations (such as when under particular pressure at work, or other situations where a state of deep concentration and cognitive efficiency is required). The following quote explains very well, how the respondent is aware of the usefulness of being in flow for getting the job done: “I tend to stop when the inspiration fades out. But the experience learned me (sic) to continue and finish the job.” (Administrator - flow at work). Also, examples from two interviewees about their reflections on the timing of their flow experiences at work illustrate their awareness of the usefulness of this state: “When I need to enter a creative or operation phase like writing a report or thinking about the next thing to do or pulling things together, then I can really concentrate, or when I’m sorting out a problem … For me it’s when I make my breakthroughs. It’s when I move things to a shaped level.” (Manager – flow at work). “Once you are in it, when you’ve started the flow, there is something like, yes I can do this and I can get through it and you can actually see an end” (Manager – flow at work).

Others showed awareness that while in flow, they are able to increase their task focus, make connections, and generate various ideas. When does it happen during the activity? “For me, it's normally when I'm on my own, sat at the computer, often with no idea of what I will produce, once I start to draw, the ideas just flow, and then I can create, and it feels great. Once I start getting ideas, they run and run, turning into other things, I often find I have too many ideas to capture them all and sometimes feel like I could sit there forever just churning them out! I have to stop to sleep” (artist – flow at work). When does it happen during the activity? “The most intense moments are after I've settled into the work, found my feet and managed to hold the problem at hand completely in my head. Then when you let your mind wander around the topic, you start to make connections with other things” (IT specialist – flow at work).

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There is also preliminary evidence that respondents hold both positive and negative beliefs about the importance of deadlines or external pressure for achieving the flow state. For some, pressure seems to be a necessary condition, as the following accounts show: “I tend to let others into my work too much, and the 'things are going well' feeling comes as deadlines and urgency approach, and I ignore interruptions from others” (manager – flow at work); “I would need to feel challenged and absorbed, so that my mind is working quickly to keep solving problems, keep performing better. It is partly a response to pressure. I don't often find the same flow if I am not being asked to perform” (writer – flow at work); What keeps it going? “If it is a high pressure, stressful environment then it keeps going” (consultant – flow at work). While for some, pressure appears to be a necessary condition, for others, this can be detrimental to achieving flow: How does it feel? “Ok, unless there are time pressures, this feels stressful” (technician – flow at work); When does it happen? “Usually happens when I am relaxed and there is no pressure on me and when I am happy” (consultant – flow in leisure). Lastly and linked to this point, is also the awareness that positive emotions can be a key characteristic of the flow experience, “…a good feeling which is also highly satisfying”, which can facilitate (e.g., “It doesn't always happen. Need to be in the right frame of mind.” Manager – flow at work) and sustain flow (“Staying positive and enjoyment in what I am doing.” Consultant – flow at work). The link between positive emotions and flow is well documented (e.g., Massimini et al., 1988). We, however, are arguing that explicit awareness of these emotions describes a flow specific metacognition. Based on a preliminary study, this part of the chapter presented some initial evidence on a number of potential, flow specific metacognitions. However, it should be noted that we do not claim to have comprehensively captured the full range of flow specific metacognitions there might be. We also found that a particular group of workers, (surgeons and medical staff) appear to utilise the flow experience as a way of coping with difficult situations. This is described separately in the next section.

5. FLOW AND COPING The previous part introduced a new concept, flow specific metacognitions based on qualitative examples. This section focuses on another aspect of the flow experience that to date, has received very little attention – flow as a way of coping with difficult or stressful situations. As discussed earlier, appraising a situation or activity as challenging is one of the key components of flow experiences (Jackson & Csikszentmihalyi, 1999). In order to provide optimal conditions to experience flow, challenges ideally slightly outweigh the level of skills, without exceeding the skills to such an extent that it would lead to anxiety (Moneta, 2004b). Previous research has shown that flow does not only occur during leisure, but also that experiencing flow can lead to enhanced performance when more is at stake, such as at work, study, or professional sports (e.g., Bakker, Oerlemans, Demerouti, Bruins Slot, & Karamat Ali, 2011; Engeser & Rheinberg, 2008; Jackson & Roberts, 1992). Flow was also linked to adaptive approaches to studying during academic examination preparation (Cermakova, Moneta, & Spada, 2010). Given that flow has the potential to foster performance, we suggest

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that people who are under pressure to achieve or to perform at their best may actively or strategically use flow to cope with this challenge. Along similar lines, Weimar (2005) suggested, that flow can, in addition to being the outcome of the coping process, also be a way of coping. Evaluating a situation as challenging is one part of a cognitive appraisal process. As described by Lazarus and Folkman (1984), this includes primary appraisal, secondary appraisal, and reappraisal (i.e. re-evaluating one’s appraisal based on new information). Primary appraisal refers to a person’s evaluation of a situation as being “irrelevant”, “benignpositive”, or “stressful”, depending on the level of demand experienced. Only situations appraised as stressful require further attention as these may have harmful effects on one’s current or future welfare. Stress appraisals can take the form of harm/loss, threat, or challenge appraisals. Whilst both harm/loss and threat appraisal are characterised by negative consequences for the person, such as death or injury, appraising a stressful situation as challenging can have positive consequences, and goes hand in hand with emotions of “eagerness, excitement, and exhilaration” (p.33). Not only the situation, but also “the person's beliefs about the potential for mastery" (Lazarus & Launier, 1978, p. 304) can influence appraisal. The flow experience provides this “potential for mastery”, where one is able to stretch one’s skills to match the demands of the situation, leading to ever increasing levels of competency. Csikszentmihalyi (1990) highlighted that flow experiences can transform potentially stressful events into intrinsically rewarding experiences. For example, it was suggested that flow can act as a “buffer” from the negative consequences of stress on managers’ health (Csikszentmihalyi, 1993). Logan (1988) described flow as a way of coping with solitary ordeals by seeking out activities that can create flow to overcome hardships during extreme events such as captivity or isolation. The way we appraise a stressful situation and the actions we take determine the outcome of this event. Selye (e.g., 1973, 1974) was the first to highlight the adaptive function of stress. He recognised that a stressor can evoke both negative and positive affective responses. He drew a distinction between “distress”, or what we usually understand by the negatively connotated word “stress”, and “eustress”. Eustress is “a positive psychological response to a stressor as indicated by the presence of positive psychological states” (McGowan, Gardener, & Fletcher, 2006, p. 93). Challenge appraisal and task focused coping were found to be antecedents of eustress, whilst distress was more likely to be associated with threat appraisal and emotion focused coping (McGowan et al., 2006). There is a marked similarity between eustress and flow. However, we argue that, although they are related, they are not the same. Flow goes far beyond a positive affective state arising from a stressful event. Both flow and eustress may be more likely to arise from challenge appraisal and task focused coping. However, a stressful event is not a necessary condition for flow experiences, but it is for eustress. “Eustress is not simply the result of a positive experience with positive events. It arises from effective negotiation of the stress process rather than a process of passive savouring” (McGowan et al., 2006, p. 93). Secondary appraisal is concerned with evaluating the options in response to the perceived demand. Lazarus and Folkman (1984) define coping “as constantly changing cognitive and behavioural efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person.” (p.141). We argue that one of these options can be flow; i.e., the situation is being perceived as challenging and there is a belief that being in flow, a state of deep concentration, can aid to overcome this challenge. Early on, Lazarus,

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Kanner, and Folkman (1980), acknowledged the role flow can play during the coping process. They referred to flow as an emotion which helped people keep going during the coping process, or as they described it, flow acted as a “sustainer of coping”. “What has recently been referred to as “flow” (see Csikszentmihalyi, 1976; Furlong, 1976) appears to be an extremely pleasurable, sustaining emotion that arises when one is totally immersed in an activity and is utilizing one’s resources at peak efficiency. (…) Although the experience of flow is characterized by a feeling of effortlessness, it occurs at times when great coping effort is usually required and during these times serves as a powerful sustainer of coping. (Lazarus et al., 1980, p.209).

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Two types of coping, approach and avoidance coping, appear to have particular relevance in the context of flow research. Zuckerman and Gagne (2003) described the main characteristics of approach coping as, taking action to overcome a problem (e.g., “I take direct action to get around the problem”); planning (e.g., “I make a plan of action”); and suppressing competing activities (e.g., “I try hard to prevent other things from interfering with my efforts at dealing with this”) (Zuckerman & Gagne, 2003, p. 177). In contrast, avoidance coping refers to denial (e.g., “I refuse to believe that it has happened”); behavioural disengagement (e.g., “I admit to myself that I can’t deal with it, and quit trying”); mental disengagement (e.g., “I try to forget the whole thing”); and refusal to admit self-blame and instead blaming others (e.g., “I accuse someone of causing my misfortune”) (Zuckerman & Gagne, 2003, p. 177). In particular, “mental disengagement” as a maladaptive way of coping seems to be relevant in the context of flow. It is easily conceivable that the complete absorption in an activity helps to forget and escape. This is similar to what Lazarus et al. (1980) describe as “breathers” from stress; i.e., “to engage in pleasurable diversionary activity” and to “free oneself temporarily from a stressful experience” (p.208). A quote by one of Csikszentmihalyi and Csikszentmihalyi (1988) interviewees illustrates this “escapist flow” clearly: “Sometimes on court I think of a problem, like fighting with my steady girl, and I think that’s nothing compared to the game. You can think about a problem all day, but as soon as you get in the game, the hell with it!” (Csikszentmihalyi & Csikszentmihalyi, 1988, p.33)

Arguably more interesting is the potential link between flow and adaptive coping. Tackling the problem head-on by focusing on the task at hand and blocking out other activities are both features of adaptive coping strategies and the flow experience. Asakawa (2010) briefly touched on this subject in a study which looked at the characteristics of the autotelic personality based on a sample of Japanese college students. It was found that those students who experienced flow more frequently in their daily lives, and were therefore described as being more autotelic, were also more likely to employ problem-focused or emotion-focused coping strategies and less likely to engage in maladaptive coping, characterised by problem avoidance. Yet, as Moneta (in press b) highlighted, the reverse could also be true and the use of more adaptive coping strategies (which among other characteristics, includes the suppression of competing activities) may facilitate experiencing flow. However, we argue that being in flow can in itself be an adaptive way of coping with a difficult situation. A person may get into flow in order to master the situation. Some pre-

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liminary evidence supports this argument. The qualitative extracts from the mixed professions sample used in the previous analysis also included completed Flow Questionnaires of 47 medical staff and surgeons, just under half (22 people) reported having flow at work. Interestingly, the descriptions of their flow experiences stood out from the rest of the sample, both by the remarkable similarity of their accounts, but also by the circumstance that just under half of these described experiencing flow during demanding or stressful work related situations, such as carrying out surgery or having to deal with difficult patient consultations. The other half experienced flow mainly during therapy sessions or more routine treatments or assessments. Early on in flow research the work of surgeons had been identified as particularly prone to flow, especially when the circumstances were right. The intensity of flow during surgery was compared to the one experienced by artists and sportsmen (Csikszentmihalyi & Csikszentmihalyi, 1975). It is, therefore, unsurprising that the surgeons and medical staff in this sample also showed an acute awareness of the flow state. Despite flow being characterised as enjoyable, the medical staff showed signs that they appraised the situation as stressful or challenging. They vividly described a range of negative physical symptoms and emotions when in flow. Some experienced a state of anxiety, with the accompanying physical symptoms of sweating and increased heart rate (e.g., “high anxiety and increased heart rate and intense”; “It feels like my heart beats faster and my hands become a bit sweaty!”; “I feel a sense of empathy, anxiety and a real need to problem solve”). Whilst one described the feeling as “exhilarating” and another described his state just before an operation as being “clam”. This could be attributed to their different levels of expertise or experience. However, some may always experience a level of anxiety before performing an operation, similar to the emotions of a boxer before a big fight or an actor just before entering the stage. This is also supported by the transactional model of stress, as it was hypothesised, that situations can elicit both threat and challenge appraisals and can “shift” between the two; as Lazarus and Folkman (1984) comment, “threat and challenge appraisals are not mutually exclusive” (p.33). However, Csikszentmihalyi and Csikszentmihalyi (1975) argued that emergencies produce “tension and anxiety” which eliminate flow during the operation. “But at any moment a routine operation with few opportunities may change into a challenging situation that produces flow, or into an emergency that produces tension and anxiety, if a new problem is uncovered, a patient’s body reacts in an unexpected way, or a member of the operating team fails to act appropriately.” (Csikszentmihalyi & Csikszentmihalyi, 1975, p.127).

Despite their emotions and physical symptoms, the medical staff seemed to be getting into flow almost automatically (“In my fingers and head and I bring my focus onto the task like being sucked into a television.” “The feeling gets started physically through my heart beat and stomach and then somewhat directs my thought processes. To get it started I focus my gaze and my hearing directly on the people involved.”; “It is a spontaneous feeling that starts as soon as I am 'in action'.”) This could partly be explained by the extensive training they undergo or by the flow proneness of the task they complete. Further, their accounts emphasised their beliefs about the usefulness, and perhaps inevitability of, the need to be in flow to perform their job as best they can and to deal with a difficult situation. As one surgeon commented, flow is kept going by “the procedure which can be a matter of life or

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death” and the “professional desire to succeed at the task”. Another one commented that it is “the need to do a perfect job”. However, the findings presented here need to be viewed in the context of their exploratory nature and, therefore, inherent limitations. Hence, caution should be applied when generalising these. Only a limited number of instances in a fairly narrow work context were identified where being in flow was interpreted as an adaptive way of coping with difficult situations. There are a number of possible explanations as to why this is. Firstly, participants were not specifically asked to reflect on particular beliefs they held about flow, nor were they asked to comment on whether they employed flow as a strategy for coping with stressful situations. Secondly, as a coping strategy, flow may only occur in extreme events and these “life or death” situations are, luckily, rare occasions for most of us but may, however, be more frequent for certain professions, such as the medical staff described here. Thirdly, and related to the preceding point, is the circumstance that the Flow Questionnaire, from which this data was drawn, asks to focus on those experiences where flow is most salient. Therefore, flow which is experienced during stressful encounters may not be as readily recalled as situations or activities during which flow occurs more regularly. Yet, the scarceness of these accounts should not be seen as an indication of the importance of their occurrences and further work is necessary to determine the frequency of these experiences. It will be important to see if there are other contexts in which being in flow can serve as an adaptive way of coping and also to learn more about the direction of the relationship between flow and coping. In particular, the metacognitions or beliefs people hold about the usefulness of flow as a way of coping will be of interest, as previous research has shown the adaptive function of positive metacognitions on coping (Beer & Moneta, in press a).

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CONCLUSION This chapter introduced a new concept, flow specific metacognitions characterised by an awareness of the self-regulation of flow experiences. Potential flow specific metacognitions (beliefs about being able to create flow; awareness of the flow-achievement link; other beliefs about flow regarding the importance of emotions and pressure) were identified based on qualitative accounts of people’s flow experiences as gathered via the Flow Questionnaire and supplemented by interviews with a sample of highly educated workers. In addition, the potentially adaptive function of flow during stressful encounters, as a way of coping, was discussed. Although most accounts were of flow experiences during tasks which did not put people under strain, a selected number showed clearly that flow played an important role in their ability to cope with the situation. Given that we identified preliminary evidence of flow specific metacognitions and flow as a way of coping, we could now be more direct in our approach, i.e., interviewing people about flow specific metacognitions who may also be likely to experience flow as a way of coping, particularly among paramedics, military personnel, police officers, flight traffic controllers, or other groups who may have to make difficult decisions during emergency situations. This chapter opens up the debate for a number of areas worth future investigation. Firstly, until now, flow specific metacognitions have not been conceptualised or measured. This

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seems to be a promising area of research which will help us to gain a better understanding of the adaptive function of flow experiences. Given the preliminary evidence presented here, the next step could be to try to measure these in order to identify potentially underlying factors. Secondly, future research should provide further empirical evidence for flow as a way of coping, and more specifically, the role flow specific metacognitions play in this context. It is conceivable that people in particular professions are more prone to using flow as a way of coping, especially where it is crucial to optimise one’s performance because the stake is high and the time is limited. Thirdly, it will be important to learn more from those people who have shown that they are aware of their flow experiences and can “make flow” happen, particularly in difficult situations, and to investigate how this knowledge could be transferred to others via specific interventions.

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REFERENCES Asakawa, K. (2010). Flow experience, culture, and well-being: How do autotelic Japanese college students feel, behave, and think in their daily lives? Journal of Happiness Studies, 11, 205–223. Bakker, A.B. (2008). The work-related flow inventory: Construction and initial validation of the WOLF. Journal of Vocational Behavior, 72, 400-414. Bakker, A.B., Oerlemans, W., Demerouti, E., Bruins Slot, B., & Karamat Ali, D. (2011). Flow and performance: A study among talented Dutch soccer players. Psychology of Sport and Exercise, 12, 442-450. Beer, N., & Moneta, G.B. (2010). Construct and concurrent validity of the Positive Metacognitions and Positive Meta-Emotions Questionnaire. Personality and Individual Differences, 49, 977-982. Beer, N., & Moneta, G.B. (in press a). Coping and perceived stress as a function of positive metacognitions and positive meta-emotions. Individual Differences Research. Beer, N., & Moneta, G.B. (in press b). Adaptive metacognitive self-regulation and resiliencerelated assets in the midst of challenge: A qualitative analysis. In V. Chatzi (Ed.), Psychology of Self-Regulation, Hauppage, NY: Nova Science Publisher (in press). Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77-101. Cartwright-Hatton, S., & Wells, A. (1997). Beliefs about worry and intrusion: The metacognitions questionnaire and its correlates. Journal of Anxiety Disorders, 11, 279315. Cermakova, L., Moneta, G.B, & Spada. M.M. (2010). Dispositional flow as a mediator of the relationships between attentional control and approaches to studying during academic examination preparation. Educational Psychology, 30, 495-511. Csikszentmihalyi, M. (1975/2000). Beyond boredom and anxiety. San Francisco, CA: JosseyBass. Csikszentmihalyi, M. (1990). Flow: The psychology of optimal experience. New York: Harper Perennial. Csikszentmihalyi, M. (1993). The evolving self. A psychology of the third millennium. New York: Harper Perennial.

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Csikszentmihalyi, M. (1996). Creativity: Flow and the psychology of discovery and invention. New York: Harper Perennial. Csikszentmihalyi, M. (1997). Finding flow. The psychology of engagement with everyday life. New York: Basic Books. Csikszentmihalyi, M., & Csikszentmihalyi, I. (Eds.). (1988). Optimal experience. Psychological studies of flow in consciousness. Cambridge University Press. Csikszentmihalyi, M., & Larson, R. (1987). Validity and reliability of the experiencesampling method. The Journal of Nervous and Mental Disease, 175, 526-536. deCharms, R. (1968). Personal causation: The internal affective determinants of behavior. New York: Academic Press. Delle Fave, A. & Massimini, F. (1988). Modernization and the changing context of flow in work and leisure. In M. Csikszentmihalyi, & I. Csikszentmihalyi (Eds.), Optimal experience. Psychological studies of flow in consciousness (pp. 193-213). Cambridge University Press. Delle Fave, A., & Massimini, F. (2003). Optimal experience in work and leisure among teachers and physicians: Individual and bio-cultural implications. Leisure Studies, 22, 323-342. Engeser, S., & Rheinberg, F. (2008). Flow, moderators of challenge-skill –balance and performance. Motivation and Emotion, 32, 158-172. Flavell, J.H. (1979). Metacognition and cognitive monitoring. A new area of cognitive developmental inquiry. American Psychologist, 34, 906-911. Getzels, J.W., & Csikszentmihalyi, M. (1976). The Creative Vision: A Longitudinal Study of Problem Finding in Art. New York: Wiley. Jackson, S. A., & Csikszentmihalyi, M. (1999). Flow in Sports. The keys to optimal experiences and performances. USA: Human Kinetics. Jackson, S.A., & Eklund, R.C. (2002). Assessing flow in physical activity: The Flow State Scale-2 and Dispositional Flow Scale-2. Journal of Sport and Exercise Psychology, 24, 133-150. Jackson, S.A., & Eklund, R.C. (2004). The Flow Scales Manual. Morgantown, WV: Fitness Information Technology. Jackson, S. A., & Roberts, G. C. (1992). Positive performance states of athletes: Toward a conceptual understanding of peak performance. The Sport Psychologist, 6, 156–171. Lazarus, R., & Folkman, S. (1984). Stress, Appraisal, and Coping. New York: Springer Publishing Company. Lazarus, R. S., Kanner, A. D., & Folkman, S. (1980). Emotions: A cognitivephenomenological analysis. In: R. Plutchnik, & H. Kellerman (Eds.), Emotion. Theory, Research, and Experience, Vol. 1, Theories of Emotion (pp. 189-217). Academic Press: New York. Lazarus, R.S., & Launier, R. (1978). Stress-related transactions between person and environment. In L. A. Pervin, & M. Lewis (Eds.), Perspectives in Interactional Psychology. New York: Plenum. Logan, R.D. (1988). Flow in solitary ordeals. In M. Csikszentmihalyi & I. Csikszentmihalyi (Eds.), Optimal experience. Psychological studies of flow in consciousness (pp. 172-180). Cambridge University Press.

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Maki, R.H., & McGuire, M.J. (2002). Metacognitions for text: findings and implications for education. In T.J. Perfect, & B.L. Schwartz (Eds.), Applied metacognition (pp.39-67). Cambridge: Cambridge University Press. Massimini, F., Csikszentmihalyi, M., & Delle Fave, A. (1988). Flow and biocultural evolution. In M., Csikszentmihalyi & I., Csikszentmihalyi (Eds.), Optimal experience. Psychological studies of flow in consciousness (pp. 60-81). Cambridge University Press. McGowan, J., Gardner, D., & Fletcher, R. (2006). Positive and negative affective outcomes of occupational stress. New Zealand Journal of Psychology, 35, 92-98. Moneta, G.B. (2004a). The flow experience across cultures. Journal of Happiness Studies, 5, 115-121. Moneta, G.B. (2004b). The flow model of state intrinsic motivation in Chinese: Cultural and personal moderators. Journal of Happiness Studies, 2, 181-217. Moneta, G.B. (2010). Flow in work as a function of trait intrinsic motivation, opportunity for creativity in the job, and work engagement. In S. Albrecht (Ed.), The handbook of employee engagement: Perspectives, issues, research and practice (pp. 262-269). Edward-Elgar Publishing House. Moneta, G.B. (2011). Metacognition, emotion, and alcohol dependence in college students: A moderated mediation model. Addictive Behaviors, 47, 781-784. Moneta, G.B. (in press a). On the measurement and conceptualization of flow. In S. Engeser (Ed.), Advances in flow research. Springer. Moneta, G. B. (in press b). Positive psychology: A critical introduction. Palgrave MacMillan. Nakamura, J., & Csikszentmihalyi, M. (2005). The concept of flow. In C. R. Snyder & S. J. Lopez (Eds.), Handbook of positive psychology (pp. 89–105). Oxford: University Press. Nelson, T.O., & Narens, L. (1990). Metamemory: A theoretical framework and new findings. In G.H. Bower (Ed.), The Psychology of Learning and Motivation, 26, 125-173. San Diego, CA: Academic Press. Noelle-Neumann, E. (1995). AWA Spring Survey. Allensbach Institute für Demoskopie. Perfect, T.J., & Schwartz, B.L. (Eds.). (2002). Applied metacognition. Cambridge University Press. Rathunde, K. (1988). Optimal experience and the family context. In M. Csikszentmihalyi & I. Csikszentmihalyi (Eds.), Optimal experience. Psychological studies of flow in consciousness (pp.342-363). Cambridge University Press. Schüler, J., & Brunner, S. (2009). The rewarding effect of flow experience on performance in a marathon race. Psychology of Sport & Exercise, 10, 168-174. Seligman, M.E.P., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist, 55, 5-14. Selye, H. (1973). The evolution of the stress concept. American Scientist, 61, 692-699. Selye, H. (1974). Stress without distress. NY: J.B. Lippincott. Solem, S., Håland, A.T., Vogel, P.A., Hansen, B., & Wells, A. (2009). Change in metacognitions predicts outcome in obsessive–compulsive disorder patients undergoing treatment with exposure and response prevention. Behaviour Research and Therapy, 47, 301–307. Spada, M.M., Langston, B., Nikčević, A.V. & Moneta, G.B. (2008). The role of metacognitions in problematic internet use. Computers in Human Behavior, 24, 23252335.

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Spada, M. M., Mohiyeddini, C., & Wells, A. (2008). Measuring metacognitions associated with emotional distress: factor structure and predictive validity of the Metacognitions Questionnaire 30. Personality and Individual Differences, 45, 238-242. Spada, M.M, Nikčević, A. V., Moneta, G.B., & Wells, A. (2008). Metacognition, stress, and negative emotion. Personality and Individual Differences, 44, 1172-1181 Spada, M. M., & Wells, A. (2010). Metacognitions across the continuum of drinking behaviour. Personality and Individual Differences, 49, 425-429. Teng, C. (2011). Who are likely to experience flow? Impact of temperament and character on flow. Personality and Individual Differences, 50, 863-868. Ullén, F., et al. (2012). Proneness for psychological flow in everyday life: Associations with personality and intelligence. Personality and Individual Differences, 52, 167–172. Weimar, D. (2005). Streß und Flow-Erleben. Eine empirische Untersuchung zur Bedeutung von Kognitionen, Emotionen und Motivation bei Lehramtsstudierenden, Referendaren und Lehrern. [Stress and flow experience. An empirical study on the meaning of cognitions, emotions and motivation in teaching students, trainee teachers, and teachers]. Berlin: Logos Verlag. Wells, A. (2000). Emotional disorders and metacognition: Innovative cognitive therapy. Chichester, UK: Wiley. Wells, A., & Cartwright-Hatton, S. (2004). A short form of the metacognitions questionnaire: properties of the MCQ-30. Behaviour Research and Therapy, 42, 385–396. Wells, A., & Matthews, G. (1994). Attention and emotion. A clinical perspective. Hove: Erlbaum. Wells, A., & Matthews, G. (1996). Modelling cognition in emotional disorder: the S-REF model. Behaviour Research and Therapy, 34, 881-888. Zuckerman, M., & Gagne, M. (2003). The COPE revised. Proposing a 5-factor model of coping strategies. Journal of Research in Personality, 37, 169-204.

