Coping Strategies

Coping Strategies- Problem-focused Versus Emotion-focused

Coping strategies refer to the specific efforts, both behavioral and psychological, that people employ to master, tolerate, reduce or minimize stressful events. There are two general coping strategies which have been distinguished. Problem-focused strategies are efforts to do something active to alleviate stressful circumstances, where as emotion-focused coping strategies involve efforts to regulate the emotional consequences of stressful or potentially stressful events. Typically, people use both problem-focused and emotion-focused coping in their stressful episodes, which suggests that both types of coping are useful for most stressful events (Folkman & Lazarus, 1980). The predominance of one type of strategy over another is determined, in part, by personal style and the type of stressful event.

The empirical studies found below focus on the usage of both problem-focused and emotion-focused coping styles. They look at in which context each coping style is used and also how effective each style is in dealing with different stressful events.

In a study conducted by Hasida Ben-Zur in 2005 (Ben-Zur 2005), research was conducted to evaluate whether people used problem-focused or emotion-focused strategies more often for stressful situations. The main purpose of the study was to find out which type of coping style worked best in lowering distress. The research was conducted by a public-opinion survey institute in Israel. 510 people completed the survey questionnaires which was based on a 30 item coping scale (the original 60 item scale was found to be too lengthy). The coping data was analyzed and separated into two different coping scales: problem-focused and emotion-focused. The Problem-Focused Coping Scale included active coping, planning, suppression of competing activities, instrumental support, emotional support, and positive reinterpretation. The Emotion-Focused Coping Scale included acceptance, mental and behavioral disengagement, denial, ventilation, religion, humor, and restraint. Distress was measured by the Brief Symptom Inventory (BSI). The results of the study showed small negative associations of problem-focused strategies with distress, whereas emotion-focused strategies showed substantial positive associations with distress. The data gathered suggests that problem-focused coping strategies are only somewhat effective in lowering distress, whereas emotion-focused strategies are powerful in heightening it (Ben-Zur 2005).

A couple of conclusions can be drawn from this research. On average, participants in the study reported high levels of problem-focused coping and lower levels of emotion-focused coping. Coping effects on distress are revealed under stressful conditions, and specifically, the relation of problem-focused strategies with distress is much stronger at a time of stress. Some emotion-focused strategies are functional and are sometimes helpful in solving the problem, but most are considered ineffective and dysfunctional. Thus, it seems that people who tend to se problem-focused strategies can cope better under stress than those who use emotion-focused strategies.

A limitation in this study in regards to us in America is the fact that we come from different cultures which may adapt to stress very differently. Types of stress that people may feel in other cultures may be significantly different than stress we feel in our culture. How people deal with stress (coping style) may also be different. This could severely weaken the external validity of the data.

In a study conducted by Haisda Ben-Zur in 2001 (Ben-Zur 2001), 73 married, female breast cancer patients were interviewed in regard to the coping strategies of themselves and their spouses. The spouses were also given questionnaires assessing their own coping strategies as well as their perceptions of how their wives were coping with their illness. The participants of the study were given a 30 item, short Hebrew version of the COPE scale. Both patients and spouses were instructed to assess the use of coping options by the spouse in dealing with the patient's illness. The Brief Symptom Inventory (BSI) was used to assess distress. Interviews were held at the couples homes in which each person was interviewed separately. Each interview took 30-45 minutes.

The results from the study showed a variety of things. Firstly, perceptions of emotion-focused strategies in one's spouse was inversely related to one's personal distress and adjustment. When the spouse thought that the wife was using emotion-focused coping more often than problem-focused coping, it was found that it was related to the patient's elevated distress and lower functioning. Conversely, when the husbands perceived their spouse as coping with problem-focused strategies it was associated with their own better functioning. Results showed that perceptions of the breast cancer patients of their husband's coping strategy did not have a significant effect on their own distress levels. The results of the study are in line with cognitive theories of stress and coping and show that emotion-focused coping is related to pessimism and low control, whereas problem-focused coping is correlated with optimism and high control (Ben Zur 2001).

One limitation of the study is its design. Because the study is correlational in nature, cause and effect relationships cannot be established. The study also did not take into account the social support of the patients and their spouses. Taking the studies limitations into account, its results suggest that inter-spouse perceptions of coping are related to one's own distress and functioning.

Another study assessing breast cancer patient's coping styles was evaluated by researchers Dana Osowiecki, JoAnne Epping-Jordan, et al (Osowiecki et al. 1999) In this study, 80 female breast cancer patients were interviewed and given several written questionnaires assessing psychological variables. The measures included a structured interview, medical variables such as stage of breast cancer were found using their medical charts, optimism was measured by the Life Orientation Test (LOT), monitoring using the Miller Behavioral Style Scale (MBSS), stress response symptoms using the Impact of Event Scale (IES), coping was assessed by the Coping Strategies Inventory (CSI), and emotional distress was measured by the symptom checklist-90-revised scale. The purpose of the study was to examine the process of psychological adjustment to breast cancer at baseline, 3 month, and 6 month follow ups with women with Stage I- Stage IV breast cancer.

The results of the study which are significant in regards to the topic area at hand are as follows. Optimism was found to play a

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