CHAPTER 3
Coping and Social Support
SHARON MANNE
51COPING 51
Theories of Coping 51
The Role of Coping in Health Behaviors and in
the Management of Health Risk 54
Coping and Health Outcomes 54
Coping and Psychological Adaptation to Disease 55
Other Coping Processes: Social Comparison 57
Studies of Coping with Chronic Pain 57
Challenges to the Study of Coping with
Chronic Illness 58
Conclusions and Directions for Future Research 59
SOCIAL SUPPORT 59
Introduction 59
Social Support Definitions 59
Social Support and Health Outcomes 60
Disease Progression and Mortality 62
Social Support and Psychological Outcomes 64
Cancer 64
Conclusions and Directions for Future Research 67
REFERENCES 68Coping and social support are among the most widely written
about and researched topics in health psychology. Both con-
structs have been hypothesized as reasons why particular in-
dividuals are at increased risk for developing illnesses such
as cardiovascular disease and cancer, why some individuals
do not adapt well once they develop a disease, and, more re-
cently, linked with disease course and survival once an illness
is diagnosed. In this chapter, we explore the historical context
of coping and social support in the context of health, as well
as the empirical work examining the role of coping and social
support in disease etiology, disease management, and out-
comes. Each section is divided into a historical discussion,
current theoretical perspectives on each construct, and de-
scriptive studies. Key challenges and areas for future re-
search are also discussed.
COPING
Over the past two decades, there has been a substantial
amount of research devoted to understanding the role of
coping in disease etiology, management of health risk, adap-
tation to disease, and disease outcomes. In the context of
health risk and outcomes, the role of coping in psychologi-
cal adaptation to disease has received the most empirical
attention.
Theories of CopingStress and Coping ParadigmResearch on stress and coping exploded with Lazarus and
Folkman•s stress and coping theory (1984). They put forth
the transactional stress and coping paradigm and the most
widely accepted de“nition of coping. According to Lazarus,
coping refers to cognitive and behavioral efforts to manage
disruptive events that tax the person•s ability to adjust
(Lazarus, 1981, p. 2). According to Lazarus and Folkman,
coping responses are a dynamic series of transactions be-
tween the individual and the environment, the purpose of
which is to regulate internal states and/or alter person-
environment relations. The theory postulates that stressful
emotions and coping are due to cognitions associated with
the way a person appraises or perceives his or her relation-
ship with the environment. There are several components of
the coping process. First, appraisals of the harm or loss posed
by the stressor (Lazarus, 1981) are thought to be important
determinants of coping. Second, appraisal of the degree of
controllability of the stressor is a determinant of coping
strategies selected. A third component is the person•s evalua-
tion of the outcome of their coping efforts and their expecta-
tions for future success in coping with the stressor. These
evaluative judgments lead to changes in the types of coping
employed. In addition, they play a role in determining