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Chapter 7

HOW TO COPE WITH WORK-FAMILY CONFLICTS IN AN INTERNATIONAL CAREER CONTEXT? Liisa Mäkelä1, Kati Saarenpää1, Vesa Suutari1, and Olivier Wurtz2 1

University of Vaasa, Department of Management, Finland 2 Ecole Hotelière de Lausanne, Switzerland

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ABSTRACT The aim of the present article is to discuss the coping strategies adopted by international managers when they face conflicts between work and family life due to the international nature of their work. We reflect the experiences of two different groups of international managers: Global careerists who work on long-term international assignment and have experience of several expatriate assignments (n=20), and those whose work involves frequent international business traveling (n=15). The findings are reported in four dimensions, combining on the one hand problem- and emotion-focused coping strategies and on the other individual- and family-level coping strategies. The results indicate that both groups of respondents actively use problem-focused coping strategies at both an individual and a family level, but that emotional coping strategies were also used on occasion.

Keywords: Work-family conflicts, coping strategies, expatriates, global careerists, international business travelers

INTRODUCTION The globalization of business has led to an increasing number of people working abroad on various assignments. In addition to people working on traditional long-term expatriate assignments, short-term assignees, international commuters, and international business travelers (IBTs) (Tahvanainen, Welch & Worm, 2005; Collings, Scullion & Morley, 2007; Suutari & Brewster, 2009) have become an important part of the international labor force.

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In recent literature, the term ‘international business traveler’ (or ‘frequent business flyer’) refers to those engaged in work characterized by numerous and regular trips abroad and is defined as “one for whom (international) business travel is an essential component of their work” (Welch and Worm, 2006: p.284). The term ‘expatriate assignment’ is typically used to describe the internal transfer of an employee to a foreign affiliate of an international organization. An expatriate assignment typically lasts more than one year, with three years being quite common. Existing research indicates that international work, in its different forms, creates many challenges for expatriates and their families (e.g., Shaffer & Harrison 2001; Shaffer, Harrison, Gilley & Luk, 2001). Even among the most experienced global careerists, with long-term experience of coping in an international career environment, management of the work-family interface is seen to be among the key challenges (Suutari, 2003). Forster (2000) has even argued that such a career environment is far too challenging for most individuals and their families. Although there is more evidence available from surveys of expatriates, the emerging research on IBTs is similar in showing that continual overseas travel poses a considerable challenge to the interface of work and personal life (Demel & Mayerhofer, 2010; Konopaske, Robie, & Ivancevich, 2009; Mayerhofer, Hartmann & Herbert, 2004; Mayerhofer, Muller & Schmidt, 2010). The general literature on the interface of work and family life has focused on questions about the ways in which people cope with the two interconnected parts of their lives (Eby, Casper, Lockwood, Bordeaux & Brinleya, 2005; Frone, 2003). Interest has centered on the direction of influence: Whether work affects family or vice versa and, if so, in what ways. The work domain has been more strongly favored in the existing research than the family domain, and in general, work-life balance research has been interested in the negative effects of clashes between the two life spheres. This literature has thus focused on work–family conflict, defined as “a form of inter-role conflict in which the role pressures from work and family domains are mutually incompatible in some respect” (Greenhaus & Beutell, 1985). We will apply such a conflict perspective in the present article. Empirical studies are usually conducted to find antecedents or outcomes of such worklife conflicts (Eby et al., 2005). There is, however, a scarcity of research on the coping strategies used to counter these conflicts (Hyman, Scholarios & Baldry, 2005), although there has been increasing interest in better understanding the coping strategies which individuals and families use to cope with their work-life conflicts. Coping, in the context of work-family conflicts, has been described as an ability to deal with stressful situations, and is defined as the efforts an individual may exhibit at the cognitive, behavioral or emotional level to meet internal or external challenges they lack the resources to meet (Lazarus & Folkman, 1984, Pienaar, 2008). In addition to such an individual perspective, there has been discussion of family-level adaptive strategies, a concept which is suggested to be comparable to coping strategies (Voydanoff, 2002). Family-level adaptive strategies are the actions families devise in order to cope with the challenges of living and achieving their goals in the face of structural barriers (Moen & Wethington, 1992). In addition to recognition of the overall lack of research on coping strategies concerning work-life conflicts, there has been a call for studies which take into account different career contexts (Gutek & Gilliland, 2007), such as the international career context (Mäkelä &

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Suutari, 2011). It is also important to recognize that the international career context encompasses different types of international jobs which, in turn, have quite different impacts on work-life balance issues. We include two such types in the present study: International frequent travelers and expatriates who move abroad, typically for several years. Given that the overall empirical research on international business travelers is inadequate (Tahvanainen et al., 2005; Collings et al. 2007; McKenna & Richardson, 2007), it is not surprising that work-family conflicts or related coping strategies have not been subject to a great deal of study in such a career context. There has been a greater amount of study in the case of expatriates’ work-life challenges, but research on the coping strategies used to handle such conflicts is still scarce. In light of this background, the main focus of the present article is to discuss the coping strategies applied by international managers in order to cope with the work-life conflicts they face due to the international nature of their work. We will provide evidence from two different groups of international managers: Those working on long-term international assignment and those whose work involves frequent international travel. In the case of expatriates we will reflect on the findings elicited from global careerists—that is, international managers with previous experience of several international assignments—which have been reported in greater detail elsewhere (Mäkelä & Suutari, 2011). With regard to IBTs, we will provide new evidence from an on-going project on the work-life interface of such workers. The findings are thus drawn from two studies, both of which adopted a qualitative research design based on semi-structured interviews (Eriksson & Kovalainen, 2008). We interviewed 20 expatriate managers with long-term global careers (i.e., careers involving three or more international assignments in their working lives) and 15 IBTs based in Finland. The interviews lasted between 30 minutes and more than two hours, resulting in an extensive database of verbatim transcripts for analysis. In the interviews we used semi-structured openended questions with sufficient flexibility to enable participants to raise unanticipated issues or allow the researchers to ask probing follow-up questions (Mason, 2002b). The interviews started with a general discussion about the career paths and current assignments of international careerists. The focus then turned to the work-family interface and how that was managed by respondents. In the following sections, we will first briefly review the existing literature on coping strategies. We will then discuss the coping mechanisms of expatriates and IBTs. After that we will target the discussion further toward methods of coping in the area of work-life interface. We will then report our findings on the work-family conflicts and the related coping strategies applied by experienced global careerists and IBTs. Finally, we will offer the conclusions and practical implications drawn from our findings among these two different international groups.

COPING STRATEGIES The coping framework has been developed, notably by Lazarus and his colleagues, since the 1960s (e.g., Lazarus & Folkman, 1984). It refers to the way individuals react in problematic situations. Coping is precisely defined as: “efforts (...) to manage (i.e., master,

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tolerate, reduce, minimize) environmental and internal demands and conflicts among them, which tax or exceed a person’s resources” (Lazarus & Launier, 1978: 311). There are many different ways to react to difficult situations. Carver and colleagues identified 15 different types of reactions (coping strategies): acceptance, active coping, behavioral disengagement, denial, focus on and venting of emotions, humor, mental disengagement, planning, positive reinterpretation and growth, religious coping, restraint, suppression of competing activities, use of emotional social support, use of instrumental social support, and substance use (Brissette, Scheier & Carver, 2002). The distinction most commonly used to broadly group coping strategies (e.g., Stahl & Caligiuri, 2005) is two high-order categories: emotion-focused coping strategies, and problem-focused coping strategies. The former encompasses reactions that focus on and try to handle the emotions generated by the difficult situations being encountered. They generally aim to limit troublesome emotional consequences. These coping mechanisms are also called symptom-focused (Selmer, 2002), because they focus on the symptom (such as stress) more than on the factors causing it. Typically, such strategies could be drinking alcohol or taking drugs to try to forget the problems, or denying them. Acceptance and humor are also emotionfocused coping strategies. Problem-focused coping, on the other hand, aims to tackle the problem and alter the situation (Lazarus & Folkman, 1984; Stahl & Caligiuri, 2005). Such mechanisms include active coping and planning: That is, actively planning how to solve the problems faced and taking action to solve them. Very typically an individual facing a problematic situation will use different coping reactions in combination or in series. It is important to remember that although coping reactions are usually understood as a positive and effective way to handle a problem, they are not necessarily always successful. Coping is usually understood in terms of reactions on an individual level. However, a parallel concept to coping strategies—family-level adaptive strategies (Voydanoff 2002)— has been proposed to encompass important actions developed by families to cope with the challenges faced by a family (Moen & Wethington, 1992).

Coping in an International Career Context In this section we will review research on coping in an international career context with a focus on our two target groups: Expatriates and frequent travelers. Expatriation can be a difficult experience. Individuals are crossing several boundaries at the same time (e.g., Fan & Wanous, 2008). They enter a new country, a new culture, and a new organization. They experience major disruptions in their old professional and private routines (Black, Mendenhall & Oddou, 1991). They are likely to face isolation and uncertainty (e.g., Black, et al., 1991; Tung, 2004). Unsurprisingly, clinical studies have shown that stress levels are higher in expatriates (Anderzen & Arnetz, 1997, 1999), presumably owing to the need to cope with the various hardships and challenges generated by this disturbing experience. Research on expatriates’ general methods of coping has shown evidence of some elements influencing expatriates’ coping reactions. For instance, cultural distance may have an impact (Selmer 2002), as may the culture of origin (Selmer, 1999b). Individuals coming from more culturally distant countries may use more problem-focused coping strategies and less emotion-focused ones (Selmer, 2002). Psychological factors, such as willingness to adjust or the perceived inability to do so, also affect coping reactions (Selmer 2001).

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Furthermore, research has also shown that some coping reactions (e.g., displaying patience and tolerance, trying to solve the problems faced) were related to outcomes such as expatriates’ adjustment, intent to leave, or feelings of depression. Some problem-focused reactions are negatively related to depression (Ward & Kennedy, 2001) and positively associated with adjustment (Selmer, 1999a; Stahl & Caligiuri, 2005). This positive influence may be stronger when cultural distance is greater (Stahl & Caligiuri, 2005). Some emotionfocused coping strategies (e.g., avoidance, substance use) have been shown to be detrimental, or at least to be positively related to outcomes such as depression (Ward & Kennedy, 2001) and negatively related to intent to remain or professional performance (Feldman & Thomas, 1992). To some extent, international business travelers are likely to face the same challenges as expatriates and global careerists. Due to their frequent traveling abroad, they can experience the feeling of being far from home, isolated, and facing the uncertainty of foreignness. However, they still live in their home country and are not permanently located overseas. From a coping and a psychological point of view, this ability to maintain a very strong connection to one’s home country may make for a significant difference between the experiences of expatriates and IBTs, and may notably limit the potential for psychological distress, which expatriates may be more be prone to. However, IBTs are found to suffer from disturbances of their everyday routines, such as eating and sleeping habits, hobbies, and social activity (Demel & Mayerhofer, 2010; Mayerhofer et al., 2004a; Mayerhofer et al., 2004b). Their peculiarities are likely to lead to the development of specific coping strategies. Following on from the above discussion of coping in an international career context, we will now focus on coping with the work-family interface.

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Coping with Work-Family Conflicts in an International Career Context Coping with work-family conflicts could be described, according to Lazarus & Launier’s (1978) definition of coping, as efforts to manage the conflicts between and among professional and family demands which diminish or exceed a person’s resources. The relationship between work and family is particular in expatriation for several reasons. First, it seems that spillover and contagion between work and family lives are more likely in expatriate than in domestic settings (e.g., Takeuchi, Yun & Tesluk, 2002; Lazarova, Westman & Shaffer, 2010). The boundaries between professional and private life appear to be weaker: The stress and problems created in one area are more likely to generate stress in the other area. The isolation experienced by many expatriates may render the relationship with the family more sensitive, more emotional, and more loaded. This phenomenon may also be strengthened by the fact that the family may be the only source, or among the most important sources, of the expatriate’s social support; the expatriate may also be the only source of the family’s social support. Therefore, work-life balance is likely to be a major problem related to international careers. This is certainly the case for expatriate careers, but may also be true for international travelers. In fact, in the context of isolation caused by expatriation, the influence of the family on the expatriate can surprisingly contribute positively either helping integration or at least decreasing isolation. This positive effect can be a result of the networks generated by the expatriate family—for instance, in the context of children’s day-care and school environ-

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ments. The partners of expatriates may, however, feel even more isolated than the expatriates, notably because in many cases they are not working and are therefore deprived of workplace socialization. Therefore, their family and/or partner may generate difficulties for the expatriate, which in turn explains why family-related matters have been found to be among the stronger reasons for expatriation failures (e.g., Bhaskar-Shrinivas, Harrison, Shaffer & Luk, 2005). While research on expatriates’ methods of coping has not widely focused on work-life balance and conflicts, there is some research that can shed light on this problem. For instance, Tung (1998) showed that expatriates considered the coping reaction ‘keeping busy with work all the time’ to be relatively useful in facilitating their adjustment, but she reports that ‘spending more time with one’s family’ is even more useful. These apparently opposing findings cast an interesting light on the phenomenon: Some expatriates will spend much of their time at work, which is likely to generate work-family conflicts, but others—or maybe even the same ones— acknowledge the positive role that being with one’s family plays with regard to adjustment, which may potentially lead to family-work conflicts. To a certain extent, IBTs are likely to experience the same problems. However, the stronger link they keep with their home country may limit spillover effects—at least for their partners and families, whom the international context does not directly affect. Nonetheless, the specific strains caused by IBTs’ professional situations and, notably, the fatiguing effect of their frequent traveling, may generate considerable stress, and therefore create a negative spillover from work to family life. Moreover, IBTs are often away from home, and this can generate family problems associated with a parent or spouse being absent (Mayerhofer et al., 2004b). There is then a specific need to cope with such absences and such stress and fatigue. Above, we have briefly reviewed what is known about coping strategies and how such coping issues appear in an international career context coming to focus on coping with the work-life conflicts in the context of an international career. In the next section, we will present empirical evidence of this.

FINDINGS This section reports our findings on the coping strategies that managers and their families have used to either prevent or cope with the conflicts they face in an international career context. We will open with a brief discussion about the nature of conflicts faced by the respondents. We will then focus on their coping strategies.

Coping Strategies Applied by Global Careerists and their Families The data from experienced global careerists on international assignment indicate that work-life conflicts between their work and family lives are common (Mäkelä & Suutari, 2011). The most commonly reported conflicts are caused by the long working hours undertaken by the expatriates due to the requirements of their work. The expatriates’ assignments also commonly involve international traveling, due to their international role as coordinators between HQs and foreign affiliates and the multi-territory responsibilities many

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of them have. A typical feature of expatriate jobs confirmed by our respondents is a high level of autonomy and less corporate support than would be the case if they were working at headquarters, where for instance, expert advice would usually be available. The combination of such a level of autonomy with a high level of responsibility and the challenging nature of the international business environment typically leads to conflicts between work and family life. These job-based sources of conflict are extended by conflicts caused by the specific nature of international assignments, in which expatriates and their families have to learn to live in a totally new culture and living conditions. Moving between countries has an impact on the social connections of expatriates and their families (e.g., friends, relatives, work colleagues) and the frequent moves undertaken by global careerists create a very uncertain career environment, with the expatriate and their family never certain about where they will be living in a few years’ time. Expatriates planning to return to their home country at some point were familiar with the possible repatriation challenges which they might face. Work-family conflicts among IBTs are typically related to long absences from home caused by their business trips and, to a greater or lesser degree, to irregular working hours owing to the nature of the international working environment and the requirement to be available around the clock. IBTs with children particularly find that the reduction in their free time and absences from their family contribute to a precarious work-life balance and cause conflicts between working life and family life. The duration of the IBTs’ trips, and the distance between their destination and home, seems to strongly affect the extent to which the work-family conflict is experienced. IBTs find it difficult and complicated to maintain relationships with relatives and friends because of the unpredictability of their trips and their regular schedule changes. This is an issue for both single IBTs and those with families. Starting or maintaining activities can also be an issue owing to their inability to participate regularly. Marital problems and difficulty in finding the time and energy needed to fulfill the demands of being a parent and/or spouse and employee are mentioned as outcomes of a job involving international travel. A significant proportion of those interviewed say that their traveling causes arguments with their spouses. The IBTs report experiencing boredom and fatigue caused by their traveling. Regular travel is described as enervating and isolating, and the distance between the traveler and their homeland and family as creating a sense of being an outsider as they are rarely able to involve themselves with everyday chores. Above all IBTs state that problems related to flights, such as delays and cancellations, are irritating and annoying both personally and for their family, because unexpected changes often require reorganization within the family. Our international managers mainly seem to adopt active coping strategies, but some emotional coping strategies are also used (cf. Mäkelä & Suutari, 2011). In addition to individual-level coping strategies, the importance of family adaptive strategies in an international career context emerges very clearly. We therefore decided that we would report the results in the form of four dimensions, combining on the one hand problem- and emotionfocused coping strategies and on the other, individual- and family-level coping strategies (see Figure 1). In considering these four dimensions, we will discuss in parallel the experiences of frequent travelers and global careerists with experience of several expatriate assignments.

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INDIVIDUAL Individual Emotional Coping

Individual Problembased coping

EMOTIONAL

PROBLEMBASED Familylevel Emotional Coping

Familylevel Problembased coping FAMILY

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Figure 1. Quadrant 1. Individual problem-based coping strategies.

On an individual level, problem-based coping strategies are commonly used by the global careerists (Mäkelä & Suutari, 2011). Their often high level of autonomy makes it possible for the expatriates to influence their own schedules; that in turn means they can proactively address conflicts by re-arranging work schedules and taking leave, by trying to limit the number of days spent traveling, or even changing roles and/or employers. Much expatriate work is cyclical (in that assignments will be stated to be of a certain duration), and those respondents with experience of this form of working report that with experience comes the opportunity to have more say in the type of assignments and host countries they accept. That in turn allows them have more influence over their work-life balance. As one of our participants says: “When I changed my employer one and half years ago I said, to myself and to my wife, this is at least a two year project. Two years and then we will look at how it has been and after that we will consider if we want to continue there... (to) continue with the same job in the same location or to go somewhere else.” The global careerists have also learned that social capital has an important role in facilitating transfers – they have learned to actively seek guidance from their expatriate predecessors or relocation consultants. They also make efforts to stay in touch with their former colleagues, relatives, and their home country in order to maintain their social connections despite the mobility in their life. As do global careerists, IBTs apply active coping strategies. In particular, they report trying to resolve work-family conflicts by arranging their own work – especially by arranging their own travel schedules, limiting the number of days spent traveling, and avoiding unnecessary travel. Several IBTs have reduced or tried to reduce the time they spent traveling after the birth of a child: “These trips are quite enough, it takes so much time, so you try to plan your travel and in a way travel only when it is necessary. I cannot say, that I try to avoid travel, but avoid unnecessary travel.”

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There are also IBTs in our group who have looked for a new job involving less travel, which we interpret as another kind of active coping. In fact, one of our global careerists reports that the main reason for recently changing job was the need to decrease the time he spent traveling: “In my present job I don’t travel very much. That’s one reason why I changed job. For the past couple of years I was traveling 200 days per year and you do not want to do that for very long. You can do that for some time but then you have to come down from the air and decrease the amount of traveling. […] You have to think […] due to your own wellbeing as well as due to your family’s well-being that you can’t spend years in airplanes.” Many of our participants also cope with conflicts by seeking help and advice from their colleagues, and take advantage of their employers’ flexibility with regard to working hours and the possibility of distance working now and then. IBTs consider orderliness remarkably important in combining work and private life. They also try to compensate for their absences from home and avoid disputes with their spouses by sharing the burden of domestic work. As one of our interviewees said: “When I come home, I involve myself with the childcare one hundred percent, from the moment I step inside the door. I relieve her of that responsibility.”

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Quadrant 2. Family-Level Problem-Based Coping Strategies As at the individual level, family-level adaptive strategies are commonly utilized. Due to the extensive impact career and assignment decisions have on the whole family, the global careerists have learned that in each case, family-level decisions need to be made together with other family members: “We make decisions together and when we left for our second assignment we discussed it with the children too. Before making any further plans you need to talk together” (Mäkelä & Suutari, 2011). They also actively support the family’s adjustment through joint preparations (e.g., housing, schools), handling arrangements on their own before the family moved, reducing working hours in the early stages of the family’s adjustment process and trying to maximize the family’s living standards from the beginning of the assignment: “Something I have learned during these years is that you really need to build a certain living environment for your family so that they feel at home. It is the basis for doing work like this.” They also try to ensure that their housing arrangements make it possible to welcome visitors from their home country, and regularly visit their home country in order to stay in touch with friends and relatives. “We built a house in the area where my wife I and come from. It is [a] sort of Finnish nest for our family. We regularly spend our summers and Christmas holidays there. It keeps our children’s Finnish identity alive.” The global careerists have also learned to actively utilize corporate support. The most senior request support in their contract negotiations for cross-cultural training and support with their international move and the related bureaucracy help with school arrangements or paid family trips home, and even for their family to have an opportunity to visit their potential destination to see how they feel about it beforehand. “We visited this place in advance and started organizing some issues even before we had signed the agreement.” Corporate support could be consultative, financial, or both. Some compensation packages include provision for leisure-related expenses such as club memberships or more ‘soft’ elements such as flexible work-time options. An additional important aspect of active support is the instrumental support of a partner, which manifests itself as a partner making their own career decisions on the basis of the other

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partner’s expatriate career decisions. This is described in the literature as a ‘flexible partner role’ (Mäkelä, Suutari & Känsälä, 2011). Here, spouses have in some cases decided to abandon their careers, and in others have changed their career plans to fit with the ‘trailing spouse role.’ Some decisions led to permanent changes; in others the changes lasted for a certain period of time (e.g., for the duration of a single assignment). Partners willing to suspend or abandon their own careers might become more focused on the family and take a greater role in family affairs than would otherwise be the case, in order to allow their expatriate worker partners to handle their challenging jobs. Among IBTs, family-level active coping strategies appear, but not as much as those applied at an individual level. The majority of our informants traveled extensively before starting a family, but those who had not had usually discussed the issues with their spouses before starting a new job. IBTs with children highlight the role played by their spouse in managing the family, which makes it possible for them to continue in a job involving a great deal of travel. This partner support was noticeable for instance when spouses (in the present cases, wives) had changed job or taken extended leave to enable their husbands to travel. Support from other relatives is significant for IBTs’ families. Grandparents seem to be crucial in helping to successfully combine family obligations and work involving travel. One of our female interviewees reports that she is able to manage her traveling with the support of her mother, who takes long-term leave from her own work in order to take care of her grandchild. Contrary to other forms of international assignments, like those undertaken by expatriates, taking advantage of corporate policy plays but a minor role in assisting frequent flyers to cope with the challenges of their work. Aside from cultural and language training, our interviewees were unable to nominate specific support that they receive from their employer. Instead, interviewees mention flexible working options, like flexible working hours and the possibility of taking days off, and the opportunity to influence their travel periods, as an important way for them to maintain work-life balance.

Quadrant 3. Individual-Level Emotional Coping Strategies Among global careerists, individual-level emotional coping strategies are not seen as often as active problem-solving strategies (Mäkelä & Suutari, 2011). Such coping is reflected in comments concerning how respondents had mentally accepted the fact that such challenges are an integral part of a global career. As in any job, both challenges and motivational factors are involved. If the whole ‘package’ is still considered as positive, for example, from the total rewards perspective (Tornikoski, 2010), people tend to cope with challenging elements by accepting them as part of the reality of their career and trying to find the positive aspects of the challenging elements of the job. Sometimes people also cope by emphasizing that their job is so important that they are happy to cope with the challenges it brings. The application of a reappraisal strategy by global careerists is another aspect related to emotional coping at the individual level. It is not a strategy often raised in the interviews but there are still several occasions when the developmental aspect of international assignments is emphasized. Such a developmental perspective is widely emphasized in literature where international assignments are seen as important methods for management development and global leadership development (Jokinen, Suutari & Brewster, 2008). From a reappraisal perspective, complex and intellectually challenging situations are interpreted and later

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described as important and positive experiences driving the person toward personal growth and development. Similarly, the challenges involved in dual-career couple situations in an international career context might be interpreted positively—at least by the expatriates, as their spouses were not interviewed— owing to their resulting in the spouses being able to take a greater role in family affairs. When family-related adjustment problems emerged, they are often later interpreted as positive developmental experiences which developed the whole family, and sometimes also tightened family relationships through shared coping: “I think that when we are abroad, we are in a foreign place, there we are very much together and we care each other much more compared to the situation we are in in Finland.” The use of avoidance strategies is also noted, but with regard to decision-making concerning future assignments rather than any specific work-related situation. The global careerists have learned through their experiences that work-life balance issues need to be taken into account when planning whether or not to accept an assignment, or whether or not to repatriate to their home country at some point. It also appears that, due to the cyclical nature of their lives, some expatriates admit that they try to avoid developing very close relationships with local people, as they know they will be leaving the area after a few years: “I have made friends with locals but let’s see how these relationships continue. For instance, from my previous assignment to Spain, none of those relationships have continued in a way that we would keep contact regularly, a card at Christmas and so on.” Instead, the importance of sustaining active, good family relationships was stressed. Turning the discussion from the experience of global careerists to that of international business travelers, acceptance as a coping strategy is discernible in the IBTs’ comments about how they have learned to live with regularly leaving their home and family, even if it is hard and unpleasant. One of our interviewees, who is rather weary of traveling and has tried unsuccessfully to find another job, thought that he had no choice other than to ‘grin and bear it’ and continue to travel. A female IBT expressed similar sentiments: “When I have to go, it feels so hard sometimes. But when you set off, you only think that I just go and it’s only one day more and I will soon be back home, and I just do it.” As highlighted earlier, flight delays and schedule changes are common. IBTs consider such uncertainty something they cannot change and have to accept it as a drawback of their job: “Sometimes these flight delays and some such, might mess things up really badly, [but] usually I’m able to cope […] It’s annoying, of course, sometimes you miss out on something in your private life, you miss like the celebration of Midsummer, Christmas or something else.” Acceptance was also highlighted by some interviewees’ decisions not to have children while in their current work situation. Although this is considered an emotional coping strategy, it can also be seen as an active, problem-focused coping strategy: To refrain from having children in order to better handle their professional responsibilities, particularly because these same interviewees would also considering changing job, if they were to have children. Furthermore, many of our IBTs are involved in project work, which is characterized by busy periods involving a lot of traveling. Reappraisal coping occurred sometimes when they reflected on these busy working periods. While they found the situation challenging both for themselves and for their spouses, they nevertheless describe international business travel as an important part of their job and something that advances their career and professional

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development. At the same time, however, some research participants considered that promotion to a more demanding role would not be feasible as it would be likely to involve even more international travel, which would make maintaining a work-life balance more difficult. A number of frequent flyers note that although work involving travel increases the time they spend away from their spouse, it has strengthened their relationship, as the partners have a greater appreciation of the time they spend together.

