The role of coping responses and social resources in attenuating the stress of life events

Journal o f Behavioral Medicine, Vol. 4, No. 2, 1981

The Role of Coping Responses and Social Resources in Attenuating the Stress of Life Events

A n d r e w G. Bil l ings 1 and R u d o l f H. M o o s 1

Accepted for publication: November 12, 1980

The nature of individual coping responses to stressful life events was explored in a representative adult community sample. Two approaches to the classification of coping strategies were operationalized. Using these measures, small but significant gender and contextual differences in coping were identified. Mood and symptom levels were related to coping responses and to quantitative and qualitative measures o f social resources. Measures of coping and social resources attenuated the relationship between undesirable life events and personalfunctioning.

KEY WORDS: coping; stressful life events; social resources; physical symptoms; community.

I N T R O D U C T I O N

Although significant life change events may affect an individual's physical, social, and emotional functioning, recent studies suggest that such events do not necessarily have disruptive long-term ,effects (Andrews and Tennant, 1978; Cassel, 1976; but see Brown and Harris, 1978). In an attempt to identify the most stressful aspects of life change, events have been categorized along such dimensions as degree of adjustment required, desirability, predictability, controlability, and entrances vs exits from the

This research was supported in part by NIAAA Grant AA02863 and Veterans Adminis- tration Medical Research Funds.

1Social Ecology Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University and the Veterans Administration Medical Center, Palo Alto, California 94305.

139

0160-7715/81/0600-0139503,00 �9 1981 Plenum Publishing Corporat ion

140 Billings and Moos

social field (Dohrenwend and Dohrenwend, 1974, 1978). Evidence indi- cates that undesirable events (such as death of a family member or job loss) are more likely to be associated with impaired functioning than are desired events such as job promotion or marriage (Mueller et al., 1977; Sarason et al., 1978; Vinokur and Seizer, 1975). However, individual variation in the appraisal of and response to specific life events (Redfield and Stone, 1979) has prompted a search for personal and social resources that may be moderating factors.

Many investigators have speculated that the way in which people handle stressful life circumstances may be one important set of moderators. Increasing emphasis has been placed on the individual's attempts to utilize personal and social resources to manage stress reactions and to take specific actions to modify the problematic aspects of the environment, a diverse collection of cognitions and behaviors labeled coping responses (Lazarus, 1966, 1980). This paper presents an attempt to operationalize and classify the coping responses used by a nonclinical, adult community sample. Gender differences and variations in coping responses among several types of stressful life events are described. The role of coping responses and social resources as mediators of the effects of life events on mood and physical symptoms is evaluated.

CLASSIFICATION AND MEASUREMENT OF COPING

Individuals' attempts to cope with life events usually have been viewed as a complex set of processes directed toward moderating the impact of such events on their physical, social, and emotional functioning. Conceptualizations of the nature and role of coping responses and related measurement strategies have evolved rapidly in recent years (see Coelho et al., 1974).

One approach has viewed coping as a cluster of primarily intrapsychic processes (such as denial) by which an individual's emotional functioning is protected from external and intrapsychic threat. This line of inquiry has included research on ego-defense mechanisms (Haan, 1977; Vaillant, 1977) and trait definitions (such as the sensitization-repression dimension) of coping. However, critics have noted that it is difficult to make reliable inferences about ego-defense mechanisms and that trait measures alone are often inadequate predictor s of actual coping behavior (Magnusson and Endler, 1977). Further, this approach limits the concept of coping to the maintenance of psychological or emotional equilibrium and does not consider either overt problem-solving behavior directed at changing the external stressor or active attempts to avoid it. More recent approaches have broadened the conceptualization of coping to include cognitive and behavioral responses attempting to deal with the external

Coping Responses to Stressful Life Events 141[

stressor as well as behavioral responses that serve to avoid the problem (Lazarus, 1980; Moos, 1976, 1977).

Considering the complexity and diversity of environmental stressors and our attempts to deal with them, it is not surprising that efforts to operationalize these conceptualizations of coping are at an early stage. Some investigators have obtained information on how people typically' deal with generalized and relatively enduring sources of stress (e.g., economic strain; Pearlin and Schooler, 1978). In contrast, we have chosen to focus on the cognitive and behavioral reactions individuals report in response to stressful events which have occurred recently in their lives (see also Folkman and Lazarus, 1980; Sidle et al., 1969).

There have been several efforts to develop descriptive classification schemes for coping responses. One formulation of coping, subsequently referred to as the method of coping, has divided active attempts to resolve the stressful event into cognitive (intrapsychic) and behavioral strategies, while separately clustering responses which attempt to avoid the problem or reduce the emotional tension associated with the stressor (Lazarus, 1966; Moos, 1977). Active-cognitive coping includes attempts to manage one's appraisal of the stressfulness of the event, such as "tried to see the positive side of the situation" and "drew on my past experiences in similar situations." Active-behavioral coping refers to overt behavioral attempts to deal directly with the problem and its effects, such as "tried to find out more about the situation" and "took some positive action." Avoidance coping refers to attempts to avoid actively confronting the problem (for example, "prepared for the worst," "kept my feelings to myself") or to indirectly reduce emotional tension by such behavior as eating or smoking more.

