Health Psychology : a Textbook

been studied with a focus on type A behaviour and personality and the role of

hostility (see Chapter 15 for details in the context of CHD).


 Actual or perceived control: control over the stressor may decrease the effects of stress

on the individual’s health status.

Coping with stress, social support, personality and control will now be examined in

greater detail (see Figure 11.4).

COPING

Over the past few years the literature on coping has grown enormously and has explored

different types of coping styles, the links between coping and a range of health outcomes

and the nature of coping itself. How individuals cope with illness was described in

Chapter 3 with a focus on coping with a diagnosis, crisis theory and cognitive adaptation

theory. This chapter will describe how coping relates to stress and the stress illness link.

What is coping?

Coping has been defined by Lazarus and colleagues as the process of managing stressors

that have been appraised as taxing or exceeding a person’s resources and as the ‘efforts to

manage... environmental and internal demands’ (Lazarus and Launier 1978). In the

context of stress, coping therefore reflects the ways in which individuals interact with

stressors in an attempt to return to some sort of normal functioning. This might involve

correcting or removing the problem. Or it might involve changing the way a person

thinks about the problem or learning to tolerate and accept it. For example, coping with

relationship conflict could involve leaving the relationship or developing strategies to

make the relationship better. In contrast it could involve lowering one’s expectations

of what a relationship should be like. Lazarus and Folkman (1984) emphasized the

dynamic nature of coping which involves appraisal and reappraisal, evaluation and

re-evaluation. Lazarus’s model of stress emphasized the interaction between the person

Fig. 11-4 The stress–illness link: psychological moderators

268 HEALTH PSYCHOLOGY