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Quadrant 4. Family-Level Emotional Coping When looking at family-level emotional coping, it appears that partner support, as a coping strategy, also includes an affective perspective. It was stressed that when expatriates’ working environments are challenging and complex, stability in family life and emotional support from spouses become very important. If the family has adjustment problems, the situation can easily become too great a burden for the expatriate. It is thus not surprising that family-related problems are among the major reasons for expatriate failures. In some cases, the expatriates also stress how important they consider emotional support from their children. Particularly if the children are older, some respondents see it as psychologically important for the decision to leave or to stay abroad for a longer time to be supported by the whole family. Similarly, in decisions concerning the timing of a possible repatriation to the home country, the interests of the whole family must be taken into account. Such joint decision-making and shared support provides a strong foundation from which to face those repatriation adjustment problems commonly discussed in the literature. “And of course, my parents and my wife’s parents get older, schooling of our children and questions like this are ahead of us. Where are we going to take care of issues like that. We haven’t decided anything yet but repatriation may be a possibility at some time.” Family-level emotional coping did not commonly appear from our IBTs’ data. Similar to global careerists, IBTs saw their partner as a source of emotional support and stability and stated that their spouses had accepted or become used to their partner traveling a lot, even if they considered it disagreeable. IBT’s might describe their families as restricting work and traveling, but they also value them as a resource. Spouses both enable traveling, by taking care of everyday chores, and act as an anchor in the IBTs’ lives. As one traveler said: “I would not be in such work if I had no family, work doesn't mean anything if you don't have your family, if matters at home are not okay.” Although frequent flyers found it difficult to maintain friendships, they did highlight the importance of support from friends. Friends whose work also involved travel were mentioned as an important source of peer group support: “I have my dudes with me, in a sense they understand it. Many of my friends also travel a lot, so the support kind of comes from there. They know… those buddies don’t vanish, even if I travel a lot.” Having presented the different coping strategies that international managers and their families adopt in order to cope with work-family conflicts, the chapter concludes with a discussion before presenting its conclusions.

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CONCLUSION This chapter has discussed the coping strategies adopted by international managers when they face conflicts between work and family life due to the international nature of their work. We reflected the experiences of two different groups of international managers: Global careerists who work on long-term international assignment and have experience of several expatriate assignments (n=20), and those whose work involves frequent international business traveling (n=15). In line with previous literature, our findings show that both groups—global careerists and IBTs—reported facing considerable challenges in combining their work and family lives. In some areas, the international working environment created similar conflicts in the work and family lives of both types of international employees, but very often the challenges facing the two groups were different. Work tasks with a high level of challenge and responsibility typically took up a lot of international managers’ time and energy, and therefore participants from both groups discussed the difficulties they found in combining their two life spheres. The creation and maintenance of social connections was a challenge noted by both groups, but they described it differently: Participants who lived abroad said that moving to a new living environment meant that they needed to build all their relationships from the beginning, whereas IBTs told us that it was very challenging to participate in any social activities and to maintain relationships due to the unstable nature of their jobs. Instability in life due to frequent moves to new locations every few years was also mentioned by global careerists, and was found to have negative effects on their work-family balance. Furthermore, our IBTs told us that their families have had to adapt to a situation in which a spouse and/or parent is very often absent, while our global careerists noted that adjustment to a new living environment was an essential challenge they and their families had to face. Global careerists sometimes also mentioned that they traveled a lot due to their work and thus faced both kinds of work-family conflicts. In this article our main interest is the discussion of how international managers and their families cope with work-family conflicts. We look at coping through four perspectives; whether coping took place on an individual or a family level and if it was problem-focused or emotion-focused. We found that individual-level problem-based coping strategies were commonly adopted by both global careerists and IBTs and related mostly to organizing their work, for example through flexible working hours or distance working. Employer changes were also mentioned by both groups as a way of easing problems in their work-family interface. Active coping at a family level emerged much more often among global careerists than among IBTs. Our participants living abroad highlighted the importance of decisionmaking as a family issue when moving to a new location, and of organizing their stay abroad in such a way that it was possible to make regular family visits to their home country and to have relatives and friends from home visit them. These issues did not seem relevant to our IBT participants, which may reflect the fact that the impacts of traveling around the world and often being absent from home were rarely seen as bringing the sort of significant life change that has to be addressed as a family-level issue, despite the lifestyle frequently having a negative effect on family life. In addition, most of our IBT participants noted that the job they were in when they started their family involved

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traveling, and thus it was not a new situation which needed to be negotiated again at a family level. Moreover, both of our international manager groups highlighted the important roles played by their partners. In the case of global careerists, this often took the form of partners suspending their careers to run the home while the family lived abroad. In the case of IBTs, partners usually managed the family’s daily routines alongside their own work, which in some cases they had also reorganized in order to enable their spouse to travel. At the family level, corporate support was utilized only by global careerists, as employers’ support for IBTs’ work did not take their families into account at all. Emotional coping, a more passive way of reacting to challenges between work and family life than problem-focused coping, emerged far less often in our data. This may be partly a result of our qualitative data collection method – it may be much easier for interviewees to talk about concrete, problem-focused coping actions which describe how they managed challenging situations than to describe more passive ways of doing so through emotional coping strategies. The respective problem-focused coping strategies are perhaps more socially accepted, and therefore easier to discuss, than emotion-focused reactions. Where emotional coping was mentioned, at an individual level it related mostly to expressions of acceptance, with both global careerists and IBTs stating that they have accepted the challenges caused by their jobs. Moreover, in some cases they also reinterpreted difficulties in a way that transformed them into something helpful or potentially having a positive outcome. Both global careerists and IBTs coped with possible work-family conflicts by avoiding situations that could create conflict (including by turning down job opportunities or delaying starting a family); situations which would make achieving a good work-family balance even more difficult. We did not find many different kinds of family-level emotional coping strategies in our data. However, affective partner support was mentioned very often as an important source of balance between work and family lives, and children were mentioned in the same context. All in all, our research makes it clear that working in an international context challenges employees’ capability to combine their work and family lives in an agreeable way. Conflicts between these two life spheres appeared to be common, and thus international managers need to find ways to cope with these situations. It appears that different methods are used to cope with the hardships generated by international work. Our data indicates that active, problemfocused coping was the most typical coping mechanism. Earlier research has found that the use of such coping strategies typically leads to better outcomes than the use of other types. Several limitations should be taken into account when interpreting the findings. First, the target group was relatively homogenous. The respondents were Finns. This may affect reactions in several ways. Finns have good language skills, which may facilitate some coping reactions. More generally, the host culture affects coping (e.g., Selmer, 1999b). Some cultural characteristics, and notably the high level of equality between men and women in Finland, may affect reactions related to work-family conflicts. The respondents were typically educated to university level, most commonly in business studies. Education level, as well as the chosen education major, may affect reactions. All the expatriates interviewed are very experienced, with many international assignments and much related learning experience behind them, meaning their coping strategies may differ from those of workers on their first assignment.

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Second, the data collection method (interviews) may have affected the results. Some interviewees may have been reluctant to mention some less socially acceptable reactions, such as denial, expression of emotions, and use of emotional social support. Future research could consider using a combination of methods (qualitative and quantitative) in order to further investigate international managers’ coping mechanisms and work-family conflicts. Some quantitative methodologies may help respondents express less socially acceptable responses. Furthermore, analysis of the effectiveness of coping reactions may also provide interesting insights for those studying, for instance, the occupational wellbeing of international managers. These are also issues which should be further studied at the level of the family, taking account also of the coping mechanisms and well-being of the worker’s spouse and children. Several practical implications can be drawn from this study. First, it becomes clear that coping with work-family conflicts should be understood as an important issue for both employees and employers. In order to advance international managers’ ability to balance their personal and professional lives, organizations should provide coping-related training to show them that the wide variety of responses available, and therefore help them select the most appropriate for their own experience. Overall, companies should take better account of the work-family challenges caused by expatriation and/or frequent business traveling, and pay attention to developing practices and policies to help their international managers, who are part of an important pool of talent.

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REFERENCES Anderzen, Ingrid and Arnetz, B. Bengt. 1997, “Psychophysiological reactions during the first year of a foreign assignment: Results of a controlled longitudinal study”. Work & Stress, 11:304–318. Anderzen, Ingrid and Arnetz, B. Bengt. 1999. “Psychophysiological Reactions to International Adjustment: Results from a Controlled, Longitudinal Study.” Psychotherapy and Psychosomatics, 68:67-75. Bhaskar-Shrinivas, Palsule, David Harrison, Margaret Shaffer and Dora Luk, 2005, “Inputbased and time-based models of international adjustment: Meta-analytic evidence and theoretical extensions”. Academy of Management Journal, 48:259-281. Black, J. Stewart, Mark Mendenhall and Gary Oddou, 1991, “Toward a comprehensive model of international adjustment: An integration of multiple theoretical perspectives”. Academy of Management Review, 16(2):291-317. Brissette, Ian, Michael Scheier and Charles Carver, 2002, “The role of optimism and social network development, coping, and psychological adjustment during a life transition”. Journal of Personality and Social Psychology, 82(1):102-111. Collings, David, Hugh Scullion and Michael Morley, 2007, “Changing patterns of global staffing in the multinational enterprise: Challenges to the conventional expatriate assignment and emerging alternatives”. Journal of World Business, 42(2):198-213. Demel, Barbara and Wolfgang Mayrhofer, 2010, "Frequent business travelers across Europe: Career aspirations and implications". Thunderbird International Business Review, 52(4): 301-312.

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Chapter 8

ADOLESCENCE: SEQUENCE OF COPING BEHAVIOURS Donna-Maria B. Maynard The University of the West Indies, Cave Hill Campus, The School of Education, Barbados

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ABTRACT We propose that a sequence of coping behaviours is utilised by Caribbean students when faced with problems that arise in the school environment. The sequence involves a dynamic process of seven cognitive decision-making and behavioural steps that the adolescents engage in, in their quest to effectively cope with daily problems (Maynard & Welch, 2009). How adolescents cope with problems is very important, for educators and psychologists wish to gain a better understanding of the psych-socio-cognitive functioning of young people at this stage of development, which serves as a foundation for young adulthood. In our quest to discover how adolescents were coping we employed a phenomenological approach and conducted a qualitative study using semi-structured interviews with a purposive sample to examine the coping strategies of ‘problem’ adolescents in the Caribbean, specifically in regard to their interactions with peers and teachers. Data were collected from twenty 14-16 year olds in Barbados. The overarching finding was that adolescents employ a sequence of coping behaviours in an attempt to actively seek to prevent problems from progressing to a maladaptive level, and avoid permanent damage of the relationship.

INTRODUCTION The concept of coping has been researched extensively by psychologists and educators (Compas, Malcarne & Fondacaro, 1988; Dumont & Provost, 1999; Seiffge-Krenke & Klessinger, 2000). Richard Lazarus has contributed much to our understanding of coping, starting with his book ‘Psychological Stress and the Coping Process’ (1966), which initiated a flow of research in the area (Folkman & Moskowitz, 2004).

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The focus on coping, prior to Lazarus’ initiative, was largely on the theory and techniques involved in ego psychology and defence mechanisms (Jacobs, 1999). However, by defining coping strategies as the specific behavioural and cognitive efforts that individuals utilize to endure or reduce the effect of stressful events, Folkman and Lazarus (1980) breathed new life into the psychological enquiry of coping. They identified two types of coping: (i) problem-focused, and (ii) emotion-focused. Problem-focused coping involves active attempts to alleviate stressful circumstances, while emotion-focused coping involves taking steps to regulate the emotions triggered by stressful or potentially stressful events; hence it is an internal process that involves changing thoughts associated with a stressful event, rather than taking direct behavioural action against it (Mikulincer & Solomon, 1989). This chapter examines the concept within the context of the lives of Caribbean middle adolescents in Barbados, who have been identified as “problem students” within the school environs. The research presented seek to uncover the kinds of coping strategies most often utilised by the youth and the true intention behind them as perceived by themselves; those who activate the coping strategies.

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Adolescence Inherent in adolescent development is the experience of stress and anxiety as children move from the dependent role of childhood to the expectant independence of adulthood (Branwhite, 2000). How adolescents navigate their way through this often tumultuous phase of human development is characterised by the kinds of coping strategies that they engage along the way. European and North American research have identified support, emotional, avoidance and problem-focused coping strategies, to be paramount among adolescents, in response to daily stresses relating to family, school and peers (Seiffgre-Krenke, 1995; Windle & Windle, 1996). Dunahoo, Hobfoll, Monnier, Hulsizer, and Johnson (1998) have argued that coping research fails to capture the diversity of coping dynamics and strategies among different cultures. While others suggest that the focus of coping research has largely been on self-directed and more individualistic processes (Kuo, Roysircar, & Newby-Clark, 2006; Yeh, Chang, Arora, Kim, & Xin, 2003). The main findings of European and North American studies indicate a relationship between adolescents’ use of avoidance coping strategies, such as withdrawal, and their emotional and behavioural problems, as well as their involvement in risk-taking behaviours (Ben-Zur & Reshef-Kfir, 2003; Seiffge-Krenke & Klessinger, 2000). The literature suggests that research on coping has tended to be consistent with psychology's origins in European theories that value autonomy (Hobfall, 1998), omitting to integrate the Afrocentric worldview characterised by unity, cooperation, mutual responsibility and interdependence. (Asante, 1987; Jenkins, Lamar, & Thompson-Crumble 1993; Nobles, 1986). The Caribbean is predominantly populated by peoples of African origin; hence research on Caribbean coping strategies is scant as the European oriented theories lack appeal. We conducted a study that sought to identify the typical coping strategies of Caribbean middle adolescents at school who had been categorised as “problematic” (Maynard & Welch, 2009). Coping is a response to perceived stress and involves frequent changes in cognitive and behavioural efforts to manage specific demands (external and/or internal) that are appraised as challenging or beyond the resources of the individual (Lazarus and Folkman 1984). Hence,

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coping strategies are those cognitive behavioural tactics employed to handle a stressful situation (Lazarus & Folkman, 1984) which are unique to the individual. I have already indicated that the developmental period of adolescence is a significant phase of growth constituting the transition from the dependency of childhood to the selfreliance of adulthood. This developmental period is considered to be one of the most stressful in lifespan development (Clarke, Perlmutter and Freidman 1988; Harper and Marshall 1991) as individuals are inundated with a wide array of stressors, not only are they consciously experiencing their rapid physical growth as they speed through puberty, but they are also dealing with cognitive development to social and emotional changes. It is during this phase of development that individuals develop their personal values and sense of identity, fulfill social roles with same and opposite sex peers and complete the requirements of their formal education and engage in decision-making with regards to a career (Raikhy & Kaur, 2010). Adequate coping skills and adaptive cognitive and behavioural styles are vital for effective transition and adjustment to adulthood (Frydenberg and Lewis 1993). An inability to cope in adolescence may have a number of negative consequences in terms of poor academic achievement and poor social relations (Ferrari and Parker 1992). Further, contemporary theorists have redefined adolescence moving away from the traditional view of it as a period of ‘stress and strain’ to one that is characterised as a period of ‘challenge and potential’ hence, there is an urgent need to know and understand the experiences of adolescents from a different perspective (Ranganathan 2003). For that reason we endeavored to study adolescents who are already experiencing challenges within the school environment to understand the coping strategies that they have adopted, from their phenomenological perspective. A distinction is made between active and avoidant coping strategies in the coping literature; with active coping strategies being identified as those responses designed to change the nature of the stressor itself or how one thinks about it, and avoidant coping strategies being those responses leading individuals into activities, such as drug use or mental states such as withdrawal. Active coping strategies generally are considered to be the better approach to deal with stressful events, while avoidant coping strategies seem to be a psychological risk factor that could possibly heighten adverse responses to stressful life events (Holahan & Moos, 1987). Most often considered to be a critical period in life-span development, adolescence; a developmental stage when many physical, psychological, cognitive and social changes take place (Berk, 2001; Briggs, 2002; Feldman, 1997; Kroger, 1996; Melgosa, 1997), is a period characterised by change. The inundation of changes are frequently considered to be responsible for the often turbulent, complex and aggressive behaviours observed in adolescents’ interpersonal relationships (Boxer & Tisak, 2003; Goldstein & Tisak, 2004; Renk & Creasey, 2003). Adolescents employ a combination of action-oriented and intrapsychic elements in coping with stressors (Folkman & Lazarus, 1988; Lazarus & Folkman, 1984; Folkman & Moskowitz, 2004). Those typically consist of strategies formed and executed to manage external and internal demands and conflicts, so as to make it possible for the individual to function effectively (Judge, 2003). Recently, much research (cf., Boxer & Tisak, 2003; Goldstein & Tisak, 2004; Keltikangas-Jarvinen, 2002; Wells & Miller, 2002) has centred on aggression as a problemsolving strategy used in adolescent relationships, rather than the traditional view of

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aggression as a problem-generating strategy. Keltikangas-Jarvinen’s (2002) found in a study of aggressive problem-solving strategies among adolescents that some adolescents’ employ aggressive strategies primarily to gain social acceptance of their peers. Within the North American and European contexts research on coping as related to daily hassles, life events and stress in general, has expanded present knowledge of adolescents in these settings (cf., Branwhite, 2000; Petersen, Kennedy, & Sullivan, 1991; Seiffge-Krenke, 1995; Wolman, 1998). However within the Caribbean context adolescent problem behaviours, such as cursing, issuing threats, fighting with peers, non-compliance, disregard for authority figures, in Caribbean schools has been increasing, both as it relates to the number of incidents as well as the severity of the behaviour (Comprehensive Study of School Discipline Issues in the OECS: Research Report Summary, 2006; National Consultation on violence and indiscipline in schools, 1989). This trend reflects the situation in most western societies and has ignited much discussion and consultation both within and beyond the Caribbean (Briggs, 2002; Lahey, Moffitt & Caspi, 2003; Payne, 1999). The research that we did sought to clarify why adolescents engage in some problem behaviours during their interaction with peers and teachers, and was guided by the aim to assist adolescents in effectively adjusting their coping strategies in conflicting and stressful situations. The various coping strategies adolescents employ and their reasons for using them were also examined. Significant to this research was the adolescents’ views on the appropriateness of the strategies that they used. The focus of much research on adolescents’ coping behaviours and coping strategies has been on identifying the different types of coping strategies employed by adolescents to manage stress, daily hassles and life events (Aiden, 1997; Lai King, 1991; Windle & Windle, 1996). Increasingly,, research has shifted to looking at the effect that these coping strategies have on adolescents’ academic performance, social functioning and mental health (HermanStahl, Stemmler, & Peterson, 2002; Pifer, 2000) in addition to how they are best able to adjust these strategies to situations they face on a daily basis (Griffith, Dubow, & Ippolito, 2000; Printz, Shemis & Webb 1999; Torquati & Vazsonyl, 1999). The outcome has been that much research has found that counseling and psychological interventions are effective in helping adolescents learn how to improve their general coping strategies, especially as they apply to specific situations (Antonella, 2003; Ben-Zur & ReshefKfir, 2003; Lasser & Tharinger, 2003). This has been highlighted in a shift in focus of coping research towards relational issues that influence how adolescents cope, and an examination of the internal and external factors that affect the strategies they employ (Chapman & Mullis, 2002; Sandstrom, 2004; Torquati & Vazsonyl, 1999). This change in focus calls for narrative experiences and adolescents’ views concerning their coping efforts with actual problems (Aunola, Stattin & Nurmi, 2000; Folkman & Moskovitz, 2004; Herman-Stahl, Stemmler & Petersen, 2002). Payne (1999) focused on students’ views as to how they felt their misdemeanours should be handled by teachers in a study of Caribbean adolescents’ perspectives on handling problem behaviours in secondary schools in Barbados. Problem behaviours; such as arriving late for lessons, breaking rules, and shouting across the classroom, were reported by the students, they shared views that implied that those “problem behaviours” were in effect employed to cope with stressors within the school environment. In addition, Payne (1999) identified several themes whereby misbehaving was considered to be necessary at times and unavoidable, and directly related to the students’ “problem behaviours” being employed as coping strategies within the school

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setting. The students reported that the problem behaviours brought their school and families into disrepute, affected their academic performance, interpersonal relationships and future job prospects, hence they generally disapproved of the coping strategies that they themselves employed. The Caribbean is often depicted as a care-free culture (Ward & Hickling, 2004), which could mislead one to believe that Caribbean adolescents live a stress-free life. Caribbean adolescents, in reality encounter most of the same stressors as their North American or European counterparts, including preparation for high-stakes tests, dysfunctional studentteacher relationships, and such like. The saliency of the stressors may even be greater within the realm of education where the pressure to achieve starts as soon as the child enters primary school in having to prepare for the ‘Barbados Secondary School Entrance Examination (BSSEE)’; a high-stakes test taken at 11 years old, with the purpose of placing the adolescent in a secondary school aligned with his or her academic ability as exemplified in the BSSEE. The secondary schools are ranked academically and informally at a public level, which accentuates the pressure to pass so as to be accepted into a “good” school, as indicated by the higher marks needed to be attained on the BSSEE for enrolment to the particular schools (Maynard, 2010). The intensity of the pressures experienced within the school setting often lead to dysfunctional teacher-student relationships; ranging from accusations of favouritism and victimization, to expressions of feelings of anger, mistrust and betrayal in adults in general and even those in supportive roles (Crowley, 1993; Snyman, Phil, Poggenpoel & Myburgh, 2003). Some adolescents complain of their inability to succeed because teachers constantly ignore them while giving attention to peers who appear more competent, thus contributing to their feelings of inferiority, denigration and worthlessness (Crowley, 1993; Nolen-Hoeksema, 1998; Synman, Phil, Poggenpoel, & Myburgh, 2003, Maynard, 2010). In addition, within the Caribbean context very often parents and teachers are familiar with each other whether via friendships or extended family networks. This familiarity often blurs the line between school and home environments, again placing extra pressure on adolescents who are almost assured that reports on their behaviour at school will inevitably reach home via some extra-familial source.

The Study The qualitative research presented here employed a phenomenological methodology (Tshiswaka, 2003a) to conduct an investigation of the coping strategies of problem adolescents in the Caribbean; those who have frequently exhibited disruptive behaviours in the school, such as swearing, fighting, etc., which have led them to being referred to the school guidance counsellor or to an intervention programme conducted by a juvenile correctional agency such as the Probation Department, the adolescent detention centre or the Out-of-School detention centre. The objectives of the study were to identify the typical coping strategies used by problematic adolescents, in order to examine the reasons for their choice of coping strategies, and to assess their appropriateness.

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METHODOLOGY Using a phenomenological perspective we employed a qualitative methodology to investigate the coping strategies of problematic adolescents in the Caribbean from their own perspective. A small number of individuals were studied in an attempt to examine the ways they think about and interpret the world around them. Semi-structured interviews were the phenomenological method used, which, helped, in the development of patterns or relationships of meaning from the responses, to describe, explain and elucidate the structure and essence of the adolescents’ subjective experiences (Hunt & Main, 2001; Tshiswaka, 2003a). Data gathered provided insight into what motivated adolescents’ problem behaviours at school. The phenomenon of interest was the coping strategies of adolescents identified as problem students. Listening to adolescents’ perspectives about what motivated their choice of coping strategy, the nature of their peer relationships, and how teachers, counsellors and the administration could assist them, was integral to a general understanding of the adolescents’ social interactions.

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Sample Description Using purposive sampling assistance was solicited from teachers, of a rural coeducational secondary school in Barbados, to identify problem students whose characteristic behaviours included; flouting of authority, engaging in fights, truancy, and ongoing conflict with peers and teachers. The teachers selected twenty participants; ten males and ten females aged between 14 and 16 years to participate in the research. The sample was classified as low achievers currently involved in the school’s guidance and counselling programme. Initial permission was sought from the management of the school. Following which both the participants and their parents were asked to sign a joint consent form as confirmation that they assented to the study, with the understanding that participation was voluntary and confidentiality would be maintained throughout the study.