Another formulation is composed of two categories concerned with the focus of coping: problem-focused and emotion-focused coping (cf. Antonovsky, 1979; Lazarus, 1980; Pearlin and Schooler, 1978). Problem- focused coping includes attempts to modify or eliminate the sources of stress through one's own behavior. Emotion-focused coping includes behavioral or cognitive responses whose primary function is to manage the emotional consequences of stressors and to help maintain one's emotional equilibrium. Our analyses focus on these two approaches to categorizing coping responses (method of coping and focus of coping) and on their roles in moderating the effects of stress.

N A T U R E A N D ROLE OF COPING

Despite the growing consensus that coping skills play a central role in the effectiveness of an individual's response to stressors, there is little information on variations in their use, according to the type and severity


of the stressor and the personal characteristics of the individual involved, or on the extent to which they attenuate stress. Much of our existing knowledge on coping derives from studies of relatively specific events such as doctoral examinations, natural disasters, imprisonment, serious injury, and physical illness. In one of the few descriptive studies on an adequately functioning sample, Folkman and Lazarus (1980) observed that work-related stressors were associated with increased problem- focused coping while health-related stressors were associated with increased emotion-focused coping. There were gender differences in the sources of stressors, but gender differences in coping were relatively small after controlling for the source of stressors.

Pearlin and Schooler (1978) recently found that coping responses may be effective in reducing the emotional distress associated with relatively enduring social strains. They concluded that self-reported coping strategies as well as psychological resources such as self-esteem and a sense of environmental mastery attenuated the impact of strain on functioning as indexed by reported mood and symptom levels. Men were more likely to use more effective types of coping than were women. Although based on traditional sex-role conceptions, it is commonly assumed that women are more emotionally responsive and sensitive while men tend to be more analytic and task oriented. Hence, women may be more likely to use emotion-oriented and less likely to use problem-oriented coping responses than are men.

SOCIAL RESOURCES AND STRESS

The inverse relationship between individuals' social resources and their psychological impairment and complaints of psychosomatic symptoms (Cobb, 1976; Mechanic, 1977) suggests that the presence (and presumed use) of such resources may also moderate the effects of life stress. Low levels of social support have been associated with psychological distress (Andrews et al., 1978; Dean and Lin, 1977; Eaton, 1978; Lin et al., 1979), psychosomatic complaints (Theorell, 1976), and physiological indices and stress (Gore, 1978). Most research in this area has utilized quantitative measures of social resources (such as the number of friends and memberships in clubs and organizations). Recent reports have indicated that the quality of support derived from social relationships may also be associated with the adequacy of functioning (Chan, 1977; Henderson, 1977; Holahan and Moos, 1981).

Coping Responses to Stressful Life Events 143

OVERVIEW OF THE PRESENT STUDY

Our review underscores the need to focus on coping responses and social resources as intervening processes mediating the effect of life events on personal functioning. This paper reports a step in that direction. We address methodological issues relating to the measurement of coping responses, as well as substantive issues concerning the interrelationship of negative life events, coping, social resources, and mood and symptom levels among a representative adult community sample. Preliminary data on a technique for collecting information on coping responses and on categorizing such responses are presented. The measures of coping are related to the magnitude and type of event toward which the coping responses were directed and gender differences are examined. We also assess (a) the extent to which measures of coping and social resources predict symptom and mood levels after controlling for the incidence of recent negative life events and (b) whether the individual's coping responses and social resources attenuate the potential impact of life events on personal functioning.

METHOD

Sample Selection

A random selection of families within specified census tracts in the San Francisco Bay Area was contacted. The specification in census tracts occurred because the family sample was selected both for studies focused on the role of coping and social support among normal individuals and as a comparison group matched for census tract with a sample of families of alcoholic patients. Since the alcoholic sample was composed of patients in a wide range of public and private treatment programs, patients' home census tracts represented a broad range of relevant demographic characteristics (Bromet et al., 1977).

After census tracts had been identified, a street segment was chosen from each of the four randomly selected blocks. One residence was then randomly chosen from each of the four street segments. Finally, a family to be contacted was selected randomly from the four residence addresses. If the family could not be contacted by either telephone or letter, another residence address was selected randomly from the remaining addresses. Further details on sample selection are available elsewhere (Moos et al., 1981).


Respondent Characteristics

Of 360 families mailed surveys, a total of 294 (82%) completed them. Among respondents, 27 were single-parent families and 267 were families with both husbands and wives. Results are presented for a sub- sample of 194 families in which both partners responded to items concerning their coping responses and social resources. The mean age in this sample was 45.0 (SD = 14.8) for men and 43.5 (SD = 14.3) for women. The ethnic distribution for men was 81.6% white, 5.3% Mexican American, 3.7% Asian, 3.4% black, and 6.2% other ethnic backgrounds. The ethnic distribution for women was quite similar: 82% white, 5.4% Mexican American 3.7% Asian, 3.5% black and 5.4% other ethnic backgrounds. The median annual family income was approximately $18,500. These demographic characteristics are comparable to those of the San Francisco Bay Area in terms of age and annual family income, though the sample contains a slight overrepresentation of white respondents and an underrepresentation of Mexican American and black respondents.

