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Coping Theory and Research: Past, Present, and Future

RICHARD S. LAZARUS, PHD

INTRODUCTION

In this essay in honor of Donald Oken, I emphasizecoping as a key concept for theory and research onadaptation and health. My focus will be the contrastsbetween two approaches to coping, one that empha-sizes style—that is, it treats coping as a personalitycharacteristic—and another that emphasizes proc-ess—that is, efforts to manage stress that changeover time and are shaped by the adaptational con-text out of which it is generated.

I begin with an account of the style and processapproaches, discuss their history briefly, set forththe principles of a process approach, describe myown efforts at measurement, and define coping andits functions from a process standpoint. This is fol-lowed by a digest of major generalizations that re-sulted from coping process research. The essay con-cludes with a discussion of special issues of copingmeasurement, in particular, the limitations of bothcoping style and process approaches and how theselimitations might be dealt with.

There has been a prodigious volume of copingresearch in the last decade or two, which I can onlytouch on very selectively. In this essay, I also ignorea host of important developmental issues that haveto do with the emergence of coping and its cognitiveand motivational bases in infants, as well as a grow-ing literature on whether, how, and why the copingprocess changes with aging.

APPROACHES TO COPING: STYLE VERSUSPROCESS

In one form or another the concept of coping hasbeen with us for a long time, though it began tocome into its own formally during the 1960s and1970s, along with the burgeoning interest in stress.

If we think of coping as a generic concept thatincludes ego-defenses, which deal with threats toone's psychological integrity, then the psychoanal-

Address reprint requests to: Richard S. Lazarus, Ph.D., 1824Stanley Dollar Drive, Walnut Creek, CA 94595.

Received for publication May 11, 1992; revision received Au-gust 4. 1992.

ytic interest in defense was clearly its forerunner.The earliest psychoanalytic interest in defense cen-tered on its role in psychopathology as a character-istic style for managing threat. A powerful psy-choanalytic concept, which greatly influenced per-sonality and clinical psychology, was that each formof psychopathology was associated with a particulardefensive style. For example, hysterical neuroseswere linked to repression, obsessive-compulsiveneuroses to intellectualization and undoing, para-noia to projection, and so forth.

This view flowed from the theoretical conver-gence postulated in Freudian theory between threedevelopmental variables: (a) the psychosexual stageof childhood development at which trauma occurs;(b) the primary impulses and conflicts of each par-ticular stage—for example, oral dependency, anal-centered struggles over the social control of instinc-tual drives, and phallic and oedipal conflicts; and (c)the child's cognitive characteristics at each stage,which presumably shape the defensive style.

Despite the elegance and potential power of thisformulation, the close association between devel-opmental stage, the content of impulses, and cogni-tive characteristics does not show up clearly enoughin observation to provide adequate support for it.The link between forms of psychopathology andspecific defenses is also a bit too neat to be generallyapplicable—it is more a conceptual ideal rather thana clinical reality. In many quarters, psychosexualtheory has given way to a greater emphasis on othercognitive-motivational processes—an outlook artic-ulated in psychoanalytic ego-psychology—such asthe development of competence and control and, ofcourse, defense. In any case, the psychosexual for-mulation has lost influence in clinical research andpractice.

Some of the familiar writers who were activelypursuing variants of this psychoanalytic thesis in-cluded Rapaport et al. (1) with their influential mon-ograph, Diagnostic Psychological Testing, Schafer(2), Holzman and Gardner (3), Witkin et al. (4), Klein(5), Shapiro (6), and their many ego-psychology anddevelopmental mentors (see also Ref. 7 for a detailedhistorical account). These are classic works thatwere greatly admired by many of us of an earliergeneration.

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Psychosomatic Medicine 55:234-247 (1993)

COPING THEORY AND RESEARCH

Coping as Hierarchical Styles

The work of Menninger (8), and more recentlyHaan (9) and Vaillant (10), drew on a hierarchicalapproach to coping derived from the developmentalpsychoanalytic formulation. Some defenses weresaid to be more healthy or less regressed than oth-ers—presumably as a result of stress or trauma. Forexample, Haan proposed a tripartite hierarchy withcoping as the most healthy and developmentallyadvanced process of adaptation, defense as a neu-rotic process, and ego-failure as the most severelyregressed and perhaps psychotic adaptive process.

A Chicago research group, headed by Roy Grinker,Sr., at Michael Reese Hospital (e.g., Ref. 11)—which,incidently, included Donald Oken—focused less onthe strictly Freudian developmental formulationswith its emphasis on early childhood and more onthe contemporary scene of the patient's life. For thisgroup, too, coping and defense were also centralconcepts.

Hierarchical, developmental approaches tended tospawn trait measures of coping, such as the contrastbetween repression (avoidance or denial in someversions)—sensitization (vigilance, isolation, or in-tellectualization in some versions). In a review ofcoping theory and assessment, Cohen (12) cites anumber of questionnaire measures of this contrast,treated either as a single dichotomy or a continuousdimension. Her list includes a questionnaire pub-lished by Byrne (13), another by Epstein and Fenz(14), and a non-questionnaire measure developed byGoldstein (15), named the Coping-Avoidance Sen-tence Completion Test. She also cites two Rorschachindexes, one by Gardner et al. (16), the other byLevine and Spivack (17), which employ the relatedlanguage of repression-isolation. Finally, two mul-tidimensional sets of measures, The Defense Mech-anism Inventory of Gleser and Ihilevich (18), andthe Coping-Defense Measure of Joffe and Naditch(19), are also mentioned.

Not all research on coping style draws on stand-ardized measures, such as those cited above. Manyare ad hoc procedures using in-depth clinical inter-views (20-22). Still others have employed GroundedTheory (23), which does not employ interpretivecriteria in advance but generates models and hy-potheses about what is happening from spoken orwritten products (e.g., Ref. 24).