Interviews The guidance counsellor’s office was used to conduct the semi-structured interviews, which were each of approximately thirty minutes in duration. The individual interviews were guided by a set of questions formulated to consider the adolescents’ experiences at school. Questions 1 - 3 focussed participants on identifying the coping strategies they typically used (e.g., “How do you handle problems you face with other students?”). Questions 4 and 5 required participants to reflect on their choices and to examine what determined those choices. Finally, questions 6 and 7 invited them to assess the suitability of the coping strategies they used. The interview process was piloted prior to the study, using four adolescents who were not participants in the study (McLeod, 2003; Neuman, 2003). Essential to each interview was the

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element of flexibility which allowed for complete freedom of expression and the drawing out of pertinent information critical to the collection of a rich body of data. All participants were posed with the initial questions, though the interviewer deviated at times from the standard flow of questions in order to pursue relevant material.

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Procedures The interviews were tape-recorded and transcribed for analysis. the first step in the analysis was “open coding” of data, this involved an examination of repetitions of words and ideas, and culminated in the emergence of broad themes (Tshiswaka, 2003b). The next step in the data analysis was axial coding, which primarily focused on the initial coded themes rather than on the raw data itself (Neuman, 2003). The themes were then categorized in preparation for further analysis. This process proceeded throughout the data collection stage. Gradually, the identification of the major themes of the research led to selective coding. The process involved the scanning of data and previous codes in an effort to select cases that illustrated themes and made comparisons and contrasts. This allowed for the emergence of general trends and the organization of an overall analysis. The collection, coding, categorizing of themes and rescanning process ultimately led to an in-depth analysis of the data. The aim here was to search for and identify patterns in the raw data that would indicate behaviour or a body of knowledge that could be interpreted to arrive at an understanding of social behaviour. Narrative accounts of the relationship between the categories, allowed the data to tell the story of the participants’ experiences for themselves. The language used to communicate the ideas of the participants was primarily expressed in the Barbadian dialect (i.e., “I does doan want to get send home, so I does resist the temptation.”) Member checks; a technique employed for addressing credibility of the information gathered and the researchers’ analytical skills (Lincoln & Guba, 1985), were engaged to ascertain and confirm the true meaning of what was being conveyed by the participants.

FINDINGS The findings suggested ‘a sequence of coping behaviours’ that evolved from what actually, in the adolescents’ views, motivated and exacerbated their behaviour. Variability in coping strategies, adolescent-peer experiences and adolescent-teacher experiences, were key concepts that interacted to present an emerging explanation of what motivated the adolescents’ manifest behaviours. The structure of the findings presented a general analysis of the participants’ experiences, and interspersed the researchers’ voice with that of the adolescent males and females, which captured the richness of the data. The main themes that emerged from the participants’ responses in regard to coping strategies were identified as problem-focused, emotional-focused, support-seeking and avoidance coping. Problem-focused coping involves addressing the problem causing distress by making a plan of action or concentrating on the next step (Folkman & Moskowitz, 2004); for example, a participant stated;

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Donna-Maria B. Maynard “Sometimes I feel like getting up and giving them a lash, but I tell myself that I would only get myself in trouble so I does just cool myself...I does just stop and think about it... and I think about the consequences.”

Emotional-focused coping is aimed at ameliorating the negative emotions associated with the problem by engaging in distracting activities; for example, using alcohol, fighting or seeking emotional support (Folkman & Moskowitz, 2004). For example, one participant stated; “I tell them back the things they tell me sometimes, or if they come in front of me beat them or something.”

Support-seeking coping engages the help of significant persons in alleviating personal distress (Ben-Zur & Reshef-Kfir, 2003; Lazarus & Folkman, 1984); for example a participant commented; “I... go to the Guidance Counsellor...I does go to the form teacher for assistance and help.”

Avoidance coping represents a cognitive mechanism that enables an individual to disregard or ignore the element of threat inherent in the other’s behaviour; for example, a participant shared;

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“I don’t tell anybody cause I feel they will come and beat me up... I would like to leave the school.”

All four types of coping were present in both the male and female participants’ responses. Male adolescents reported most often using support and avoidance coping strategies, and less often employing emotional coping strategies. Female adolescents also used avoidance coping strategies, just as much as they employed emotional and support coping strategies. The twenty male and female adolescents interviewed revealed that they preferred to use avoidance coping strategies, in contrast to emotional coping strategies, which was used the least by the male participants. The most marked difference between the male and female participants was that males’ reported greater use of support coping strategies. The context themes that emanated from the participants’ responses were identified as adolescent-peer experiences and adolescent-teacher experiences, which related to the settings in which the adolescents were typically faced with employing coping strategies. Adolescentpeer experiences involved using coping strategies prompted by the frustration they often experienced with repeated aggression from their peers, escalating tensions amongst each other, and their need to release pent-up anger. Adolescent-teacher experiences usually related to support coping strategies that highlighted the fact that the foremost adult relationship students experience outside of the parent-child relationship is that of the teacher-student relationship. Adolescents in most instances expressed dissatisfaction with the lack of support they received from their teachers. The first step towards external support typically was directed at teachers, which implied that they thought highly of the teachers’ abilities and skills potentially to resolve the situation.

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However, the adolescents often expressed disappointment at the outcome of reporting troubling situations to their teachers. The development of patterns of meaning of various coping behaviours reported by the adolescents was conceptualized by the researchers in terms of a “sequence of coping behaviours.” This sequence appeared to commence from the moment an adolescent began to recognize that his or her peers’ behaviour created some emotional discomfort. A desire to quell such emotions so that the relationship would be stabilized, and then repaired, was the dynamic of this process. The steps involved in the “sequence of coping behaviours” seemed to be as follows.

Step One: Ignore and Walk away: Avoidance Coping Both male and female participants almost always used avoidance behaviour as their initial coping strategy; for example, “I does walk along and ignore them, and after don’t pay them any mind.” The majority (18) of the participants related that it was easy at the initial stage to distance themselves and to ignore the person irritating them. There was usually no great build up of tension or undue pressure, but a feeling and understanding by the participants that the initial intention of the other’s behaviour was to “play pranks” or “make sport”. In the majority of instances these pranks were recognized by peers as harmless: “They have a habit where they does stick things on your back all the time.” Such actions seemed meant to produce similar harmless responses. It was expected that either the ‘victim’ would reciprocate in the activity, or would “... tell them leave me alone”, and move from the immediate vicinity, without any malice.

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Step Two: Avoid the Situation: Avoidance Coping The adolescent participants sensed when they were being targeted by their peers and tried to protect themselves and maintain a level of control by seeking to avoid those who were intentionally pursuing them. “I does keep myself to myself” was a frequent expression used by participants and indicated their sense of safety in isolation. By employing avoidance coping, the participants were acknowledging that they were accountable to themselves, with this being testimony to their awareness of themselves as individuals, each responsible for their own actions. The aim at this stage seemed to be to prevent what was envisioned could become an explosive situation. An assessment at this stage also typically caused them to determine that it was not an appropriate time to confront the ‘perpetrator’. Rather, it was the belief of the adolescent being targeted, that the best thing to do at that time was to monitor the situation and to be hopeful that their passive behaviour would send a message that avoiding the antagonist would be better than getting themselves into trouble.

Step Three: Complain to Some Significant Other: Support-Seeking Coping Participants typically turned to external resources next, in an effort to alleviate the distress that was building internally and often simultaneously within the school environment.

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The adolescents seemed at this juncture to have already tapped into all the internal resources they considered they had available. Avoidance coping skills they had learned and subsequently practiced, in an attempt to relieve pressure imposed by other students had been implemented, hence the next step was to seek external support. A participant shared: “I go and complain to the teacher... and I does go and explain to my mother... sometimes I does tell the principal.”

The first active step on their part to enlist support and involve a third party, signified that they had assessed the situation as sensitive, and regarded the experience and expertise of adults as integral to the termination of matters involving their peers. Inviting the mediation skills of adults seemed a positive step by these adolescents so as not to become entangled in disruptive behaviour, but to continue to exercise self-restraint.

Step Four: Waiting for the Significant Other to Take Action: SupportSeeking Coping This procedure used by the adolescents now was one of “wait and see.” No hasty decisions were made to succumb or react to the progression of pressure that was often mounting and affecting the adolescent in an emotional way. Usually carefully and patiently the adolescent waited, observed and planned; for example one shared:

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“She (teacher) will tell them to leave me. To don’t interfere wid me. Or if they keep interfering wid me, put them in detention or something.”

Sometimes they were satisfied with the support given; for example, “... if I complain to the teacher they does sort it out...”, and sometimes they became disillusioned; for example, “They only listen to one part of the story… .” Typically the expectation was that after the teacher’s intervention, the situation would be resolved, the ‘perpetrator’ challenged or punished, and the ongoing interference halted. In the event that the ‘perpetrator’ continued with his or her misconduct, it became evident to the participants that their confidence in some teachers was questionable; e.g., “some teachers don’t try as hard with some children as others.” Ultimately, adolescents expected that punishment, rather than verbal reprimands would be administered; e.g., “They will stop when they get sent home, or when it is a case that’s real bad and the police gotta come.”

Step Five: Anger: Emotional-Focused Coping Generally, the participants seemed to exercise great self-restraint. They often reported that they suppressed their emotions in an attempt to maintain ongoing relationships with the ‘perpetrator(s)’ and other bystanders: “I does try to talk back with them... cause I don’t always want to be unfair to people.” Emotions frequently reached a point though where participants recognized that they must find an outlet for their anger: “They keep on telling me about she [mother]... They does go back and tell their friends a lot of stupidness about she... . That is

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when the anger does really get into me.” The internal pressure to stifle long suppressed feelings against the external forces of peers and teachers or to reciprocate, were in conflict, and, typically, eventually the adolescent ‘victim’ succumbed to the latter: “... when they keep doing it, and doing it...I will go up in the face.” This anger seemed to be experienced primarily because of ongoing and unprovoked provocation and aggression from peers, who were seemingly intent on maintaining tensions, and goading their ‘victim’ into action.

Step Six: Retaliating: Emotional-Focused Coping Participants reported using abusive language, physical violence and emotional aggression when they felt that the situation merited it. Most adolescents expressed feelings at some time of being “pushed to the limit”; for example, a participant stated:

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“I does just get in this anger and...I does can’t hold it back.”

Retaliation occurs to the extent that even if a best friend was involved, although every peaceful strategy would be implemented first to prevent discord, the ‘perpetrator’s perseverance in distressing the victim, would result in some aggressive reaction. It was unequivocally stated by participants that they tried to resist the temptation to engage in nonproductive behaviour, which they believed did more harm than good in the long term; e.g., “If you keep on letting it build up inside, and you let it explode, you might do something you will regret for the rest of your life. The participants’’ retaliation seemed dependent on the mood that that they were in at the time and how the environment was impacting on them; e.g., “Sometimes you don’t be in a mood... . If I angry and I en the mood to fight, and you hit me I gine fight.” The majority (18) of the participants reported yielding at times to the pressure, and felt that their actions often had a positive impact since they gained respect; e.g., “...they [other students] don’t come around you...they will keep far from you.” By retaliating they sent a clear message that they were to be feared; e.g., “If you fight with somebody, the rest a children will say… he just beat dah person.” Eventually responding to the environment also seemed to prove effective in helping adolescents establish an identity: “...that’s the only way you can get them to stop [and] let them know that I en no sissy.”

Step Seven: Seeking to Rebuild the Relationship Data collected revealed that eighteen (18) of the participants reported that the major daily hassles they experienced primarily involved valued peer relationships; e.g. ”We were friends, and we used to catch the bus together.” Friendships amongst the adolescent peer group were complex and somewhat inconsistent. On the one hand, nothing or no one could get between a pair of adolescents who had vowed to remain friends, and had committed themselves to the relationship. On the other hand, when someone or something infiltrated that union, jealousy often emerged, and the two then became ‘enemies’; e.g., “We were good friends before...then something happen that he friend tell he... . He has always been a problem to me.” The participants painted a picture of quite volatile peer relationships.

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Although the adolescents reported that they felt anger and frustration toward their friends, they still, in all of the cases, intentionally made every effort to renew and regain meaningful relationships with peers whom they considered important to them; e.g., “When he was by heself I went and sit down...I wanted to be friends and thing... .” Adolescent relationships were obviously dynamic, and the degree to which the environment was permitted to influence and impact on those relationships were determined by the adolescents themselves. Whereas some adolescents after constant harassment would resort to aggression, a number often used non-aggressive strategies with beneficial effects; e.g., “I talk to them and tell them what is wrong or right, and tell them not to follow bad company... that it don’t get them no way...I tell them that I am their friend, and if they want anything they can come to me. I does help them out with their home work and thing.”

DISCUSSION Semi-structured interviews were conducted with a purposive sample of adolescents to examine their coping strategies in regard to external stressors that they employed at school. A broad sequence of coping behaviours, involving a dynamic process of cognitive decisionmaking, selection of coping strategies, dependence on support, suppression of emotions, retaliation, and the rebuilding of friendships, emerged from data analysis. Variability in coping strategies, adolescent-peer experiences and adolescent-teacher experiences were three distinct concepts that formed the framework of the research.

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Concept: Variability in Coping Strategies The adolescents communicated through their interviews that they actively applied a variety of coping strategies. The coping strategies (problem-solving, emotional, support, avoidance) identified were similar to those found in the literature (Folkman & Moskowitz, 2004; Judge, 2003; Lazarus & Folkman, 1984). These findings confirmed the results of previous studies (Chapman & Mullis, 2002; Herman-Stahl, Stemmler & Petersen, 2002; Sandstrom, 2004) that also identified adolescents’ use of a variety of strategies to assist them in handling stressful and problematic situations.

Concept: Adolescent-Peer Experiences Findings in this research identified that relational aggression, used as a problem-solving strategy in adolescent relationships to manage aggressive behaviour and to gain social acceptance was a theme permeating the data (Wells & Miller, 2002; Keltikangas-Jarvinen, 2002; Boxer & Tisak, 2003; Goldstein & Tisak, 2004). Relational aggression was influenced by emotional instability, social negativity, and environmental unease; for example, a participant stated; “...sometimes when somebody want to make me shame, I don’t like dah... . Say a fella come and slap me in my face now, everybody and the crowd there will think I is a softy cause I tek that. They will go round the school with it, so that’s why I don’t tek nothing right.”

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Adolescents in the study defined themselves as targets and consistently experienced frustration and distress, which consequently led them to name-calling, using abusive language, and fighting. These acts of aggression were consistent with research conducted by Boxer and Tisak (2003), which examined adolescents’ attribution to aggression, and found that temperamental disposition, early learning history, and social cognitive mediation were responsible for how they dealt with peers.

Concept: Adolescent-Teacher Experiences Males more so than females in the study expressed strong views associated with their disappointment of the paucity of support received from teachers. It was the general consensus among males that teachers demonstrated partiality, were inconsistent with handling complaints, and many times minimized issues that the adolescents considered pertinent. Consistent with these findings, a study by Snyman, Phil, Poggenpoel and Myburgh, (2003) had identified that some teacher-student relationships were considered to be dysfunctional, and students accused teachers of favouritism and victimization.

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Concept: Sequence of Coping Behaviours Most notable in the study was the discovery of a broad ‘sequence of coping behaviours’. Findings identified a dynamic process of seven cognitive decision-making and action steps that adolescent participants engaged in their quest to manage and efficiently cope with the hassles they encountered daily as part of their interactions with peers and teachers. Future research needs to examine this ‘sequence of coping behaviours’ in a quantitative study to assess the reliability of the proposed model, as well as to provide answers to such questions as: ‘Is the ‘sequence of coping behaviour’ specific to problematic adolescents in the Caribbean, adolescents of the African Diaspora across the world, or adolescents in general?’ The steps in the ‘sequence of coping behaviours’ included the adolescents’ efforts to ignore and walk away, avoid the situation, complain to teachers, wait for action to be taken by teachers, recognize that anger was building as aggression escalated, retaliate when unable to take any more emotional and physical pressure, and ultimately seek to rebuild friendships. The efforts made by adolescents in the study were in accord with extant research (Folkman & Moskowitz, 2004; Judge, 2003; Lazarus & Folkman, 1984) that recognized that coping consisted of multiple efforts that individuals had to give thought to if they were to manage, reduce or minimize situations in their environment that were in conflict with their everyday existence. In relation to cultural differences, it is important to note that one of the main themes that unites the steps of the ‘sequence of coping behaviours’ seemed to be the adolescents’ desire to manage the relationship with the intent of eventually resuming the friendship. This may be directly related to Caribbean adolescents’ Afrocentric worldview (Asante, 1987; Jenkins, Lamar, & Thompson-Crumble 1993; Nobles, 1986). Alternatively, it could be due to the reality of living in a small island society with a population of 268,792 persons (2000 Population and Housing Census, 2002), which inevitably increases the likelihood that you will ‘cross paths’ later in your adult life whether socially or professionally.

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Knowledge of the steps adolescents take in the ‘sequence of coping behaviours’ can be of benefit to counselling. Counsellors will be able to identify the ‘stage’ adolescents are at, when they are referred to or attend counselling. Recognition of the stage at which adolescents are operating, will make it possible to interpret and analyse the adolescents’ cognitions and the proceeding behavioural step(s) they are likely to take. Based on the reports from the respondents it was evident that aggression is not generally an impulsive behaviour for this sample of Caribbean adolescents; as stated by one participant, “I does ignore them sometimes. Sometimes I feel like getting up and giving them a lash, but I tell myself that I would only get myself in trouble so I does just cool myself... . I does just stop and think about it... and I think about the consequences. Sometimes if the teacher soft I does go to a teacher that stricter.”

Adolescents can be assisted to collaborate with counsellors to effectively use intervention strategies to help them prevent, diffuse and resolve peer-related problems. Problem-solving strategies, conflict resolution and mediation skills are indispensable to motivate and recondition adolescent behaviour. The suggestion for intervention is in accord with findings by Wells and Miller (2002) that recommended that intervention for aggressive problems with adolescents be timely, coupled with the teaching of self-management skills, and the inclusion of skills to control their aggressive tendencies. Individual or group counselling with adolescents can also be of benefit while seeking to halt the escalation of the steps in the sequence. Adolescents should be viewed as holistic beings who will collaborate with a treatment plan that would target the way they think, feel and behave.

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Limitations There was a clear weakness in the participants’ understanding and comprehension skills that caused the interviewer to engage in much probing and clarifying. Another limitation was the absence of previous assessment, which would have given insight concerning any psychological disorders and learning disabilities.

Recommendations The findings of the study have led to the following recommendations. Adolescents must gain awareness that stressors and hassles can be managed in a meaningful way and they can be taught cognitive-behavioural strategies and practical skills to manage conflict. The study found that adolescents genuinely wanted to maintain healthy relationships with their peers. Hence the sequence of coping behaviours they employed, and their intention to repair friendships that become strained. It is important, therefore, to explore with adolescents what is involved in building and maintaining friendships. Teachers and school administrators must seriously address students’ complaints, and give individual attention to adolescents who approach them for support. Extant literature emphasizes that the dysfunctional nature of some teacher-student relationships are fraught

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with partiality and favouritism, and often contribute to feelings of inferiority, denigration and worthlessness (Crowley, 1993; Nolen-Hoeksema, 1998; Snyman, Phil, Poggenpoel & Myburgh, 2003). When positive support is forthcoming, adolescents display socially accepted behaviours, emotional stability, and achieve academic and behavioural goals (Crowley, 1993). The study revealed that adolescent-teacher experiences are among the most significant relationships for the adolescent. Both male and female participants respectively stated views captured by the notion, “I does feel a lot more relief …when I go and complain to the teacher” and “I does go to the form teacher and ask the form teacher for assistance and help.” This is further supported by the fact that adolescents sought external support from their teachers early in the sequence since they believed that teachers were capable of resolving the problems with their peers, or helping them with solutions. Parents, teachers, psychologists, counsellors and school administrators should be familiar with the evident ‘sequence of coping behaviours’, which outlines the process through which adolescents arrive at an appropriate and meaningful strategy to manage challenging situations. Results in this research show that adolescents engage these steps in an effort to alleviate discomfort, seek support, establish autonomy and retain peer relationships. Halama (2000) found that adolescents’ coping strategies were multidimensional, and were motivated by their perception of “meaning”, which was a source of positive coping. Adolescents who experience personal and social problems should be referred to the guidance counsellor so that they may be encouraged to collaborate in an intervention programme., since research has found that the client who accesses counselling does not require a ‘cure’ for the presenting problem(s), but aims to improve his or her daily functioning, and make personal adjustments in their environment (Crowley, 1993; Dalton & Pakenham, 2002; Vogel, Epting & Wester; 2003; Synman, Poggenpoel & Myburgh, 2004). Knowledge of the steps involved in the ‘sequence of coping behaviours’ could assist counsellors working with Caribbean adolescents in particular, helping them to provide counselling experiences that halt the sequence and effectively improve the adolescent’s daily functioning within the school, by teaching them problem-solving skills and addressing developmental issues. Previous research proposes that counselling a client also requires the integration of theories and techniques that will foster awareness and insight, provide emotional release and reduce tension, give support, and encourage exploration and relearning. It includes a journey with the client that will facilitate his or her growth, development and self-actualization (Kirchenbaum & Land Henderson, 1989; Corey, 2001; Gladding, 2000). Aiden (1997) and Lai King (1991) have reported that social and environmental factors impact on adolescents’ coping. Consequently adolescents find that being asked to take responsibility can be difficult and solving problems painful. The study showed that similar factors, as well as emotional issues were typical motivators for the coping strategies utilized.

CONCLUSION The findings of this study witnessed the apparent existence of a ‘sequence of coping behaviours’ that adolescents, Caribbean adolescents in particular, seem typically to employ

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during their daily interactions with peers and teachers. This dynamic cognitive and behavioural process of coping manifested in this group of problematic Caribbean adolescents needs to be researched further to assess the reliability and validity of this ‘sequence of coping behaviours’ for a larger sample of Caribbean adolescents and adolescents in general. Educators, counsellors, parents and interested stakeholders can be informed by these results, which have highlighted the importance of the steps taken by adolescents in order to effectively manage the daily hassles and stresses they encounter in the school environment. Contrary to what teachers and other observers often suggest, most adolescents interviewed believed that they made every effort not to become embroiled in problematic behaviour. This was evident from the variety of coping strategies they used, their expressed feelings about these strategies, the emotions they experienced and the aggression they endured, their expressed disappointment at the lack of support received by teachers, and their final attempts to repair broken relationships. It is evident that within a Caribbean context coping strategies may have to be inclusive in nature, due to a leaning toward a traditionally more collectivist culture. Future research on this phenomenon can be undertaken from a quantitative perspective to complement the qualitative findings. Adolescent-peer relationships and adolescent-teacher relationships need to be further examined in a longitudinal study, in terms of the effect of intervention, and as their interactions are monitored. Another complement to such research would involve the observation of adolescents as they interact with and utilize coping strategies within the school environment.

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Compas, B. E., Malcarne, V.L, & Fondacaro, K.M. (1988). Coping with stressful events in older children and young adolescents. Journal of Consulting and Clinical Psychology, 56(3), 405-411. Comprehensive Study of School Discipline Issues in the OECS: research Report Summary, (2006). Retrieved September 15, 2008, from http://www.oecs.org/oeru/documents /Comprehensive%20Study%20of%20Research%20School%20Discipline%20Issues%20i n%20the%20OECS.pdf Corey, G. (2001). The art of integrative counselling. USA: Wadsworth/Thomson. Crowley, P. (1993). A qualitative analysis of mainstreamed behaviourally disordered aggressive adolescents’ perceptions of helpful and unhelpful teacher attitudes and behaviours. Exceptionality, 4 (3), 131-151. Dalton, M., & Pakenham, K. (2002). Adjustment of homeless adolescents to a crisis shelter: Application of a stress and coping model. Journal of Youth and Adolescence, 31 (1), 7993. Dumont, M. & Provost, M.A. (1999). Resilience in adolescents, Protective role of social support, coping strategies, self-esteem, and social activities on experience of stress and depression. Journal of Youth and Adolescence, 28(3), 343-363Dunahoo, C.L., Hobfoll, S.E., Monnier, J., Hulsizer, M.R., & Johnson, R. (1998). There’s more than rugged individualism in coping. Part I: Even the Lone Ranger had Tonto. Anxiety, Stress, and Coping, 11, 137-165. Feldman, R. (1997). Essentials of understanding psychology (4th ed.). New York: McGrawHill. Folkman, S., & Lazarus, R. S. (1988). Ways of Coping Questionnaire. Palo Alto, CA: Consult. Psychology Press. Folkman, S. & Moskowitz, T. (2004). Coping: Pitfalls and promise. Annual Review of Psychology, 55, 755-774. Gladding, S. (2000). Counseling: A comprehensive profession (4th ed.). New Jersey: Prentice-Hall. Goldstein, S., & Tisak, M. (2004). Adolescents’ outcome expectancies about relational aggression within acquaintanceships, friendships, and dating relationships. Journal of Adolescence, 27, 283-302. Griffith, M., Dubow, E., & Ippolito, M. (2000). Developmental and cross-situational differences in adolescents’ coping strategies. Journal of Youth and Adolescence, 29 (2), 183-200. Halama, P. (2000). Meaning of Life and Coping with Frustration. Studia Psychologica, 42, 339-350. Herman-Stahl, M., Stemmler, M., & Petersen, A. (2002). Approach and avoidant coping: Implications for adolescent mental health. Journal of Youth and Adolescence, 24 (6), 649-663. Hobfall, S. (1998). Stress, culture, and community: The psychology and philosophy of stress. New York: Plenum Press. Holahan, C. J., & Moos, R. H. (1987). Risk, resistance, and psychological distress: A longitudinal analysis with adults and children. Journal of Abnormal Psychology, 96, 313. Hunt, S., & Main, T. (2001). Trans-Gender Expressions. Retrieved November 29, 2003, from http://www.tg2tg.0rg/sosupport/research/soffa-study/.htm

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Raikhy, C., & Kaur, S. (2010). Corporal punishment: Coping strategies adopted by the adolescents. Studies on Home and Community Science, 4(1), 57-62. Renk, K., & Creasey, G. (2003). The relationship of gender, gender identity, and coping strategies in late adolescents. Journal of Adolescence, 26, 156-168. Sandstrom, M. (2004). Pitfalls of the peer world: How children cope with common rejection experiences. Journal of Abnormal Child Psychology, 32 (1), 67-78. Seiffge-Krenke, I. (1995). Stress, coping and relationships in adolescence. New Jersey: Lawrence Erlbaum. Sefiffge-Krenke, I., & Klessinger, N. (2000). Long-term effects of avoidant coping on adolescents depressive symptoms. Journal of Youth and Adolescence, 29 (6), 617-629. Snyman, M., Phil, M., Poggenpoel, M., & Myburgh, C. (2003). Young adolescent girls’ experience of non-clinical depression. Education, 124 (2), 269-285. Torquati, J., & Vazsonyi, A. (1999). Attachment as an organizational construct for affect, appraisals and coping of late adolescent females. Journal of Youth and Adolescence, 28 (5), 533-545. Tshiswaka, E. (2003a). Action research and phenomenology. In UWI (Ed.), Research Methods Part II: Qualitative Research Methods Unit 4 Course 0962H. Mona, Jamaica: Department of Obstetrics, Gynaecology, and Child Health. Tshiswaka, E. (2003b). Qualitative data analysis. In UWI (Ed.), Research Methods Unit 12, Course 0962H. Mona Jamaica: Department of Obstetrics, Gynaecology, and Child Health. Vogel, D., Epting, F., & Wester, S. (2003). Counsellors’ perceptions of female and male clientsJournal of Counselling and Development, 81 (2), 131-147. Ward, T., & Hickling, F. (2004). Psychology in the English-speaking Caribbean. The Psychologist, 17 (8), 442-444. Wells, D., & Miller, M. (2002). Adolescent affective aggression: An intervention model. Adolescence, 28 (12), 781-791. Windle, M., & Windle, R. (1996). Coping strategies, drinking motives, and stressful life events among middle adolescents: Associations with emotional and behavioural problems and with academic functioning. Journal of Abnormal Psychology, 105, 551-560. Wolman, B. (1998). Adolescence: Biological and psychosocial perspectives. Westpoint, CT: Greenwood Press. Yeh, C. J., Chang, T., Arora, A., Kim, A.B., & Xin, T. (2003, August). Development of the Collectivistic Coping Scale: Report from six studies. Poster presented at the 2003 Annual Convention of the American Psychological Association, Toronto, Canada.

