Folkman (2004). “Coping: Pitfalls and promise

Coping refers to the thoughts and behaviours used to manage internal and external demands of situations that are appraised as stressful.

Coping is a process that unfolds in the context of a situation or condition that is appraised as personally significant and as taxing or exceeding the individual’s resources for coping. The coping process is initiated in response to the individual’s appraisal that important goals have been harmed, lost or threatened and these appraisals are often characterized by intense negative emotions. Emotions are essential in the coping process.

Coping is sensitive to the environment (1), its demands (2), resources (3) and personality dispositions that influence the appraisal of stress (4). Coping is strongly associated with the regulation of emotion and escapist coping techniques are associated with poor mental health outcomes.

Measurement (1), nomenclature (2) and determination of effectiveness (3) are criticized in the research on coping.

The first measurements of coping included retrospective reports. This allowed for multi-dimensional descriptions of situation-specific coping thoughts and behaviours. However, there are several limitations to the use of these inventories:

1. The length can be too long
2. It often uses inadequate sampling
3. It often has response keys that are difficult to interpret
4. There are variations in the recall period
5. The accuracy of recall is not always good
6. There are changes in meaning of a given coping strategy, depending on when it occurs
7. Some people are unable to recall the coping strategies, thoughts and behaviours
8. There is confounding with the outcomes

These problems were overcome using momentary assessment. However, this might lead to people focussing on concrete events and not mentioning more complex, abstract events (1), people not mentioning all the coping efforts (2) and people focusing on specific thoughts and actions rather than a broader conceptualization of coping (3).

Narrative approaches ask a person to recall a stressful event, what happened and the emotions associated with it. This could provide information in understanding what a person is coping with (1) and provide information on ways of coping not included in checklists (2).

One challenge to coping research is finding common terminology which allows for the diverse coping strategies to be compared and discussed in a meaningful manner across studies. The coping responses have been clustered according to a theory (1), according to factor analysis (2) or through a mixture of both (3).

Problem-focused coping refers to addressing the problem causing distress. Emotion-focused coping refers to ameliorating the negative emotions associated with the problem. This is one terminology that has been used. Meaning-focused coping refers to the use of cognitive strategies to manage the meaning of the situation. Social coping also exists. Problems of these categories are that it might mask differences within categories (1), the internal consistency might not be good (2) and the factors within the multifactorial scale are not independent of each other (3).

It is difficult to address the effectiveness of coping as coping is not inherently good or bad but depends on the situation and the appraisal of that situation. In order to assess this, the appropriate outcomes need to be selected (1) and fit between coping and the demands of the situation need to be assessed (2).

Outcomes refer to the status of diverse goals that are personally significant to the individual (i.e. coping goals). It is difficult to assess the effectiveness of coping to outcomes as some outcomes are distal and some are proximal (1), the effectiveness of coping depends on the situation (2), coping does not necessarily permanently solve the problem (3) and the effectiveness of coping depends on who evaluates the outcome (e.g. getting drunk to forget a problem might be a successful outcome for an individual but not for an observer) (4).

The context of the situation needs to be taken into account in order to assess the effectiveness of coping. Situations can be categorized as threat (1), loss (2) or challenge (3). The goodness of fit refers to the fit between the appraisal of controllability of the situation and coping.

Coping flexibility refers to people’s ability to modify their coping according to the situational demands. This involves the systematic use of a variety of strategies across different situations.

NEW DEVELOPMENTS
Future-oriented coping refers to coping in advance to prevent or mute the impact of events that are potential stressors. The importance of building a reserve of resources that can be used to offset future net losses (1), recognition of potential stressors (2), initial appraisals of potential stressors (3), preliminary coping efforts (4) and the elicitation and use of feedback about one’s success of one’s efforts (5) are important for pro-active coping.

Reactive coping refers to alluding to harm or loss experienced in the past. Anticipatory coping refers to efforts to deal with a critical event that is certain to occur. Preventive coping refers efforts to deal with an event that is not certain to occur. Proactive coping refers to efforts do deal with upcoming challenges that are potentially self-promoting.

The dual process model of coping (DPM) specifies a dynamic process of coping where a bereaved person oscillates between loss and restoration. Loss-oriented coping includes avoiding changes associated with restoration. Restoration-oriented coping refers to attending to secondary stressors that come as a consequence of the loss and the loss-oriented coping. Adaptive coping refers to involving oscillation between loss- and future orientations, between approach and avoidant coping and between positive and negative reappraisals.

Most models of coping are focused on the individual and do not pay a lot of attention to social aspects of coping. Communal coping refers to coping responses that are influenced by and in reaction to the social context. This type of coping can be pro-social or anti-social.

Religion influences how people appraise events and how they respond psychologically and physically to those events over the long term. Religious coping refers to employing religion and becoming involved with religion as a method of coping. Research into religious coping needs to distinguish religious coping from religious dispositions and psychological and religious outcomes (1), define methods related to religious coping (2), deal with confounds between religious and non-religious coping (3) and distinguish between religiosity and spirituality (4).  

Positive religious coping refers to an expression of spiritual connectedness with others. Negative religious coping refers to a religious struggle in the search for significance.

Emotional approach coping refers to actively processing and expressing emotion and is not related to emotion-focused coping, which is associated with more distress due to methodological flaws. It appears to be adaptive in the short-term but may be maladaptive in the long-term as it may become ruminative.

Rumination refers to the tendency to passively and repeatedly focus on negative emotions and the possible consequences of those negative emotions. This is associated with increased symptoms of depression and anxiety.

Emotion regulation refers to the process by which individuals influence which emotions they have, when they have them and how they experience and express these emotions. This can be an automatic or controlled process. The coping process is prompted by negative emotions and emotion regulation is not necessarily prompted by negative emotions, differentiating emotion regulation from coping.

There are two types of emotion regulation:

1. Emotion regulation involving regulating the internal feeling states and associated physiological processes.
2. Emotion regulation involving regulating the behavioural outcomes of emotion.

Antecedent-focused regulation includes situation selection (1), situation modification (2), attentional deployment (3) and cognitive change (4). Response-focused regulation includes response modulation.

Positive emotion can occur frequently in stressful contexts. There often is a co-occurrence of positive and negative emotions in stressful contexts. It appears as if some coping strategies reduce distress (i.e. reduce negative emotions) while other coping strategies improve positive emotions. During enduring stressful conditions, people consciously seek out positive meaningful events or infuse ordinary events with positive meaning to increase their positive affect, which reduces distress and helps replenish resources and sustains coping.

Stress-related growth (i.e. post-traumatic growth; benefit finding) refers to a greater appreciation of life and reprioritizing of goals after a traumatic event.

Cognitive processing refers to deliberate, effortful or long-lasting thinking about the stressor. Discovery of meaning refers to major shift in values, priorities or perspective in response to a stressor. Benefit reminding refers to effortful cognitions in which the individual reminds himself or herself of the possible benefits stemming from the stressful experience.