Coping as ProcessIn the late 1970s a major new development in

coping theory and research occurred in which the

hierarchical view of coping, with its trait or styleemphasis, was abandoned in favor of a contrastingapproach, which treated coping as a process. Froma process perspective, coping changes over time andin accordance with the situational contexts in whichit occurs.

A hierarchy of coping strategies based on precon-ceived notions about their inherent health or pa-thology runs the danger of confounding process andoutcome, which is particularly evident in Vaillant'sotherwise impressive longitudinal research. Diag-noses of the type of defense employed by his subjectsdepended to some unkown extent on prior notionsabout how healthy they are as coping strategies,which may well have influenced later evaluationsof the quality of adaptation. As we shall see, a tenetof process approaches is that process and outcomeshould be measured independently.

My own approach to the study of the coping proc-ess had its origins in stress film and sound trackresearch at Berkeley in the 1960s (see Refs. 25-29,76). In the late 1970s, and within a few years of eachother, a number of researchers including myself(e.g., Refs. 30, 31; see also a review of 10 years ofresearch by Lazarus and Folkman (32); also Refs.33-35) developed measurement approaches bearingthe same metatheoretical stamp. These pioneeringefforts were followed by additional questionnaireversions designed also to measure and study copingas a process and examine its consequences for ad-aptation. These additional versions overlappedheavily with earlier ones (e.g., Refs. 36, 37).

Principles of the Process Approach

Below is a set of the metatheoretical principles mycolleagues and I have enunciated over the yearsthat, I believe, is reasonably representative of mostcurrent approaches to coping as a process:

1. Coping thoughts and actions under stress mustbe measured separately from their outcomes in orderto examine, independently, their adaptiveness ormaladaptiveness. I make the contextualist assump-tion—with considerable empirical support—thatwhether a coping process is good or bad, adaptation-ally speaking, depends on the particular person, thespecific type of encounter, in the short or long run,and the outcome modality being studied, for exam-ple, morale, social functioning, or somatic health.There may be no universally good or bad copingprocesses, though some might more often be betteror worse than others.

Thus, denial, which was once regarded by ego-

Psychosomatic Medicine 55:234-247 (1993) 235

R. S. LAZARUS

psychologists as pathogenic, may be useful for ad-aptation under certain definable circumstances, as Iproposed some years ago in discussing its costs andbenefits (38). Although a full analysis of definitionaland measurement problems with respect to denialhas not been made—for example, to what extentdenial is different from avoidance and illusion—much interest in the consequences of denial forsomatic and mental health has been generated inrecent years. Health-related targets of this interestinclude heart attacks, surgery, asthma, and otherillnesses.

In this vein, observations of the course of a heartattack suggest that denial has different conse-quences, a) when symptoms first arise and must beinterpreted by the victim to decide what to do, b)during the post-coronary period in the hospital, andc) after discharge from the hospital. Denial appearsto be counterproductive and dangerous when theperson is interpreting symptoms—it commonly re-sults in delays in getting help at a most dangeroustime—however, it is useful in the post-coronaryhospital care period, but again becomes increasinglycounterproductive and dangerous if it continues asa strategy of coping too long after discharge from thehospital (e.g., Refs. 39, 40). A full current review ofthis kind of research would, I think, be a veryworthwhile enterprise.

Research has also suggested that denial has favor-able consequences for several adaptational out-comes of surgery, for example, rate of healing, pres-ence of minor complications, and the duration ofhospitalization (41). The story is different for asthma,however. Although denial leads to lower levels ofapprehension when symptoms of an upcoming asth-matic attack begin to appear, it is also associatedwith a greater likelihood of hospitalization for anacute asthmatic attack. Vigilant coping, on the otherhand, may lead to effective efforts to abort the attackby, say, using an inhaler or taking other medication,so that patients who cope in this way are rarelyhospitalized (42).

2. If one asks patients how they cope post-sur-gically with, say, breast cancer, the answer is apt tobe misleading because the coping strategy dependson whether, at any given time, they are dealing withone or another of the diverse threats engendered bythe disease. Thus, what a person does to cope de-pends on the context in which the disease occurs,and this will change over time because what isattended to, and the threats themselves, also change(43-45).

The threat focused on by the patient at any mo-ment might be the likelihood of recurrence of the

malignancy—depending, of course, on whether it isnear the time at which a post-surgical diagnosticexamination is scheduled. If it is, then the danger ofrecurrence will probably be at the center of atten-tion. However, at other times thoughts about recur-rence may be avoided. Alternatively, the focus ofthreat may be having to tell a spouse, friends, par-ents, or children about what is happening. The stageof the illness, that is, whether the cancer is early orwell-advanced, strongly influences the patient'sstate of mind. An advanced cancer may create theneed in a patient to thank about whether to continueor discontinue debilitating treatment, to deal withthe growing imminence of death (46), and so forth.

The principle here is that the process of copingemployed for the different threats produced by can-cer, or any other complex source of psychologicalstress, whether disease-based or not, varies with thediverse adaptational significance and requirementsof these threats. Therefore, when studying how thepatient copes with this illness, it is necessary tospecify the particular threats of immediate concernto the patient and to treat them separately ratherthan broadening the focus of attention to the overallillness.

3. What is most needed in coping measurementis to describe what a person is thinking and doing inthe effort to cope with stressful encounters. Theinference about how the person is coping is thenmade not by the person being studied but by theprofessional observer.

This sort of measurement should also be employedrepeatedly over time and across diverse stressfulencounters in research designs that are intraindivi-duaJ as well as interindividuai. This would enablethe researcher to examine both consistencies andinconsistencies in the way individuals cope overtime and across stressful encounters.

