Coping with Chronic Stress Edited by

Benjamin H. Gottlieb University of Guelph Guelph, Ontario, Canada

PLENUM PRESS • NEW YORK AND LONDON

Contents

I: INTRODUCTION 1. Conceptual and Measurement Issues in the Study of Coping with Chronic Stress

3

Benjamin H. Gottlieb

Introduction Acute and Chronic Stressors: Fluid Boundaries and Interactive Effects The Challenges of Assessing Coping with Chronic Stress Determining the Focus of Coping Documenting Coping without Relying on Eventful or Stressful Markers Temporal Changes in Coping with Chronic Stressors Prominent Modes of Coping with Chronic Stress .. ? Vigilance and Respite Future Outlook Making Meaning through Cognitive Reinterpretation Acceptance, Resignation, and Religiosity Instrumental Coping The Bases of Efficacy. Organization and Overview of the Volume References Xlll

3 5 10 10 12 16 19 20 24 25 27 28 29 32 37

xiv

CONTENTS II: THEORY AND PERSPECTIVES

2. The Nature of Chronic Stress

;

43

Blair Wheaton

Prefatory Note Introduction Of Stressors, Stress, and Stress Outcomes Defining Stress Elaborating the Stress Domain Models of the Stress Concept—Reconsidered Events versus Chronic Stressors Forms of Chronic Stress Threats •. Demands Structural Constraints Underreward Complexity Uncertainty Conflict Restriction of Choice Resource Deprivation Measuring Chronic Stress Conclusions Appendix: Classification of the Chronic Stress Items from the Stress Measurement Survey References

43 44 44 45 48 49 52 57 57 58 59 60 61 62 63 63 64 65 68 69 72

3. Theories of Coping with Chronic Stress: Illustrations from the Health Psychology and Aging Literatures

75

Carolyn M. Aldwin and Jennifer Brustrom

Theoretical Models of Coping Coping with Acute Stress Critique Application of Current Models of Chronic Stress Models of Coping with Chronic Stress Patterns of Coping with Chronic Illness Predictors of Coping Patterns

76 76 80 81 82 85 85

CONTENTS

xv

Outcomes of Coping Efforts Limitations of Studies Aging as a Paradigm for Coping with Chronic Stress A Deviation Amplification Model of Coping with Chronic Stress Future Research References

87 90 92 95 98 99

4. Effortful and Involuntary Responses to Stress: Implications for Coping with Chronic Stress

105

Bruce E. Compos, Jennifer Connor, Dana Osowiecki, and Amy Welch

Acute and Chronic Stress ' Responses to Stress: Effortful and Involuntary Processes Coping as an Effortful Process: Try and Try Again Involuntary Responses to Stress: Unwanted Effects of Unintended Reactions Engagement and Disengagement Responses to Stress Rumination, Avoidance, and Distraction A Framework for Distinguishing Responses to Stress Understanding Responses to Chronic Stress Involuntary Processes Contribute to Chronic Stress Affective and Physical Consequences of Avoidant Coping Efforts Involuntary Thoughts, Avoidance, and Effortful Engagement Coping Future Directions References

107 109 109 110 115 116 117 121 121 123 125 126 128

III: THE SOCIAL CONTEXT OF COPING WITH CHRONIC STRESS 5. Social-Environmental Influences on the Chronic Stress Process

133

Stephen J. Lepore

Overview Social Origins of Chronic Stress

133 133

xvi

CONTENTS

Loneliness Social Stimulus Overload Stressful Life Events Social Roles Stigma Migration Summary Social Environment as a Modifier of Chronic Stress Chronic Stress Buffer Chronic Stress Amplification Summary Social Environment as a Mediator of Chronic Stress Support Deterioration Stress Transmission '. Summary Conclusion References

135 136 137 137 139 139 140 141 141 144 149 150 150 152 153 154 156

6. Coping with Chronic Stress: An Interpersonal Perspective .. 161 Tess Byrd O'Brien and Anita DeLongis

The Interpersonal Context of Coping Sources of Strain in Chronic Stress Contexts Dyadic Patterns of Coping and Their Significance for Weil-Being The Role of Close Relationships in Coping and Weil-Being . . . The Role of Coping in Disrupting Relationships and Diminishing Support ,Relationship-Focused Coping: Sustaining Social Relationships during Periods of Chronic Stress Empathic Coping Other Forms of Relationship-Focused Coping Conclusion References 7. Families Accommodating to Chronic Stress: Unintended and Unnoticed Processes

162 162 164 169 171 173 174 183 184 185

191

Rena L. Repetti and Jenifer Wood

Coping as an Interpersonal Process The Unintentional Involvement of Others in Coping

