strategies than the WOC questionnaire. However, there is considerable overlap
between these two measures and both have proved popular and have been widely used
in coping research over the last 20 years.
Lazarus (1999) argues that there is no universally effective (or ineffective) coping
strategy. What works in one situation will not work in another. Furthermore, Lazarus
suggests that the effectiveness of coping strategies will depend on the type of person
and the outcome they are considering. Different coping strategies may also be useful
at different stages of dealing with a stressor. Folkman and Lazarus (1985) found that
just before an exam, problem-focused coping strategies are used most, whereas in the
period waiting for results, emotion-focused strategies predominate. Emotion-focused
approaches, such as denial, are often unhelpful because they leave the threat unchanged.
However, in some situations, they may be useful in the short term. For example, when
experiencing the symptoms of a heart attack, denial is likely to be dangerous and even
life threatening because it may lead to delay in seeking treatment. However, once in
hospital, denial may be helpful in reducing the anxiety that is likely to exacerbate the
medical condition. Once the patient is discharged from hospital denial again may be
dangerous as it may lead to resistance to modifying health behaviours.
Lazarus (1999) suggests that when there is nothing that can be done to alter the
stressor or reduce the harm (i.e. when there is little control) then denial can be
beneficial. Emotion-focused coping may also be important for people with high trait
anxiety who are more likely to become anxious when faced with potential stressors.
In a prospective study, Sultan et al. (2008) found that emotion-focused coping
enhanced glycaemic control among diabetics high in trait anxiety (so that trait anxiety
moderated the emotion-focused coping–health outcome relationship). However,
problem-focused coping was also found to reduce trait anxiety, suggesting that for this
highly anxious group of patients both coping strategies were important.
Critical evaluation of coping research
The literature on coping is extensive and complex and has been much criticized, not
least because it has provided limited information on which to base interventions (e.g.
Somerfield, 1997). The limitations of classification systems and the over-reliance on
questionnaires are key problems.
In this chapter we have considered two well-established classification systems but
many others have been proposed. In a review, Skinner et al. (2003) found over 100
different classification systems, which collectively generated more than 400 ways of
coping. Typically, these are classified into a range of higher order categories. The three
most common higher-level categories were (a) problem-focused versus emotion-
focused; (b) approach versus avoidance; and (c) cognitive versus behavioural. Skinner
et al. (2003) suggest that this range of diverse classifications has made it difficult to make
progress. They argue that many systems such as the two discussed above are based on
exploratory factor analyses and as a result have a number of flaws. First, there is often
a lack of clarity or distinctiveness in the different categories. Second, it is difficult to
ensure that the categories are comprehensive and finally, even where items do load onto
a single category they may still represent more than one underlying category, which
perhaps has a single underlying emotional tone. For example, both rumination and
avoidance coping may load on to a single factor because worrying is common to both,
94 COPING RESOURCES