A combined intra- and interindividuai researchdesign allows us to view coping in both its state andtrait aspects, state representing instability (flux) orchange, trait representing stability or consistencyacross diverse conditions. If we emphasize copingconsistency over time and across encounters, we aredealing with the trait concept; if we emphasize con-textual influences and coping inconsistency overtime and across encounters, we are dealing with thestate concept or process. They are two sides of thesame coin, and both sides are usually relevant. Themore consistency, the more the trait side stands out;the more inconsistency, the more the state (or proc-ess) side stands out. The trait-process (state) issuecannot be studied empirically unless coping strate-

236 Psychosomatic Medicine 55:234-247 (1993)


gies are examined in the same persons over time oracross stressful encounters.

These considerations, in part, led the BerkeleyStress and Coping Project to develop the Ways ofCoping Questionnaire (47), which is currently themost widely used technique of its kind, whether itis used in the form of an interview or self-adminis-tered. This approach was designed to make possiblea process, contextually oriented approach to copingrather than to study coping as a stable disposition.Our process coping scales—and others like them—invite the subject to endorse whatever thoughts andactions, presented as a list, were employed to copewith a particular stressful encounter. The most so-phisticated versions are factor-analyzed to generatea set of different strategies, constructed on the basisof both theory and the way the items behave psy-chometrically.

There are eight factors in the Ways of CopingQuestionnaire. Table 1 presents sample items fromeach scale. The scales developed by other research-ers contain overlapping, though not identical, items

and are defined by overlapping, though not identi-cal, conceptual labels.

4. From a process standpoint, coping is defined asongoing cognitive and behavioral efforts to managespecific external and/or internal demands that areappraised as taxing or exceeding the resources ofthe person. The definition can be simplified—though with a loss of some information—by sayingmerely that coping consists of cognitive and behav-ioral efforts to manage psychological stress. From ameasurement and research standpoint, this type offormulation emphasizes that the coping effort is in-dependent of the outcome so that its role in influ-encing adaptational outcomes can be independentlyassessed.

Notice that the term coping is used whether theprocess is adaptive or nonadaptive, successful orunsuccessful, consolidated or fluid and unstable.Adaptive refers to the effectiveness of coping inimproving the adaptational outcome, for example,morale, physical health, and social functioning. Suc-cess refers to the extent a coping-related (or defen-

TABLE 1. Sample Items from the Ways of Coping Questionnaire

Factor1. Confrontive coping

46 Stood my ground and fought for what I wanted.7. Tried to get the person responsible to change his or her mind.

17 I expressed anger to the person(s) who caused the problem.2. Distancing

44. Made light of the situation; refused to get too serious about it41. Didn't let it get to me; refused to think about it too much.21. Tried to forget the whole thing.

3. Self-controlling14. I tried to keep my feelings to myself.43. Kept others from knowing how bad things were.35. I tried not to act too hastily or follow my first hunch.

4. Seeking social support8. Talked to someone to find out more about the situation.

31. Talked to someone who could do something concrete about the problem.42 I asked a relative or friend I respected for advice.

5. Accepting responsibility9. Criticized or lectured myself.

29. Realized I brought the problem on myself.51. I made a promise to myself that things would be different next time.

6. Escape-avoidance58. Wished that the situation would go away or somehow be over with.11. Hoped a miracle would happen.40 Avoided being with people in general.

7. Planful problem solving49 I knew what had to be done, so I doubled my efforts to make things work.26. I made a plan of action and followed it.39. Changed something so things would turn out all right.

8 Positive reappraisal23. Changed or grew as a person in a good way.30. I came out of the experience better than when I went in.36. Found new faith.

From Folkman and Lazarus, 1988 (Ref. 47).


R. S. LAZARUS

sive) reappraisal is believed by the person. Consoli-dated means that the person has achieved a stableway of coping or defending under a variety of cir-cumstances; most coping processes, including defen-ses, are probably the result of a fluid, contextuallysensitive struggle to appraise what is happening ina way that is responsive to the realities of a situationyet is also hopeful or even optimistic about howthings are going. For example, a person might tryunsuccessfully to deny a threat saying, as in aninternal dialogue, "I tried to tell myself I was notdying, but I couldn't make it stick."

5. The theory of coping as a process emphasizesthat there are at least two major/unctions 0/coping,problem-focused and emotion-focused. The distinc-tion is suscribed to widely by coping researchers.The function of proWem-focused coping is to changethe troubled person-environment relationship byacting on the environment or oneself. The functionof emotion-focused coping is to change either a) theway the stressful relationship with the environmentis attended to (as in vigilance or avoidance) or b) therelational meaning of what is happening, whichmitigates the stress even though the actual condi-tions of the relationship have not changed (48). Thelatter involves a more benign or less threateningreappraisal, as illustrated, for example, in denial anddistancing.

Changing the relational meaning of what is hap-pening is a very powerful—and widely employed—device for regulating stress and emotion. For exam-ple, a loved one makes a disparaging comment,which is taken as demeaning. Now suppose therecipient of the provocation wishes very much toavoid feeling and displaying the resulting anger withits potentially negative consequences. If that recipi-ent is capable of making excuses for the loved one,for example, that he or she is ill, worn out, orbesieged by work stress—which calls for empathyand forbearance rather than anger—the provocationcan be overlooked and the anger need not then befelt or expressed.

In passing, I have long been tempted to think thatthis strategy of coping is a healthy form of repressionor denial. It is not that a recurrent, threateningimpulse is blocked from consciousness, but that areappraisal of what is happening has been made,which eliminates the threat. That the threateningimpulse is no longer relevant, and does not have tobe blocked from consciousness or from being actedout, makes this change of meaning a healthy andpowerful approach to coping. Perhaps some of whatwe call repression and denial is of this sort.