Measures

All measures were contained in two self-administered instruments which were completed individually by each respondent: (1) The Hea|th and Daily Living Form is a questionnaire composed of items covering a broad array of personal, social, and health-related information. 2 Some of the sets of items were adapted from previous literature (Bradburn and Caplovitz, 1965; Gough and Heilbrun, 1965; Holmes and Rahe, 1967; Langner, 1962). (2) The Family Environment Scale assesses a respondent's perceptions of his or her family setting in terms of 10 dimensions (Moos, 1979; Moos and Moos, 1981).

In addition to background information, data on the following four groups of measures were collected: (1) negative life change events; (2) coping responses; (3) social resources; and (4) three mood and symptom dimensions-depression, anxiety, and stress-related physical symptoms.

(1) Negative Life Change Events. Using an adaptation of the Social Readjustment Rating Scale developed by Holmes and Rahe (1967), the survey ascertained the number of negative life change events (from 0 to 10) the respondent had experienced during the previous 12-month period. Our focus on negative events was based on recent evidence (Mueller et al., 1977; Sarason et al., 1978; Vinokur and Selzer, 1975) that negative events

2The Health and Daily Living Form is available on request to the authors.


are more strongly related to impaired functioning than are events reflecting life change in general. Examples of these negative events are a substantially decreased (20%) income, legal problems, and the death of a close friend.

(2) Coping Responses. Respondents indicated a recent personal crisis or stressful life event and then answered 19 yes/no items probing how they dealt with the event. The items were selected from a previous inventory (Sidle et al., 1969) and a review of the literature on coping responses in a variety of situations (Moos, 1976, 1977). The items were grouped into the three method of coping categories shown in Table I (active-cognitive, 6 items; active-behavioral, 6 items; avoidance, 5 items) according to cluster analyses, the ratings of several judges, and previous research. The items were also classified into two focus of coping categories (problem- focused, 6 items; emotion-focused, 11 items; see Table 1) which were established according to previous conceptual and empirical literature (Folkman and Lazarus, 1980; Lazarus, 1980). 3 The score for each coping measure was the percentage of items answered "Yes."

Given the underlying assumptions of reliability theory (Guttman, 1945), typical psychometric estimates of internal consistency may have limited applicability in assessing the psychometric adequacy of measures of coping (Hartmann et al., 1979; Zuckerman, 1979). Our attempt to minimize item redundance within each coping category resulted in clusters of relatively independent coping strategies being grouped within each category. Furthermore, an upper limit may be placed on internal consistency coefficients by the fact that the use of one coping response may be sufficient to reduce stress and thus lessen the need to use other responses from either the same or other categories of coping. Bearing in mind these considerations, the internal consistencies (Cronbach's corrected for number of items) of the method of coping categories were 0.72 for active-cognitive coping, 0.80 for active-behavioral coping, and 0.44 for avoidance coping. These coefficients indicate that the sub- categories of coping responses, as well as the entire set of items (oe = 0.62), exhibit moderate internal homogeneity. The intercorrelations among the three method of coping categories (X = 0.21) are relatively low, indicating that the categories are relatively independent. Adequate internal consistency and independence of the focus of coping categories have been demonstrated previously (Folkman and Lazarus, 1980) and were noted again in our classification of items according to this approach.

aWe thank Susan Folkman and Richard Lazarus for making their categorization of these two types of coping responses available to us.


Table I. Composition of Method and Focus of Coping Measures

Coping items

Tried to see positive side Tried to step back from the situ-

ation and be more objective Prayed for guidance or strength Took things one step at a time Considered several alternatives

for handling the problem Drew on my past experiences; I was

in a similar situation before Tried to find out more about the

situation Talked with professional person

(e.g., doctor, clergy, lawyer) about the situation

Took some positive action Talked with spouse or other relative

about the problem Talked with friend about the

situation Exercised more Prepared for the worst Sometimes took it out on other

people when I felt angry or depressed

Tried to reduce the tension by eating more

Tried to reduce the tension by smoking more

Kept my feelings to myself Got busy with other things in order

to keep my mind off the problem Didn't worry about it; figured

everything would probably work out fine

Method of coping Focus of coping

Active Active Problem Emotion cognitive behavioral Avoidance focused focused

X X

X X X X X X

X X

X X

X X

X X

X

X X

X X

X

X X X

X X

X X

X X X X

X

x

A d d i t i o n a l c o r r e l a t i o n s s h o w e d a r e a s o n a b l e d e g r e e o f i n d e p e n d e n c e

b e t w e e n the m e t h o d a n d f o c u s o f c o p i n g ind ices .

(3) Social Resources. Soc ia l r e s o u r c e s w e r e assessed by t w o indices .

