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
Determines outcome
Variety in Coping is related to good outcome

4. 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

5. 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

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
Q: Which is linked to longevity?

8. 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?

9. 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

10. 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

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 (e.g., preparing for birth of baby, doing premarital counseling)

12. 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

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. 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)

15. 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

16. 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

17. 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

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

19. 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

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

21. 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

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
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

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
Negative: Can lead to bad health habits, Underfunction and increase dependency

25. 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

26. 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!

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 (trust)

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