Of the two functions of coping, problem-focused

and emotion-focused, there is a strong tendency inwestern values to venerate the former and distrustthe latter. Taking action against problems ratherthan reappraising the relational meaning seemsmore desirable. Nevertheless, there is ample evi-dence that under certain conditions—particularly,those in which nothing useful can be done to changethe situation—rational problem-solving efforts canbe counterproductive, even likely to result inchronic distress when they fail; then emotion-fo-cused efforts would offer the best coping choice (49).

MAJOR GENERALIZATIONS FROMRESEARCH ON COPING AS A PROCESS

Our research using the Ways of Coping, and byothers using scales with a similar outlook and meth-odology, has produced a number of important andwidely replicated generalizations that can be sum-marized as follows:

1. People use most of the factor analytic strategiesof coping in every stressful encounter (31). Whyshould this be so? Because stressful encounters arecomplex and take time. However, it is difficult tosay to what extent coping strategies are linked eitherto particular facets of the encounter—say, the threatcontents, the goal that is at stake, prior beliefs—orto temporal factors; for example, people might tryone strategy but change to another on the basis offeedback about its consequences. This profoundquestion about whether coping strategies depend onparticular threat contents or trial and error overtime has not yet been addressed in research. To findthe answers requires a microgenetic type of researchdesign.

2. Some strategies of coping are more stable orconsistent across stressful encounters than others.For example, in one study we explored five majorstressful encounters in the same persons, one permonth over 5 months (44, 45). Autocorrelations wereused to evaluate the degree of consistency in thesame persons across encounters.

We found that some coping strategies were some-what consistent and others very inconsistent acrossstressful encounters. For example, seeking socialsupport was very inconsistent, whereas positivereappraisal was modestly—but significant statisti-cally—consistent. In effect, if given persons soughtsocial support in one encounter, there was littlelikelihood that they would seek it in another. How-ever, if given persons employed positive reappraisalin one encounter, they were also likely to employ itin other encounters. Thus, one could reasonably say



that seeking social support is highly dependent onthe social context while positive reappraisal can beviewed to some extent as a stable coping disposition.

In a similar vein, Scheier et al. (37) have shownthat the tendency to be optimistic or pessimisticinfluences the way the person copes with stressfulencounters, thus implicating a personality trait inthe coping process. Much more research of this sortis needed to reveal the degree to which diversecoping strategies are influenced by the social con-text, personality variables, or both.

3. Coping also changes from one time to anotherin any given stressful encounter. This is an empiricalstatement of what it means to talk about coping asprocess. A college examination is not a unitary eventbut involves a complex series of stages related to theformal testing arrangements specified by the instruc-tor. The stages consist of a period of warning of theimminence of the examination, a waiting periodafter the examination has been taken but beforegrades are announced, and a period after the gradesare announced. There is also a confrontation stagewhen the students are actually taking the exami-nation, but it is not practical to try to study this stagedirectly during the examination because studentswould not cooperate with research that would in-terfere with their performance when their gradedepended on it.

The adaptational demands and information avail-able are quite different in these separate stages. In aquasi-experimental study that separated each of theother stages for observation, Folkman and Lazarus(43) demonstrated that the emotion and coping pat-terns of students changed dramatically across thesestages. With respect to coping, seeking informationand social support occurred quite frequently in theanticipatory stage, but dropped sharply in laterstages; distancing was the most frequently employedcoping strategy during the waiting period but wasinfrequently employed during other stages.

Thus, if the examination had been treated as asingle stressful encounter, and coping had been sum-mated across stages, there would have been greatdistortion in what might have been learned. Tocollapse what is happening over time is apt to pro-duce findings that are at best uninterpretable and atworst misleading. Smith and Ellsworth (50) havemade similar observations about appraisal, copingand emotion in a college examination, with compa-rable findings.

It troubles me that in spite of the popularity of ourmethod of coping measurement, the consistent the-oretical logic that lies behind it, and the substantialevidence that coping changes with the context and

over time as the status of a problem changes, fewstudies on coping pay more than lip service to thebasic idea, even when they use these scales or onesthat are comparable.

4. When stressful conditions are viewed by a per-son as refractory to change, emotion-focused copingpredominates; when they are appraised as controJ-JabJe by action, problem-focused coping predomi-nates (see, for example, Refs. 31, 32). This frequentlyreplicated finding links secondary appraisal, whichhas to do with the options for coping, with the copingstrategy employed, and is reminiscent of the sensi-ble, epigrammatic motto of Alcoholics Anonymous,which goes: "God grant me the courage to try tochange what can be changed, the serenity to acceptwhat cannot be changed, and the widsom to knowthe difference."

5. Coping is capable of mediating the emotionaloutcome, that is, it changes the emotional state fromthe beginning to the end of the encounter. Folkmanand Lazarus (51) assessed subjects' emotional statesat the beginning and end of a number of stressfulencounters, focusing on the amount and directionof change as a function of the coping strategy re-ported. We found that some coping strategies, suchas planful problem solving and positive reappraisal,were associated with changes in emotion from neg-ative to less negative or positive, while other copingstrategies, such as confrontive coping and distanc-ing, correlated with emotional changes in the op-posite direction, that is, toward more distress.

In another study (44) subjects reported on a mul-tiple choice scale that the stress had either been a)unresolved or made worse, b) not changed, c) re-solved but not to their satisfaction, d) resolved butimproved, or e) resolved to their satisfaction. Satis-factory outcomes were defined as those rated asunresolved but improved (d above) or resolved totheir satisfaction (e above).

