Coping Pitfalls and Promise

2 Dec 2003 18:53 AR AR207-PS55-26.tex AR207-PS55-26.
sgm LaTeX2e(2002/01/18) P1: GCE

10.1146/annurev.psych.55.090902.141456
Annu. Rev. Psychol. 2004. 55:745–74

doi: 10.1146/annurev.psych.55.090902.141456
Copyright °c 2004 by Annual Reviews. All rights reserved
First published online as a Review in Advance on November 3, 2003
COPING: Pitfalls and Promise

Susan Folkman and Judith Tedlie Moskowitz
Osher Center for Integrative Medicine, University of California, San Francisco,
by University of Texas - HOUSTON ACADEMY OF MEDICINE on 04/28/08. For personal use only.
California 94143-1726; email: folkman@ocim.ucsf.edu, moskj@ocim.ucsf.edu

Annu. Rev. Psychol. 2004.55:745-774. Downloaded from arjournals.annualreviews.org
Key Words coping critique, coping measurement, positive emotion, coping

effectiveness, coping and meaning
■ Abstract Coping, defined as the thoughts and behaviors used to manage the inter-
nal and external demands of situations that are appraised as stressful, has been a focus
of research in the social sciences for more than three decades. The dramatic prolifera-
tion of coping research has spawned healthy debate and criticism and offered insight
into the question of why some individuals fare better than others do when encounter-
ing stress in their lives. We briefly review the history of contemporary coping research
with adults. We discuss three primary challenges for coping researchers (measurement,
nomenclature, and effectiveness), and highlight recent developments in coping theory
and research that hold promise for the field, including previously unaddressed aspects
of coping, new measurement approaches, and focus on positive affective outcomes.
CONTENTS
INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 746
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 746
The Contextual, Cognitive Model of Coping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 747
What Have We Learned? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 747
CHALLENGING ISSUES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 748
Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 748
Coping Nomenclature: Conceptual and Empirical Approaches . . . . . . . . . . . . . . . . 751
Coping Effectiveness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 753
NEW DEVELOPMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 756
Future-Oriented Proactive Coping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 757
Dual Process Model of Coping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 757
Social Aspects of Coping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 758
Religious Coping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 759
Emotional Approach Coping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 761
Emotion Regulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 762
Coping and Positive Emotion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 764
CONCLUSIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 768
0066-4308/04/0204-0745$14.00 745
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746 FOLKMAN ¥ MOSKOWITZ
INTRODUCTION
The past 35 years have seen a dramatic proliferation of coping research across social
and behavioral science, medicine, public health, and nursing. Research ranges
from small-sample qualitative studies to large-scale population-based studies, with
content ranging from the exploration of abstract theoretical relationships to applied
studies in clinical settings. Many investigators undertook this research with the
hope that the concept of coping might help explain why some individuals fare
better than others do when encountering stress in their lives. Many other concepts,
such as culture, developmental history, or personality, can also help explain these
individual differences, but coping is unlike these other concepts in that it lends
itself to cognitive-behavioral intervention. As such, its allure is not only as an
explanatory concept regarding variability in response to stress, but also as a portal
for interventions.
Background
A large proportion of contemporary coping research can be traced back to the
publication of Richard Lazarus’s 1966 book, Psychological Stress and the Coping
Process. Previously, most research on coping had been couched in the framework
of ego-psychology and the concept of defense, as exemplified by the work of Haan
(1969), Menninger (1963), and Vaillant (1977). This research was often concerned
with pathology and depended on the evaluation of unconscious processes. In his
book, Lazarus presented a contextual approach to stress and coping that helped set
a new course. Lazarus’s formulation expanded the boundaries of coping beyond
defense and an emphasis on pathology to include a wider range of cognitive and
behavioral responses that ordinary people use to manage distress and address the
problems of daily life causing the distress. Lazarus’s theory placed great emphasis
on the role of cognitive appraisal in shaping the quality of the individual’s emotional
response to a troubled person-environment relationship and to the ways in which
the person coped with the appraised relationship. His cognitively oriented theory
of stress and coping occurred within the context of the “cognitive revolution” and
its intense interest in the relation between cognition and emotion (e.g., Mandler
1975, Simon 1967) and information processing under conditions of stress (e.g.,
Horowitz 1976, Janis & Mann 1977, Leventhalet al. 1980). This historical context
undoubtedly helped create the fertile environment in which Lazarus’s theory of
stress and coping took root.
Coping as a distinct field of psychological inquiry emerged during the 1970s and
1980s. By 1974 publications included a major book edited by Coelho, Hamburg,
& Adams titled Coping and Adaptation, as well as scholarly books on coping
with illness (Antonovsky 1979, Moos & Tsu 1977) and coping with childhood
and adolescence (Murphy & Moriarty 1976). Lazarus & Folkman (Folkman &
Lazarus 1980, Lazarus & Folkman 1984) defined coping as thoughts and behaviors
that people use to manage the internal and external demands of situations that
COPING 747
are appraised as stressful. This definition became widely accepted (Tennen et al.
2000) and tools with which to measure these coping thoughts and behaviors were
developed (e.g., Billings & Moos 1981, Folkman & Lazarus 1980, Pearlin &
Schooler 1978). By the early 1980s, reports of empirical studies of coping began to
appear in growing numbers. Since then many new measures have been developed
and tens of thousands of studies have been published (Somerfield & McCrae
2000). Major books on coping were published, including Stress, Coping, and
Development (Aldwin 1994) and The Handbook of Coping (Zeidner & Endler
1996). Although defense-focused research continued throughout this period within

