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COPINGCOPING
Pittsburgh Mind-Body Center Pittsburgh Mind-Body Center
Summer InstituteSummer Institute
20062006
Overview of TalkOverview of Talk
• Conceptualizing the coping processConceptualizing the coping process
• Measuring copingMeasuring coping
• Place of coping in Center modelPlace of coping in Center model
• Development of copingDevelopment of coping
• Issues in copingIssues in coping- Dispositional styles vs. situational responsesDispositional styles vs. situational responses
- Adaptive vs. maladaptive ways of copingAdaptive vs. maladaptive ways of coping
Conceptualizing CopingConceptualizing CopingLazarus and Folkman ModelLazarus and Folkman Model
Primary AppraisalPrimary Appraisal
• Significance of event for personSignificance of event for person
- ThreatThreat
- ChallengeChallenge
- Harm/LossHarm/Loss
Secondary AppraisalSecondary Appraisal
• What can I do? How can I cope?What can I do? How can I cope?
Dimensions of CopingDimensions of CopingLazarus and Folkman ModelLazarus and Folkman Model
Problem-focused copingProblem-focused coping
– Action taken to counteract the source of the Action taken to counteract the source of the
stressstress
Emotion-focused copingEmotion-focused coping
– Responses designed to alter the emotions Responses designed to alter the emotions
produced by the eventproduced by the event
Dimensions of CopingDimensions of CopingSuls and Fletcher ModelSuls and Fletcher Model
Approach copingApproach coping
– Responses focused on source of stress and Responses focused on source of stress and
reactions to itreactions to it
Avoidant copingAvoidant coping
– Responses designed to place focus away Responses designed to place focus away
from source of stress and reactions to itfrom source of stress and reactions to it
Dimensions of CopingDimensions of CopingMoos ModelMoos Model
Differentiates responses along Differentiates responses along
two independent dimensionstwo independent dimensions
– Active vs. avoidantActive vs. avoidant
– Behavioral vs. cognitiveBehavioral vs. cognitive
Measuring CopingMeasuring Coping
Omnibus measures:Omnibus measures:
– Ways of Coping Checklist Ways of Coping Checklist (Folkman & Lazarus, 1980; (Folkman & Lazarus, 1980;
revised 1985)revised 1985)
– The COPE The COPE (Carver, Scheier, & Weintraub, 1989)(Carver, Scheier, & Weintraub, 1989)
Dimension-specific measures:Dimension-specific measures:
– Impact of Events Scale Impact of Events Scale (Horowitz et al., 1979)(Horowitz et al., 1979)
– Emotional Approach Coping Scale Emotional Approach Coping Scale (Stanton et (Stanton et
al., 2000)al., 2000)
The COPEThe COPE
• 60 item self-report questionnaire60 item self-report questionnaire
- Dispositional and Situational versionsDispositional and Situational versions
• 15 broad coping subscales15 broad coping subscales
• Broad range of strategies:Broad range of strategies:- BehavioralBehavioral- AffectiveAffective- CognitiveCognitive
(Carver et al., 1989)(Carver et al., 1989)
COPE SubscalesCOPE Subscales
Active Coping:Active Coping: Taking action, exerting efforts to remove or Taking action, exerting efforts to remove or circumvent the stressor.circumvent the stressor.
Planning:Planning: Thinking about how to confront the stressor, Thinking about how to confront the stressor, planning one’s active coping efforts.planning one’s active coping efforts.
Seeking Instrumental Social Support:Seeking Instrumental Social Support:Seeking assistance, information, or advise Seeking assistance, information, or advise about what to do.about what to do.
COPE SubscalesCOPE Subscales
Seeking Emotional Social Support:Seeking Emotional Social Support: Getting sympathy or emotional support from Getting sympathy or emotional support from someone.someone.
Suppression of Competing Activities:Suppression of Competing Activities: Suppressing one’s attention to activities in Suppressing one’s attention to activities in which one might engage, in order to which one might engage, in order to concentrate more completely on dealing with concentrate more completely on dealing with the stressor.the stressor.