The relationships between each coping scale andoutcome are shown in Table 2. Inspection showsthat some coping strategies, such as planful problemsolving and positive reappraisal, were significantlyassociated with satisfactory outcomes, whereas oth-ers, such as confrontive coping and distancing, wereassociated with unsatisfactory outcomes, thoughthese latter two only approached statistical signifi-cance.

Since the research design employed in this studyrequired subjects to reconstruct stressful encountersand coping strategies after the stressful encounterhad ended, these findings cannot prove the causalrole of coping, though they are consistent with the-oretical expectations. However, in a prospective


R. S. LAZARUS

TABLE 2. Relation between Coping and Encounter Outcomes: Intraindividual Analysis

Univanate Tests

Coping scale1. Confrontive coping2. Distancing3. Self-controlling4. Seeking social support5 Accepting responsibility6. Escape-avoidance7. Planful problem-solving8. Positive reappraisal

UnsatisfactoryOutcomes

(M)

3.983.355.984.711.922.866.332.70

SatisfactoryOutcomes

(M)

3.312.785 365.161.652.647.593.90

F

3.343.382.531.221.100.508.679.67

P

0 0710 0690.1150.2810.2980.4820.0040.003

Note. Multivanate F(8,76) = 4.64, p < 0.001.From Folkman, Lazarus, Dunkel-Schetter, Delongis, and Cruen, 1986, (Ref. 44).

study in which coping was measured after the startof the stressful encounter but before the outcome,Bolger (52) obtained findings that strongly supportedthe proposition that coping plays a causal, media-tional role in the emotional outcome.

With respect to the coping mediators of emotion,I might add in passing that under conditions differ-ent from those above, for example, in the examina-tion stress study already discussed, when studentshad nothing to do but wait for word about theirgrades (43), distancing was a very useful copingstrategy, which illustrates the point about the dan-gers of generalizing about the adaptational value ofcoping strategies without considering the context inwhich they occur. Again and again we have foundthat a coping strategy that produces positive out-comes in one context, or in one person, may not inanother. We need research to develop rules aboutthe circumstances in which particular coping strat-egies may have good or bad outcomes.

Another illustration of this applies to wishfulthinking, which consists of a subset of items fallingwithin the broader coping factor of escape-avoid-ance. We have noted that escape-avoidance mayhave positive adaptational value, but this seemsnever to have been the case in our research thus farfor the wishful thinking subset of the escape-avoid-ance scale. It is tempting to think that we have, atlast, found a universally bad coping strategy. Afterall, one will normally not try to do anything abouta negative person-environment relationship if one'scoping strategy is to dream or wish that it will goaway by itself.

I am reluctant to make this generalization, how-ever, because, like denial, if there is nothing to bedone, then wishing should not be harmful. Thecontextual principle should still be that only whendenial or wishful thinking prevents a person from

trying more productive strategies in a situation thatcan be ameliorated should these strategies havenegative consequences. We need more observationto resolve this question.

6. Coping research tends to be directed at twoseparate but related issues, namely, a) the variablesinfluencing choice of coping strategies and b) theeffects of these strategies on adaptational outcomes.With respect to outcomes, the theory of coping linksefficacy to the quality of the fit between the copingstrategy, its execution, and the adaptational require-ments of the encounter. This fit will surely dependon the appraisal that is made, as well as on theextent to which the encounter provides viable cop-ing options.

Although there are many reports of significanteffects on adaptational outcomes using process cop-ing scales, the weakest set of generalizations aboutcoping has to do with empirical evidence of its ad-aptational effects. In much of the research in thisarea, these outcomes have tended to be based onself-reports of emotional distress or psychologicalsymptoms (for a small sample, see Refs. 22, 44, 53.54).

Heavy dependence on self-report criteria of adap-tational outcomes in coping research, illustrated bymy own cited above (51), increases the possibilitythat the correlations are, in some unknown degree,confounded by overlapping antecedent and conse-quent measures. This is a perennial problem thathas plagued research in stress and health, as evi-denced by the debate between Dohrenwend et al.(55) and Lazarus et al. (56); see also Lazarus (57), forfurther discussion of this.

There are, however, some notable.exceptions. Themost impressive prospective study I have found—using independent observer judgments of adapta-tional outcomes—is an unpublished dissertation (20)



in which an effort was made to predict individualdifferences among cancer-induced laryngectomy pa-tients in how rapidly and effectively they learned totalk with a prosthesis. This is—for many—a verydifficult, discouraging, and stressful process, but itis accomplished quite well by some and badly byothers. Neither the objective severity of the surgicaldamage nor the personality traits that were meas-ured beforehand predicted these individual differ-ences. Yet how the subjects appraised and copedwith the learning task were strongly predictive oflater rehabilitative success, which was reliably eval-uated by clinical judgment.

It is very difficult to mount multimethod researchin which behavioral and physiological criteria areemployed, which is one reason for the extensivedependence on self-reports. Nor would I want tovenerate other methods, which have serious prob-lems of their own, by denigrating the value of self-reports. However, multimethod research could dem-onstrate whether obtained relationships betweencoping and adaptational outcomes, such as self-re-ported emotional distress and dysfunction, are ca-pable of being replicated across different researchmethods or are merely instances of method variance.A general review of research on coping and adapta-tional outcomes would be valuable, since it wouldaddress a major reason for the study of coping,namely, its role in these outcomes.

SOME SPECIAL ISSUES OF COPINGMEASUREMENT

The two approaches to coping measurement, thoseof style and process, ask different questions andprovide different types of answers about coping.Coping style emphasize personality dispositions ortraits, which to some extent transcend the influenceof situational context and time on the choice ofcoping strategy. Coping process emphasizes tem-poral and contextual influences on coping, and thechanges associated with them.