psychology (e.g., Vaillant 2000, Cramer 2000), cognitive approaches prevailed.
The Contextual, Cognitive Model of Coping

Coping is a process that unfolds in the context of a situation or condition that
is appraised as personally significant and as taxing or exceeding the individual’s
resources for coping (Lazarus & Folkman 1984). The coping process is initiated
in response to the individual’s appraisal that important goals have been harmed,
lost, or threatened. These appraisals are characterized by negative emotions that
are often intense. Coping responses are thus initiated in an emotional environment,
and often one of the first coping tasks is to down-regulate negative emotions that
are stressful in and of themselves and may be interfering with instrumental forms
of coping. Emotions continue to be integral to the coping process throughout a
stressful encounter as an outcome of coping, as a response to new information,
and as a result of reappraisals of the status of the encounter. If the encounter
has a successful resolution, positive emotions will predominate; if the resolution
is unclear or unfavorable, negative emotions will predominate. To date, empha-
sis has been given to negative emotions in the stress process. However, new re-
search about the role of positive emotions in the stress process and the role of
coping in generating and sustaining these emotions has been prompted by re-
cent evidence that positive and negative emotions co-occur throughout the stress
process.
What Have We Learned?

In the years since the early 1980s, we have learned that coping is a complex,
multidimensional process that is sensitive both to the environment, and its de-
mands and resources, and to personality dispositions that influence the appraisal
of stress and resources for coping. We have found that coping is strongly asso-
ciated with the regulation of emotion, especially distress, throughout the stress
process. We have found that certain kinds of escapist coping strategies are consis-
tently associated with poor mental health outcomes, while other kinds of coping—
such as the seeking of social support or instrumental, problem-focused forms of
coping—are sometimes associated with negative outcomes, sometimes with posi-
tive ones, and sometimes with neither, usually depending on characteristics of the
appraised stressful encounter. We have learned about the development of coping
over the life span. And we have learned that coping skills can be taught through
cognitive-behavioral therapies.
Despite the substantial gains that have been made in understanding coping per
se, we seem only to have scratched the surface of understanding the ways in which
coping actually affects psychological, physiological, and behavioral outcomes both
in the short- and the longer-term. The discovery task is not simple. Coping is not
a stand-alone phenomenon. It is embedded in a complex, dynamic stress process
that involves the person, the environment, and the relationship between them.
Our goals in this chapter are twofold: first, to review central issues in coping
research, and second, to review recent developments in coping theory and research
that hold promise for the field. The literature on coping is vast, and we found it
necessary to limit our review in several ways. We focus on coping research that is
consistent with the cognitive, contextual approach as opposed to trait approaches
or approaches based primarily on defense processes. We also focus on research
with adults as opposed to children, and on populations that are not impaired by
severe psychopathology.
CHALLENGING ISSUES
Numerous articles have been published that contain forceful criticisms of coping
research, especially methodology (for review, see Somerfield & McCrae 2000). In
this section we discuss three major issues that are widely debated in the coping
literature: measurement, nomenclature, and the determination of effectiveness.
Measurement
The widespread interest in a contextual approach to stress and coping of the 1970s
and 1980s motivated the development of new measures to assess coping in spe-
cific stressful situations. For the most part, the first generation of these new coping