Religion:Religion:Increased engagement in religious activities.Increased engagement in religious activities.
COPE SubscalesCOPE Subscales
Positive Reinterpretation and Growth:Positive Reinterpretation and Growth:
Making the best of the situation by growing Making the best of the situation by growing from it, or viewing it in a more favorable from it, or viewing it in a more favorable light.light.
Restraint Coping:Restraint Coping: Coping passively by holding back one’s Coping passively by holding back one’s coping attempts until they can be of use.coping attempts until they can be of use.
Acceptance:Acceptance:Accepting the fact that the stressful event Accepting the fact that the stressful event has occurred and is real.has occurred and is real.
COPE SubscalesCOPE Subscales
Focus on and Venting of Emotions:Focus on and Venting of Emotions: An increased awareness of one’s emotional An increased awareness of one’s emotional distress, and a concomitant tendency to ventilate distress, and a concomitant tendency to ventilate or discharge those feelings.or discharge those feelings.
Denial:Denial: An attempt to reject the reality of the stressful An attempt to reject the reality of the stressful event.event.
Use of Drugs or Alcohol:Use of Drugs or Alcohol: Turning to the use of alcohol or other drugs as a Turning to the use of alcohol or other drugs as a way of disengaging from the stressor.way of disengaging from the stressor.
COPE SubscalesCOPE Subscales
Behavioral Disengagement:Behavioral Disengagement: Giving up or withdrawing effort from the Giving up or withdrawing effort from the attempt to attain the goal with which the attempt to attain the goal with which the stressor is interfering.stressor is interfering.
Mental Disengagement:Mental Disengagement:Psychological disengagement from the goal Psychological disengagement from the goal with which the stressor is interfering, through with which the stressor is interfering, through daydreaming, sleep or self-distraction.daydreaming, sleep or self-distraction.
Humor:Humor:Making jokes about the stressor.Making jokes about the stressor.
Four Main ClustersFour Main Clusters
ActiveActive .72.72 DenialDenial .80 .80
Pos Rein & GrowthPos Rein & Growth .71.71 Beh DisengageBeh Disengage .76 .76
PlanningPlanning .67.67 Mental DisengageMental Disengage .58 .58
Supp Comp ActivSupp Comp Activ .63.63
Restraint CopingRestraint Coping .59.59
AcceptanceAcceptance .52.52
Emot Soc SuppEmot Soc Supp .86.86 HumorHumor .67 .67
Instru Soc SuppInstru Soc Supp .79.79 ReligionReligion -.59-.59
Focus on/Vent EmotFocus on/Vent Emot .76.76 Use of drugs/alcoh Use of drugs/alcoh .47 .47
Chronic/Stable Burdens and Resources
Coping dispositions
Acute Precipitating
Event
Psychological Pathways
Affect, Quality of life,
Perceived stress, Depression,
Purpose
Emotion-focused coping
Behavioral Pathways
Active coping
Biological Pathways
DisabilityDisease
Place of Coping in Center ModelPlace of Coping in Center Model
Development of Coping Development of Coping
• Influence of genesInfluence of genes
– Temperaments/IQTemperaments/IQ
• Influence of learningInfluence of learning
– Idiosyncratic experience/trial and errorIdiosyncratic experience/trial and error
– Parent/peer modelingParent/peer modeling
How do coping tendencies How do coping tendencies develop?develop?
CMU Parent StudyCMU Parent Study
Subjects:Subjects:
44 college students,44 college students,their parents (42 mothers, 41 fathers), their parents (42 mothers, 41 fathers), and their roommates (43).and their roommates (43).