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In: Handbook of the Psychology of Coping Editors: Bernando Molinelli and Valentino Grimaldo

ISBN: 978-1-62081-464-2 © 2012 Nova Science Publishers, Inc.

Chapter 9

HOW DIFFERENTIAL COPING STYLES IN RODENTS MAY EXPLAIN DIFFERENCES IN DISEASE SUSCEPTIBILITY IN HUMANS Gretha J. Boersma* Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, US

ABSTRACT

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For many disorders the origins of an increased susceptibility for development of the disorder is not clear. This is especially the case in disorders characterized by heterogeneity in symptoms, such as depression, anxiety, and the metabolic syndrome. Indicating a single risk factor that predicts disease onset and severity has proven difficult. Due to the polygenetic origin of such disorders, a prediction based on a risk profile rather than a single risk factor may be more accurate. Recent advances in animal research have indicated the coping style, characterized by a behavioral and associate physiological profile in response to changes in the environment, may have high predictive value for the incidence of both psychiatric and somatic disorders. Rodents with a passive stress coping style, for example, are more prone for depression like behavior, and this stress coping style is also associated with an increased susceptibility for the metabolic syndrome. The proposed chapter will give an overview of recent studies investigating the role of the coping style in the vulnerability for both psychiatric and somatic disorder using animal models. The chapter will summarize the neuroendocrine mechanisms indicated to play a role in the interaction between coping style and disease susceptibility. Finally, in the chapter the translational value of animal models for coping style will be discussed.

*

Contact information: Gretha Johanna Boersma, PhD. Current Address: Johns Hopkins University, School of Medicine; Department of Psychiatry and Behavioral Sciences, 720 Rutland Avenue, Ross 612, Baltimore, MD, 21205. Tel: +1 410 955 2996; Email: [email protected].

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1. STRESS AND DISEASE SUSCEPTIBILITY An association between stress and disease risk has been implied for years and there is ample evidence for this assumption. Exposure to major life stressors was shown to both increase disease susceptibility and decrease recovery. In particular, immune and metabolic disorders have been linked to elevated stress exposure (recently reviewed in (50, 77)). Even though direct effects of glucocorticoids and indirect effect of impaired immune reactivity could partially explain the link between stress and disease risk, more research is need to fully understand the mechanisms behind these stress effects. Additionally, although most individuals are exposed to stressors at some point in their life, not all are equally susceptible to the deleterious effects that stress can have on a person’s health. This chapter will summarize some of the animal studies aimed at elucidating these individual differences, and attempts to translate these findings to the human population.

2. DEALING WITH STRESS: PERSONALITY AND STRESS COPING STYLE

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2.1. Personality The way an individual responds to stress in their life (“coping style”) may best be predicted by their personality. The concept of personality has been described in several different ways. Most current theories on personality are, however, based on the behavioral disposition model proposed by Allport in 1937. This theory stated that a personality characterized individual in terms of a set of stable disposition trait that are distinctive for the individual and determine a wide range of behavioral responses. A personality is thus a set of behavioral responses that are genetically imbedded within an individual and these behavioral strategies are employed throughout life to interact with the environment. Even though this theoretic framework of the behavioral disposition model is well accepted, scientific descriptions of the personality are mostly methodology based; the method used to assess personality traits also determines the definition of personality. The most well known methodology used to assess personality is the Big Five model (25, 51). This model describes five personality traits: Neuroticism, Extraversion, Conscientiousness, Agreeableness, and Openness to experience (51). In 1934, Thurstone (78) had already identified these factors after discovering that these five factors could account for the variation found in personality types in 1,300 test subjects using 60 personality adjectives. These five personality traits have been shown to remain stable throughout development from infancy to adulthood and are not affected by major live events (51).

2.2. Coping Style in Humans and Animals Personality characterization using the questionnaire-based method has shown to be extremely useful in the diagnostic psychology practice. However, when studying the underlying mechanisms mediating personality, using this method has proven complicated.

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Not only does the personality itself affect the rating process, direct links between each of the personality traits and physiological responses are not clear. When studying the physiological and neural mechanisms underlying the individual differences in personality or coping style, the use of an animal model might therefore be useful. But can one define “personality” in animal? Studies in several different animal species ranging from primates to invertebrates have identified distinct behavioral phenotypes within a population. The nomenclature used to describe these animal “personalities” differs from study to study. Terms often used are behavioral syndrome (71), behavioral profile (36), or coping style (43). Since the term “coping style” is most frequently described in the stress research literature, this is the terminology used in this chapter. The development of a coping style is aimed at controlling the environment successfully with the ultimate goal being survival (84). In most animal species, including humans, two distinct coping strategies are described: the proactive coping and the reactive (passive) coping strategy (43). The first coping strategy, the proactive coping style, is based on the so-called fight/flight response. The fight/flight response is a stress response predominantly mediated by activation of the sympathetic nervous system. Due to release of catecholamines, the heart rate, blood pressure and blood flow to the muscles is enhanced allowing the animal to escape the threat (40). Individuals with a proactive coping style are not only characterized by this proactive response to stressors, these individuals display higher levels of aggression, impulsivity, and they are more prone to develop routines (4, 81). The second strategy, a passive (or reactive) coping style, originates from a conservation/withdrawal response. This response, first described by Engel et al (28), is mediated by activation of the Hypothalamic-Adrenal-Pituitary axis (HPA axis). HPA axis activation leads to increased glucocorticoid levels, which induces freezing behavior. The freezing response minimizes the change of being attacked and, thereby, lowers the risk of being harmed by the threat. Individuals with a passive coping style are also characterized by a low aggressive nature, low levels of cue dependency and high levels of behavioral flexibility (4, 9, 81). Summarizing these two coping strategies, the proactive individuals are characterized by a low HPA axis reactivity, but high sympathetic reactivity in response to stressful stimulation. In contrast, passive individuals showed higher HPA-axis reactivity and parasympathetic reactivity, but low sympathetic reactivity (22, 41, 44). In wild populations of animals the coping strategy of individuals within the population follows a bimodal distribution; individuals that display an extreme coping style, either passive or proactive have higher chance of survival. This bimodal distribution was, for example, shown in wild populations of the great tit (parus major) and the mouse (mus musculus domesticus) (4, 82). In a stable territorial environment, a proactive coping animal, with high levels of aggression and a strong tendency to form routines will have a high fitness. In contrast, in a migratory setting the passive coping animals, with higher behavioral flexibility, will most likely do better. An animal with an intermediate coping style will not have a high survival rate in either a stable, territorial setting nor in a variable, migratory setting and, therefore, this intermediate strategy is not observed within wild populations. In laboratory or domestic settings there is no environmental pressure pushing the population into a bimodal distribution and therefore in domesticated populations, like domesticated pigs and most laboratory rat strains, a normal distribution in coping strategies is observed (75).

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2.3. Coping Style and Regulation of the Stress Response In general, passively coping individuals are characterized by increased HPA axis activity compared to proactive individuals. The different aspects of the HPA axis have been thoroughly studied in animal models. Although there are no differences in glucocorticoid levels under baseline conditions between passive and proactive rodents, several studies have shown that the circadian rise in glucocorticoids was higher in passively coping rats. Additionally, in response to mild stressors, such as a novel environment or a sudden noise, the glucocorticoid response is typically higher in the passively coping rats. These differences in glucocorticoid levels may be mediated by differences HPA axis functioning. Higher plasma andrenocorticotropic hormone (ACTH) levels after exogenous corticotrophin releasing factor (CRF) administration have been reported in rats selectively bred for a passive coping style (83), an effect that was associated with higher in vitro release of ACTH by dispersed pituitary cells in culture. These data suggest increased capability of glucocorticoid secreting cells from passive rats to respond to endogenous CRF, which may contribute to the enhanced stress-induced glucocorticoid release. Additionally, the negative feedback system regulating the HPA axis may be altered in passive coping rats, which is indicated by a lower number of glucocorticoid receptors in the passive rats (83). In addition to differences in HPA axis activity, passive and proactive coping individuals differ in sympathetic activation after stress. In rats, no differences in the baseline activity of the sympathoadrenal system were observed (21). However, under stress conditions the proactive coping rats display higher sympathetic reactivity, resulting in increased plasma norepinephrine and epinephrine level in these rats. Furthermore, the proactive rats display increased heart rate, blood pressure and blood glucose, consistent with higher sympathoadrenal activity (70). The mechanism behind these differences has been less investigated. However, some studies indicate that the proactive adrenergic hyperreactivity may be mediated by increased β2-adrenergic and decreased α2A-adrenergic receptor sensitivity (12, 45, 72, 79).

2.4. Coping Style and Immune Function Since stress is associated with alterations in immune function one may suggest that the stress coping style has implications for immune function. Several studies in rodents show that this is indeed the case. Passively coping Wistar rats were shown to have heightened lymphocyte proliferation, decreased interleukin-10 and interferon-γ production compared to proactive rats (67). Additionally, mice characterized by a more passive behavioral strategy, the Balb/c mouse strain, showed lower humoral and higher cellular immune responses than proactive coping C57Bl/6 mice (69). In the C57Bl/6 mice strain it was also shown that acute stress induced immune stimulation in the proactive coping individuals, whereas a similar acute stressor induced immune-suppression in the passive coping individuals (23). Overall, data indicate that stress differentially affects immune function in passive and proactive individuals.

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2.5. Coping Style and Energy Metabolism It is generally assumed that the development of coping strategies within species is driven by fitness trade-offs that act or have acted over the course of evolution (86). A proactive personality, characterized by high levels of aggression, routine formation and low levels of anxiety, is believed to be well-adapted to a territorial environment that remains stable over a prolonged period of time. In contrast, a passive personality type, characterized by high levels of behavioral flexibility, is thought to be adapted to a migratory setting. It is reasonable to assume that these adaptations also have repercussions on energy homeostasis characteristics of the individual. Under standard laboratory conditions only minor differences in body weight or food intake were observed in rats selected for a proactive versus a passive coping style. More detailed investigation of feeding behavior revealed differences in meal patterning and circadian organization of eating behavior (6). Proactive rats ate fewer meals during a 24-hour period, but had a higher eating rate and larger meals. They also displayed a more distinct day/night rhythm in food intake than passive rats. Additionally, analysis of body fat distribution showed a higher storage of visceral fat in the passive rats than in the proactive rats, without a difference in total adiposity. These data show that proactive and passive rats are equally able to maintain a stable body weight, but that they employ different strategies to reach this ability. Although there were no major differences in food intake under standard laboratory conditions, when passive coping rats were put on a palatable high fat diet, they gained more weight than the proactive coping rats (7). A recent evolutionary theory with regards to the interaction between the coping style and the energy balance is the “predation release hypothesis”, introduced by Speakman (74), which may explain the coping style dependent weight gain. The predation release hypothesis is based on the concept of a “set-range” rather than a “set-point” for the maintenance of energy balance. The theory suggests that the lower boundaries of this set-range are determined by evolutionary selection pressures related to the risk of starvation. The higher boundary of the set-range in this hypothesis is determined by selection pressure related to the risk of predation. When there is a high risk of predation, body weight should not be too high since a high weight decreases escape possibility. When, however, the predation risk is low, like in current society, the upper boundary for maximal body mass could be set at a higher level. This theory becomes interesting with respect to the research discussed in this paper if proactive and passive individuals prove to be differentially affected by predation risk. Hints that a differential predation risk is indeed observed in proactive and passive coping individuals are found in populations of sticklebacks. Sticklebacks from high predation populations tend to show increased aggressive and bold behaviors compared to fish from low predation populations (3). This suggests that a proactive coping style is preferred in environments with high predation risk, whereas a passive coping style is more successful in low risk environments. Combining the predation release hypothesis with the observed differences in coping styles in low and high predation risk environments in sticklebacks may lead to a new hypothesis on energy maintenance in differentially coping individuals. One may hypothesized that that in the current low predation environment co-selection of a passive personality with higher upper boundary of the energy balance might have caused the increased risk of developing obesity in passive coping individuals (summarized in Figure 1).

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Figure 1. Schematic representation of the metabolic set range in passive and proactive rats. It is suggested that due to increased perceived predation risk the passive coping rat has a higher acceptable level than the proactive coping.

Overall, we may conclude that evolutionary drift may have induced co-selection of traits for a passive behavioral strategy and obesogenic traits. The mechanisms responsible for this evolutionary drift, however, remain to be elucidated.

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3. IMPLICATIONS FOR HUMAN PATHOLOGIES Although predation risk is low for humans in current society, the different stress responses among coping styles have been conserved. Using the Trier Social Stress test paradigm, for example, clear individual differences in the HPA axis response have been observed that seem to correlate with the personality characteristics fitting with a passive coping strategy, such as high scores of avoidance behavior and low scores on hostility measures (60). Based on the consistency in the physiology related to coping styles in humans and rodents it seems that rodent models for coping style may have predictive value for human disease. In the following section we will look further into the relationship between the coping style of an individual and their risk to develop somatic and psychiatric disorders.

3.1. Stress Coping and Psychiatric Disorders 3.1 1. Depression and Anxiety When investigating the mechanisms responsible for development of mood disorders, such as major depression, the use of animal models may be difficult, since mood disorders cannot be diagnosed in animals. However several characteristics of depression, such as anhedonia, reduced activity and a passive attitude can be studied in animal models. Using behavioral test measuring anhedonia, like a sucrose preference test, passively coping rats and mice were shown to be more susceptible to depression like behavior than their proactive litter mates (43). In concordance with this, people with a passive stress coping strategy were shown to have a higher risk to develop depressive symptoms in their life (64). Similarly, a passive

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coping style is often associated with high levels of anxiety in both the rodent models as well as in humans (43, 52). These differences may be mediated by differences in the serotonin systems of passive and proactive copers. Serotonin has long been implicated to play a role in the development of depression, as is exemplified by the efficacy of serotonin modulating agents in the treatment of this disorder. By investigating rodents selectively bred for their coping style it became apparent that the basal release of serotonin in the cortex, as well as the basal tone in the dorsal raphe was higher in proactively coping individual (34). Additionally, the uptake of serotonin was higher in proactive rats as well. This was complemented with higher serotonin binding in the hippocampus, fore- and mid brain and a higher affinity of the serotonin transporters in proactive individuals. In contrast to these baseline differences, when the animals were exposed to stress, the passive individuals showed a sharp increase in the serotonergic reactivity, whereas this response was not affected in proactive rats (27). Taken together these data suggest that the proactive rats have a stronger serotonergic feedback system under baseline conditions, but that this system is more triggered in the passive rats during stress exposure. Interestingly, the most commonly used anti-depressants, the serotonin re-uptake inhibitors (SSRI), are aimed at altering this feedback system. These SSRI’s are generally effective for the treatment of depression, but treatment efficacy is highly variable. Further research should investigate whether these variable results may be explained by the coping style of the individual.

3.1.2. Other Psychiatric Disorders Evidence for a link between other psychiatric disorders and the coping style are less pronounced. Some studies show correlations between a proactive coping style and attention deficit hyperactivity disorder (ADHD). However, since ADHD is characterized by high levels of impulsivity, this correlation may be due to a shared impulsivity trait rather than the complete behavioral syndrome. Similarly, parallels between a proactive coping strategy and schizophrenia have been suggested. One of the characteristic of patients with schizophrenia is behavioral stereotypy, a characteristic that fits well with enhanced routine formation in proactive individuals (48). However, since animal models for these pathologies can only focus on the non-cognitive characteristics of these disorders, it has proven difficult to investigate the link between these pathologies and the coping style in rodents. Disorders in the dependency disorders category seem, however, clearly associated with a proactive coping style. Both proactive rodents and proactive humans have been shown to have an increased risk to develop drug dependency (19, 65, 85). These coping style specific differences in drug dependency are most likely due to difference in the dopaminergic signaling. Studies in rodents have shown that both the dopamine 1 and dopamine 3 receptors are more sensitive in proactively coping rats. This enhanced sensitivity seems to be mostly due to an increased receptor density of these receptors in the proactive rats (33). Studies investigating the effects of dopaminergic drugs showed similar results in humans (reviewed in (54)).

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3.2. Stress Coping and Somatic Disorders

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3.2.1. Cancer/Immune Function As mentioned previously, passive and proactive individuals differ significantly in immune function. It is often suggested that personality or coping style in also an important risk factor for immune disease. However, evidence for this interaction in humans is limited. Some epidemiological data suggests a role for the coping style in allergies, dermatitis and related immune disorders (13, 68). Additionally a study in the US army found an association between aggression traits and cellular immunity (35). The mechanism behind these associations have not been elucidate yet. Studies in rodent models may provide more clear views on the possible relation between coping style and immune disease vulnerability. Proactively coping rats selected from a wild rat population were more vulnerable for the induction of the autoimmune disease experimental allergic encephalomyelitis (EAE). A similar observation was made in rats originally selected for hypo-reactive dopamine systems. These rats are characterized by a proactive behavioral profile, and had an increased susceptibility to EAE. This high vulnerability for EAE in proactive copers is thought to be due to high sympathetic activity, leading to up regulation of pro-inflammatory cytokines (42). In contrast to immune disorders, rats with a more passive coping style were observed to have a larger risk to develop pulmonary metastases in an experimental tumor model. This differential tumor susceptibility may be related to different NK cell and T helper cell activity due to differential glucocorticoid release in proactive and passive copers (14). The decreased NK cell activity suggests a decrease immune reactivity in the passive coping rats. Based on these data it seems that proactive individuals are more vulnerable to disorders related to immune hyperactivity, whereas passive copers are more susceptible to disorders related to cell growth and decreased immune function. 3.2.2. Cardio Vascular Disease Many studies have suggested that high levels of stress could be a risk factor for cardiovascular disease (CVD) (10, 37, 66). Stress increases heart rate and blood pressure, and it is therefore not hard to assume that this may have repercussions for individuals at risk for stroke or acute cardiac failure. However, some argue that there is currently a lack of evidence of the effects of stress on the incidence of cardiovascular events (5). This lack of evidence may be due to large individual differences in the stress responses and environmental factors an individual is exposed to. In epidemiological studies it was shown that personality of the individual plays a pivotal role; a type A personality, and particularly high levels of aggression and hostility, were associated with a increased risk to CVD (18, 76). This association was explained in two different ways, first, since individual with hostility traits may respond more negatively toward peers they may be exposed more frequently to social stressors. Secondly, a type A personality is characterized by a higher sympathetic activation during stress, which may explain the increased blood pressure in these individuals (56). Since in the human studies the environmental factors are hard to dissociate from the physiological effects, we may wonder what we can learn from animal models. A frequently used model investigating hypertension is the spontaneously hypertensive rat (SHR). These SHR rats present with significantly elevated blood pressure in the absence of obesity or clear changes in other parameters associated with the development hypertension. Studies examining the stress

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responsivity in the SHR rats show contradicting results, some show increased ACTH and corticosterone levels, some show decreased corticosterone levels, whereas others report finding no differences between SHR and control rats (39, 87). Whether or not differences in stress responses are observed between SHR and control rats seem highly dependent on the type of stressor employed (discussed in (26)). Behaviorally, the SHR have been characterized as being more aggressive than control rats, and additionally they seem more explorative in novel environments, which may suggest they have a more proactive coping strategy than controls (32, 59). Even though studies with adrenalectomized and corticosterone supplemented SHR rats suggest a association between hypertension and glucocorticoids release in SHR rats (30, 38) and behaviorally SHR rats show characteristics of a proactive coping style, it is too soon to speculated that hypertension in this animal model may be related to coping style. Geerse and colleagues (31) observed that rats characterized for passive or proactive behavior in an open field test did not differ in their mean arterial pressure (MAP) under basal conditions. However, when the rats were exposed to foot shock stress, the passive coping rats appeared to have an elevated MAP. In addition, rats selectively bred for a passive coping style, the Roman Low avoidance (RLA) rats, show elevated MAP and systolic pressure already under basal conditions (6). A possible mechanism for the development of hypertension in these rats is a differentially regulated arginine-vasopressine system in passively coping individuals. Aubry and colleagues showed that passive coping rats have elevated vasopressin levels in the paraventricular nucleus of the hypothalamus under basal conditions (2). Central vasopressin is known be involved in blood pressure regulation (20), and intracerebroventricular administration of arginine-vasopressin leads to an increase of blood pressure (58). These rats, however, also show insulin resistance and visceral obesity under basal conditions, and thus the hypertension observed in the passively coping rats may be due to the metabolic syndrome. Taken together the data from both the human and the rodent studies, the relationship between coping style and cardiovascular disorder seems complex. Since most of the cardiovascular pathologies are directly associated with increased adiposity, effects of adiposity and coping style may interact. When studying the relation between coping style and cardiovascular risk factors, perhaps one should dissociate these risk factors in a group that are related to increased sympathetic activity and a group that are the result of increased adiposity. Proactive copers may be more prone to the first group of pathologies, whereas the passive copers might be particularly sensitive to the latter group.

3.2.3. Metabolic Syndrome The metabolic syndrome is a metabolic phenotype characterized by obesity, hypertension, type 2 Diabetes, and visceral obesity. The role of the coping style in the vulnerability to hypertension was previously discussed. The question remains, whether the coping style also influences the other symptoms of the metabolic syndrome. In paragraph 2.5 we reported that rats selectively bred for a extreme passive coping style distributed more fat in the visceral compartment, suggesting the a passive coping style may predict susceptibility for visceral obesity. Consistent with this view, when exposed to a palatable diet, passively coping rats, either selectively bred or selected from wild rat population, gained more adipose tissue than proactively coping rats (7). However, the most convincing evidence for a link between a passive coping strategy and vulnerability for the metabolic syndrome comes from studies

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investigating susceptibility for Type 2 Diabetes in rats selected for their coping style. When insulin resistance is assessed using the Intravenous glucose tolerance test (IVGTT), passive coping rats display hyperinsulinemic responses to glucose infusion, which is one of the hallmarks of insulin resistance (8). Moderately passive rats displayed a relatively mild hyperinsulinemic response to an IVGTT on a standard diet, but displayed severe hyperinsulinemia when fed high fat diet (7). Proactively coping rats, both extreme and moderate, appeared resistant to the deleterious effect of HF diet on insulin sensitivity. These data suggest that relative to proactive coping rats, passively coping rats have increase susceptibility for deregulation of the energy balance and fuel homeostasis when subjected to environmental challenges. An alternative approach to investigate a potential cause-effect relation between the coping style of an individual and the risk to development of metabolic derangements is to study the behavioral profiles of well known models for hyperinsulinemia, insulin resistance and obesity. From the data mentioned previously it appears that in particular the passively coping rats are vulnerable to the metabolic derangements induced by feeding a HF diet. Dietinduced obesity is a frequently used paradigm to study obesity in rodents; with this model rodents are fed a calorically dense diet and as a consequence about half the number of rats becomes obese on this diet (DIO rats), whilst the other half does not develop obesity and are thus diet-resistant (DR) (47). Diet-induced obesity is often accompanied by insulin and leptin resistance, hyperlipidemia and hypertension. Interestingly, DIO rats were characterized by higher sympathic output, as measured by increased noradrenalin levels (46). Furthermore, DIO rats subjected to a HF diet have higher increases in glucocorticoids, and have higher levels of anxiety than DR rats (11). This suggests that the DIO rats in those studies have a mixture of the proactive and passive phenotypes. In the DIO/DR model, the DIO rats have significantly higher energy intake that the DR rats (47), a difference that was not observe between the rats selected for proactive or passive coping. Furthermore, another major difference characterizing DIO and DR rats is their difference in body weight gain on a HF diet. Although the passive coping rats have higher adiposity that the proactive rats, we did not observe major difference in body weight gain. We may therefore state that the proactive coping rats are not necessarily diet resistant with respect to body mass increase, but that these proactive coping rats may be resistant to the maladaptive (pathological) consequences of DIO. Studies in rat models selected on the basis of a genetic defect are consistent with the view that a passive coping style is only uni-directionally related to visceral adiposity and insulin resistance. The spontaneously diabetic Fa/Fa rat, for example, is characterized by a genetic defect in the leptin receptor leading to obesity, hyperlipidemia, insulin resistance and hyperglycemia (57). These rats were investigated in several different behavioral paradigms, like the open field, elevated plus maze and the black/white box tests, however, no behavioral differences were found between the diabetic Fa/Fa rats and their heterozygous non-diabetic counterparts (17). This suggests that insulin resistance, leptin resistance or obesity do not per se alter the behavioral profile of a rat. We can thus state that insulin resistance associated with hyperinsulinemia would not lead to a more passive behavioral profile, which suggests that the coping style of passive individuals is not the consequence of an altered metabolic profile. Instead, the passive coping style of an individual triggers maladaptive responses to abundance of energy, which than in turn leads to a higher susceptibility to develop metabolic derangements.