measures took the form of a checklist of thoughts and behaviors that people use to
manage stressful events. Respondents were usually asked to provide a retrospec-
tive report of how they coped with a specific stressful event or they were asked
to respond to vignettes that portrayed stressful situations. Answers were scored
Yes/No or on Likert scales. Examples of inventories intended to be applicable
in general populations include the Ways of Coping (Folkman & Lazarus 1980,
1988); the COPE (Carver et al. 1989); Coping Response’s Inventory (Moos 1993);
the Coping Strategy Indicator (Amirkhan 1990); and the Coping Inventory for
Stressful Situations (Endler & Parker 1990; see Schwarzer & Schwarzer 1996 for
a comprehensive review of coping measures).
These inventories are helpful in that they allow multidimensional descriptions
of situation-specific coping thoughts and behaviors that people can self-report
(Stone et al. 1992). Nevertheless, the inventory approach has many limitations,
including:
COPING 749
■ potentially burdensome length (Stone & Neale 1984)

■ inadequate sampling of coping inherent in checklist approaches and response
keys that are difficult to interpret (Stone et al. 1992)
■ variations in the recall period (Porter & Stone 1996)
■ changes in meaning of a given coping strategy depending on when it occurs
(e.g., logical analysis before the problem would be constructive thinking,
afterward it could be rumination)
■ unreliability of recall (Coyne & Gottlieb 1996), and

■ confounding of items with their outcomes (Stanton et al. 1994).
The most prominent of all the criticisms of the checklist approach concerns the
problem of retrospective report and the accuracy of recall about specific thoughts
and behaviors that were used one week or one month earlier. Stone & Neale (1984)
developed the Daily Coping Inventory, a measure of daily coping efforts, to remedy
the problem of recall. Instead of asking subjects to recall their most stressful
event retrospectively across one week, two weeks, or a month, as most inventories
request, subjects are asked to think about the most bothersome event that occurred
that day. A study by Ptacek et al. (1994) provided support for shortening the
recall period to one day. They compared brief daily coping reports completed by
college students over seven days with retrospective reports of coping over the same
period. Correlations between daily coping measures (averaged across days) and
the retrospective measures ranged from 0.47 to 0.58.
Stone and his colleagues subsequently developed momentary coping assess-
ments using ecological momentary assessment techniques (Stone et al. 1998) in a
study that compared the “real-time” approach of the momentary assessments with
one- and two-day retrospectively reported coping. Approximately 30% of the par-
ticipants failed to retrospectively report items they had reported on the momentary
assessments, and conversely, approximately 30% of the participants retrospectively
reported items that were not reported on the momentary assessments.
Momentary and retrospective accounts yield different information about cop-
ing. Approaches with short recall are especially useful in intraindividual designs
to study the relationship between changes in coping and changes in proximal out-
comes such as mood or illness symptoms (Tennen et al. 2000). Some suggest that
intraindividual designs are by far the preferred way to understand how coping
affects physical and emotional well-being (Lazarus 2000). The momentary as-
sessment procedure, however, has its own shortcomings. As Stone et al. (1998)
point out, their subjects were asked repeatedly to recall their coping efforts, which
may have resulted in some coping not being reported, perhaps because participants
thought they already had reported it. Further, the momentary focus may result in
reports of very concrete, discrete events, thereby missing ongoing problems or
more abstract, complex problems. The momentary assessments might also elicit
literal reports of specific thoughts and actions, and miss the broader conceptual-
izations of coping that are better perceived with the benefit of some retrospection,
such as those that involve finding meaning. Conversely, retrospective accounts