A number of important limitations inhere in boththe style and process approaches. These limitationshave important implications that I would like nowto address. I shall not take up purely psychometricissues here because they are tactical or methodolog-ical rather than strategic or theoretical, and beingsomewhat parochial, they are of less interest to thegeneral reader. A few writers have been concernedwith the psychometric issues that apply to processmeasures (58, 59).

Limitations of the Coping Style Approach

The emphasis on coping style emerged out of anego-psychology theoretical perspective, which wascentered on inner psychodynamics rather than onexternal environmental forces. In the 1970s, theemphasis shifted for a time to the environment,especially environmental change or life events.However, because the current emphasis is on bothsets of factors, the person and the environmentwhich are said to interact, person-environment re-lationships and especially relational meanings aboutthem are an even more appropriate focus than thesimple contrast between intrapsychic and environ-mental.

If, for example, one is concerned with emotionaland coping traits, which are dysfunctional in partic-ular clients in treatment, the main interest lies inthe consistent ways these clients interpret self andthe world and, therefore, how they cope with stress.Presumably the appraisal and coping processes theseclients draw on recurrently are what get them intoadaptational trouble. The pathogenic dispositionsthat lead to dysfunctional appraisals and copingprocesses are, therefore, at the center of treatmentdesigned to lead to changed ways of relating to theworld (see Refs. 60, 61, for discussions of emotiontraits and processes in psychotherapy). Then onewould want to examine coping dispositions or stylesin clinical assessment.

The most serious problem with this emphasis isthat one ends up assessing overbroad styles of relat-ing to the world, often as a single continuum ordichotomy, such as repression-sensitization. Stylesdo not provide us with a description of the detailed,specific strategies of coping employed in particularstress contexts. For example, what do different peo-ple think and do when self-esteem has been threat-ened, when they feel unequal to a task on whichsocial- and self-esteem depends, when there is athreat to health, functioning, and survival, whenthere has been an irrevocable loss, when anotherperson whose acceptance or affection is an impor-tant goal has given signs of rejection or lack ofaffection, and so on?

To sum up, broad coping styles do not adequatelyexplain or predict intraindividual variations in theway given sources of stress are dealt with in specificcontexts. The unidimensional typologies are, per-haps, too restricted in what they say about complexadaptational struggles to have much utility in ex-plaining and predicting what people do when con-fronted with the many forms of harm, threat, andchallenge to which all persons are exposed. Evenwhen multidimensional measures are employed, as


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is the case of certain defense mechanism assess-ments (18), environmental conditions eliciting thecoping process tend to be ignored because the focusis centered on consistent coping styles.

Are process approaches capable of identifying cop-ing styles? Two valid methods are available for this.In the first, if we study the same persons repeatedlyover time and in different stressful contexts, it ispossible to develop a superficial picture of the moreconsistent strategies of coping the person selects fordealing with diverse and recurrent sources of stress.This kind of picture can be obtained for stressesassociated with illnesses such as cancer, for exam-ple, as health status deteriorates, in the process-centered methodology employed by Mendelsohn(46), which I cited earlier.

However, there has been little process researchgeneralizing about strategies of coping across differ-ent kinds of stressful encounters, using a bottom-upor inductive approach, as it were, an exception being(44). The approach synthesizes coping styles frommany specific coping thoughts and acts, which aremeasured in process terms in a number of particularstressful encounters. The lack of research makes itimpossible at present to know whether this kind ofapproach is a viable alternative to the more tradi-tional methods of measuring coping styles based ona single assessment occasion. The bottom-up ap-proach also permits cluster analyses of patterns ofcoping in different persons, thereby making it pos-sible to group people on coping patterns, as well asto test the stability of these patterns over time andacross stressful encounters.

A second method, which has been used exten-sively because it is easy to manage, consists of alter-ing the wording of the coping measure by askinghow the person usually copes rather than how thatperson copes with specific threats or stressful en-counters. By changing the wording in this way, theprocess measure of coping is converted into a stylemeasure, on the assumption that the coping patternreported as "usual" actually took place some of thetime, rather than being a construction designed tomake sense but which is more fantasy than reality.Our original research purpose of sampling a numberof actual, specific stressful encounters was to avoida fictive answer by the subject. We reasoned that ifsubjects must remember or relive an actual incidentand the coping thoughts and actions employed, thereis a good chance that they actually thought or didwhat they reported.

I think it may be a bad assumption that a subjectactually copes in any specific encounter in the wayindicated when the word "usually" is used in the

measurement, which is the typical trait or styleassessment procedure. Subjects may be giving noth-ing more than a vague impression about how theywould prefer to cope, perhaps influenced by whatthey believe is socially desirable or ideal, ratherthan what they actually have thought or done. Thisproblem is also inherent in measures of subjectivewell-being, which are usually made for an extendedtime frame rather than a specific moment or circum-stance, resulting in a subjective calculus for esti-mating overall well-being whose mode of operationremains more or less unclear (62, 75).

Large numbers of researchers have used the Waysof Coping Questionnaire in a trait-centered way,sometimes by changing the wording to make it atrait measure, and sometimes without even makingthe wording change, but following the even morequestionable assumption that what is thought ordone in any single encounter is characteristic of theperson across encounters. To verify this assumptionone would have to try the method repeatedly overtime or across encounters, something that is rarelydone.

I also have found an interesting example of re-search in which the authors (63) converted a processscale, The Ways of Coping Questionnaire, into a traitscale by arranging the response format so that sub-jects rated each of the endorsed thoughts or actionson the basis of how "characteristic" it was of theperson. In still other instances, researchers seem tohave misunderstood the difference between a dis-positional or trait approach and a process approachto coping measurement (see, for example, Ref. 64, inwhich process measures are criticized for not beingtrait measures, which they were never intended tobe).