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To investigate whether other specific aspects of coping style, such as HPA-axis activity, play a role in the development of the metabolic profile characteristic for the different coping styles, it can be useful to study animal models displaying either the behavioral or the physiological characteristics of a coping style, but not both. Potential rat models of interest in this respect are the Fischer344/Lewis inbred rat strains. The Fischer344 rat is characterized by increased HPA-axis activity, whereas the Lewis rats have blunted glucocorticoid responses to stress and generally have lower diurnal glucocorticoid levels (24). The Fischer and Lewis rats display some similarities to, respectively, the passive and proactive coping rats. Several other, but not all related behavioral characteristics of passive/proactive” have homology to those found in the Fisher/Lewis strains. For example, the Lewis rats are more explorative in a novel environment than the Fisher rats (15). However, in contrast to the proactive/passive coping strains, the Lewis and Fischer strains do not display differences in anxiety or aggression. These rats thus seem to display the physiological parameters typical for the coping styles, but not all of the behavioral characteristics. Moreover, both the Lewis and Fischer rats are prone to develop obesity. It is not known to what extent this may be a consequence of inbreeding rather than a strain specific effect since inbred rats are known to develop obesity easily (80). The point here is that the more HPA-axis reactive Fischer rats were shown to be less insulin sensitive than Lewis rats (49). In young Fischer rats, the decreased insulin sensitivity does not lead to insulin resistance and glucose intolerance, however, a considerable percentage of Fischer rats develop insulin resistance at a later age (29). It thus seems that a hyperactive HPA-axis, induced through increased stressor sensitivity or a differential genetic profile, is a risk factor for the development of insulin resistance in these animals; an effect that might be independent of the behavioral expression of a passive coping style. Unfortunately, the eating patterns, nor physical activity patterns of these rats have been investigated leaving it impossible to conclude whether the increased HPA-axis activity also plays a crucial role in the other differences in energy regulation observed in the passively and proactively coping rat strains. An important issue regarding the findings obtained in the animal studies is whether they have relevance for the human population. To what extent can the differential susceptibility for development of metabolic derangements found in proactive and passive rats be translated to humans with a proactive or passive personality? Based on the animal studies we hypothesized that humans characterized as having a passive coping style would be more prone to develop metabolic derangements under standard conditions. In humans, however, data on the interaction between the personality and the risk to develop metabolic derangements is contradictory. Studies using questionnaires to assess personality generally report an increased risk to symptoms of the metabolic syndrome and diabetes development in proactive personalities (63, 73, 88), but others report an increased risk in the passive individuals (55, 62). However, results from studies assessing personality related a passive coping style to several of physiological and behavioral characteristics, including increased HPA-axis activity and anxiety (16, 53). Since the latter are viewed as risk factors for the development of the metabolic syndrome, it might be justified to point out that individuals characterized by a passive personality are at least more at risk for the development of hyperinsulinemia and related co-morbidities (1, 16, 53, 61). For future studies investigating the interaction in humans it may thus be suggested to combine personality questionnaires with more scrutinized analysis of physiological/neuroendocrine parameters. Overall the studies presented here indicate that the interactions between coping style and environment are key in understanding

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individual differences in the development of obesity and metabolic disease. Certain physiological/neuroendocrine characteristics of a coping style are strong indicators for pathology development. Since questionnaire assessed personality types are not always correlated to these physiological/neuroendocrine parameters in humans (due to variations in environment), future research should focus on the identification of easily measurable physiological/neuroendocrine biomarkers indicative of the coping style in humans. These biomarkers and tailored interventions may help to halt or even turn around the current epidemic in metabolic diseases. Finally, improved understanding of the evolutionary basis and epigenetic mechanism underlying the link between coping style and energy balance and fuel homeostasis may prove to be an important angle to understand development of metabolic derangements.

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CONCLUSION Studies in rodents clearly indicate that the stress coping style could play a crucial role in explaining individual variation in disease vulnerability. These studies also show that there is not a vulnerable coping style, but that the interactions between coping style and disease susceptibility are disease specific. Where passive coping individual seem to have enhance risk to develop the metabolic syndrome, depression and disorders related to decreased immune function. Proactive individuals are more vulnerable to acute cardiac failure, addiction and hyperactivity of the immune system. In addition, there are several disorders that are not easily predicted by the coping style alone, but rather depend on coping style/environment interactions. The differences in disease susceptibility between the coping styles are most likely a result of adaptive changes due to evolutionary pressure. Like stress is in itself an adaptive response to a threatening environment, that only becomes maladaptive under chronic conditions, the same seems to hold true for the enhanced disease vulnerabilities of the coping styles. The different metabolic and immune characteristics are adaptive under the ideal environmental conditions for the specific coping styles, but become maladaptive when the individual is exposed to a different environmental setting. When translating these data to the human population one must keep in mind that a distribution onto two personality characteristics may be too simplistic to describe the variation observed within the human population. Most rodent studies have used animals selected for an extreme coping style and although this approach is useful to unravel mechanism behind the observed difference, it may have lost some face validity for translation to the human. However, the biomarkers elucidated in these rodent models, like difference in the HPA-sympathetic balance, may proof an important predictor for disease vulnerability. And secondly, knowledge about the evolutionary setting of each coping style may provide useful information for targeted life style and behavioral treatments strategies for both psychiatric and metabolic disorders. When it becomes clear under which circumstance an individual’s response are adaptive, the environment of this individual may be altered to suit its biological needs better. Furthermore, the biomarkers elucidated in the rodent models, such as differential neurotransmitter and stress hormone release, may provide novel target for the development of drugs targeted at the individual.

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ACKNOWLEDGMENTS I would like to thank Dr. Kellie LK Tamashiro (Johns Hopkins University, Baltimore, USA) for the thoughtful discussions and comments on the manuscript. And I am grateful to Dr. Anton JW Scheurink (University of Groningen, Groningen, the Netherlands) for the valuable discussions on the framework described in the manuscript.

REFERENCES

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In: Handbook of the Psychology of Coping Editors: Bernando Molinelli and Valentino Grimaldo

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Chapter 10

FACTORS THAT INFLUENCE COPING SELF-EFFICACY AFTER TRAUMA Christina L. Meads and Melanie D. Hetzel-Riggin Western Illinois University, Illinois, US

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ABSTRACT Past research has demonstrated that coping self-efficacy (CSE), the belief that one is capable of seeking out resources that help to adapt successfully to challenges, plays a role in the coping process. CSE is associated with psychological well-being and mental health outcomes following a traumatic event (Cieslak, Benight, and Lehman, 2008; Regehr et al., 2003; Luszczynska, Benight, and Cieslak, 2009). However, relatively little research has investigated what factors may be related to positive or negative CSE. Since the field understands the positive impact of CSE, research investigating factors associated with positive or negative CSE is imperative. In order to investigate factors related to positive and negative CSE, 97 undergraduate students completed several online assessments measuring CSE, trauma history and previous counseling, perceived effectiveness of coping, coping style, psychological distress, perceived control, trauma attribution, and resiliency. CSE was significantly and positively associated with perceived coping effectiveness, present control, and resiliency; CSE was significantly and negatively associated with duration of previous counseling, greater trauma history, distraction and avoidant coping, behavioral and characterological self-blame, past control, and psychological distress. These variables were entered into a stepwise multiple regression equation predicting CSE. Five variables entered the equation: psychological distress (β = -.37***), resiliency (β = .41***), TLEQ total scores (β = -.20**), perceived coping effectiveness (β = .23**), and past control (β = -.13*), which was significant, R2 = .74, F(5, 73) = 42.40***. Prevention efforts may benefit from targeting variables related to coping effectiveness, past control, and resiliency. Primary and secondary prevention efforts could be developed to teach coping strategies that are usually successful, such as cognitive reappraisal (Gross, 2001), mindfulness (Goldin and Gross, 2010), problem solving and emotional expression (Jaser and White, 2010). Resilience imagery and skills training has been successful at improving mood and performance as well as the ability to handle stress (Arnetz et al., 2009). Interventions for attention-control, inhibitory-control, and affect regulation (Hofman, Friese, and Roefs, 2009) have increased self-regulation ability. Combined, these programs could help to improve CSE.

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FACTORS THAT INFLUENCE COPING SELF-EFFICACY AFTER TRAUMA According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), a traumatic stressor is defined as “direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate” (p. 467; American Psychiatric Association [APA], 2000). While specific prevalence rates vary concerning exposure to trauma, research has found that traumatic events affect a significant portion of the population. A longitudinal study tracking children through puberty into adulthood examined the prevalence of trauma exposure (Angold, Costello, Erkanli, and Fairbank, 2002). Twenty five percent of participants reported experiencing a high magnitude traumatic experience in his or her lifetime and more than one fourth had experienced a low magnitude event in the three months prior to the interview. Hanson, Hesselbrock, Tworkowski, and Swan (2002) demonstrated the significance of trauma research to the area of clinical psychology. Surveys were distributed to nineteen agencies in Connecticut, and clinician surveys were distributed to all clinical staff at the lead public mental health providers in the same area. On average, over fifty percent of clients had traumatic histories (Hanson et al., 2002). An overwhelming array of literature suggests that exposure to trauma can precede a variety of negative psychological outcomes. With mental agency surveys, Hanson et al. (2002) discovered that a majority of clients had not only experienced trauma, but 56% of clients had a diagnosis related to trauma. Kolassa et al. (2010) reported that individuals exposed to high numbers of traumatic events were at a high risk of developing lifetime and current PTSD and PTSD symptoms. Traumatic exposure and PTSD have an impact on other areas of mental health as well. In a survey of adolescents, Macdonald, Danielson, Resnick, Saunders, and Kilpatrick (2010) found that approximately 55% of girls and 57% of boys reported experiencing more than one potentially traumatic event. Of the 11.3% of girls and 6.3% of boys that demonstrated PTSD, 12% of girls and 20% of boys reported comorbid PTSD. Other prevalent issues displayed were mood disorders and substance abuse. Given the magnitude of traumatic exposure and the prevalence of negative outcomes experienced, research aiming to understand coping processes and how they impact psychological outcomes is critical. Specifically, the current research aims to emphasize the importance of coping selfefficacy and investigate factors that predict an individual’s coping self-efficacy.

Coping Self-Efficacy Benight and Bandura (2004) define self-efficacy as the “belief that one has the power to produce desired effects by one’s actions” (p. 1131). Coping self-efficacy (CSE) is one’s perceived ability to adapt and cope. According to Benight and Bandura, coping self-efficacy is the belief that one is capable of seeking out resources that help to adapt successfully to challenges and therefore impact one's adjustment. As a result, coping self-efficacy plays a momentous role in the coping process and psychological well-being after a traumatic event.

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Benight and Bandura (2004) discuss the role of coping self-efficacy in posttraumatic recovery within a social cognitive model. They suggest that both environmental and psychosocial factors play a role in an individual’s functioning. Social cognitive theory suggests that active personal enablement is more essential to resilience to trauma than environmental events. Functioning and adaptation are directly related to the individual’s active attempts to manage stressful situations. The model states that self-efficacy is central to human agency, because without a belief in one’s capabilities to produce a desired outcome, one will not act productively in response to traumatic experiences. Self-efficacy is vital within cognitive, motivational, affective, and decisional factors in the face of trauma. Specifically, self-efficacy beliefs determine if an individual will think in self-enhancing or self-defeating ways, how motivated one is to face difficulties, the type of emotions and vulnerabilities one experiences, and the decisions made in life. Self-efficacy influences the thinking patterns and cognitive appraisals related to coping mechanisms in the face of stressful and traumatic events. Individuals with appraisals characterized by a lack of control and an inability to manage stressors magnify threats. This, in turn, increases distress and impairs functioning. The model suggests that self-efficacy sustains coping efforts because self-efficacy determines whether an individual will attempt to change stressful situations into more manageable situations. In addition, the model proposes that self-efficacy influences whether an individual feels he or she can control and stop pervasive negative thoughts in the aftermath of traumatic experiences. As a result, individuals with better self-efficacy are more likely to regulate emotions and behaviors in a more constructive way that leads to more adaptive functioning (Benight and Bandura, 2004). A review of significant research indicates that coping self-efficacy plays a role in coping and psychological outcomes following a variety of traumatic events. To demonstrate the value of CSE, Cieslak, Benight, and Lehman (2008) studied two groups of participants: female victims of childhood sexual abuse and survivors of motor vehicle accidents. In both populations, the authors found that CSE mediated the relationship between an individual’s negative cognitions and PTSD symptoms. In a meta-analysis investigating the role that CSE plays in outcomes after exposure to traumatic events, Luszczynska, Benight, and Cieslak (2009) found that longitudinal and cross-sectional studies provided evidence that CSE was related to lower PTSD symptom severity, distress, depressive symptoms, anxiety, and negative affect. In addition, Benight, Flores, and Tashiro (2001) investigated bereavement coping self-efficacy (BCSE) in a group of widows whose husbands had passed away within the previous twelve months of the study. The results indicate that BCSE predicted both positive and negative outcomes of bereavement. Low BSCE predicted emotional difficulties, and high BCSE was related to greater perceived emotional control, sense of direction, selfdetermination, positive feelings about the self and others, and more positive spiritual wellbeing. Benight, Cieslak, Molton, and Johnson (2008) emphasize the significance of changes in CSE for traumatic distress. Motor vehicle accident survivors were assessed at three different times: seven days, thirty days, and ninety days after an accident. Initial distress was negatively related to distress after thirty and ninety days and was predictive of posttraumatic distress three months after the accident. Furthermore, CSE at thirty days after the event mediated acute distress and posttraumatic distress after three months. These findings reveal that CSE and changes in CSE are important in predicting psychological outcomes and likely influence an individual’s perceptions of coping capacity with ongoing stressors. Overall, a plethora of research provides evidence that CSE is a vital aspect of the coping process.

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While a significant amount of research has demonstrated the importance of CSE in coping and psychological well-being, relatively little research has investigated the factors that predict an individual’s CSE. Previous literature has demonstrated the significance of numerous variables in the coping process and psychological outcomes. Therefore, the current study aims to investigate the potential role these factors might play in predicting an individual’s CSE. We provide a review of research to establish an understanding of the factors that have been shown to be related to coping and therefore may be predictive of CSE.

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Coping Style and Perceived Coping Effectiveness Following a traumatic experience, individuals may cope in a variety of ways. Research has illustrated that coping is a complex process involving appraisals, environment, cognitions, emotion, demands and resources, and personality. According to Folkman and Moskowitz (2004), research on coping attempts to organize coping efforts into distinct categories and often aims to evaluate coping effectiveness. The two initial categories of coping included problem-focused coping and emotionfocused coping, although recent research has added coping categories of social coping, meaning-focused coping, and avoidance coping. Krause, Kaltman, Goodman, and Dutton (2008) investigated the impact of avoidant coping on victims of domestic violence. Participants that used more avoidant coping also reported more PTSD symptoms, and the association between avoidant coping and PTSD symptomology was also present at a one year follow up study (Krause et al., 2008). Gil (2005) provides an example of how coping strategies can be influential in trauma victims. Eighty-one students exposed to a terrorist bus explosion were studied two weeks prior to the explosion and one week, one month and six months after the explosion. Results indicate avoidance coping is a predictor of PTSD. Low levels of state problem-focused coping were also a predictor of PTSD (Gil, 2005). Littleton, Horsley, John, and Nelson (2007) conducted a meta-analysis of forty-four studies that assessed coping following trauma. Results indicate a significant relationship between overall avoidance strategies and PTSD symptoms. No relationship was found between approach strategies and distress. These findings suggest that problem-focused coping leads to desirable outcomes and avoidant, emotion-focused coping leads to poor outcomes. When evaluating coping effectiveness, research primarily measures psychological symptoms and adjustment in order to understand which forms of coping are effective and adaptive. However, relatively little research accounts for the client’s perception of coping effectiveness and what role it plays in the coping experience. Coping self-efficacy and perceived coping effectiveness both address an individual’s belief about personal coping abilities and processes. Therefore, specific coping methods in addition to an individual’s perception of coping effectiveness were investigated in the current study to understand how they related to CSE.

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Perceived Control and Attribution An individual’s perception of control associated with traumatic events is an influential factor in psychological well-being following the event. Frazier, Mortensen, and Steward (2004) conceptualized control in four important forms: Past control, present control, future control, and future likelihood: past control refers to an individual’s perceived control over the traumatic event, while present control defines control over current events and feelings. Future control can be understood as control over life after the traumatic event, and future likelihood refers to an individual’s belief of the likelihood of the event reoccurring. Frazier et al. (2011) studied the impact of perceived control on individuals exposed to controllable and uncontrollable events. The authors found that those with higher levels of present control over a stressor demonstrated lower levels of both general distress and eventspecific distress. On the other hand, for uncontrollable events, past and future control was related to higher levels of distress. For controllable events, individuals with higher levels of future control showed more outcomes that were positive. The results demonstrate the importance of control perceptions for both controllable and uncontrollable events. They also demonstrate the importance of future control in controllable situations (Frazier et al., 2011). Likewise, Frazier’s (2003) longitudinal research investigated the effect of attribution and perceived control on distress levels in women coping with sexual assault. Participants displaying higher perceptions of present control over the recovery process also showed lower levels of distress. A perception of personal control over the incident was related to higher distress levels at all four time periods measured in the study. In addition, as distress decreased over each time, past control decreased and future control increased (Frazier, 2003). Additionally, attributions concerning the traumatic event and control over the event affect coping and adjustment. Daigneault, Tourigny, and H´ebert (2006) investigated victims of sexual assault and discovered abuse specific attributions of blame predicted anxiety, depression, post-traumatic stress, sexual concerns, dissociation, and anger. General attributions mediated the relationship between abuse specific attributions and psychological outcomes. In other words, attributions of blame generalize across events and have implications on psychological well-being (Daigneault et al., 2006a). In further analysis with this sample, Daigneault, H’ebert, and Tourigny (2006) found that attributions have noteworthy ramifications on adolescent functioning. General self-attributions and specific self-attributions correlated positively with anxiety, depression, and PTSD.

Resiliency According to Agaibi and Wilson (2005), resiliency is defined in broad terms as “the ability to adapt and cope successfully despite threatening or challenging situations” (p. 198). Bonanno (2008) expands this definition stating that resilience can be understood as "the ability to maintain a stable equilibrium" (p. 102) when exposed to a potentially highly disruptive event. Resiliency has often been misunderstood and underestimated because a significant amount of research focuses on individuals that experience negative psychological outcomes after trauma. It is often misperceived as rare and pathological. Bonanno (2008) reviewed relevant research demonstrating that resilience is common and should be viewed as healthy adjustment. This review of research found support for potential pathways to resiliency

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including hardiness, self-enhancement, repressive coping, positive emotion, and laughing (Bonanno, 2008). Bonanno, Galea, Bucciarelli, and Vlahov (2007) found that gender, age, education, ethnicity, income change, and social support were all factors that played a role in an individual’s level of resilience to negative consequences following trauma. In a study following the September 11 terrorist attacks, resilient individuals showed lower rates of depression and adjusted more adaptively in the aftermath of the attacks (Bonanno et al., 2007). Ong, Fuller-Rowell, and Bonanno (2010) provide further evidence that resilience affects an individual’s adaptation to traumatic experiences. They measured trait resilience in individuals before the loss of a spouse. Following the loss, high levels of resilience were predictive of higher levels of positive emotions. Smith, Vitaliano, Yi, Yi, and Weinger (2008) demonstrated the importance of resilience on physical health as well. Resilience had a positive effect on physical health in patients with diabetes. Low resilience scores were associated with lower self-care behaviors when individuals were faced with high levels of distress.

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Current Study As demonstrated above, literature suggests that coping self-efficacy is a key factor in the process of coping and adjustment (Cieslak et al., 2008; Luszczynska et al., 2009; Benight et al., 2001). Literature suggests that a plethora of other variables may influence coping and psychological well-being after stressful experiences (Folkman and Moskowitz, 2004; Frazier et al., 2011; Bonanno et al., 2007). However, relatively little research has investigated what factors may be related to positive or negative CSE. Since the field understands the positive impact of CSE, research investigating factors associated with positive or negative CSE is imperative. The current study investigated several factors related to psychological outcomes of trauma exposure in order to identify potential predictors of positive and negative CSE.

METHODS Participants A total of 150 undergraduate students in psychology from a large, Midwestern university participated in the study. Of the initial 150 participants who completed the study, 97 reported a traumatic event that also caused helplessness, fear, or horror; the analyses only include those participants who met the DSM-IV-TR criterion A for a traumatic event (APA, 2000). The average age of the participants was 19.8 (SD = 3.2), and the sample was predominantly female (64.2%) and single (96.8%). Participants reported their year in school as follows: 41.1% freshman, 18.9% sophomore, 16.8% junior, and 23.2% senior. The sample was primarily Caucasian (77.1%), followed by African American (12.5%), Latino (5.2%), Asian or Asian American (3.1%), and other (2.1%). The sample was predominantly heterosexual (88.5%). Most participants (62.1%) had never received any counseling services, and 16.8% had received counseling for less than 2 months. Of the remaining participants, 8.4% received

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counseling for 2-6 months, 8.4% had received counseling for 6-12 months, and 4.2% had received counseling for more than a year. The participants reported that the population of their hometown as follows: 4.2% unicorporated, 20.8% below 10,000 people, 36.5% 10,00050,000 people, 15.6% 50,000-100,000 people, and 22.9% above 100,000 people.

