Coping is the conscious effort to reduce stress. Psychological coping mechanisms are commonly termed coping strategies or coping skills. Coping skills develop from infancy and are learned by watching others and trial and error. Perceived control is an important resource in coping with stressful situations. It develops from prior mastery of stressful situations and within social relationships. Affiliation with others is a basic human response for managing stress. The effectiveness of coping strategies in reducing distress is dependent on the strategies used and the self-belief that one can cope, also known as coping self-efficacy. Functional magnetic resonance imaging has shown that emotion regulation paradigms can be conceptualized into four dimensions: affect intensity and reactivity, affect modulation, cognitive modulation, and behavioral control.
Coping is part of health and wellbeing, that includes healthy environments, responsive parenting, sense of belonging, healthy activities, coping, resilience and the treatment of illness. Environmental conditions during development contribute to the heterogeneity of an individual's response to adversity encountered as an adult. Social factors both reduce emotional reactivity and help modulate stress responses. Healthy activities—sleep, nutrition, physical activity and pleasurable and mastery activities—can help reduce emotional reactivity. Resilience is the consequence of coping with stressful situations—bouncing back after adversity. Functional changes have been noted in the amygdala and anterior corticolimbic brain circuits that control cognitive, motivational, and emotional aspects of physiology and behavior induced by learning as an aspect of coping in the context of stress exposure therapy highlighting functional neuroadaptations in brain regions that mediate emotion regulation and resilience.
There are psychological and physiological changes in response to acute and chronic stressors. There is acute functional neuroplasticity during stress, with distinct and separable brain networks that underlie critical components of the stress response, and a specific role for ventrolateral prefrontal cortex (VmPFC) neuroflexibility in stress-resilient coping. Greater neural flexibility signals in the VmPFC during stress are correlated with active coping whereas lower dynamic activity in the VmPFC is associated with a higher level of unhealthy coping behaviors, including binge-drinking, emotional eating, and arguments and fights.
Perceived stress also causes changes in the production of the pro-inflammatory cytokines, TNF-α, IL-6 and IFN-γ, and negative immunoregulatory cytokines, IL-10 and IL-4, take part in the homeostatic response to psychological stress and that stress-induced anxiety is related to a T-helper-1-like response.
Acute stressors are associated with potentially adaptive upregulation of some parameters of natural immunity and downregulation of some functions of specific immunity. Brief stressors tend to suppress cellular immunity while preserving humoral immunity. Chronic stressors were associated with suppression of both cellular and humoral measures. Effects of event sequences vary according to the kind of event (trauma vs. loss). Subjective reports of stress generally do not associate with immune change. In some cases, physical vulnerability as a function of age or disease also increase vulnerability to immune change during stressors.
The development of coping skills develops in infancy and is supported by early caregivers. Infants rely on their caregivers to carry out coping actions for them in response to the infant's needs. In preschool, parents provide direct help with implementing coping strategies. During middle childhood, parents support their child's coping efforts. During adolescence, parents move from reminding, to backing up coping to finally monitoring the coping of their young adult children.
Some sex differences have been noted in coping responses. There is evidence that males often develop stress due to their careers, whereas females often encounter stress due to issues in interpersonal relationships. Early studies indicated that "there were gender differences in the sources of stressors, but gender differences in coping were relatively small after controlling for the source of stressors"; and more recent work has similarly revealed "small differences between women's and men's coping strategies when studying individuals in similar situations." In general, such differences as exist indicate that women tend to employ emotion-focused coping and the "tend-and-befriend" response to stress, whereas men tend to use problem-focused coping and the "fight-or-flight" response, perhaps because societal standards encourage men to be more individualistic, while women are often expected to be interpersonal. An alternative explanation for the aforementioned differences involves genetic factors. The degree to which genetic factors and social conditioning influence behavior, is the subject of ongoing debate.
Good theories of coping need to have functional homogeneity and distinctivenss that link higher-order coping with adaptive processes. Three conceptualizations tie overarching theories and explicitly use top-down criteria to organise coping strategies.
- Health-focused (healthy or unhealthy)
- Voluntary vs. involuntary
- The Skinner & Edge model
- Defense mechanisms
Health-focused model of coping
The health-focused model of coping acknowledges that all strategies and behaviors are an attempt to reduce distress and may initially be effective. Healthy strategies are those that are likely to help a person cope and have no negative consequences. The coping planning framework groups these into self-soothing (e.g., deep breathing, coping self-talk, positive self-talk, being mindful, or prayer), relaxing or distracting activities, social support, and seeking support from health professionals if personal strategies are not effective. Unhealthy strategies are those that might help in the short-term, but are likely to have negative consequences. They include negative self-talk, activities (e.g., emotional eating, conflict with others, alcohol and drugs, self-harm), social isolation and suicidal ideation. The aim of coping planning is to make a plan about how to cope and then use the plan as a prompt to use healthy coping strategies when anxious, depressed or distressed. The plan increases the likelihood of using healthy coping strategies before using habitual unhealthy strategies. While healthy coping strategies are associated with general wellbeing, they have a much greater influence in predicting how distressed a person feels when things aren't going well. The combined implicit and explicit focus on coping not only improves emotional regulation, but also decreases unpleasant emotions associated with the event.