Measures:Measures:
COPE: 60 item inventory assessing COPE: 60 item inventory assessing 15 conceptually distinct coping 15 conceptually distinct coping strategiesstrategies
Correlations between student’s Correlations between student’s coping responses and coping coping responses and coping
responses of parents and responses of parents and roommatesroommates
ActiveActive PlanningPlanning SuppressionSuppression RestraintRestraint PositivePositivecopingcoping competingcompeting copingcoping reinterpretreinterpret
activitiesactivities and growthand growth
MotherMother - .16- .16 - .06- .06 .00.00 - .12- .12 .01 .01
FatherFather - .26- .26 - .12- .12 .19.19 - .15- .15 - .21- .21
RoommateRoommate - .23- .23 - .08- .08 .22.22 -.07-.07 - .15- .15
Correlations between student’s Correlations between student’s coping responses and coping coping responses and coping
responses of parents and responses of parents and roommatesroommates
HumorHumor InstrumentalInstrumental Religion Religion Emotional Emotional Acceptance Acceptancesoc support soc support soc supportsoc support
MotherMother .20.20 - .16 - .16 .46 .46 - .11 - .11 .11 .11
FatherFather .09.09 .00 .00 .20 .20 .14 .14 .19 .19
RoommateRoommate .50.50 .01 .01 .23 .23 .11 .11 - .18- .18
** p < .05 p < .05
**
**
Correlations between student’s Correlations between student’s coping responses and coping coping responses and coping
responses of parents and responses of parents and roommatesroommates
Denial Denial Focus on Focus on MentalMental Behavioral Behavioral Use ofUse of & venting& venting disengage-disengage- disengage-disengage- drugs ordrugs or
of emotionsof emotions mentment ment ment alcoholalcohol
MotherMother - .19 - .19 .02.02 - .12 - .12 - .07 - .07 .29.29
FatherFather .02 .02 .14.14 .04.04 .01.01 .40 .40
RoommateRoommate - .04 - .04 .00.00 .27.27 .06.06 .16.16
** p < .05 p < .05
**
Issues in CopingIssues in Coping
• Dispositional vs. situational assessmentDispositional vs. situational assessment
• Adaptive vs. maladaptive ways of copingAdaptive vs. maladaptive ways of coping
– Importance of engagement vs. Importance of engagement vs.
disengagementdisengagement
Dispositional vs. Dispositional vs. Situational AssessmentSituational Assessment
• Is the notion of coping styles Is the notion of coping styles
useful?useful?
• How do these relate to coping How do these relate to coping
responses in particular situations?responses in particular situations?
• Which is better to assess?Which is better to assess?
Some Some questions:questions:
College Adaptation Study College Adaptation Study (CAPS)(CAPS)
Sample:Sample:
– 89 first-semester undergraduates89 first-semester undergraduates
COPE:COPE:
– Dispositional — Start of the semesterDispositional — Start of the semester
– Situational — 12 to 16 weeks laterSituational — 12 to 16 weeks later
Outcomes:Outcomes:
– DepressionDepression
– Perceived stressPerceived stress
– Subjective healthSubjective health
00.10.20.30.40.50.60.70.80.9
1
Active coping
Planning Suppressionof competing
activities
Restraintcoping
Instrumentalsocial
support
College Undergraduates:
(Scheier et al., 2000)
Correlations between Correlations between Dispositional and Situational Dispositional and Situational
Coping (CAPS)Coping (CAPS)
Corr
ela
tion C
oeffi
cient
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Denial BehavioralDisengagement
MentalDisengagement
Use of drugs oralcohol
Acceptance
College Undergraduates:
(Scheier et al., 2000)
Correlations between Correlations between Dispositional and Situational Dispositional and Situational
Coping (CAPS)Coping (CAPS)
Corr
ela
tion C
oeffi
cient
00.10.20.30.40.50.60.70.80.9
1
Focus on andventing ofemotions
Emotional SocialSupport
Religion PositiveReinterpretation
and growth
Humor
College Undergraduates:
(Scheier et al., 2000)