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Measures Traumatic Life Events. We assessed trauma history using a modified version of the Traumatic Life Events Questionnaire (TLEQ; Kubany et al., 2000). In this version, participants were asked to check the box next to any and all of the 21 traumatic events that have occurred in their lives. Examples of traumatic events included motor vehicle accidents, robbery, life-threatening illness, physical assault, sexual abuse, and natural disasters. Participants identified the traumatic events that had the greatest impact on their lives and whether this event caused helplessness, fear, and/or horror (criterion A for PTSD; APA, 2000). The original TLEQ exhibited good temporal stability, rates of disclosure, and predictive power. In a sample of undergraduates, Kubany et al. (2000) found good convergent validity. A comparison of the TLEQ and a structured interview assessment found a 92% average agreement between items for same day administration and an 85% average agreement of items with a one week delay between administration of the TLEQ and the interview. Testretest results in the Kubany et al. study found good reliability, with kappa coefficients .40 or higher for fourteen of sixteen items and .60 or higher for eight items (Kubany et al., 2000). Coping Self-Efficacy. A modified version of a Coping Self-Efficacy Measure (CSE) for victims of domestic violence (Benight, Harding-Taylor, Midboe, and Durham, 2004) was used to assess coping self-efficacy after the experience of a traumatic event. We modified the original version by removing four items that were abuse-specific, rewording the remaining items to remove abuse-specific language, and rewording the instructions to ask about coping self-efficacy after any type of trauma. Participants were asked to rate the 26 items on a Likerttype scale from 1 (not at all capable) to 6 (totally capable) based on how confident they were in their ability to cope with various types of feelings, thoughts, and reactions of others. Total scores could range from 26-156, with higher scores indicating greater coping self-efficacy; the sample had a mean score of 125.3 (SD = 25.2). Internal consistency for the current sample was excellent (Cronbach’s α = .97), and previous research on the original measure has shown good convergent validity (Benight et al., 2004). Coping Style. We measured coping style using the Brief COPE (Carver, 1997). Participants were asked to respond to the 28-item questionnaire using a four-point, Likerttype scale from 1 (I haven’t been doing this at all) to 4 (I have been doing this a lot) as to how often they were engaging in that coping activity. The Brief COPE assesses 14 coping styles and scores for each coping style can range from 2-8. Each coping style score contains two questions: active coping (M = 4.7, SD = 1.7), planning (M = 4.0, SD = 1.7), positive reframing (M = 4.7, SD = 1.9), acceptance (M = 6.1, SD = 1.6), humor (M = 3.1, SD = 1.6), religion (M = 3.7, SD = 2.1), using emotional support (M = 5.0, SD = 1.9), using instrumental support (M = 4.6, SD = 2.0), self-distraction (M = 5.4, SD = 1.6), denial (M = 2.7, SD = 1.3), venting (M = 4.0, SD = 1.4), substance use (M = 2.9, SD = 1.7), behavioral disengagement (M = 2.8, SD = 1.2), and self-blame (M = 3.5, SD = 1.8). Previous research has reported

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acceptable internal consistency values for each coping style (.50-.90); we found similar results for the present sample. Coping Effectiveness. The Coping Effectiveness Scale (Gottlieb and Rooney, 2004) was utilized to assess overall coping effectiveness. The items assessed the participants’ view of overall effectiveness of coping (e.g. “This problem upsets me as much now as it ever did; I haven’t really got used to it.”). The responses include seven items that are rated on a fourpoint Likert-type scale from 1 (strongly disagree) to 4 (strongly agree). Total scores range from 7 to 28; the mean score for this sample was 14.8 (SD = 3.8). The scale has been shown to have good internal consistency in previous research and in the current study (Cronbach’s αs = .69 and .76, respectively). Psychological Distress. The 21-item Depression, Anxiety, and Stress Scales (DASS; Lovibond and Lovibond, 1995) was used to measure psychological distress. Participants answered the items using a four-point, Likert-type scale from 1 (did not apply to me at all) to 4 (applied to me very much, or most of the time). Total scores for the scale can range from 21-84; the mean score for this sample was 35.4 (SD = 12.7). We chose to use the total score for the DASS rather than subscale scores given the high correlations among the three subscales of depression, anxiety, and stress (rs = .73-.79). The internal consistency of the entire DASS was very good (Cronbach’s α = .94) and supported the use of the entire scale. Crawford and Henry (2003) showed that the DASS-21 depression scale demonstrated good convergent validity with the SAD depression scale (r = .78), and DASS-21 anxiety scale demonstrated good convergent validity with the HADS anxiety scale (r = .66). Previous research has shown that the DASS exhibits good temporal stability and validity (Antony, Bieling, Cox, Enss, and Swinson, 1998). Perceived Control. The Perceived Control Over Stressful Life Events (PC; Frazier, Berman, and Steward, 2002) was used to assess participants’ sense of past, present, and future control over their traumatic events and resulting life changes. The PC asks participants to answer how they have felt in the past two weeks about 22 items regarding control on a fourpoint Likert-type scale from 1 (strongly disagree) to 4 (strongly agree). An example of a past control item is, “I could have done something to prevent this event from happening”, whereas an example of a present control item is, “How I deal with this event now is under my control.” An example future control item is, “I can do things to make sure I will not experience a similar event in the future,” while a sample future likelihood item is, ” I’m sure something similar will happen to me again.” Mean scores for each of the subscales for the present sample were; past control: M = 10.8 (SD = 4.4), present control: M = 23.7 (SD = 4.1), future control: M = 7.8 (SD = 2.8), and future likelihood: M = 12.3 (SD = 4.3). Each of the four subscales has exhibited good internal consistency (.82-.93) and four-to-six week testretest reliability (.57-.77) in previous studies; for the present sample, internal consistency estimates continued to be good (Cronbach’s αs = .74-.86 for the four subscales). Frazier et al. (2011) found that present control was related to better mental healh in multiple samples. Trauma Attribution. A modified version of the Rape Attribution Questionnaire (Frazier, 2003) was used to assess attributions associated with why the traumatic event occurred. Participants are asked to respond on a five-point Likert-type scale from 1 (never) to 5 (very often) about how often they have had these thoughts in the past month. The original scale contained five subscales: behavioral self-blame, characterological self-blame, chance, rapist, and society.

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We removed the items associated with the last two subscales and modified the language for the remaining subscales to be nonspecific as to the type of trauma experienced; each subscale had five questions and had total scores ranging from 5 to 25. An example of a behavioral self-blame question was, “I used poor judgment;” the behavioral self-blame subscale had a mean score of 11.3 (SD = 4.7). A characterological self-blame question example was, “I am just the victim type” and the subscale had a mean score of 10.2 (SD = 4.1); an example of chance was, “It was just bad luck” and the subscale had a mean score of 12.1 (SD = 4.0). For the present study, internal consistency estimates were acceptable (Cronbach’s αs = .70-.82 for the three subscales). Previous research has shown that the subscales are stable across time (6 week test-retest reliability = .68-.70; Frazier, 2003). Resiliency. The 14-item Resilience Scale (Wagnild and Young, 1993) was used to assess for resiliency after trauma in the present sample. Participants rate on a seven-point Likert-type scale from 1 (strongly disagree) to 7 (strongly agree) the extent to which each statement best indicates their feelings about each item. An example item is, “I usually manage one way or another.” Total scores can range from 14 to 98, and the mean score for the present sample was 80.4 (SD = 11.8). Overall internal consistency for the present sample was excellent (Cronbach’s α = .92), and the scale has shown acceptable convergent validity with related measures and constructs (Wilks, 2008). Demographics. Participants provided information about their age, gender, marital status, ethnicity, and counseling history.

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Procedures Participants were recruited through an online human subjects management system available to all students enrolled in general education psychology courses; participants received credit in their psychology course for participating in research experiences. Two trained, advanced undergraduate research assistants assessed participants in groups of no more than ten. Participants sat with one seat in between them in order to maintain confidentiality of the data. The research assistants read the informed consent information to the participants, who then signed a paper copy of the consent form after having an opportunity to ask questions. Participants then completed the questionnaire packet; all participants took less than an hour to complete the questionnaires. They first completed the modified TLEQ. Participants completed the remaining questionnaires in regards to their experience of potentially traumatic events. When participants finished they gave their completed questionnaire packet to the research assistants, who provided the participants with a debriefing sheet explaining the purpose of the study and information about local counseling resources. This study was approved by the university’s Institutional Review Board.

Statistical Design We first examined the relationship among coping self-efficacy and all of the other variables of interest (demographic information, trauma exposure, coping style, perceived

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coping effectiveness, psychological distress, perceived control, trauma attribution, and resiliency) by examining the Pearson correlations. Those variables significantly correlated with coping self-efficacy were entered into a stepwise regression equation and allowed to compete.

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RESULTS The 97 participants who experienced a traumatic event that caused helplessness, fear, or horror, reported a number of previous traumatic events. The participants reported the following traumatic events, which are not mutually exclusive: 22.7% fire or accident, 32.0% natural disaster, 2.1% military trauma, 72.2% sudden or unexpected death of a loved one, 40.2% self or loved one survived serious illness or accident, 3.1% robbed, 18.6% beaten by a stranger, 22.7% witnessed beating or death of another, 33.0% threatened with death, 12.4% childhood physical abuse, 28.9% witnessed family violence, 24.7% dating or domestic violence, 17.6% childhood sexual abuse, 16.5% adult sexual assault, 21.6% stalked, and 12.4% abortion or miscarriage. A total of 86.6% of these participants reported at least two potentially traumatic events, and one person reported experiencing 12 potentially traumatic events. The modal number of potentially traumatic events was three. None of the variables exhibited substantial skewness or kurtosis, and there were no univariate or multivariate outliers. Missing data were minimal and were handled using listwise deletion. The participants reported an overall high level of CSE after trauma, with a mean CSE score of 125.3 (SD = 25.2). Table 1 presents the means, standard deviations, and correlations with the CSE scale for all of the possible predictor variables. As can be seen in Table 1, none of the demographic variables was significantly associated with coping selfefficacy (ps > .10). The TLEQ total scores were significantly and negatively associated with CSE total scores. For coping style, self-blame, self-distraction, denial, substance use, behavioral disengagement, and venting were all negatively associated with CSE total scores, whereas use of emotional support and positive reframing were positively associated with CSE total scores. Overall perceived coping effectiveness was positively associated with CSE, while psychological distress as measured with the DASS was negatively associated with CSE. For perceived control, past control was negatively related to CSE and present control was positively related to CSE. Both the behavioral and characterological self-blame subscales of the Trauma Attribution Scale were negatively associated with CSE. In addition, resiliency was positively associated with CSE. The variables that were significantly associated with CSE were entered into a stepwise multiple regression equation predicting CSE and were allowed to compete. The overall regression equation was significant, R2 = .74, F(5, 73) = 42.40***. Five variables entered the equation: psychological distress (β = -.37***), resiliency (β = .41***), TLEQ total scores (β = -.20**), perceived coping effectiveness (β = .23**), and past control (β = -.13*). None of the coping style subscales entered the equation.

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Table 1. Means, Standard Deviations, Percentages, and Correlations of Variables with Coping Self-Efficacy Variable Demographic Variables Age Gender (% female) Marital Status (% single) Ethnicity (% Caucasian) Counseling Duration (% no counseling) TLEQ Total Score Brief COPE Self-Blame Self-Distraction Active Coping Denial Substance Use Using Emotional Support Using Instrumental Support Behavioral Disengagement Venting Positive Reframing Planning Humor Acceptance Coping Effectiveness Scale Perceived Control Scale Past Control Present Control Future Control Future Likelihood DASS Trauma Attribution Scale Behavioral Self-Blame Characterological Self-Blame Chance Resilience Scale

Mean (SD)

r

19.8 (3.2) 64.2% 96.8% 77.1% 62.1% 22.0 (2.5)

-.12 -.07 -.07 -.15 -.13 -.32**

3.5 (1.8) 5.4 (1.6) 4.7 (1.7) 2.7 (1.3) 2.9 (1.7) 5.0 (1.9) 4.6 (2.0) 2.8 (1.2) 4.0 (1.4) 4.7 (1.9) 4.0 (1.7) 3.1 (1.6) 6.0 (1.6) 14.7 (3.8)

-.55*** -.31** .21 -.40*** -.36*** .22* .20 -.52*** -.27* .22* -.07 .05 .11 .51***

10.9 (4.4) 23.7 (4.0) 7.9 (3.0) 12.4 (4.3) 37.0 (13.2)

-.30** .57*** -.19 -.04 -.70***

12.0 (4.7) 10.8 (4.0) 12.4 (4.1) 79.5 (12.4)

-.50*** -.56*** -.18 .65***

Note. N = 97. SD = Standard Deviation. * p < .05; ** p < .01; *** p < .001.

DISCUSSION Previous research has shown that coping self-efficacy is a strong predictor of positive outcomes after trauma (Cieslak et al., 2008; Luszczynska et al., 2009; Benight et al., 2001). Yet there is a paucity of research investigating what variables influence CSE. The current study assessed a number of variables related to coping with trauma (including trauma history, coping style, perceived coping effectiveness, attributions, sense of control, and resiliency) to identify potential predictors of CSE.

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Past research has demonstrated that a significant number of individuals are exposed to traumatic experiences during their lives (Angold et al., 2002; Hanson et al., 2002). In accordance with previous data, participants in the current study reported high levels of traumatic exposure. Almost sixty-five percent of all participants originally recruited met DSM-IV-TR criterion A for a traumatic event (APA, 2000). Specifically, these individuals experienced a traumatic event that caused helplessness, fear, or horror. Over 86% of individuals reported experiencing two potentially traumatic events. The current study provides evidence of the high prevalence of traumatic exposure in society. Several variables that have been shown to be associated with psychological outcomes of trauma exposure, including coping style, perceived coping effectiveness, sense of control, trauma attribution, psychological distress, and resiliency (Bonanno et al., 2007; Folkman & Moskowitz, 2004; Frazier et al., 2011) were evaluated in relation to CSE in the current study. As predicted, the results indicate that several of these variables were associated with an individual’s CSE. Of the factors significantly related to CSE, the results highlight the most significant predictors of coping self-efficacy following traumatic exposure as psychological distress, resiliency, overall trauma exposure, perceived coping effectiveness, and sense of past control. An individual’s level of psychological distress was the most significant predictor of his or her coping self-efficacy. Greater levels of psychological distress predicted lower coping selfefficacy. This finding corresponds with previous literature that has found exposure to trauma may lead to negative mental health outcomes, including psychological distress (Hanson et al., 2002; Macdonald et al., 2010). While psychological distress is a potential result of trauma, this distress could lead to further negative outcomes. In light of the current study, it seems that psychological distress following trauma exposure decreases an individual’s belief that he or she is capable of coping with the event. As a result, this may prevent distressed individuals from making an effort to overcome the adverse consequences of trauma. In addition, resiliency was highly predictive of an individual’s coping self-efficacy. Participants that demonstrated high resiliency, or a greater ability to adapt to adversity, were more likely to have positive beliefs about their coping capabilities. The literature suggests that resilient individuals demonstrate greater adjustment and more positive psychological outcomes following trauma (Bonanno et al., 2007; Ong et al., 2010). The current study suggests that coping self-efficacy seems to play an important role in this relationship. Following a traumatic event, resilient individuals are more likely to have higher coping selfefficacy. Indeed, it may be that resilient individuals have likely overcome adverse situations in the past, leading to positive beliefs about their ability to cope with stress in the future. As a result, positive beliefs in one’s ability to cope successfully likely leads to more adaptive coping efforts and better psychological outcomes. Furthermore, an individual’s overall trauma exposure was significantly predictive of coping self-efficacy. Past research showed that greater trauma exposure was related to more negative psychological outcomes. For example, childhood abuse has been shown to be related to greater risk of adult abuse (Balsam, Lehavot, and Beadnell, 2011; Aosved, Long, and Voller, 2011), and revictimization has been shown to be related to increased risk of negative psychological outcomes (Balsam et al., 2011). It seems that exposure to a greater number of traumatic events leads to poorer beliefs in one’s ability to cope. The findings suggest that as an individual experiences a greater frequency of traumatic experiences, his or her coping selfefficacy decreases. The individual may gain a sense of helplessness due to repetitive exposure

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to trauma, which may manifest in a low sense of coping self-efficacy. As a result, the individual may no longer exert the energy and efforts to attempt to cope adaptively. Relatively little past research analyzing coping methods and psychological outcomes after trauma has taken the individual’s perception of the effectiveness of his or her coping into account. The current study reveals that an individual’s perception of his or her coping is essential. If an individual believes his or her coping methods are effective, the individual will also have greater positive beliefs that he or she is able to cope successfully. A more positive perception of coping methods and one’s ability to cope may lead to outcomes that are more positive. The results also found that past control was predictive of coping self-efficacy. The belief that one had control over a traumatic event decreases the individual’s belief in his or her ability to cope with the event. This finding corresponds with previous research demonstrating that past control is associated with negative outcomes. For example, Frazier (2011) found that high levels of perceived past control for uncontrollable events was related to higher levels of distress. It is possible that a perception of past control over the traumatic events will be associated with feelings of personal responsibility concerning the event. The individual may experience negative perceptions of his or her actions in relation to the event. These negative self-concepts in relation to the trauma may then lead to negative self-concepts related to coping with the event. As a result, the individual may develop negative coping self-efficacy, which likely leads to less adaptive adjustment and coping. This is especially likely if the individual perceives their coping to be ineffective. Because coping self-efficacy has been associated with positive adjustment following traumatic exposure, variables that predict coping self-efficacy should be the focus of prevention and intervention efforts. Prevention efforts may benefit from addressing an individual’s psychological well-being, previous trauma history, resiliency, sense of control, and perceptions of coping. As a result, assessments might highlight specific strengths or vulnerabilities that affect an individual’s coping self-efficacy. At-risk populations could be identified, and prevention efforts could target the specific variables that increase an individual’s coping self-efficacy. Similarly, clinical assessment of trauma victims should assess these variables. Professionals could then utilize these assessments in order to employ intervention efforts that foster specific variables in order to bolster an individual’s coping self-efficacy. Specifically, these efforts may benefit by targeting variables related to coping effectiveness, past control, and resiliency. For instance, professionals might find specific primary and secondary prevention efforts that teach adaptive coping strategies. Research suggests that cognitive reappraisal, mindfulness, problem solving and emotional expression can be effective (Gross, 2001; Goldin and Gross, 2010; Jaser and White, 2010). Research also suggests that interventions for attention-control, inhibitory-control, and affect regulation (Hofman et al., 2009) lead to increased self-regulation ability. Professionals should also consider interventions that target and bolster resiliency. Resilience imagery and skills training lead to improve mood, performance, and the ability to handle stress (Arnetz et al., 2009). Overall, these techniques could improve an individual’s coping self-efficacy and enhance an individual’s coping and adjustment. Although other variables in the study were not predictive of CSE, we found several coping styles that correlated with CSE. Self-blame, self-distraction, denial, substance use, behavioral disengagement, and venting were associated with low coping self-efficacy. These

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findings support previous literature that suggests self-blame and avoidant coping strategies are associated with negative outcomes (Ford, 2011; Filipas and Ullman, 2006; Dyson and Renk, 2006; Schnide, Elhai, and Gray, 2007). Further examination of the data showed that all of these coping styles were signficantly associated with poorer perceived coping effectiveness (rs = -.26 to -.53), suggesting that while they may not directly lead to poorer CSE, they may indirectly influence CSE because individuals perceived these coping styles as being ineffective. Conversely, use of emotional support and positive reframing were positively associated with coping self-efficacy. The current study suggests that specific coping strategies are associated with an individual’s belief in his or her ability to cope successfully. In addition, sense of control and blame attributions correlated with an individual’s coping self-efficacy. Having a greater sense of present control was related to more positive CSE. This is consistent with Frazier’s (2011) findings that high levels of present control are more adaptive after specific traumatic events. Consistent with research demonstrating the negative consequences of self-blame variables (Ullman et al., 2007; DePrince, Chu, and Pineda, 2011), behavioral self-blame and characterological self-blame were related to low coping self-efficacy. Professionals might benefit from assessing an individual’s coping style, present control, and blame attributions when treating trauma victims.

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Limitations, Future Directions, and Practical Applications Limitations in the methodology of the current study should be noted. Due to the crosssectional nature of data collection, causal inferences cannot be determined with complete confidence. A longitudinal method would enable researchers to understand how variables more specifically influence CSE and adjustment over time. Additionally, the current study did not assess mediators or moderators in the relationship between trauma and psychological outcomes. Future research should assess whether the variables found to correlate with CSE mediate or moderate the relationship between coping self-efficacy and psychological outcomes. Additionally, the current study does not assess when participants experienced specific traumatic events. Time elapsed since the trauma might potentially influence overall adjustment and coping variables. Furthermore, the self-report nature of data collection represents a potential limitation due to the potential of inaccurate reporting and participants’ recall bias. Moreover, limitations concerning the study’s sample should be noted. A sample of undergraduate students served as participants in the current study. Previous literature suggests that an undergraduate population may be more adjusted to traumatic exposure than the general population (Haugaard and Emery, 1989). The findings with this population may not be completely generalizable to the general population, especially concerning trauma research. In addition, participants were predominantly Caucasian and heterosexual. Research suggests that ethnicity and sexual orientation may play a significant role in traumatic exposure and psychological outcomes (Balsam, Lehavot, Beadnell, and Circo, 2010; Roberts, Gilman, Breslau, Breslau, and Koenen, 2011). As a result, the findings may not accurately depict coping patterns of minority populations and various sexual orientations.

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CONCLUSION The current research has expanded our knowledge on coping self-efficacy. Although the field understands the positive benefits of coping self-efficacy, research investigating factors related to positive or negative coping self-efficacy has been relatively absent from literature. The current study has expanded current knowledge by highlighting specific predictors of coping self-efficacy. Due to the relationship between CSE and positive adjustment, it is essential for professionals working with trauma victims to understand individual variables that lead to positive beliefs about one’s ability to cope. It may be beneficial to foster specific variables in at-risk populations to prevent negative consequences to adverse events. In addition, professionals should understand the pathways that explain the link between trauma exposure and psychological outcomes in order provide more effective prevention techniques and interventions.

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REFERENCES Agaibi, C.E. and Wilson, J.P. (2005). Trauma, PTSD, and resilience: A review of literature. Trauma, Violence, and Abuse, 6, 195-216. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author. Angold, A., Costello, E.J., Erkanli, A., and Fairbank, J.A. (2002). The prevalence of potentially traumatic events in childhood and adolescence. Journal of Traumatic Stress, 15, 99-112. Antony, M.M., Bieling, P.J., Cox, B.J., Enns, M.W., and Swinson, R.P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10(2), 176-181. Aosved, A.C., Long, P.J., and Voller, E.K. (2011). Sexual revictimization and adjustment in college men. Psychology of Men and Masculinity, 12(3), 285-296. Arnetz, B.B., Nevedal, D.C., Lumley, M.A., Backman, L., and Lublin, A. (2009). Trauma resilience training for police: Psychophysiological and performance effects. Journal of Police and Criminal Psychology, 24(1), 1-9. Balsam, K.F., Lehavot, K., and Beadnell, B. (2011). Sexual revictimization and mental health: A comparison of lesbians, gay men, and heterosexual women. Journal of Interpersonal Violence, 26(9), 1798-1814. Balsam, K.F., Lehavot, K., Beadnell, B., and Circo, E. (2010). Childhood abuse and mental health indicators among ethnically diverse lesbian, gay, and bisexual adults. Journal of Consulting And Clinical Psychology, 78(4), 459-468. Benight, C.C., and Bandura, A. (2004). Social cognitive theory of posttraumatic recovery: the role of perceived self-efficacy. Behaviour Research and Therapy, 42(10), 1129-48. Benight, C.C., Cieslak, R., Molton, I.R., and Johnson, L.E. (2008). Self-evaluative appraisals of coping capability and posttraumatic distress following motor vehicle accidents. Journal of Consulting and Clinical Psychology, 76(4), 677-85. Benight, C.C., Flores, J., and Tashiro, T. (2001) Bereavement coping self-efficacy in cancer widows. Death Studies, 25, 97-125.

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Benight, C.C., Harding-Taylor, A.S., Midboe, A.M., and Durham, R.L. (2004). Development and psychometric validation of a domestic violence coping self-efficacy measure (DVCSE). Journal of Traumatic Stress, 17(6), 505-508. Bonanno, G.A. (2008). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? Psychological Trauma: Theory, Research, Practice, and Policy, S(1), 101-113. Bonanno, G.A. Galea, S., Bucciarelli, A., and Vlahov, D. (2007). What predicts psychological resilience after disaster? The role of demographics, resources, and life stress. Journal of Consulting and Clinical Psychology, 75(5), 671-82. Carver, C.S. (1997). You want to measure coping but your protocol’s too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4, 92-100. Cieslak, R., Benight, C.C., and Lehman, V.C. (2008). Coping self-efficacy mediates the effects of negative cognitions on posttraumatic distress. Behaviour Research and Therapy, 46(7), 788-98. Crawford, J.R., and Henry, J.D. (2003). The Depression Anxiety Stress Scales (DASS): Normative data and latent structure in a large non-clinical sample. British Journal of Clinical Psychology, 42(2), 111-131. Daigneault, I., Hebert, M., and Tourigny, M. (2006). Attributions and coping in sexually abused adolescents referred for group treatment. Journal of Child Sexual Abuse, 15, 3559. Daigneault, I., Tourigny, M., and Hébert, M. (2006). Self-attributions of blame in sexually abused adolescents: A mediational model. Journal of Traumatic Stress, 19(1), 153-157. DePrince, A.P., Chu, A.T., and Pineda, A.S. (2011). Links between specific posttrauma appraisals and three forms of trauma-related distress. Psychological Trauma: Theory, Research, Practice, and Policy, 3(4), 430-441. Dyson, R., and Renk, K. (2006). Freshmen adaptation to university life: Depressive symptoms, stress, and coping. Journal of Clinical Psychology, 62(10), 1231-1244. Filipas, H.H., and Ullman, S.E. (2006). Child sexual abuse, coping responses, self-blame, posttraumatic stress disorder, and adult sexual revictimization. Journal of Interpersonal Violence, 21(5), 652-672. Folkman, S., and Moskowitz, J. (2004). Coping: Pitfalls and promise. Annual Review Of Psychology, 745-774. Ford, J.D. (2011, May 2). Ethnoracial and educational differences in victimization history, trauma-related symptoms, and coping style. Psychological Trauma: Theory, Research, Practice, and Policy. Frazier, P. (2003). Perceived control and distress following sexual assault: A longitudinal test of a new model. Journal of Personality and Social Psychology, 84, 1257-1269. Frazier, P., Berman, M., and Steward, J. (2002). Perceived control and posttraumatic stress: A temporal model. Applied and Preventative Psychology, 10, 207-223. Frazier, P., Keenan, N., Anders, S., Perera, S., Shallcross, S., and Hintz, S. (2011). Perceived past, present, and future control and adjustment to stressful life events. Journal of Personality and Social Psychology, 100(4), 749-765. Frazier, P., Mortensen, H., and Steward, J. (2004). Percieved control and adjustment to trauma: A comparison across events. Journal of Social and Clinical Psychology, 23, 303324.