T h e q u a n t i t a t i v e i n d e x m e a s u r e s t he n u m b e r o f r e l a t i o n s h i p s a n d a m o u n t

o f soc ia l a c t i v i t y w i t h f a m i l y a n d re la t ives , f r i ends , c o - w o r k e r s , a n d

c o m m u n i t y o r g a n i z a t i o n s . T h e i t e m s i n c l u d e t h e n u m b e r o f f r i ends , t h e

n u m b e r o f c lub a n d o r g a n i z a t i o n a l m e m b e r s h i p s , t he f r e q u e n c y o f

a t t e n d a n c e a t r e l ig ious serv ices , a n d t h e n u m b e r o f i n d i v i d u a l s a v a i l a b l e

fo r d i scuss ing a p r o b l e m ( i n c l u d i n g f a m i l y o r re la t ives , c lose f r i ends , a n d


employers)o 4 A qualitative index of social relationships, the Family Relationships Index, was derived from the Family Environment Scale (Moos and Moos, 1981). This index is based on the three subscales that comprise the relationship domain of the Family Environment Scale (see Holahan and Moos, 1981). The subscales are C o h e s i o n - t h e degree to which family members are helpful and supportive of each other; Expressiveness--the extent to which family members are encouraged to act openly and to express their feelings directly; and C o n f l i c t - t h e extent to which the open expression of anger and aggression and generally conflictual interactions are characteristic of the family. 5

(4) Mood and Symptom Measures. Three indicators of psychological and physical distress were adapted from earlier work by Langner (1962) and Bradburn and Caplovitz (1965): (a) dep res s ion - the sum of yes responses to 7 symptoms experienced "fairly often" such as "felt sad or blue," "felt that nothing turned out right for you"; (b) a n x i e t y - t h e sum of yes responses to 5 symptoms experienced fairly often such as "felt weak all over," "felt nervous, fidgity or tense"; and (c) physical s y m p t o m s - a n index composed of 12 symptoms experienced fairly often over the previous 12 months, such as headaches, acid stomach or indigestion, in- somnia, and poor appetite.

RESULTS

Gender and Respondent Characteristics

All categories of coping responses were used fairly often. On the average, respondents reported more frequently using active-behavioral (60.9%) and active-cognitive (62.7~ coping strategies with less reliance on avoidance strategies (24.0070). They employed somewhat more problem-focused (49.9070) than emotion-focused (38.0070) responses. The mean percentages of items answered in the scored direction for men and women on each measure of coping and the partial correlations (controlling for gender) of these measures with respondents' age, education, employment status, and income are shown in Table II.

Although there were statistically significant (t tests) gender differences in coping, the magnitudes of the differences were relatively small.

4This measures social support in the manner in which it has traditionally been assessed in prior studies; we have previously referred to it as the Traditional Social Support Index (TSSI) (Holahan and Moos, 1979).

5The direction of scoring on the Conflict subscale was reversed so that all the subscales would be scored in the same direction.


Table II. Mean Coping Responses by Gender and Partial Correlations (N = 338) with Respondent Characteristics Controlling for Gender

Means Partial correlations

Employment Coping Measures Men Women Age Education status a Income

Method of coping Active cognitive 61.5 63.8 -0.08 0.10" 0 .01 0.13"*

(% yes of 6)

Active behavioral 5 8 . 1 63.7* -0.01 0.07 0.10" 0.13"* (% yes of 6)

Avoidance 21.0 26.8** -0.05 -0.15"* -0.05 0.02 (% yes of 5)

Focus of coping Problem focused 49.7 50.0 -0.03 0.13"* 0.04 0.12"*

(07"0 yes of 6)

Emotion focused 34.5 41.3"* -0.02 -0.07 -0.02 0.05 (% yes of 11)

aEmployment status was a four-point scale ranging from unemployed to both full-time and part-time employment. *p < 0.05.

**p < 0.01.

Men reported less frequent use of active-behavioral, avoidance, and emotion-focused coping than did women. The partial correlations ind ica te that persons with more education were more likely to use active-cognitive and problem-focused coping and less likely to use avoidance coping. Amount of income was positively related to active-behavioral, active- cognitive, and problem-focused coping. Age and employment status were weakly related to the coping measures.

Severity and Type of Event

Is there a relationship between the severity or stressfulness of an event and the number and type of responses used to cope with that event? To focus on this issue, the severity of the event selected by each respondent as the target event for the coping inventory was estimated using an adaptation of the Life Change Units established by Holmes and Rahe (1967). For events not included in the Holmes and Rahe schedule, metric- equivalent weights were estimated from the PERI Life Events Scale (Dohrenwend et al., 1978). None of the correlations between the severity of the event and the coping measures was significant (range, - 0 . 0 5 to 0.03). There was no significant difference between men and women in the severity of the target event (t = 0.53, df -- 382).