192 192

CONTENTS

xvii

The Daycare Study Long-Term Implications of Coping as an Interpersonal Process What Can Short-Term Responses to Stress Tell Us about Coping with Chronic Stress? Family Accommodation to Chronic Stress Implications for Coping Assessment Accommodation to Poverty and Community Violence Summary References

198 208 208 211 213 216 218 219

8. Reciprocity in the Expression of Emotional Support among Later-Life Couples with Stroke

221

Mary Ann Partis Stephens and Sarah L. Clark

Stroke as a Chronic Stressor for Married Couples Emotional Support in the Context of Chronic Illness A Dyadic Study of Couples Coping with Stroke Sample Characteristics Measures of Interpersonal Communication and Distress Supportive and Unsupportive Communications Comparing Partners on Psychological Distress and Communications Reciprocity in Communications Some Observations on Couples Coping with Stroke Concluding Comments References

221 222 225 227 228 230 232 232 235 239 240

IV: CONSIDERATIONS OF EFFICACY IN COPING WITH CHRONIC STRESS 9. Changes in Coping with Chronic Stress: The Role of Caregivers' Appraisals of Coping Efficacy

245

Monique A. M. Gignac and Benjamin H. Gottlieb

Introduction Coping with the Chronic Demands of Caregiving Appraisals of Coping Efficacy

245 246 248

xviii

CONTENTS

The Relationship between Coping and Appraisals of Coping Efficacy The Stability of Coping Appraisals The Impact of Efficacy Appraisals on Coping Summary and Conclusions References

254 258 260 263 266

10. The Role of Two Kinds of Efficacy Beliefs in Maintaining the Weil-Being of Chronically Stressed Older Adults

269

AlexJ. Zautra, Jeanne M. Hoffman, and John W. Reich Origins of Research on Efficacy Beliefs The Life Event and Aging Project Assessment of Efficacy Beliefs for Positive and Negative Events: Development of Two Efficacy Measures Factor Analysis of Control Beliefs Stability of Efficacy Ratings The Relationship of Efficacy Beliefs to Adjustment Efficacy Effects on Well-Being over Time Correlates of Efficacy Beliefs with Clinical Outcomes: The Arthritis Project Examining the Antecedents of Efficacy Beliefs Social Influences on Efficacy Beliefs Social Encouragement of Self-Reliance versus Dependency Implications for Understanding Coping with Chronic Stressors References

270 273 274 275 276 277 278 279 281 282 . . . 283 286 289

V: ILLUSTRATIONS OF COPING WITH PERVASIVE LIFE DIFFICULTIES

11. Positive Meaningful Events and Coping in the Context of HIV/AIDS

293

Susan Folkman, Judith Tedlie Moskowitz, Elizabeth M. Ozer, and Crystal L. Park

Introduction

293

CONTENTS

xix

Positive Meaningful Events: Relevant Findings and Theoretical Issues Goals of This Chapter Background: The UCSF Coping Project Method: Coding Scheme Coding Process Findings Mood The Context of Meaningful Events Source of Meaning Self-Agency Discussion Theoretical Implications Clinical Implications Conclusion References

295 297 298 299 304 304 305 305 306 307 308 309 311 312 313

12. A Framework for Understanding the Chronic Stress of Holocaust Survivors

315

Boaz Kahana, Eva Kahana, lev Harel, Kathy Kelly, Pam Monaghan, and Lani Holland

Chronic Stressors Faced by Elderly Holocaust Survivors Sample and Methods Trauma-Related Stressors Prewar Stressors Holocaust Traumatic Stressors Postwar Stressors Coping with Chronic Posttraumatic Stressors Coping with Intrusive Memories of Trauma Coping with Fear and Mistrust Coping with the Chronic Stress of Social and Psychological Isolation Coping with Stigma Normative Chronic Life Stressors: Characteristics and Coping Efforts Childhood Life Stressors Adult Life Stressors Chronic Stressors of Aging Conclusion References

317 318 321 321 321 322 322 323 326 328 330 332 333 333 337 339 340

xx

CONTENTS

13. Coping with Chronic Work Stress

343

C. Gail^Hepburn, Catherine A. Loughlin, and Julian Barling

Introduction Chronic Work Stressors Sources of Chronic Stress in the Workplace Contemporary Sources of Chronic Work Stress Perceptions of Workplace Stressors Outcomes of Workplace Stressors Methodological Problems in Connecting Chronic Stressors to Specific Effects Coping with Chronic Work Stress The Measurement of Coping Workplace Stressors and Coping Strain and Coping Coping as a Moderator Further Methodological Problems in the Study of Coping . . . . Workplace Interventions for Chronic Work Stress Tertiary Preventive Interventions Secondary Preventive Interventions Primary Prevention Conclusion References

343 344 344 346 348 349 350 351 351 353 354 356 35,7 358 359 359 360 361 363

Index ;

367