may be more subject to distortion associated with participants’ efforts to create a
coherent narrative of what happened or to find meaning in the event. Stone et al.
point out that retrospective accounts may actually be better predictors of future
outcomes than the momentary assessments. One explanation for this may be that
what participants report as coping has become the “true story” for them and thus
predicts future actions.
Narrative approaches provide an interesting alternative to checklist approaches.
A great deal can be learned by asking people to provide narratives about stressful
events, including what happened, the emotions they experienced, and what they
thought and did as the situation unfolded. Narrative approaches are helpful in
understanding what the person is coping with, which is especially important when
the stressful event is not a specific event named by the investigator, such as coping
with exams, or a particular health-related procedure, such as an endoscopy. For
example, Folkman et al. (1994) analyzed the narratives of the caregiving partners
of men with acquired immunodeficiency syndrome (AIDS) who had been asked to
report the most stressful event related to caregiving. Within the general category of
caregiving, narratives revealed many different sources of stress, including adjusting
to illness progression, the shifting of responsibilities from the caregiver to the
patient, unexpected improvement in the patient’s health, and role conflict. These
insights were helpful in understanding the caregivers’ perspectives regarding what
they were actually coping with in their daily lives.
Narrative approaches are also useful for uncovering ways of coping that are
not included on inventories. In their analysis of narratives provided by caregivers
of people with dementia, for example, Gottlieb & Gignac (1996) identified ways
of coping not included on most inventories, such as ways of making meaning
(normalizing experiences and feelings, “reading” cognitions and internal states of
the care recipient) and vigilance (continuous watchfulness). Moskowitz & Wrubel
(2000) analyzed 246 stressful event narratives in a sample of 20 human immuno-
deficiency virus positive (HIV+) men who each had up to 13 interviews over a two-
year period. They coded the narratives for coping thoughts and behaviors and tried
to match them to the eight categories of coping contained in the Ways of Coping
(Folkman & Lazarus 1988). Moskowitz & Wrubel identified coping processes
not included on the Ways of Coping inventory, such as offering support, mentally
preparing for what was coming, and venting emotion through crying or writing.
Moskowitz & Wrubel also examined the overlap between a quantitative measure
(the Ways of Coping, Folkman & Lazarus 1988) and their narrative analysis. First
they examined the extent to which the eight kinds of coping measured by the Ways
of Coping appeared spontaneously in the narratives and found the proportion of
matches ranging from 8% to 42%. They then looked in the opposite direction and
found that spontaneous accounts of the eight kinds of coping that appeared in the
narratives were matched by reports on the Ways of Coping much more consistently,
the proportion of matches ranging from 57% to 100%. These findings suggest that
narrative and quantitative approaches overlap, but are not equivalent.
COPING 751
There is no gold standard for the measurement of coping. Momentary accounts

address the problem of bias due to recall, but they may underrepresent the com-
plexity of coping over time and the complexity of what people actually cope with.
Retrospective accounts address the problems of complexity, but introduce the ef-
fects of coping processes that take place in the interim. Retrospective accounts, in a
sense, may be telling us what the person is doing now to cope with what happened
then, as well as what the person did then to cope with what happened then. Some
might call this “error” or “noise.” We consider it another aspect of coping. Finally,
narrative methods generate ways of coping that are not contained in checklists.
However, without the prompting of a checklist, people may overlook some of the
ways they coped.

The measurement of coping is probably as much art as it is science. The art
comes in selecting the approach that is most appropriate and useful to the re-
searcher’s question. Sometimes the best solution may involve several approaches.
A narrative approach with a small sample can be very useful in defining the do-
mains of stressors that are relevant for the study population. This information can
then be used to define a limited range of stressors to be used with a quantitative
measure. This approach is also useful for uncovering ways of coping that are not
included on standard coping inventories Momentary and retrospective accounts
provide different perspectives on coping. One or the other may be preferable,
depending on whether the outcome of interest is proximal (such as mood), a be-
havioral outcome (such as resolution of interpersonal conflict or performance on
a test), or more distal (such as recovery from surgery or recurrence of mental or
physical illness).
Coping Nomenclature: Conceptual and Empirical Approaches