Varia t ions in coping responses were evaluated according to the type of event and the gender of the individual . The respondents ' target event for the coping inven to ry was categorized into one of six types: Illness (self or other family member) , death in the family, economic (loss of job , debts, subs tant ia l decrease in income), chi ldren (child ran away f rom home, child had t rouble with teachers in school), other in te rpersonal events, and other non in t e rpe r sona l events. There was a s ignif icant gender

difference (X 2 = 17.03, d f --- 5, p < 0.001) in the d i s t r ibu t ion of events

across these categories. Men were more likely t han w o m e n to select events in the economic category (30.1 vs 13.0%), whereas w ome n were more likely t han men to select events in the illness (29.9 vs 22 .4%) and children

(19.3 vs 13.1%) categories. To assess differences in coping related to gender and the type of

target event, two-way analyses of var iance (gender • type of event) were conducted for each coping measure. As previously shown, gender

differences were signif icant bu t small (see Table II). There were also s ignif icant bu t small differences in coping responses a m o n g types of

events. Since no s ignif icant gender • type of event in terac t ions were

found , only the effects of the events are presented in Table III . Illness

Table ili. Mean Percentage of Coping Responses for Each Type of Stressful Event a

Type of event

Other Other Inter- non-

Coping measures Illness Death Economic Children personal interpersonal F value

Method of coping Active cognitive

(% yes of 6) 61.8 57.8 66.5 66.2 67.2 55.3 1.99

Active behavioral (% yes of 6) 69.8 "b 55.8 a 56.3 b 60.3 66.7 57.3 4.55**

Avoidance (% yes of 5) 24.4 22.8 21.2 25.6 28.8 19.2 1.29

Focus of coping Problem focused

(% yes of 6) 54.2 ~ 40.0 ~bc 52.5 b 48.7 53.5 50.7 c 3.24**

Emotion focused (070 yes of 11) 39.1 34.6 36.7 41.4 a 41.3 b 55.3 ab 2.82*

N events 96 43 81 60 61 25

~.b,CMeans that share a similar postscript (a, b, or c) differ significantly (p < 0.05) by the Student - Newman - Keuls procedure.

*p < 0.05. **p < 0.01.


events elicited more active-behavioral and problem-focused coping than did most other categories, while death-related events elicited the least amount of these coping strategies.

Efficacy of Coping and Social Resources

We also wished to determine the extent to which an individual's coping responses and social resources could attenuate the relationship between negative life events and functioning. This issue was examined separately for men and women through a series of multiple regression analyses using the mood and symptom indices as the criterion variables. In each regression the number of negative life events was entered first, followed by the method of coping measures and then the two measures of social resources.

To understand the organization of the results in Tables IV and V, which follow the method of presentatiofl used by Pearlin and Schooler (1978), the first vertical column of regression coefficients should be examined. The first value in this column is the regression coefficient of life events on stress without considering the role of coping and social resources as moderating factors in this relationship. For instance, among the men, the regression coefficient of life events on depression is 0.22. The value of coping and social resources can be assessed by noting the extent to which the statistical effect of life events is reduced as measures of coping and social resources are included in the regression. For all the functioning criteria for both men and women, a reduction in the life events coefficient was observed as coping and social resources were sequentially entered into the analyses. After controlling for coping and social resources, life events continued to show a significant relationship to functioning among women, but not among men.

The remaining coefficients in Tables IV and V can be interpreted by comparing values on the last row within each stress criterion. These coefficients represent the "direction" and relative relationships of coping and social resources with the criterion after controlling for the effects of negative life events. The extreme right-hand column of the tables shows the multiple correlation (R) for each step of the regression. Consistent with previous literature, the incidence of negative life events is moderately associated with the mood and symptom criteria. This relationship is most evident for depression and is higher among women than among men. The coping measures add significant and, in some instances, substantial power to the prediction of stress levels after the "effects" of life change events are taken into account. Avoidance coping tends to be more highly related to the criteria than the other two methods of coping categories. The

Tab

le I

V.

Reg

ress

ion

of

Str

ess

Cri

teri

a o

n N

egat

ive

Lif

e E

ven

ts,

Co

pin

g,

and

So

cial

Res

ou

rces

fo

r M

en

Reg

ress

ion

co

effi

cien

ts o

f th

e st

ress

cri

teri

a o

n

Met

ho

d o

f co

pin

g

So

cial

res

ou

rces

Neg

ativ

e A

ctiv

e A

ctiv

e P

red

icto

r m

easu

res

life

ev

ents

co

gn

itiv

e b

ehav

iora

l A

vo

idan

ce

Qu

anti

tati

ve

Qu

alit

ativ

e R

Str

ess

crit

erio

n:

dep

ress

ion

$, =_-.

Neg

ativ

e li

fe e

ven

ts

0.2

2*

*

Met

ho

d o

f co

pin

g

0.1

4"

* -

0.03

0

.09

0

.30

"*

So

cial

res

ou

rces

0.

11

0.0

3

0.11

0

.29

**

-

0.1

4*

-

0.1

8

* *

Str

ess

crit

erio

n:

anx

iety

N

egat

ive

life

ev

ents

0

.13

M

eth

od

of

cop

ing

0

.03

-

0.1

6"*

0

.14

" 0.

