Chapter Seven: Coping, Resilience, and Social Support

1. Chapter Seven: Coping, Resilience, and Social Support

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

3. 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 • Relationship with stressful events is a dynamic process • Important aspect of coping is its breadth

4. The Coping Process 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

5. Personality and Coping Negative affectivity Positivity and illness • 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 • Can create an illusion of poor health • Promotes better mental and physical health • Linked with lower levels of stress indicators • Triggers better immune responses • Improves coping

6. 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

7. Psychosocial Resources • Self-esteem - Associated with lower levels of stress indicators • Conscientiousness • Self-confidence • Being smart • Emotional stability

8. Resilience • Helps individuals bounce back and adapt flexibly to stressful situations • Promoting resources • Sense of coherence and purpose about life • Sense of humor and trust in others • Sense that life is worth living • Religious beliefs

9. Coping Style • Propensity to deal with stressful events in a particular way • Avoidant coping style: Coping by avoiding • Approach coping style: Coping by gathering information or directly taking action

10. Problem-Focused and Emotion-Focused Coping • Problem-focused coping: Attempting to do something constructive about the stressful conditions • Emotion-focused coping: Regulates emotions experienced due to the stressful event

11. 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

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

13. 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

14. 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

15. 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

16. 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

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

18. 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

19. Coping Effectiveness Training • Teaches people how to: • Assess stressful events • Disaggregate the stressors into specific tasks • Encourages people to maintain their social support • Phases of stress management • Learning and identifying stressors

20. Coping Effectiveness Training • Acquiring and practicing skills for coping with stress • Practicing the techniques • Stress management program • Identifying stressors • Monitoring stress • Identifying stress antecedents • Avoiding negative self-talk

21. Coping Effectiveness Training • Completing take-home assignments • Acquiring skills • Setting new goals • Engaging in positive self-talk and self-instruction • Time management and planning • Identifying stress carriers and confronting them

22. 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

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

24. 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 • Can lead to bad health habits

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

26. Moderation of Stress by Social Support • Direct effects hypothesis: Social support is generally beneficial during non-stressful as well as stressful times • Buffering hypothesis: Physical and mental health benefits of social support are chiefly evident during periods of high stress

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

28. 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

29. 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

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

31. 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