Chapter Seven: Coping, Resilience, and Social Support Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. •Coping with stress and resilience •Coping and external resources •Coping outcomes •Coping interventions •Social support Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 2 •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 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 3 Stressful event, its stage, and anticipated future course Appraisal and interpretation of the stressor External resources or impediments • Tangible resources • Social support • Major life events and daily hassles Coping responses and strategies Coping tasks Coping outcomes Internal resources or impediments • Usual coping style(s) • Other personality factors that influence selection of coping responses and strategies Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 4 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 • Can create an illusion of poor health Positivity and illness • Promotes better mental and physical health • Linked with lower levels of stress indicators • Triggers better immune responses • Improves coping Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 5 •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 cognitivebehavioral techniques to reduce anxiety, improve coping, and promote recovery Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 6 •Self-esteem - Associated with lower levels of stress indicators •Conscientiousness •Self-confidence •Being smart •Emotional stability Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 7 •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 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 8 •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 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 9 •Problem-focused coping: Attempting to do something constructive about the stressful conditions •Emotion-focused coping: Regulates emotions experienced due to the stressful event Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 10 • 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 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 11 Time Friends Money Education Decent job Family Standard of living Presence of positive life events Absence of other life stressors Socioeconomic status (SES) Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 12 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 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 13 •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 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 14 •Acceptance and commitment therapy (ACT) Teaches individuals to: • Accept the problem • Be aware of its occurrence and conditions that cause it • Change behaviors Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 15 •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 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 16 •Helps individuals feel better about themselves •Lowers physiological activity and distress •Undermines defensive reactions to health threats Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 17 •Affects the physiological experience of stress by reducing arousal • Deep breathing • Progressive muscle relaxation training • Guided imagery • Transcendental meditation and yoga • Self hypnosis Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 18 •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 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 19 • 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 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 20 • Completing take-home assignments • Acquiring skills • Setting new goals • Engaging in positive self-talk and selfinstruction • Time management and planning • Identifying stress carriers and confronting them Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 21 •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 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 22 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 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 23 •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 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 24 •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 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 25 •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 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 26 •Effectiveness of social support depends on the individual •Social skills influence the ability to develop social support Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 27 •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 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 28 •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 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 29 •Stressful events •Intrusive social contact •Controlling or directive support Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 30 •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 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 31