Chapter Seven: Coping, Resilience, and Social Support

Chapter Outline Coping with stress and resilience Coping and external resources Coping outcomes Coping interventions Social support

Coping with Stress Stress moderators: Modify how stress is experienced and the effects it has Coping: Managing the internal and external demands of stressful situations using thoughts and behaviors Characteristics Determines outcome Variety in Coping is related to good outcome

The Coping Process External resources or impediments Stressful event, its stage, and anticipated future course Appraisal and interpretation of the stressor Coping responses and strategies Coping tasks Coping outcomes External resources or impediments Tangible resources Social support Major life events and daily hassles Internal resources or impediments Usual coping style(s) Other personality factors that influence selection of coping responses and strategies

Positivity and illness Affect and Health Negative affectivity Marked by anxiety, depression, and hostility Related to: Poor health All-cause mortality Higher levels of stress indicators Associated with poor health habits Do not respond well to treatments Positivity and illness Promotes better mental and physical health Linked with lower levels of stress indicators Triggers better immune responses Improves coping

Psychosocial Resources Optimism - Promotes active and persistent coping efforts Psychological control: Belief that one can exert control over stressful events Control-enhancing interventions: Use information, relaxation, and cognitive- behavioral techniques to reduce anxiety, improve coping, and promote recovery

Psychosocial Resources Self-esteem - Associated with lower levels of stress indicators Conscientiousness Self-confidence Being smart Emotional stability Q: Which is linked to longevity?

Resilience Helps individuals bounce back and adapt flexibly to stressful situations Internal resources : Characterized by… Sense of coherence and purpose about life Sense of humor and trust in others Sense that life is worth living Religious beliefs Q: How do we acquire these?

Coping Style Tendency to deal with stressful events in a particular way Avoidant coping style: not dealing with the stressor Examples? When is it adaptive??? Approach coping style: Coping by gathering information or directly taking action

Problem-Focused and Emotion-Focused Coping Types of Approach Coping: Problem-focused coping: Attempting to do something constructive about the stressful conditions Examples? Emotion-focused coping: Regulates emotions experienced due to the stressful event

Problem-Focused and Emotion-Focused Coping Emotional-approach coping: Clarifying, focusing on, and working through the emotions in response to a stressor Aids in adjusting to chronic conditions and medical conditions Helps manage stress better Proactive coping - Anticipating potential stressors and acting in advance (e.g., preparing for birth of baby, doing premarital counseling)

Coping and External Resources Time Socioeconomic status (SES) Education Decent job Friends Family Standard of living Presence of positive life events Absence of other life stressors

Coping Outcomes Reducing or eliminating stressors Tolerating or adjusting to negative events or realities Maintaining a positive self-image Maintaining emotional equilibrium Continuing satisfying relationships with others Enhancing recovery when ill Keeping low physiological, neuroendocrine, and immune reactivity

Case Vignette 10 year-old boy recently lost his grandmother he was very close to. He was diagnosed with diabetes and placed on an insulin regimen. His mother tells you that he has been expressing fear of dying, having anxiety (manifesting in stomach cramps), and believes diabetes to be life-threatening. He is also having difficulty remembering to take his insulin shots and complains about the pain. Group work: Identify possible coping interventions (emotion-focused, problem-focused, emotional- approach)

Mindfulness Meditation Teaches individuals to: Have a higher awareness of the present Focus on the present and accept it Mindfulness-based stress reduction (MBSR) - Helps people to manage their reactions to stress and the resulting negative emotions

Mindfulness Meditation Acceptance and commitment therapy (ACT) - Teaches individuals to: Accept the problem Be aware of its occurrence and conditions that cause it Change behaviors

Expressive Writing Lowers psychological and physiological indicators of stress Aids in effective coping Helps organize thoughts and find meaning Helps to focus attention on positive aspects Provides an opportunity to clarify emotions Affirms one’s personal values

Self-Affirmation Helps individuals feel better about themselves Lowers physiological activity and distress Undermines defensive reactions to health threats

Relaxation Training Affects the physiological experience of stress by reducing arousal Deep breathing Progressive muscle relaxation training Guided imagery Transcendental meditation and yoga Self hypnosis

Coping Effectiveness Training Teaches people how to: Assess stressful events Disaggregate the stressors into specific tasks Encourages people to maintain their social support )

Coping Effectiveness Training Phases of stress management Identify and Monitor Stressors (e.g, Family triggers Identifying stress antecedents Avoiding negative self-talk Acquiring and practicing skills for coping with stress Practice

Social Support Information from others that one is: Loved and cared for Esteemed and valued Part of a network of communication and mutual obligations Helps reduce stress, cope better, and live positively

Types of Social Support Provision of material support Services, financial assistance, or goods Tangible assistance Providing support through information Informational support Reassuring someone that they are important and cared for Emotional support Helping someone without him or her being aware of it Invisible support

Effects of Social Support on Illness Lowers the likelihood of illness Speeds up recovery Reduces the risk of mortality Encourages individuals to use health services and stick to their medical regimens Negative: Can lead to bad health habits, Underfunction and increase dependency

Biopsychosocial Pathways Social support has positive effects on the cardiovascular, endocrine, and immune systems Decreases cortisol responses to stress Better immune functioning Modifies brain’s responses to stress

How does Social Support help? Direct effects hypothesis: Findings indicate that social support is generally beneficial during non-stressful as well as stressful times Buffering hypothesis: Findings also indicate that physical and mental health benefits of social support are chiefly evident during periods of high stress Therefore, both applies. Social support is healthy generally AND helps us when we are most stressed!

Extracting Support Effectiveness of social support depends on the individual Social skills influence the ability to develop social support

Effective Kinds of Support Good marriage Familial support Support from the community Matching support to the stressor Matching hypothesis: Support that meets the needs of a stressful event is the most effective support

Who Provides Support? Social support is ineffective if the type of support provided is not useful Emotional support is best provided by someone close to the individual Social support is effective when the person from whom one is seeking support is perceived to be responsive to one’s needs (trust)

Threats to Social Support Stressful events Intrusive social contact Controlling or directive support

Giving Social Support Has beneficial effects on mental and physical health Enhancing social support Prevents a lot of ailments and problems Forms of beneficial social support systems Networking/Internet-based systems Family-based systems Community-based systems