coping with stressful events
History and Orientation
Stressors are demands made by the internal or external environment that upset balance, thus affecting physical and psychological well-being and requiring action to restore balance (Lazarus & Cohen, 1977). Beginning in the 1960s and 1970s, stress was considered to be a transactional phenomenon dependant on the meaning of the stimulus to the perceiver (Lazarus, 1966; Antonovsky, 1979).
Core Assumptions and Statements
The Transactional Model of Stress and Coping is a framework for evaluating the processes of coping with stressful events. Stressful experiences are construed as person-environment transactions. These transactions depend on the impact of the external stressor. This is mediated by firstly the person’s appraisal of the stressor and secondly on the social and cultural resources at his or her disposal (Lazarus & Cohen, 1977; Antonovsky & Kats, 1967; Cohen 1984).
When faced with a stressor, a person evaluates the potential threat (primary appraisal). Primary appraisal is a person’s judgment about the significance of an event as stressful, positive, controllable, challenging or irrelevant. Facing a stressor, the second appraisal follows, which is an assessment of people’s coping resources and options (Cohen, 1984). Secondary appraisals address what one can do about the situation. Actual coping efforts aimed at regulation of the problem give rise to outcomes of the coping process. In the table below the key constructs of the Transaction Model of Stress and Coping are summarized.
Evaluation of the significance of a stressor or threatening event.
Evaluation of the controllability of the stressor and a person’s coping resources.
Actual strategies used to mediate primary and secondary appraisals.
Strategies directed at changing a stressful situation.
Strategies aimed at changing the way one thinks or feels about a stressful situation.
Coping processes that induce positive emotion, which in turn sustains the coping process by allowing reenactment of problem- or emotion focused coping.
Outcomes of coping
Emotional well-being, functional status, health behaviors.
Dispositional coping styles
Generalized ways of behaving that can affect a person’s emotional or functional reaction to a stressor; relatively stable across time and situations.
Tendency to have generalized positive expectancies for outcomes.
Attentional styles that are vigilant (monitoring) versus those that involve avoidance (blunting)
Table from Glanz et al, 2002, p. 214.
See Glanz et al, 2002, p. 215.
Surveys, experiments and quasi-experiments are used.
Glanz et al (2002) use therapeutically techniques as well. Techniques such as biofeedback, relaxation and visual imagery are used. Biofeedback aims to develop awareness and control of responses to stressors. Furthermore, biofeedback reduces stress and tension in response to everyday situations. Relaxation techniques use a constant mental stimulus, passive attitude and a quiet environment. Techniques that are used are relaxation training, hypnosis and yoga. Visual imagery is a technique used for improving the mood of a person and improving coping skills. This can be done for example with visualizing host defenses destroying tumor cells.
Scope and Application
The Transactional Model of Stress and Coping is useful for health education, health promotion and disease prevention (see the example below for explanation). Stress does not affect all people equally, but stress can lead to illness and negative experiences. Coping with stress is therefore an important factor, it affects whether and how people search for medical care and social support and how they believe the advice of the professionals.
For understanding determinants of lifestyle of a cancer patient a variety of treatments are needed. This treatment should contain primary appraisals, secondary appraisals and specific coping strategies. Primary appraisals in this example are perceptions of risk of recurrence. Secondary appraisals can be self-efficacy in adopting health behavior recommendations. Specific coping strategies such as problem-focused coping, emotion-focused coping and meaning-based coping can be used (Glanz et al, 2002). These assessments could provide useful information about appraisals that facilitate or hinder lifestyle practices. Such information would be useful for interventions such as motivational messages and coping skills training techniques.
- Glanz, K., Rimer, B.K. & Lewis, F.M. (2002). Health Behavior and Health Education. Theory, Research and Practice. San Fransisco: Wiley & Sons.
- Lazarus, R.S. (1966). Psychological Stress and the Coping Process. New York: McGraw-Hill.
- Antonovsky, A. (1979). Health, Stress, and Coping. San Fransisco: Jossey-Bass.
- Antonovsky, A. & Kats, R. (1967). “The Life Crisis History as a Tool in Epidemiologic Research”. Journal of Health and Social Behavior, 8, 15-20.
- Cohen, F. (1984). “Coping” In J.D. Matarazzo, S.M. Weiss, J.A. Herd, N.E. Miller & S.M. Weiss (eds.), Behavioral Health: A Handbook of Health Enhancement and Disease Prevention. New York: Wiley, 1984.
- Lazarus, R.S. & Cohen, J.B. (1977). “Environmental Stress”. In I. Altman and J.F. Wohlwill (eds.), Human Behavior and Environment. (Vol 2) New York: Plenum.
See also Health Communication