35**

S

oci

al r

eso

urc

es

0.0

2

- 01

17**

0

.15

" 0

.35

"*

- 0.

03

- 0.

05

Str

ess

crit

erio

n:

ph

ysi

cal

sym

pto

ms

Neg

ativ

e li

fe e

ven

ts

0.13

M

eth

od

of

cop

ing

0

.09

-

0.0

4

- 0.

03

0.1

5*

S

oci

al r

eso

urc

es

0.0

8

- 0

.04

-

0.03

0

.14

-

0.01

-

0.11

0.22

**

0.38

**

0.45

**

0.1

3

0.39

**

0.40

**

0.13

0

.19

" 0.

23*

~o

*p

<

0.0

5.

p <

0

.01

.

Tab

le V

. R

egre

ssio

n o

f S

tres

s C

rite

ria

on

Neg

ativ

e L

ife

Ev

ents

, C

op

ing

, an

d S

ocia

l R

eso

urc

es f

or W

om

en

Reg

ress

ion

co

effi

cien

ts o

f th

e st

ress

cri

teri

a o

n

Met

ho

d

of

cop

ing

S

ocia

l re

sou

rces

Neg

ativ

e A

ctiv

e A

ctiv

e P

red

icto

r m

easu

res

life

eve

nts

cog

nit

ive

beh

avio

ral

Av

oid

ance

Q

uan

tita

tiv

e Q

ual

itat

ive

R

Str

ess

crit

erio

n:

dep

ress

ion

N

egat

ive

life

eve

nts

0.36

**

Met

ho

d o

f co

pin

g

0.29

**

- 0.

22**

-

0.02

0.

28**

S

ocia

l re

sou

rces

0.

26**

-

0.19

**

- 0.

02

0.21

**

- 0.

06

- 0.

22**

Str

ess

crit

erio

n:

anx

iety

N

egat

ive

life

eve

nts

0.21

"*

Met

ho

d o

f co

pin

g

0.1

7"*

-

0.21

"*

0.01

0.

21"*

S

ocia

l re

sou

rces

0.

14"

- 0.

18**

0.

05

0.1

4'

- 0.

03

- 0~

23"*

Str

ess

crit

erio

n:

ph

ysi

cal

sym

pto

ms

Neg

ativ

e li

fe e

vent

s 0.

21"*

M

eth

od

of

cop

ing

0.

17**

-

0.19

"*

- 0.

05

0.16

" S

ocia

l re

sou

rces

0

.15

" -

0.15

* -

0.02

0.

10

- 0.

02

- 0.

21 *

*

0.36

**

0.47

**

0.52

**

0.21

"*

0.33

**

0.40

**

0.21

"*

0.32

**

0.37

**

*p <

0.0

5.

**p

< 0.

01.


magnitude of the incremental prediction associated with coping measures is similar for men and women. Results from a separate series of regressions (not shown) indicated that the focus of coping measures (problem-focused, emotion-focused) also attenuated the relationship between life events and stress.

Indices of social resources also moderated the relationship between events and functioning, and provided incremental information about functioning after controlling for negative life events and coping responses. Among the women, measures of coping and social resources added roughly comparable increments to the prediction of the criteria. The, quality of their social resources was more strongly related to the criteria than was the quantity of those resources. For men, social resources were: somewhat less strongly related to the criteria than were measures of' coping. The three sets of predictor variables taken together accounted for somewhat more of the variance in functioning among women than among m e n .

DISCUSSION

We have explored the nature of the coping process among adult community members by analyzing a representative set of self-reported coping responses to a recent stressful life event. The clustering of these responses into measures of the method and focus of coping showed psychometric adequacy and moderate utility in exploring their roles as moderators of the relationship between stressful events and indices of negative mood and physical symptoms.

There were only modest differences in coping among different types of events. For instance, fewer active and task-oriented responses were noted in coping with a death as compared with an illness; this probably reflects the differential demands of these situations. Folkman and Lazarus (1980) also found that health-related stressors elicited fewer problem- focused and more emotion-focused coping than work or family stressors. Although these results suggest a moderate uniformity in the types of coping responses made to various events, the frequency with which responses were used, the temporal variations in coping processes, and the importance of situation-specific responses (see Moos, 1977; Pearlin and Schooler, 1978) cannot be determined from our data. We also found that the various categories of coping and a simple count of the number of different coping responses made to an event were only minimally related to the amount of life change required by the event. Our use of a yes/no response format rather than a measure of the frequency or intensity of each response may have constrained the magnitude of these relationships.

1S4 Billings and Moos

Indices of coping and social resources were shown to moderate the event-functioning relationship, as well as provide incremental information about stress levels beyond that attributable to the incidence of negative life events. This suggests that coping and social resources, especially qualitative indices of such resources (Chan, 1977; Henderson, 1977), play important roles in the maintenance of adequate functioning. Coping responses and social resources accounted for comparable amounts of criterion variance. Additional analyses showed that approximately one- half of the criterion variance "explained" by coping and by social resources was shared between these two sets of measures, e.g., people who use avoidance coping responses have fewer social resources and these two factors combine to detrimentally influence their functioning. Although coping and social resources are conceptually distinct, analyses including only coping responses or only social resources thus will tend to over- estimate the unique information these sets of factors provide about functioning.