Correlations between Correlations between Dispositional and Situational Dispositional and Situational
Coping (CAPS)Coping (CAPS)
Corr
ela
tion C
oeffi
cient
-0.8-0.6-0.4
-0.20
0.20.4
0.60.8
Acceptance Active Coping BehavioralDisengagement
Denial Use of drugs oralcohol
Dispositional Coping Situational Coping
Dispositional and Situational Dispositional and Situational Coping and Distress (CAPS)Coping and Distress (CAPS)
Corr
ela
tion C
oeffi
cient
-0.8-0.6-0.4-0.2
00.20.40.60.8
Turning toReligion
Restraint Coping Suppression ofcompetingactivities
Emotional socsupport
Instrumental social support
Dispositional Coping Situational Coping
Dispositional and Situational Dispositional and Situational Coping and Distress (CAPS)Coping and Distress (CAPS)
Corr
ela
tion C
oeffi
cient
-0.8-0.6-0.4-0.2
00.20.40.60.8
Focus on andventing ofemotions
Humor Mentaldisengagement
Planning PositiveReinterpretation
and growth
Dispositional Coping Situational Coping
Dispositional and Situational Dispositional and Situational Coping and Distress (CAPS)Coping and Distress (CAPS)
Corr
ela
tion C
oeffi
cient
Mediation Mediation
CopingCopingDispositionsDispositions DistressDistress
SituationalSituationalResponsesResponses
Mediation Analyses (CAPS)Mediation Analyses (CAPS)
** p < .05 p < .05 * * * * p < .01p < .01 * * ** * * p < .001 p < .001
**
DispositionalDispositional SituationalSituationalCopingCoping CopingCoping
Active copingActive coping - 0.13 - 0.13 - 0.36 - 0.36
Behavioral DisengagementBehavioral Disengagement 0.140.14 0.540.54
DenialDenial 0.200.20 0.370.37
Use of drugs or alcoholUse of drugs or alcohol 0.100.10 0.290.29
Focus on/venting emotionsFocus on/venting emotions 0.130.13 0.150.15
Pos Reinterpretation & GrowthPos Reinterpretation & Growth - 0.25 - 0.25 - 0.34 - 0.34
PlanningPlanning - 0.04 - 0.04 - 0.25- 0.25
**********
******
****
**
**
**
Conclusions Conclusions
• Coping styles predict situational responsesCoping styles predict situational responses
• Both predict adjustment (situational stronger)Both predict adjustment (situational stronger)
• Situational responses largely (but not entirely) Situational responses largely (but not entirely)
mediate effects of dispositional coping stylesmediate effects of dispositional coping styles
• Which to use?Which to use?
– Base decision on conceptual issues and/or study Base decision on conceptual issues and/or study
needsneeds
Functionality of CopingFunctionality of Coping
• Lots of work on psychological well-beingLots of work on psychological well-being
– Adjustment to chronic/acute diseaseAdjustment to chronic/acute disease
– Adjustment to medical problemsAdjustment to medical problems
• Less work on physical health/relationship Less work on physical health/relationship
to disease processesto disease processes
Characterization of field:Characterization of field:
Functionality of Coping: General Functionality of Coping: General CharacterizationCharacterization
MentalMental PhysicalPhysicalHealthHealth HealthHealth
Active CopingActive Coping +++/- ++
Avoidant CopingAvoidant Coping ---/+ --/+Moderators:Moderators:Chronicity/ControlChronicity/Control
Emotion-focused CopingEmotion-focused Coping ---/++ -/+Moderators:Moderators:Pos reint & growth, humor,Pos reint & growth, humor,acceptance acceptance (links to active coping)(links to active coping)
• Engagement vs. Engagement vs.
disengagementdisengagement
• The benefits of remaining The benefits of remaining
engagedengaged
Focus on SpecificsFocus on Specifics
• 74 gay/bisexual men74 gay/bisexual men
• Mean age: 38 yearsMean age: 38 years
• 95% white95% white
• Mean length of diagnosis: 12.2 Mean length of diagnosis: 12.2 monthsmonths
(Data from Reed et al., 1994)
Living with AIDS Living with AIDS StudyStudy
• Try to accept what might Try to accept what might happen.happen.