Limitations of the Coping Process Approach

Although process approaches are better able toencompass specific coping thoughts and actions indiverse stressful contexts that call for coping, theyhave their own limitations. The most important oneis that the measures are not usually formulated tolink up with a whole person, who has a particulargoal hierarchy and situational intentions, belief sys-tems, and a life pattern of plans and social connec-tions. Coping process measures would be far moremeaningful and useful if we knew more about thepersons whose coping thoughts and actions in spe-cific contexts are being studied. Now they tend tobe disembodied, as it were, from that person.

The above is a complaint that has also been made



against the most common approaches to research inpersonality, both experimental and correlational,which generate separate scores on a number of vari-ables of personality rather than synthesizing a func-tional portrait of a whole person. The complaint wasenunciated many years ago by Carlson (65), but itdid not succeed in turning modern personality as-sessment away from a pattern in which the personis fractionated into a number of separate traits. Suchtraits do not add up to, or get synthesized into, aliving, breathing person struggling in certain waysto adapt to the world and to life (see also Ref. 57 forarguments about this, pro and con).

What I have said above about the whole personhas also been pointed up eloquently by Block (66),in criticizing the Mischel (67) position that there areno broad consistencies in personality traits over andabove situations. Allow me to quote from Block (Ref.66, pp 9-10) about this:

" . . . we believed there was indeed anessential coherence, a deep structure topersonality functioning and in person-ality development. Sure, it was criticalto recognize the ways in which theimmediate environmental context in-fluenced behavior, as personality psy-chologists Henry Murray (68), KurtLewin (69), Robert White (70), and oth-ers had observed. But stimulus situa-tions alone could not provide, we be-lieved, a sufficient basis for under-standing behavior. Human beings arenot simply linear response systems ef-fectively at the mercy of the situationsthey encounter.

What I am urging, in effect, is not an extremecontextualism in the study of coping but an effort toexamine contextually influenced as well as stablerelationships between a person and the environ-ments, which that person pays attention to andchooses, where possible, or must deal with whenthere is no possibility of choice. I believe we musttry to place process measures of coping within thelarger framework of a person's life and ways ofrelating to the world. An approach that doesn't sup-plement contextual measurement of coping with anattempt at synthesis into a whole person is bound tobe too limited. This is, I believe, the most seriousweakness of a process approach to coping.

The aspect of personality that is most apt to bemissed in such an approach is motivational, that is,it consists of general goals and situational intentionsthat mobilize and direct the choice of the coping

strategies employed. The motivation of the copingprocess in general and in specific stressful encoun-ters is an interesting and important issue that hasbeen almost totally ignored in theory and research.I shall have more to say about this in the nextsection.

CONCLUSIONS ABOUT RESEARCH ONCOPING

Approaches to coping as style and as process areboth essential in that they each address differentaspects of the problem. These perspectives supple-ment each other, just as the trait and state perspec-tives constitute two sides of the same coin, as I saidearlier. In coping measurement, neither perspective,by itself, has progressed far enough to provide therich understanding of emotion and adaptation thatwe seek, or to facilitate the clinical study of effectiveand ineffective coping or copers. Combining theapproaches without sacrificing what is unique ineach might be a worthwhile enterprise.

To study coping over time and across diversesources of stress in the same persons in sufficientnumbers to address both its process and trait aspects,and to do this with an appreciation of the wholeperson, calls for complex, long-term research de-signs. The current institutional and research fundingclimate discourages researchers from following theirown leads and addressing the exciting challengesoffered by our brave theories and metatheories ofstress, coping, and the emotions. This makes ourempirical efforts seem pale shadows of what webelieve to be true of the most complex living crea-ture in the world, a person, in the most complex setof adaptational circumstances any living creatureever faced.

I close the discussion of coping with an attempt toindicate from my perspective some possibilities forfurther research on coping. Although fruitful possi-bilities abound, two seem particularly important andpromising to me. These have to do with a) thespecific, threatening personal meanings with whichpeople must cope in major life stresses and crises,and b) the connection between stress and the emo-tions, and the utility of measuring the latter.

A. Threatening Personal Meanings

An appraisal-centered approach to stress' directsour attention not merely to environmental stressorsbut to how these stressors are construed by a person.


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I am confident that personal meanings are the mostimportant aspects of psychological stress with whichthe person must cope, and they direct the choice ofcoping strategy (71). To truly understand copingrequires that we zero in on the main threat meaningsof a particular stress situation and how they changeover time and across situational contexts, regardlessof whether the approach to the measurement ofcoping is an in-depth interview or a standardizedinventory. For the skeptic, I need only phrase thisas a question—rather than an assumption—aboutthe link between personal meaning and coping.

As just one of many potential illustrations thatclarify this question, consider the awesome tasks ofcaretakers of declining AIDS patients, a problem thatFolkman and Chesney (72) are currently studying.They note that often the most obvious sources ofstress, for example, the onerous task of having toclean up the vomit or the bloody mess of inconti-nence made by a patient nearing death is not themost serious stresses that must be dealt with. Be-sides, doing this with grace and cheer may not onlyease the distress of the patient but also reinforcesthe caretaker's sense of control—which he badlyneeds—in an otherwise out of control situation. Norare these and other stressors necessarily the oneswith which the caretaker is most heavily preoccu-pied. Looking at the deteriorating loved one andcoming to terms with the prospect of his loss is aptto be much more threatening.

Yet there may be a far more terrible personalsignificance in this scenario for the caretaker,namely, that which is happening to the loved oneprovides a depressing model for the caretaker's owneventual fate. If, for example, the caretaker is HIVpositive, then the miserable scene that he is watch-ing day in and day out communicates loudly whatwill soon happen to him as he grows sick and pro-gresses irrevocably toward his own miserable death.This, of course, is likely to be much less of a threatfor HIV negative caretakers, though even they arenot assured of being free of the disease indefinitely.