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Gil, S. (2005). Coping style in predicting posttraumatic stress disorder among Israeli students. Anxiety, Stress, and Coping, 18, 351-359. Goldin, P.R., and Gross, J.J. (2010). Effects of mindfulness-based stress reduction (MBSR) on emotion regulation in social anxiety disorder. Emotion, 10(1), 83-91. Gottlieb, B.H., and Rooney, J.A. (2004). Coping effectiveness: Determinants and relevance to the mental health and affect of family caregivers of persons with dementia. Aging and Mental Health, 8(4), 364-373. Gross, J.J. (2001). Emotion regulation in adulthood: Timing is everything. Current Directions in Psychological Science, 10(6), 214-219. Hanson, T., Hesselbrock, M., Tworkowski, S.H., and Swan, S. (2002). The prevalence and management of trauma in the public domain: An agency and clinician perspective. The Journal of Behavioral Health Services and Research, 29(4), 365-380. Haugaard, J.J., and Emery, R.E. (1989). Methodological issues in child sexual abuse research. Child Abuse and Neglect, 13(1), 89–100. Hofmann, W., Friese, M., and Roefs, A. (2009). Three ways to resist temptation: The independent contributions of executive attention, inhibitory control, and affect regulation to the impulse control of eating behavior. Journal of Experimental Social Psychology, 45(2), 431-435. Jaser, S.S., and White, L.E. (2011). Coping and resilience in adolescents with type 1 diabetes. Child: Care, Health and Development, 37(3), 335-342. Kolassa, I., Ertl, V., Eckart, C., Kolassa, S., Onyut, L. P., and Elbert, T. (2010). Spontaneous remission from PTSD depends on the number of traumatic event types experienced. Psychological Trauma: Theory, Research, Practice, and Policy, 2(3), 169-174. Krause, E.D., Kaltman, S., Goodman, L.A., and Dutton, M. (2008). Avoidant coping and PTSD symptoms related to domestic violence exposure: A longitudinal study. Journal of Traumatic Stress, 21(1), 83-90. Kubany, E.S., Haynes, S.N., Leisen, M.B., Owens, J.A., Kaplan, A.S., Watson, S.B., and Burns, K. (2000). Development and preliminary validation of a brief broad-spectrum measure of trauma exposure: The Traumatic Life Events Questionnaire. Psychological Assessment, 12, 210-224. Littleton, H., Horsley, S., John, S., and Nelson, D.V. (2007). Trauma coping strategies and psychological distress: A meta-analysis. Journal of Traumatic Stress, 20(6), 977-988. Lovibond, S.H. and Lovibond, P.F. (1995). Manual for the Depression Anxiety Stress Scales. (2nd. Ed.) Sydney: Psychology Foundation. Luszczynska, A., Benight, C.C., and Cieslak, R. (2009). Self-Efficacy and health-related outcomes of collective trauma. European Psychologist, 14(1), 51-62. Macdonald, A., Danielson, C., Resnick, H.S., Saunders, B.E., and Kilpatrick, D.G. (2010). PTSD and comorbid disorders in a representative sample of adolescents: The risk associated with multiple exposures to potentially traumatic events. Child Abuse and Neglect, 34(10), 773-783. Ong, A.D., Fuller-Rowell, T.E., and Bonanno, G.A. (2010). Prospective predictors of positive emotions following spousal loss. Psychology and Aging, 25(3), 653-660. Regehr, C., Hill, J., Knott, T., and Sault, B. (2003). Social support, self-efficacy and trauma in new recruits and experienced firefighters. Stress and Health: Journal of The International Society for the Investigation of Stress, 19(4), 189-193.

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Roberts, A.L., Gilman, S.E., Breslau, J.J., Breslau, N.N., and Koenen, K.C. (2011). Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychological Medicine: A Journal of Research in Psychiatry and the Allied Sciences, 41(1), 71-83. Schnider, K.R., Elhai, J.D., and Gray, M.J. (2007). Coping style use predicts posttraumatic stress and complicated grief symptom severity among college students reporting a traumatic loss. Journal of Counseling Psychology, 54(3), 344-350. Smith, R.E., Vitaliano, P.P., Yi, J.C., Yi, J.P., and Weinger, K. (2008). The role of resilience on psychological adjustment and physical health in patients with diabetes. British Journal of Health Psychology, 13, 311–325. Ullman, S.E., Townsend, S.M., Filipas, H.H., and Starzynski, L.L. (2007). Structural models of the relations of assault severity, social support, avoidance coping, self-blame, and PTSD among sexual assault survivors. Psychology of Women Quarterly, 31(1), 23-37. Wagnild, G.M. and Young, H.M. (1993). Development and psychometric evaluation of the Resilience Scale. Journal of Nursing Measurement, 1, 165-178. Wilks, S.E. (2008). Psychometric evaluation of the shortened Resilience Scale among Alzheimer's caregivers. American Journal of Alzheimer's Disease and Other Dementias, 23(2), 143-149.

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Chapter 11

THE EARLY YEARS COPING PROJECT: BUILDING A SHARED LANGUAGE OF COPING Erica Frydenberg, Jan Deans, and Rachel Liang University of Melbourne, Australia

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ABSTRACT Social and emotional competence underpins healthy development, educational achievement and the well-being of a community and coping skills are considered an important index of such competence. It is helpful to construe coping as a continuum that extends from the management of stress and adaptation to the achievement of success in the pursuit of goals and meeting the challenges of everyday life. It is clear that the earlier these skills are developed the better. This chapter provides an overview of four-phase research by Frydenberg and Deans at the University of Melbourne. The researchers have engaged with children, teachers and parents to learn more about coping skills and how they can be developed. One significant outcome of this work has been the development of the Early Years Coping Cards (Frydenberg and Deans, 2011a) which is a visual resource suitable for use by parents, teachers and clinicians with children aged 4-8 years. The cards have been applied in a number of contexts including classrooms and the home and are used to stimulate conversations about situations that young children find challenging or stressful. Research findings highlight the importance of building a shared language of coping between teachers, parents, clinicians and children in order to effectively engage in deeper meaningful conversations around coping—an important step in building social and emotional competence.

Keywords: Coping in the Early Years



Correspondence: [email protected].

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INTRODUCTION To assess a child's competence in the social and emotional domains of development (specifically emotional recognition, regulation and expressiveness in interactions) it is necessary to have an understanding of the types of stresses and problems children face at each developmental stage. The aim of the Early Years Coping Project is to explore the socioemotional competencies of young children in the domain of coping and enable the assessment and development of coping skills. This four-phase project has extended the current literature on social emotional development in the early years by providing a richer understanding of how young children comprehend and talk about everyday stressors and the way they cope with these situations. This project has also provided an exemplar on how visual images in the form of Early Years Coping Cards may be used by the parents, teachers and clinicians to engage young children in discussions about coping and coping-related activities in both educational and family contexts.

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IMPORTANCE OF SOCIAL AND EMOTIONAL COMPETENCE IN THE 21ST CENTURY As children enter an increasingly diverse, globalised, media-saturated era, full of innovations, knowledge and new ways of doing things, specialized skills are required to help them confidently negotiate the diverse array of complexities that they confront. For many years it has been evident that technological advancement is not necessarily a predictor of academic or life success but rather it is the personal skills and attitudes that individuals develop that supports positive outcomes. A growing number of educators recognise that students who receive an exclusively academic education may be ill-equipped for future challenges, both as individuals and members of society (Mayer, Caruso and Salovey, 2000). This awareness and new understandings of the nature of biology, emotions and intelligence and their relation to success and happiness has led to the emergence of the field of social and emotional learning (SEL) (Durlak, Weissberg, Dymnicki, Taylor and Schellinger, 2011). The aim of SEL is to promote in children a strong sense of identity and well being, communication skills, positive attitudes to learning and relationship building. Through the achievement of such attitudes and skills individuals will be well equipped to tackle the challenges of the future. Australian early years curricula documents (EYLF and VELDF, 2009) have identified that there is overwhelming agreement that social and emotional development is critical for the success and well being of young children and particularly for school readiness. Social development refers to the process by which children engage in improving their abilities to function socially, that is, in relating to meeting and interacting with others. Emotional development, on the other hand, refers to the process of improving abilities to distinguish between and to express emotions in socially acceptable ways (Denham, 2006). As such, the emphasis of early years schooling is placed on the achievement of children having a strong sense of personal agency and learning to cope with stressors in everyday life in an ageappropriate and productive way.

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THEORIES OF COPING AND COGNITIVE APPRAISAL

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There are numerous definitions of coping. One widely cited description of coping is, “conscious and volitional efforts to regulate emotion, cognition, behaviour, physiology and the environment in response to stressful events or circumstances” (Compas, Connor-Smith, Saltzman, Thomsen and Wadsworth, 2001; p 89) confirms the importance of both emotion regulation and actions in response to demands. Lazarus and Folkman (1984) defined coping as cognitive and behavioural efforts to manage specific external or internal demands that are appraised as exceeding the resources of the individual. Eisenberg and colleagues defined coping as a subset of the broader category of self-regulation in response to stress (Eisenberg, Fabes, and Guthrie, 1997). Substantial research in child and adolescent coping has revealed that coping is similar to adaptation with situations in which temperament, developmental and environmental factors all play a part (Frydenberg and Lewis, 1993; Frydenberg, 2008). This means there is no right or wrong coping but the situation determines what is likely to achieve the desired outcomes. Coping therefore can be construed as a dichotomous dimension with both productive and non-productive coping strategies utilised in situations that the individuals encounters (Frydenberg and Lewis, 2011). It is widely acknowledged that a child’s developmental level may also both contribute to, and limit, the type of coping responses employed and hence influence the types of coping strategies that a child utilises (Rudolph, Dennig, and Weisz, 1995; Eisenberg, Fabes, and Guthrie, 1997; Compas et al., 2001; Compas, 2006). In general, as children develop and with the increase in cortical functioning, their coping repertoire increases and shifts from primarily behavioural to more cognitive actions (Skinner and Zimmer-Gembeck, 2007). This enhances both the child's self-control when facing a stressful situation and the ability to plan effective coping options (Derryberry, Reed and Pilkenton-Taylor, 2003).

PRESCHOOL CHILDREN’S COPING AND SOCIAL AND EMOTIONAL DEVELOPMENT Throughout the preschool years children make substantial gains in their understanding of emotion and are increasingly capable of incorporating emotional language into their interactions with others. Skinner and Zimmer-Gembeck (2009) suggest that in line with developmental shifts from two to eight years, coping using voluntary direct actions and cognitive strategies increases. Coping strategy use also becomes more situation specific with age as young children may have fewer coping skills and therefore have less flexibility in selecting and utilising coping strategies (Pincus and Friedman, 2004). As children progress through the preschool years, they become more able to both differentiate and verbalise their feelings, and to calm themselves and seek social support when needed (Compas et al., 2001). Research has demonstrated that preschoolers tend to seek support from adults, withdraw or engage in behavioural activities as a form of distraction in their coping repertoire (Hampel and Petermann, 2005). As their cognitive and language skills mature, children are also more likely to focus on problem-related solutions, particularly when a problem appears to be controllable (Band and Weisz, 1988). Kopp (2009) has pointed out that children also have a growing capacity to utilise strategic emotion-focused coping, particularly for a situation that

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is deemed to be outside their control, such as crying to release feelings. It is important to point out that these strategies are essentially used to accommodate to the situation and to restore the individual to a sense of wellbeing or equilibrium (Frydenberg and Lewis, 2000). The ultimate aim is to help young individuals to build up their coping repertoire overtime by promoting the development of a range of social emotional skills that are seen as essential precursors for successful learning. The Early Years Coping Project has been designed to support such outcomes and researchers of the project have worked closely with children and both their teachers and parents to further understand the young child’s coping behaviours and utilise these understandings for the development of practical and useful tools to support social emotional development. The involvement of teachers and parents is recognized as integral in supporting the cultivation of children’s social emotional competence and the development of skills such as being able to collaborate with others, to self-regulate and gradually learn to read the behaviour of others and respond appropriately are considered of paramount importance and to have lasting impact on adaptive functioning over a lifetime.

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RESEARCH OVERVIEW - PHASES I- IV The four-phase research, undertaken between 2008 and 2011, sought to expand understandings of the coping capacities of four and five year old children and explore how parents’ and teachers’ descriptions of their children’s coping concur and amplify those of the children (see Table 1 for a summary on Phases I-IV). All four phases were conducted at the Early Learning Centre, which is the research and demonstration preschool attached to the Melbourne Graduate School of Education at The University of Melbourne (www. education.unimelb.edu.au/eldi/elc.) In Phase I, the sample consisted of 19 four to five year old children and their parents. Using child interviews and parent surveys this study aimed to identify preschool children’s coping responses and to match these with their parent’s understandings. Coping responses from both the children and parents were grouped into Active, Passive and Relational Coping with results indicating that young children have the capacity to articulate their understandings of coping and are able to spontaneously provide a range of additional coping strategies than those listed by their parents. Children also reported using more active coping than passive coping. Building on this study, Phase II explored the coping strategies of 46 four-year-old children by asking them to describe their coping strategies when dealing with seven ageappropriate challenging situations. The results again indicated that the children could competently articulate coping strategies that in this study were clustered into productive and non-productive coping styles. To further extend understandings on children’s coping behaviours in different environments, Phase III of the research included teachers and parents who were asked to complete survey questionnaires. Results of 112 surveys for 46 children were analyzed and it was found that mothers reported more passive coping for their children than did the teachers. The first three phases of the research resulted in the development of measurement tools and visual tools to help teachers, parents and clinicians to assist young children to develop their coping skills.

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The Early Years Coping Project Table 1. Phases I-IV of the Early Years Coping Project Publication Deans, Frydenberg, and Tsurutani (2010)

Sample 20 4 to 5-year old inner-city Australian children (9 boys and 11 girls) and their parents.

Phase II

Chalmers, Frydenberg and Deans (2011)

46 4-year-old preschoolers attending an early learning centre in Melbourne, Australia.

Phase III

Frydenberg, and Deans (2011)

Parents (44 mothers and 22 fathers) and Teachers (4 females) of 46 of 4-year-old preschoolers attending an early learning centre in Melbourne, Australia.

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Phase I

What we did Using ‘questionanswer’ interview with children to identify coping responses Using online surveys with parents Matched parent’s understandings of their children’s coping responses to that of children’s. Thematic analysis encoded children’s description of their coping strategies for 7 age-appropriate challenging situations on visual images.

What we learned Coping strategies reported by children and their parents can be grouped into Active, Passive and Relational Coping. Children spontaneously provided more coping strategies than those listed in the parent survey. Children reported using more active coping than passive coping. Parents reported more passive coping compared to children.

Implications Children have the capacity to articulate their understandings of coping. Children are capable to comprehend and talk about complex topics. Educators can draw on these capacities to further children’s social and emotional development.

Coping strategies reported by children can be clearly clustered into productive and nonproductive coping styles. Majority of children can articulate several of the productive coping skills that they can apply across few different challenging situations. Separation anxiety was found to be the most challenging situation for children to apply productive coping skills.

Confirmed children are able to describe coping actions. Visual images may be used to engage children in coping discussions and coping-related activities.

Parents’ and teacher’s survey reports of children’s use of coping strategies. ·Compared reports to examine crossinformant understandings of child coping.

Different groupings of early childhood coping dimensions were found between the parents and teachers samples. Mothers reported more passive coping for their children than did the teachers which might be related to the differences in relationship and perspective. Fathers were more likely to rate their children worked hard at solving problems than did the mothers.

Extended previous studies by illustrating the differences between parents’ and teachers’ perceptions of children’s coping. Parents and teachers can both contribute to creating environments that support productive coping in children.

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Erica Frydenberg, Jan Deans, and Rachel Liang Table 1. (Continued) Publication

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Phase IV

Sample 16 parents (6 fathers + 10 mothers) of 4year-old preschoolers attending an early learning centre in Melbourne, Australia.

What we did Three sessions were conducted with parents: Session 1: Coping theory and Parents were given a set of situation cards. Session 2: Parents were given a set of coping cards. Session 3: Parents provided feedback on the use of cards with their children.

What we learned Parents used the cards to engage their children in coping discussions. Parents found it challenging to discuss negative topics/situations with their children. Parents expressed greater concerns when negative events were brought up. Children are able to remember and recount events that have affected them deeply.

Implications Parent has a role in developing children’s coping language. Parents increased awareness of their own coping. Possible to increase productive coping in a family context. Possible to model positive coping for young children. Scope for expanding preschoolers’ repertories of emotion words and coping strategies.

The Early Years Coping Cards (Frydenberg and Lewis, 2001a) are a visual tool designed to help stimulate conversations between children and adults, about everyday challenging situations that may cause uncertainty or fear. In 2011, Phase 1V of the research was extended to include parents’ use of this tool. Sixteen parents (6 fathers and 10 mothers) of 4-year-old children participated in focus group research and agreed to use the cards with their children in their family contexts and to provide feedback regarding their use. This research with parents has drawn attention to the important role parents play in supporting their children’s social emotional development. Findings from Phase IV have also highlighted the importance of building a shared language of coping between parents and children in order to increase the modeling of positive coping for young children. In summary, the early years coping project has extended and complemented already existing work with adults, children and adolescents in this area of study. Overall there are indications that there are a wide range of coping strategies that young children commonly adopt that are not widely recognized in current literature. Parents’ perceptions of their children’s coping vary from that of teachers and children themselves. Results from the four phases have also shown the use of visual images such as the Early Years Coping cards is an effective way to engage young children in coping discussions in a non-threatening and an age- appropriate way. Future research that continues to focus on working closely with parents could make an additional contribution to development of coping skills in the early years, enabling children and parents to expand their understandings of coping strategies and to increase productive coping in a family context.

Phase I Project Overview The first phase of the study aimed to identify preschool children’s coping responses and to match these with parent’s understandings of their children’s coping (Deans, Frydenberg and Tsuratani, 2010). The sample consisted of four to five year old (M = 4.6 years) inner-city

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Australian children, nine males and eleven females (n=19), and their parents (n=17). A ‘question-asking’ survey research approach was used in gathering data using child interviews and an on-line survey (Ary, Jacobs and Razavieh, 2002). In acknowledging the value of a child-focused process, child interviews were conducted with twenty children to give them an opportunity to offer their own responses (Clarke and Moss, 2001, Farrell, 2005). The 5-8 minute interviews allowed children to communicate their perceived stresses or worries and the range of coping strategies that they employed. The open-ended interview questions covered both general and situation-specific coping scenarios e.g. What do you do when you’re worried? / What would you do if you had a fight with a friend? The interviews were recorded and transcribed for analysis. An on-line questionnaire was used with the parent population (n=17) to give them a timeefficient and targeted opportunity to provide feedback about their children. The 10-15 minute survey was developed with reference to the social and emotional development of four-year old children (Berk, 2000) and an adapted version of the Children’s Coping Scale (Lodge and Frydenberg, 2004; Jones, 2007). Parents addressed a list of questions that related specifically to Separation, Communicative Problem Solving, Independent Problem Solving, Social Skills, and Adaptability. Parents were also provided with a list of 27 coping strategies such as ‘keeping feelings to self’ and ‘work hard’, and asked to rate whether their child used each strategy.

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Findings Both the child and parent responses were categorised into three groupings: Active, describing what children did; Passive, describing how children withdraw or avoid difficult situations and Relational, describing how children deal with situations involving others. Parent survey responses to their children’s coping strategies were used to compare child and parent responses (see Figure 1).

Figure 1. Total number of coping strategies reported by children and parents.

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Children spontaneously provided more coping strategies (n = 36) than those listed in the parent survey. These were made up of 20 active coping such as ‘just play and pretend’, ‘just try and fix it’, seven passive coping strategies, such as ‘cry, I would feel sad’, ‘I would do nothing’, and nine relational coping strategies such as ‘I would tell a grown up’ or ‘I would ask for help’. Parent survey data consisted of parent ratings of the extent to which their child uses the 27 coping strategies. These were made up of six active coping strategies such as ‘go outside and forget about the problem’, 14 passive coping strategies such as ‘cry or scream’ and seven relational coping strategies such as ‘ask for help’. It is interesting to note that the reports of relational coping strategies were similar. However, children reported using more active coping than passive coping. Also, parent survey responses reported the identification of more passive coping strategies than were reported during the child interviews.

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Implications Findings from the first phase of the study highlight that young children have the capacity to articulate their understandings of coping and are capable of comprehending and talking about complex topics. As such, teachers can utilize the question-asking format to draw on these capacities to further children’s social and emotional development. The results also reveal a wide range of coping strategies reported by children that are not recognized in the current literature (e.g. ‘I would say well I think we should have an excussion (discussion) because it wasn’t just me fighting it was sometimes him fighting.’ ‘I think about things that are happy.’) and highlight how parents’ views on children’s coping concur and differ from those of their children. This laid the foundation for Phase II of the research, specifically the development of a nomenclature of coping responses for the preschool age group including the development of visual representations of challenging situations which were to be used to stimulate children’s verbal responses about their coping strategies.

Phase II Project Overview The second phase of the study aimed to explore the coping strategies of 46 four-year-old children (Chalmers, Frydenberg and Deans, 2011). The question-asking format was used again to capture the full range of coping strategies described by preschoolers and the frequency of use of these different strategies across common age-appropriate challenging situations such as the fear of separation; fear of the dark; being teased (Fields and Prinz, 1997; Sorin, 2005). Following the first phase of the study, visual images of seven situations to be used in the interviews: 1) Separation from parent, 2) Friendship, 3) Don’t like something, 4) Relationship with teacher, 5) Teasing, 6) Night fears and 7) Making a choice, were developed. Visual images of the seven situations derived from the first phase of the study were used in the interviews. Children in this study were presented with the cards one at a time and asked the following four open ended questions for each: 1) “What do you see in this picture?” 2) “Has this ever happened to you?” 3) “How did you feel when this happened to you?” or “how do you think this person would feel in this situation?” 4) “What would you do to make yourself feel better?” or “What would you say to this person to make themselves feel better?”

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Thematic analysis was used to encode children’s description of their coping strategies when confronting the challenging situations depicted on the visual images (Aronson, 1994; Boyatzis, 1998).

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Findings In total, 268 coping responses were offered by the children in this study across the seven situations. Based on coping theory, data on coping strategies provided by children could be clearly clustered into productive and non-productive coping styles as presented in Table 2 (Fields and Prinz, 1997; Compas, 2009). The majority of children (89%) could articulate several of the productive coping skills that they can apply across a few different challenging situations. For example, the coping strategy of ‘play/do something else’ was reported by children across all of the challenging situations except one (‘don’t like something’). ‘Solving problem’ was another common coping strategy suggested by children across five out of seven challenging situations. Children in this study reported the use of both primary and secondary control strategies depending on how they appraised the situations. Primary control techniques such as problem solving and asking for help were reported for situations the children perceived as controllable. On the other hand, secondary control techniques such as self calming and seeking comfort were reported for situations that the children perceived they could not control. Moreover, separation anxiety was found to be the most challenging situation for children. When confronted with the situation of separating from parents, three out of four children in this study reported the use of non-productive coping strategies such as complaining of illness or indicating the use of pull-ups. This suggested that children would benefit from being taught more productive ways of coping with separation. Implications The findings from Phase II confirmed results from Phase I that young children are able to communicate their coping actions. It showed that children as young as 4 years old were able to regulate their distress in situations that were perceived to be within their control such as negotiating taking turns to play in a game. They were also able to see how their thinking could affect their behavior ‘I know because I can see it in my imagination, so I know which one to choose first’. Additionally, findings indicate that young children can not only regulate their emotions, but also to describe and evaluate their coping. Table 2. Productive and Non-productive Coping Strategies of reported by Preschoolers Productive Coping Non-Productive Coping Seek comfort* Seek Comfort* Play / do something else Do nothing / don’t know Solve the problem Cry / can’t feel better Think positive/Calm down Get angry / tantrum Ignore Problem Seek Help * Seek comfort was reported by children in this study for both productive and non-productive coping.

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Erica Frydenberg, Jan Deans, and Rachel Liang

This study also highlighted that four year old children have already developed a range of both productive and non-productive ways of coping. Such a result indicates that interventions for this age group should focus both on learning more useful ways of coping as well as learning to reduce use of unhelpful coping strategies. One of such interventions could be the use of visual images to engage children in coping discussions in a non-threatening and an age- appropriate way.

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Phase III Project Overview As mentioned earlier teachers and parents play a key role in observing children in different settings and can provide a wealth of information about the behaviours of young children. Parents and teachers also have different relationships with the same child therefore it is expected that observations and perspectives of parents and teachers would differ (Achenbach, McConaughy, and Howell, 1987; Gagnon, Nagel, and Nickerson, 2007). In order to extend understanding on children’s coping behaviours in different environments, Phase III of the research invited parents and teachers to complete coping surveys (n = 112), developed in the first phase of the study, for 46 four to five year old children. (Tsuratani, 2009; Frydenberg and Deans, 2011b). The parent and teacher surveys consisted of identical questions relating to general coping, stressors (i.e. types of stressful situations), and situation-specific coping. If a situation was rated applicable for a child, participants were asked to complete it in reference to coping. The coping items were taken from a pilot study using the Adolescent Coping Scale (Frydenberg and Lewis, 1993) and refined to a list of 14 main coping strategies which could be classified as productive, non-productive and reference to others (see Table 3). The design of the surveys ensured the consistency and accuracy in measurement across surveys for comparative purposes. The Parents’ and teacher’s survey reports of children’s use of the 14 coping strategies were compared using exploratory principal components analysis (PCA) and pairedsample t tests to examine cross-informant understandings of child coping (Tabachnick and Fidell, 2007). This exploratory approach was selected because clear coping dimensions for early childhood have yet to be established. Table 3. Main coping strategies identified from the pilot study Productive Strategies Play and get on with it Work Hard to fix the problem Seek comfort from special toy/blanket Think positive-thoughts

Reference to others strategies Seek help from grown-up Seek support from friends Help others

Non-productive strategies Cry/feel sad Complain of illness Do nothing Keep feelings to self Worry Get angry with self Get angry with others/blame others

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Findings The PCA using the combined parents and teachers sample produced four component groupings with several cross-loadings identified for strategies: Work hard to fix the problem, Play and get on with it, Worry, Cry/feel sad, Do nothing, and Complain of illness. The crossloadings of these strategies may reflect the variable nature of coping and the possibility that strategies may be considered to fit within multiple groupings. The four component groupings revealed low to moderate reliability ranging from Cronbach’s alpha .42 to .68. Varying range of reliabilities is not uncommon in coping measures and may be indicative of the high specificity of individual items (Maybery, Steer, Reupert, and Goodyear, 2009). Significant differences were found between parent and teacher ratings of children’s coping strategies. In general, parents reported more passive coping for their children than did the teachers which might be related to the differences in relationship and perspective (Gagnon, Nagel, and Nickerson, 2007). As shown in Figure 2. Parents’ mean ratings for children’s use of the strategies Cry, Complain of illness, Seek help from grown-up and Get angry with others/blame others were significantly greater than teachers’ ratings (p