Coping inventories usually contain several dozen specific thoughts and behaviors.
If one counted the unique items on all inventories there would probably be hun-
dreds. A challenge for coping researchers is to find a common nomenclature for
these diverse coping strategies so that findings across studies can be discussed
meaningfully.
Researchers have generally clustered coping responses rationally, using theory-
based categories; empirically, using factor analysis; or through a blend of both
rational and empirical techniques. One of the earlier nomenclatures, proposed
by Folkman & Lazarus (1980), used a rational approach to distinguish two ma-
jor theory-based functions of coping: problem-focused coping, which involves
addressing the problem causing distress, and emotion-focused coping, which is
aimed at ameliorating the negative emotions associated with the problem. Some
examples of problem-focused coping are making a plan of action or concentrating
on the next step. Examples of emotion-focused coping are engaging in distracting
activities, using alcohol or drugs, or seeking emotional support.
The theoretical distinction between problem-focused and emotion-focused
coping provides a useful way of talking about many kinds of coping in broad
brushstrokes and it is used extensively in the coping literature. Other conceptu-

alizations of coping functions often fit these categories. For example, Billings &
Moos (1981) proposed a three-factor conceptualization of coping consisting of
Active Cognitive (e.g., tried to see the positive side; considered several alterna-
tives) and Active Behavioral (e.g., talked with a friend, tried to find out more about
the situation), which are problem-focused coping, and Avoidance (e.g., tried to
reduce tension by eating more, got busy with other things to avoid thinking about
the problem), which is a form of emotion-focused coping.
Several investigators found that the problem-focused and emotion-focused dis-

tinction was a good starting point, but they identified meaning-focused coping as a
different type of coping in which cognitive strategies are used to manage the mean-
ing of a situation. Pearlin & Schooler (1978), for example, included the responses
of positive comparisons or selective ignoring in this category. Park & Folkman
(1997) also proposed a meaning-making factor as a useful way to think about
coping efforts in which the person draws on values, beliefs, and goals to modify
the meaning of a stressful transaction, especially in cases of chronic stress that
may not be amenable to problem-focused efforts. Gottlieb & Gignac (1996) found
that meaning-making coping, including making causal attributions and searching
for meaning in adversity, was caregivers’ most frequently reported way of coping
with demented care recipients’ behavior.
Empirically derived categories of coping usually include the three theoretically
derived factors mentioned above—problem-focused coping, emotion-focused cop-
ing, and meaning-focused coping—but also often include a social factor. In de-
veloping the Coping Strategy Indicator, Amirkhan (1990) started with 161 coping
responses. Principal-factor analysis produced a three-factor solution of Problem-
Solving, Seeking Support, and Avoidance that provided a good fit to the data.
Zautra et al. (1996) compared several empirical structures of coping based on an
11-subscale dispositional version of the COPE inventory (Carver et al. 1989) in a
sample of 169 recently divorced women. A four-factor solution that reflected the
now-familiar pattern of problem-focused, emotion-focused, social coping, and
meaning-focused coping provided an adequate fit to the data: Active (active,
restraint, planning), Avoidance (denial, drugs, mental disengagement), Support
(seeking instrumental support, seeking emotional support), and Positive Cognitive
Restructuring (positive reinterpretation, humor, acceptance).
Although nomenclature such as problem-focused, emotion-focused, social cop-
ing, and meaning-focused coping helps the synthesis of findings across studies,
it also runs the risk of masking important differences within categories. For ex-
ample, distancing, which is a form of coping in which the person recognizes a
problem but deliberately makes efforts to put it out of his or her mind, and escape-
avoidance, which is more of an escapist flight that can include behaviors such as
drinking, are both avoidant forms of coping that are usually grouped together under
“emotion-focused coping.” Distancing, however, is often adaptive when nothing
can be done, such as when waiting for the outcome of a test, whereas escape-
avoidance is usually a maladaptive way of coping with the same kind of situation.
COPING 753
Sometimes this kind of distinction is important to retain. If sample size allows,