Gender differences in the types of stressors for which coping responses were reported and variations in coping according to the type of stressor indicate that the context of coping must be considered in evaluating gender differences in coping. Within each type of event, small but consistent gender differences were noted on some of the coping measures. Women were more likely to use avoidance coping, which was associated with greater impairment of functioning. This is congruent with the findings of Pearlin and Schooler (1978), who also identified a tendency for women to use less effective methods of coping. Also of note is our finding that the predictive value of social support was less salient among men than among women. Given that a majority of the men were employed, while a majority of the women were homemakers, the working environment of men may be an important but missing variable in our model (Holahan and Moos, 1981).

Future assessments of the effectiveness of coping must consider the individual's baseline level of functioning as well as the context in which coping takes place. Impaired functioning may be both a cause and a result of an accumulation of unresolved stressors which themselves may stem from a failure to respond with appropriate coping responses. Additionally, social networks may serve as both a source of and a buffer against stress (Heller, 1978). For instance, the death of a loved spouse causes stress and reduces available support, but remaining social relationships may be used to deal with the stress of this event. Coping may impact on social networks; various patterns of coping may serve to either enhance or diminish social resources. Previous stressors may also lead to increased emotional sensitivity and impaired coping with the stressful effects of current life events. Loss of a parental figure at an early age may

Coping Responses 1o Stressful Life Events 155

lead to impaired coping responses to social losses and vulnerability to depression at a later time (Brown and Harris, 1978).

Given these considerations, it may not be possible to identify consistently "positive" or "negative" types of coping. However, we did find that more reliance on active attempts to deal with an event and fewer attempts to avoid dealing with it were associated with less stress. The use of these more "effective" coping strategieswas more prevalent among those with more education and income, implicating them as intervening links in the inverse relationship between socioeconomic status and psychopathology. The limited range of functioning observed in our community sample may have constrained the magnitude of the relationships between measures of coping and functioning. We are currently using a prospective research design and examining clinically defined groups of patients to attempt to clarify these issues. Future work should focus on the relationship of self-reported indices of coping and measures obtained from other perspectives, such as those of a trained interviewer or significant other or of an observer of the coping process. Our results indicate that regardless of the particular research perspective, a comprehensive evaluation of a person's response to stressful events must simultaneously consider the nature and context of available social resources and the individual's coping process.

ACKNOWLEDGMENTS

We wish to thank John Finney for coordinating the data collection, Bernice Moos and Wendy Gamble for their assistance in the data analyses, and John Finney and Ruth Cronkite for their helpful comments on an early draft of the manuscript.

REFERENCES

Andrews, G., and Tennant, C. (1978). Being upset and becoming ill: An appraisal of the' relationship between life events and physical illness. Med. J. Austral. 8: 324-327.

Andrews, G., Tennant, C., Hewson, D., and Vaillant, G. (1978). Life event stress, social support, coping style, and risk of psychological impairment. J. Nerv. Ment. Dis. 116: 307-316.

Antonovsky, A. (1979). Health, Stress, and Coping, Jossey-Bass, San Francisco. Bradburn, N. M., and Caplovitz, D. (1965). Reports on Happiness: A Pilot Study o f

Behavior Related to Mental Health, Ald!ne, Chicago. Bromet, E., Moos, R. H., Bliss, F., and Wuthmann, C. (1977). The posttreatment func-

tioning of alcoholic patients: Its relationship to program participation. J. Consult. Clin. Psychol. 45: 829-842.

Brown, G. W., and Harris, T. (1978). Social Origins o f Depression: A Study o f Psychiatric Disorder in Women, Free Press, New York.


Cassel, J. (1976). The contribution of the social environment to host resistance. Am. J. Epi- demioL 104: 107-123.

Chan, K. B. (1977). Individual differences in reactions to stress and their personality and situational determinants: Some implications for community mental health. Soe. Sei. Meal. 11: 89-103.

Cobb, S. (1976). Social support as a moderator of life stress. Psychosom. Med. 38: 300-314. Coelho, G., Hamburg, D., and Adams, J. (eds.) (1974). Coping and Adaptation, Basic

Books, New York. Dean, A., and Lin, N. (1977). The stress buffering role of social support. J. Nerv. Ment.

Dis. 165: 403-417. Dohrenwend, B. S., and Dohrenwend, B. P. (eds.)(1974). Stressful Life Events: Their

Nature and Effects, Wiley and Sons, New York. Dohrenwend, B. S., and Dohrenwend, B. P. (1978). Some issues in research on stressful

life events. J. Nerv. Ment. Dis. 166: 7-15. Dohrenwend, B. S., Krasnoff, L., Askenasy, A. R., and Dohrenwend, B. P. (1978). Ex-

emplification of a method for scaling life events: The PERI Life Events Scale. J. Health Soc. Behav. 19: 205-229.

