Coping and the stressor: According to Lazarus and colleagues one of the goals of
coping is to minimize the stressor. Much research has addressed the impact of coping on
the physiological and self-report dimensions of the stress response. For example, Harnish
et al. (2000) argued that effective coping terminates, minimizes or shortens the stressor.Coping and the stress illness link: Some research indicates that coping styles may
moderate the association between stress and illness. For some studies the outcome vari-
able has been more psychological in its emphasis and has taken the form of well-being,
psychological distress or adjustment. For example, Kneebone and Martin (2003) critic-
ally reviewed the research exploring coping in carers of persons with dementia. They
examined both cross-sectional and longitudinal studies and concluded that problem-
solving and acceptance styles of coping seemed to be more effective at reducing stress
and distress. In a similar vein, research exploring coping with rheumatoid arthritis sug-
gests that active and problem-solving coping are associated with better outcomes
whereas passive avoidant coping is associated with poorer outcomes (Manne and Zautra
1992; Young 1992; Newman et al. 1996). For patients with chronic obstructive pul-
monary disease (COPD) wishful thinking and emotion focused coping were least effective
(Buchi et al. 1997). Similarly, research exploring stress and psoriasis shows that avoidant
coping is least useful (e.g. Leary et al. 1998). Other studies have focused on more illness
associated variables. For example, Holahan and Moos (1986) examined the relationship
between the use of avoidance coping, stress and symptoms such as stomach-ache and
headaches. The results after one year showed that of those who had experienced stress,
those who used avoidance coping had more symptoms than those who use more
approach coping strategies.Coping and positive outcomes: Over recent years there has been an increasing
recognition that stressful events such as life events and illness may not only result in
negative outcomes but may also lead to some positive changes in people lives. This
phenomenon has been given a range of names including stress related growth (Park et
al. 1996), benefit finding (Tennen and Affleck 1999), meaning making (Park and Folk-
man 1997) and growth orientated functioning and crisis growth (Holahan et al. 1996).
This finds reflection in Taylor’s cognitive adaptation theory (Taylor 1983) and is in line
with a new movement called ‘positive psychology’ (Seligman and Csikszentmihalyi
2000). Although a new field of study, research indicates that coping processes which
involve finding meaning in the stressful event, positive reappraisal and problem focused
coping are more associated with positive outcomes (Folkman and Moskowitz 2000). See
Chapter 3 for further discussion.
Coping is considered to moderate the stress/illness link and to impact upon the extent
of the stressor. Much research has involved the description of the kinds of coping styles
and strategies used by people and some studies suggest that some styles might be more
effective than others.272 HEALTH PSYCHOLOGY