• Prepare myself for the worst.Prepare myself for the worst.
• Refuse to believe that this Refuse to believe that this problem has happened.problem has happened.
Realistic AcceptanceRealistic Acceptance
00.10.20.30.40.50.60.70.80.9
1
0 10 20 30 40
months
High Accept
Low Accept
(Data from Reed et al., 1994)
Realistic Acceptance Realistic Acceptance and Survivaland Survival
Perc
en
tag
e s
urv
ivin
gP
erc
en
tag
e s
urv
ivin
g
•Active copingActive coping
•Fighting spiritFighting spirit
•Vital exhaustionVital exhaustion
•Stoic acceptanceStoic acceptance
Further Manifestations Further Manifestations of Processof Process
Disengagement and Disengagement and Successful LivingSuccessful Living
• Much research suggests giving-up is badMuch research suggests giving-up is bad
• QuestionsQuestions– Is disengagement always bad?Is disengagement always bad?
– Is persistence always good?Is persistence always good?
– Might disengagement produce positive effects if Might disengagement produce positive effects if
goals are unattainable? goals are unattainable?
Components of Components of DisengagementDisengagement
• Withdrawal ofWithdrawal of effort effort
• Relinquishment ofRelinquishment of commitment commitment
ObstaclesObstaclesseem too great toseem too great to
overcomeovercome
ObstaclesObstaclesseem too great toseem too great to
overcomeovercome
Give up Give up goalgoalcommitmentcommitment,,
disengagedisengagefrom goalfrom goal
Give up Give up goalgoalcommitmentcommitment,,
disengagedisengagefrom goalfrom goal
Give up Give up efforteffort butbutremainremain
committed tocommitted to goalgoal
Give up Give up efforteffort butbutremainremain
committed tocommitted to goalgoal
1111
2222
DistressDistress,,despondency,despondency,
futilityfutility
DistressDistress,,despondency,despondency,
futilityfutility
AbsenceAbsenceof distressof distressAbsenceAbsence
of distressof distress
ObstaclesObstaclesseem too great toseem too great to
overcomeovercome
ObstaclesObstaclesseem too great toseem too great to
overcomeovercome
Give up goalGive up goalcommitment,commitment,
disengagedisengagefrom goalfrom goal
Give up goalGive up goalcommitment,commitment,
disengagedisengagefrom goalfrom goal
Scale back to more Scale back to more limited goal in limited goal in same domainsame domain
Scale back to more Scale back to more limited goal in limited goal in same domainsame domain
Pick alternatePick alternatepath to highpath to highorder goalorder goal
Pick alternatePick alternatepath to highpath to highorder goalorder goal
Form new goalForm new goalor new path toor new path tohigh order goalhigh order goal
Form new goalForm new goalor new path toor new path tohigh order goalhigh order goal
Give up goalGive up goalcommitment,commitment,no new goalno new goal
Give up goalGive up goalcommitment,commitment,no new goalno new goal
Give up effort Give up effort butbut
remain remain committed to committed to
goalgoal
1111
2222
Distress,Distress,despondency,despondency,
futilityfutility
PotentialPotentialfor for positivepositiveoutcomesoutcomes
PotentialPotentialfor for positivepositiveoutcomesoutcomes
PotentialPotentialfor for positivepositiveoutcomesoutcomes
PotentialPotentialfor for positivepositiveoutcomesoutcomes
AimlessnessAimlessness,,emptiness,emptiness,lonelinessloneliness
AimlessnessAimlessness,,emptiness,emptiness,lonelinessloneliness
PotentialPotentialfor for positivepositiveoutcomesoutcomes
PotentialPotentialfor for positivepositiveoutcomesoutcomes
aaaa
bbbb
cccc
dddd
Components of Re-Components of Re-engagementengagement
• IdentifyIdentify new goals new goals
• CommitCommit to those goals to those goals
• Pursue Pursue those new goalsthose new goals
Goal Disengagement Items Goal Disengagement Items from GASfrom GAS
If I have to stop pursuing an important goal in If I have to stop pursuing an important goal in
my life:my life:
• It’s easy for me to reduce my effort toward It’s easy for me to reduce my effort toward
the goal.the goal.