Our penchant for defining threats in terms ofevident environmental pressures defeats the moreimportant task of obtaining a proper perspective onthe threats that the person is facing and must some-how manage. These threats—though sometimesshared with others—may also be quite individual.They arise out of the total psychological situation,which includes the person's social and work role inthe world and the status of important life goals andbeliefs. The issue is how to identify the threateningmeanings with which the person must cope, and toconsider their individual and collective role in the

coping process. The same point applies to copingwith any personal life crisis, which will usually becomplex and changing.

What I have been saying points to the crucial needfor a full scale assessment of threat, since we alwayscope with something in particular—as I said muchearlier in discussing the contexts of coping as proc-ess—and the way we cope is apt to differ from onething to another. If more than lip service is to begiven to coping as a process, then much more atten-tion has to be given to the task of assessing threat inorder to make sense of the way a person is coping.

In the AIDS caretaker example, a related issue isthe often unspoken question of how it is that mostcaretakers who continue loyally to minister to theirpartner's needs hold together rather than fall apartfrom the severe and unrelenting stress. Those whoremain through the worst as caretakers are the loyalones, perhaps a select group. What enables them toretain their psychological integrity? It would be veryuseful to know.

To answer this question it is not enough merelyto look at given, mostly unchangeable social andpersonality characteristics—such as a supportivefamily, friends, financial support, ego-strength, in-telligence, and skills—which mitigate personal vul-nerability and help people through crises. Becausewe can usually do nothing about these characteris-tics, if we want to learn how to help people to copebetter, we must also examine what they are actuallydoing and telling themselves in an effort to cope.

Most important of all, we should examine whichcoping patterns succeed or fail in the short and longrun—and in what ways. We also should examinehow these strategies come together and are synthe-sized into an overarching coping style, if one can bediscerned. It is my guess that being able to sustainserviceable meanings—whatever they may be—about what is happening is the most important keyto this synthesis which, it has been suggested, alsoapplies to successful grieving (73).

B. Stress, Emotion, and Coping

I recently proposed (74, 75) that psychologicalstress is best regarded as a subset of emotion. In fact,anger, anxiety, guilt, shame, sadness, envy, jealousy,and disgust, which arise out of conflict, are com-monly referred to as the stress emotions. The emo-tions are a much richer source of information abouthow people are faring in adaptational encounters,and in their lives overall, then the unidimensionalconcept of stress. Knowing that a person in a partic-



ular adaptational encounter reacts with anger, say,rather than anxiety, guilt rather than shame, priderather than envy, and so forth, is more informativethan knowing merely that this person is under stress.

This is because stress theory usually provides onlytwo analytic categories with which to consider psy-chodynamics, high and low; and even if we takeinto account the distinctions I have made (29) be-tween harm-, threat, and challenge, there are stillonly three categories for analysis of coping psycho-dynamics. On the other hand, there are 15 or soemotions, each with its own script or story line, itsown relational theme, which provides a far richerpotential for understanding people and their situa-tions. We learn different things from each emotionabout a person's transaction with the environment,the environment itself and—if we have informationabout numerous emotional encounters—about thekind of person we are dealing with. I am, in effect,suggesting that emotions always be measured in thecontext of research on coping and the psychologicalstresses that require it.

There are good grounds in theory and research forbelieving that the coping process is linked specifi-cally to the kind of emotion experienced in an ad-aptational encounter, and the conditions that elicitit. For example, in arguments between spouses (76),husbands and wives are likely to cope by attackingthe other marital partner in an effort to repair theirwounded self-esteem. Escalation of anger serves thepurpose of self-promotion and defensiveness (pro-tecting one's self-image). However, in shared situa-tions of anxiety, husbands and wives more oftencope by suppressing their anger in the interests ofdealing with their joint threat. Mutual support andreassurances are far more likely to be given byhusband and wife in anxiety compared with angerencounters.

Such coping differences also occur when the gen-eral goals and situational intentions of the individualmarriage partners vary. Partners who are concernedprimarily with repairing damage to their self-esteemare apt to escalate anger by attacking and defending;partners concerned primarily with preserving the

relationship, in contrast, are apt to conceal theiranger or find excuses for the provocation by thepartner, thereby reappraising the encounter as notcalling for anger.

Aside from these pioneering observations aboutthe emotions and coping, we know next to nothingabout the other emotions and how coping is shapedby them. The odds are very good that each of theemotions and the situations that provoke it resultsin quite distinctive patterns of coping. I cannot thinkof any area of coping research that is more promisingfor advancing our understanding than the study ofthe functional connections between emotions andcoping.

In the past, coping has been treated as belongingwithin the rubric of decision-making, with its em-phasis solely on cognitive processes. However, itbelongs equally within the realm of motivation andemotion. One could just as easily treat coping as akind of goal, accomplished by certain strategies in avertical means-ends relationship to each other inwhich there are broader, overriding ends and nar-rower means of accomplishing them. Taking intoaccount the specific emotions, general goals (orends), and situational intentions (or means) to attaingoals in stressful encounters would, I believe, facil-itate our understanding of the basis on which copingstrategies are selected and acted on.

It distresses me that so much that is being pub-lished on coping deals with trivial issues in oversim-ple, one-session research designs when so muchneeds to be done. As a result of the present climateof research, I am not optimistic that the challengingagendas that arise in the field of coping research—and which call for relatively expensive, longtitudi-nal research—will be adequately addressed.

Fads and fashions also come and go without im-portant problems being studied in full scope anddepth, only to surface again with a repeat of thewhole, inadequate process. I hope I am wrong aboutthis and that such a promising field of theoreticaland research endeavor—one that is so important forthe study of adaptational success and failure—doesnot languish or get abandoned.

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