402 TA B L E Chapter 10 Health, Stress, and Coping 10.3 Ways of Coping Coping is deﬁned as cognitive and behavioral efforts to manage speciﬁc demands that people perceive as taxing their resources (Folkman et al., 1986). This table illustrates two major approaches to coping measured by the Ways of Coping Questionnaire: problem focused and emotion focused. Ask yourself which approach you usually take when faced with stressors. Now rank the coping skills under each major approach in terms of how often you tend to use each. Do you rely on just one or two, or do you adjust your coping strategies to ﬁt different kinds of stressors? doing 2 learn Coping Skills Problem-focused coping Confronting by Seeking social support Planful problem solving Emotion-focused coping Self-controlling Distancing Positive reappraisal Accepting responsibility Escape/avoidance (wishful thinking) Example “I stood my ground and fought for what I wanted.” “I talked to someone to ﬁnd out more about the situation.” “I made a plan of action, and I followed it.” “I tried to keep my feelings to myself.” “I didn’t let it get to me; I tried not to think about it too much.” “I changed my mind about myself.” “I realized I brought the problem on myself.” “I wished that the situation would go away or somehow be over with.” Source: Adapted from Folkman et al. (1986); Taylor (1995). beliefs allow them to bring meaning to the death of a loved one or the devastation of natural disasters that might otherwise seem senseless tragedies (Heppner et al., 2006; Powell, Shahabi, & Thoreson, 2003; VandeCreek et al., 2002). Some individuals who use humor to help them cope also show better adjustment and milder physiological reactivity to stressful events (Martin, 2001; Moran, 2002). Social Support social support network The friends and social contacts on whom one can depend for help and support. Has a good friend ever given you comfort and reassurance during troubled times? If so, you have experienced the value of social support in easing the impact of stressful events. Social support consists of emotional, tangible, or informational resources provided by other people. These people might help to eliminate a stressor (by, say, ﬁxing your car), suggest how to deal with the stressor (by recommending a good mechanic), or reduce a stressor’s impact by providing companionship and reassurance (Sarason, Sarason, & Gurung, 1997). The people you can depend on for support make up your social support network (Burleson, Albrecht, & Sarason, 1994). The stress-reducing effects of social support have been documented in people dealing with a wide range of stressors, including cancer, stroke, military combat, loss of loved ones, natural disasters, arthritis, AIDS, and even ethnic discrimination (e.g., Boden-Albala et al., 2005; Foster, 2000; Jason, Witter, & Torres-Harding, 2003; Penner, Dovidio, & Albrecht, 2001; Savelkoul et al., 2000). Social support can have health beneﬁts, too. For example, students who get emotional support from friends show better immune system functioning and than those with less adequate social support (Cohen & Herbert, 1996). This may be why people in strong social support networks are less vulnerable to colds and ﬂu during exams and other periods of high academic stress (Kop et al., 2005; Pressman et al., 2005; Taylor, Dickerson, & Klein, 2002). Having strong social support is also associated with faster recovery from surgery or illness, possibly because helpful friends and family members encourage patients to follow medical advice (Brummett et al., 2005; Grassi et al., 2000; Krohne & Slangen, 2005; Taylor, 2002). Stronger social networks are even associated with better mental functioning in old age (Barnes et al., 2004). According to some researchers, having inadequate social support can be as dangerous as smoking, obesity, or lack of exercise in that it nearly doubles a person’s risk of dying from disease, suicide, or other causes (House, Landis, & Umberson, 1988a, 1988b; Kiecolt-Glaser & Newton, 2001; Rutledge et al., 2004). Stress Mediators psychology applying 403 YOU’VE GOT A FRIEND Even when social support cannot eliminate stressors, it can help people, such as these breast cancer survivors, to feel less anxious, more optimistic, more capable of control, and more willing to try new ways of dealing with stressors (Trunzo & Pinto, 2003). Those who provide support may feel better, too (Brown et al., 2003). Exactly how social support brings about its positive effects is not entirely clear. James Pennebaker (1995, 2000) has suggested that social support may help prevent illness by providing the person under stress with an opportunity to express pent-up thoughts and emotions. Keeping important things to yourself, says Pennebaker, is itself a stressor. In a laboratory experiment, for example, participants who were asked to deceive an experimenter showed elevated physiological arousal (Pennebaker & Chew, 1985). Further, the spouses of suicide or accidental-death victims who do not or cannot conﬁde their feelings to others are especially likely to develop physical illness during the year following the death (Pennebaker & O’Heeron, 1984). Disclosing, even anonymously, the stresses and traumas one has experienced is associated with enhanced immune functioning, reduced physical symptoms, and decreased use of health services (Broderick, Junghaenel, & Schwartz, 2005; Campbell & Pennebaker, 2003; Epstein, Sloan, & Marx, 2005; Sloan, Marx, & Epstein, 2005). This may explain why support groups for problems ranging from bereavement to overeating to alcohol and drug abuse tend to promote participants’ physical health (Taylor et al., 2002). Research in this area is made more challenging by the fact that the relationship between social support and the impact of stressors is not a simple one. For one thing, the quality of social support can inﬂuence the ability to cope with stress, but the reverse may also be true: Your ability to cope may determine the quality of the social support you receive (McLeod, Kessler, & Landis, 1992). People who complain endlessly about stressors but never do anything about them may discourage social support, whereas those with an optimistic, action-oriented approach may attract support. Second, social support refers not only to your relationships with others but also to the recognition that others care and will help (Demaray & Malecki, 2002). Some relationships in a seemingly strong social network can be stormy, fragile, or shallow, resulting in interpersonal conﬂicts that can have an adverse effect on health (Ben-Ari & Gil, 2002; Malarkey et al., 1994). Third, having too much support or the wrong kind of support can be as bad as not having enough (Reynolds & Perrin, 2004). Dangerous behaviors such as smoking, for example, can be harder to give up if one’s social support network consists entirely of smokers. People whose friends and family overprotect them from stressors may actually put less energy into coping efforts or have less opportunity to learn effective coping strategies. And if the efforts of people in a social support network become annoying, disruptive, or interfering, they can increase stress and intensify psychological problems (Newsome, 1999; Newsome & Schulz, 1998). It has even been suggested that among people under intense stress, the beneﬁts of having a large social support network may be offset by the dangers of catching a cold or the ﬂu from people in that network (Hamrick, Cohen, & Rodriguez, 2002).