Eaton, W. W. (1978). Life events, social supports, and psychiatric symptoms: A re- analysis of the New Haven data. J. Health Soc. Behav. 19: 230-234.

Folkman, S., and Lazarus, R. S. (1980). Coping in an adequately functioning middle- aged population. J. Health Soc. Behav. 21: 219-239.

Gore, S. (1978). The effect of social support in moderating the health consequences of un- employment. J. Health Soc. Behav. 19: 157-165.

Gough, H., and Heilbrun, A. (1965). The Adjective Check List Manual, Consulting Psychologists Press, Palo Alto, Calif.

Guttman, L. (1945). A basis for analyzing test-retest reliability. Psychometrika 10: 255-282. Haan, N. (ed.) (1977). Coping and Defending, Academic Press, New York. Hartmann, D. P., Roper, B. L., and Bradford, D. C. (1979). Some relationships between

behavioral and traditional assessment. J. Behav. Assess. 1: 3-21. Heller, K. (1978). The effects of social support: Prevention and treatment implications.

In Goldstein, A. P., and Kanfer, F. H. (eds.), Maximizing Treatment Gains: Transfer Enhancement in Psychotherapy, Academic Press, New York.

Henderson, S. (1977). The social network, support and neurosis: The function of attach- ment in adult life. Br. J. Psyehiat. 131: 185-191.

Holahan, C. J., andMoos~ R. H. (1981). Social support and psychological distress: A longi- tudinal analysis. J. Abnormal Psychol. 49: 365-370.

Holmes, T. H., and Rahe, R. H. (1967). The Social Readjustment Rating Scale. J. Psy- chosom. Res. 11 : 213-218.

Langner, T. S. (1962). A twenty-two item screening score of psychiatric symptoms in indicating impairment. J. Health Hum. Behav. 3: 269-276.

Lazarus, R. S. (ed.) (1966). Psychological Stress and the Coping Process, McGraw-Hill, New York.

Lazarus, R. S. (1980). The stress and coping paradigm. In Eisdorfer, C., Cohen, D., Kleinman, A., and Maxim, P. (eds.), Theoretical Bases for Psychopathology, Spectrum, New York.

Lin, N., Simeone, R., Ensel, W., and Kuo, W. (1979). Social support, stressful life events, and illness: A model and an empirical test. J. Health Soc. Behav. 20: 108-119.

Magnusson, D., and Endler, N. S. (eds.) (1977). Personality at the Crossroads, Erlbaum, Hillsdale, N.J.

Mechanic, D. (1977). Illness behavior, social adaptation, and the management of illness: A comparison of educational and medical models. J. Nerv. Ment. Dis. 165: 79-87.

Moos, R. H. (ed.) (1976). Human Adaptation: Coping with Life Crises, Heath, Lexington, Mass.

Moos, R. H. (ed.) (1977). Coping with Physical Illness, Plenum, New York. Moos, R. H. (1979). Evaluating family and work settings. In Ahmed, P. I., and Coelho,

G. V. (eds.), Toward a New Definition o f Health, Plenum, New York.


Moos, R. H., and Moos, B. S. (1981). Family Environment Scale Manual, Consulting Psy- chologists Press, Palo Alto, Calif. (in press).

Moos, R. H., Finney, J. W., and Chan, D. A. (1981). The process of recovery from al- coholism. I. Comparing alcoholic patients and matched community controls. J. Studies A lcohol. (in Press).

Muetler, D. P., Edwards, D. W., and Yarvis, R. M. (1977). Stressful life events and psychiatric symptomatology: Change or undesirability? J. Health Soc. Behav. 18: 307-317.

Pearlin, L., and Schooler, C. (1978). The structure of coping. J. Health Soc. Behav. 19: 2-21.

Redfield, J. R., and Stone, A. (1979). Individual viewpoints of stressful life events. J. Con- sult. Clin. Psychol. 47: 147-154.

Sarason, I. G., Johnson, J. H., and Siegel, J. M. (1978). Assessing the impact of life changes: Development of the llfe experiences survey. J. Consult. Clin. Psychol. 46: 932-946.

Sidle, A., Moos, R., Adams, J., and Cady, P. (1969). Development of a coping scale: A preliminary study. Arch. Gen. Psychiat. 20: 226-232.

Theorell, T. (1976). Selected illneses and somatic factors in relation to two psychological stress indices: A prospective study on middle-aged construction building workers. J. Psychosom. Res. 20: 7-20.

Vaillant, G. E. (ed.) (1977). Adaptation to Life, Little, Brown, Boston. Vinokur, A., and Selzer~ M. L. (1975). Desirable versus undesirable life events: Their

relationship to stress and mental distress. J. Personal Soc. Psychol. 32: 329-337. Zuckerman, M. (1979). Traits, states, and uncertainty. J. Behav. Assess. 1: 43-54.

The role of coping responses and social resources in attenuating the stress of life events

Documents

Transcript of The role of coping responses and social resources in attenuating the stress of life events