There have been more than 400 coping frameworks proposed. Many commonly-used conceptualisations have been found to be inadequate. Single function higher-order categories, for example, problem- vs. emotion-focused ignore that coping strategies may serve more than one function. Typological categories, for example, approach vs. avoidance, active vs. passive, cognitive vs. behavioral are similarly unhelpful because all ways of coping are multidimensional.
Appraisal-focused strategies occur when the person modifies the way they think, for example: employing denial, or distancing oneself from the problem. People may alter the way they think about a problem by altering their goals and values, such as by seeing the humor in a situation: "some have suggested that humor may play a greater role as a stress moderator among women than men". One positive coping strategy, anticipating a problem, is known as proactive coping. Anticipation is when one reduces the stress of some difficult challenge by anticipating what it will be like and preparing for how one is going to cope with it.
Adaptive and maladaptive
While adaptive coping methods improve functioning, a maladaptive coping technique will just reduce symptoms while maintaining and strengthening the disorder. Maladaptive techniques are more effective in the short term rather than long term coping process. Examples of maladaptive behavior strategies include dissociation, sensitization, safety behaviors, anxious avoidance, and escape (including self-medication). These coping strategies interfere with the person's ability to unlearn, or break apart, the paired association between the situation and the associated anxiety symptoms. These are maladaptive strategies as they serve to maintain the disorder. Dissociation is the ability of the mind to separate and compartmentalize thoughts, memories, and emotions. This is often associated with post traumatic stress syndrome. Sensitization is when a person seeks to learn about, rehearse, and/or anticipate fearful events in a protective effort to prevent these events from occurring in the first place. Safety behaviors are demonstrated when individuals with anxiety disorders come to rely on something, or someone, as a means of coping with their excessive anxiety. Anxious avoidance is when a person avoids anxiety provoking situations by all means. This is the most common strategy. Escape is closely related to avoidance. This technique is often demonstrated by people who experience panic attacks or have phobias. These people want to flee the situation at the first sign of anxiety.
Problem-focused vs. emotion-focused
People using problem-focused strategies try to deal with the cause of their problem. They do this by finding out information on the problem and learning new skills to manage the problem. Problem-focused coping is aimed at changing or eliminating the source of the stress. The three problem-focused coping strategies identified by Folkman and Lazarus are: taking control, information seeking, and evaluating the pros and cons.
Emotion-focused strategies may involve: releasing pent-up emotions, distracting oneself, managing hostile feelings, meditating, and using systematic relaxation techniques. Emotion-focused coping "is oriented toward managing the emotions that accompany the perception of stress". The five emotion-focused coping strategies identified by Folkman and Lazarus are: disclaiming, escape-avoidance, accepting responsibility or blame, exercising self-control, and positive reappraisal. Emotion-focused coping is a mechanism to alleviate distress by minimizing, reducing, or preventing, the emotional components of a stressor. This mechanism can be applied through a variety of ways, such as: seeking social support, reappraising the stressor in a positive light, accepting responsibility, using avoidance, exercising self-control, and distancing. The focus of this coping mechanism is to change the meaning of the stressor or transfer attention away from it. For example, reappraising tries to find a more positive meaning of the cause of the stress in order to reduce the emotional component of the stressor. Avoidance of the emotional distress will distract from the negative feelings associated with the stressor.
Emotion-focused coping is well suited for stressors that seem uncontrollable (ex. a terminal illness diagnosis, or the loss of a loved one). Some mechanisms of emotion focused coping, such as distancing or avoidance, can have alleviating outcomes for a short period of time, however they can be detrimental when used over an extended period. Positive emotion-focused mechanisms, such as seeking social support, and positive re-appraisal, are associated with beneficial outcomes. Emotional approach coping is one form of emotion-focused coping in which emotional expression and processing is used to adaptively manage a response to a stressor. Typically, people use a mixture of several types of coping strategies, which may change over time. All these methods can prove useful, but some claim that those using problem-focused coping strategies will adjust better to life. Problem-focused coping mechanisms may allow an individual greater perceived control over their problem, whereas emotion-focused coping may sometimes lead to a reduction in perceived control (maladaptive coping). Lazarus "notes the connection between his idea of 'defensive reappraisals' or cognitive coping and Freud's concept of 'ego-defenses'", coping strategies thus overlapping with a person's defense mechanisms.
A common third category of coping, along with problem-focused and emotion-focused coping, is relationship-focused coping. The same coping strategy could be classified into different coping categories depending on how the strategy is used; for example, "social support seeking could be used to express emotions (emotion-focused coping), to gather information (problem-focused coping), and to maintain relationships with others (relationship-focused coping)".
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Some coping strategies can have mixed functions. For example, social support seeking could be used to express emotions (emotion-focused coping), to gather information (problem-focused coping), and to maintain relationships with others (relationship-focused coping). One form of coping may facilitate the use of other strategies. For example, an individual may need to first engage in emotion-focused coping to manage his or her emotions before he or she can effectively engage in problem-focused coping efforts.