• I stay committed to the goal for a long time, I stay committed to the goal for a long time,
I can’t let it go.I can’t let it go.
Goal Re-engagement Items Goal Re-engagement Items from GASfrom GAS
If I have to stop pursuing an important goal in my If I have to stop pursuing an important goal in my
life:life:
• I seek other meaningful goals.I seek other meaningful goals.
• I convince myself that I have other meaningfulI convince myself that I have other meaningful
goals to pursue.goals to pursue.
• I start working on other new goals.I start working on other new goals.
Children with Cancer StudyChildren with Cancer Study (Wrosch et. al. , 2003)(Wrosch et. al. , 2003)
Sample (cross-sectional)
• 20 parents whose children were diagnosed with cancer• 25 parents with healthy children (matched control group)
Main Measures
• Disengagement ( = .79), Re-Engagement ( = .86)• Depression (CES-D, = .94)
Phenomenon
Parents might have to restructure life goals (e.g., career goals, daily activities, being with child)
Effects of Disengagement and Effects of Disengagement and Re-Engagement on DepressionRe-Engagement on Depression
Dep
ress
ion
(CE
S-D
)
r = -.53* r = -.64**
0
10
20
30
-1 SD +1 SD
Disengagement
Cancer Parents
Contol Parents0
10
20
30
-1 SD +1 SD
Re-Engagement
Cancer Parents
Contol Parents
Goal Adjustment and Cortisol Goal Adjustment and Cortisol LevelsLevels
• Examined goal adjustment and objectiveExamined goal adjustment and objective measure of health -- cortisol secretionmeasure of health -- cortisol secretion
• Normally, cortisol peaks in the early Normally, cortisol peaks in the early morning hours & declines steadily morning hours & declines steadily throughout the daythroughout the day
• Those experiencing stress have a Those experiencing stress have a flattened cortisol rhythm, with low flattened cortisol rhythm, with low morning output or no drop in morning output or no drop in secretion during the daysecretion during the day
Wrosch, C., Miller, G.E., Scheier, M.F., de Pontet, S.B. (under Wrosch, C., Miller, G.E., Scheier, M.F., de Pontet, S.B. (under review), Giving up on unattainable goals: Benefits for health?review), Giving up on unattainable goals: Benefits for health?
Goal Adjustment and Cortisol Goal Adjustment and Cortisol LevelsLevels
• Sample…Sample…
• 54 participants54 participants
• Recruited via newspaper adRecruited via newspaper ad• 38 female; 24 Caucasian; 85% of non-38 female; 24 Caucasian; 85% of non-
Caucasians were African-AmericanCaucasians were African-American• Average age = 30.3Average age = 30.3
Goal Adjustment and Cortisol Goal Adjustment and Cortisol LevelsLevels
• Measures include…Measures include…
• Goal disengagementGoal disengagement
• Goal reengagementGoal reengagement
• Diurnal cortisol rhythm - collected Diurnal cortisol rhythm - collected on 4 separate dayson 4 separate days
Goal Disengagement and Goal Disengagement and Cortisol Levels Cortisol Levels
Salivary Cortisol LevelsSalivary Cortisol Levels
0
5
10
15
20
25
1 4 9 11
Hours from Awakening
Saliv
ary
Cor
tisol
(nm
ol/L
)
Low GoalDisengagement (BelowMedian)High GoalDisengagement (AboveMedian)
Wrosch, C., et al., Study 3.Wrosch, C., et al., Study 3.