statistical techniques such as structural equation modeling can be used to examine
unique effects of individual coping responses even though they are grouped into
larger latent factors (Hull et al. 1991).
A second set of issues related to the grouping of coping responses concerns the
evaluation of the psychometric qualities of coping scales based on the groupings.
Usually we expect measures of psychological constructs to have high levels of
internal consistency, with alphas typically above 0.85 or 0.90. This standard is
not necessarily appropriate for coping scales. Billings & Moos summarized this
problem more than 20 years ago: “. . .typical psychometric estimates of internal
consistency may have limited applicability in assessing the psychometric adequacy

of measures of coping . . . an upper limit may be placed on internal consistency
coefficients by the fact that the use of one coping response may be sufficient to
reduce stress and thus lessen the need to use other responses from either the same
or other categories of coping” (Billings & Moos 1981, p. 145).
Another psychometric issue has to do with the expectation that a multifactorial
scale should have factors that are independent of one another. Conceptually and
empirically, however, distinct kinds of coping seem to travel together. Problem-
focused coping, for example, is usually used in tandem with positive reappraisal
or meaning-focused coping. This partnership suggests that these two forms of
coping facilitate each other. Looking for the positive in a grim situation, for ex-
ample, may encourage the person to engage in problem-focused coping. Con-
versely, effective problem-focused coping can lead to a positive reappraisal of the
individual’s competence (or luck), or it may lead to an appreciation of another
person’s contribution to the solution. To insist that coping factors be uncorrelated
in order to achieve a psychometric purity by, for example, eliminating items that
correlate across factors, may actually result in a reduction of the validity of the
measure.
Coping Effectiveness
An important motivation for studying coping is the belief that within a given
culture certain ways of coping are more and less effective in promoting emotional
well-being and addressing problems causing distress, and that such information
can be used to design interventions to help people cope more effectively with the
stress in their lives. Despite the reasonableness of this expectation, the issue of
determining coping effectiveness remains one of the most perplexing in coping
research (Somerfield & McCrae 2000).
The contextual approach to coping that guides much of coping research states
explicitly that coping processes are not inherently good or bad (Lazarus & Folkman
1984). Instead, the adaptive qualities of coping processes need to be evaluated in
the specific stressful context in which they occur. A given coping process may be
effective in one situation but not in another, depending, for example, on the extent
to which the situation is controllable. Further, the context is dynamic, so that what
might be considered effective coping at the outset of a stressful situation may be

deemed ineffective later on. Thus, in preparing for an examination, it is adaptive
to engage in problem-focused coping prior to the exam and in distancing while
waiting for the results (Folkman & Lazarus 1985). Conversely, when dealing with
a major loss, such as the death of a spouse, it may be adaptive initially to engage
in some palliative coping to deal with the loss and then later, after emotional
equilibrium is returning, to engage in more instrumental coping to deal with future
plans (Stroebe & Schut 2001).
The evaluation of coping in a contextual model requires a two-pronged ap-

proach. First, appropriate outcomes must be selected. Second, attention must be
given to the quality of the fit between coping and the demands of the situation.
OUTCOMES Broadly viewed, outcomes refer to the status of diverse goals that are
personally significant to the individual or that are selected by the researcher on
an a priori basis for their relevance to the question at hand. Several investigators
have identified coping goals that are fairly generic, such as solving the problem
and feeling better (Cummings et al. 1994, McCrae & Costa 1986), or problem-
solving, managing emotional distress, protecting self-esteem, and managing social
interactions (Laux & Weber 1991). Zeidner & Saklofske (1996) name eight goals:
resolution of the conflict or stressful situation, reduction of physiological and
biochemical reactions, reduction of psychological distress, normative social func-
tioning; return to prestress activities, well-being of self and others affected by the
situation, maintaining positive self-esteem, and perceived effectiveness.
These lists are helpful, but they mask important complexities. First, some out-
comes tend to be proximal and are probably influenced by momentary coping (e.g.,
biochemical reactions) and others are more distal and are probably influenced by
coping over time (e.g., normative social functioning, return to prestress activities).
These distinctions actually make it useful to consider both distal and proximal
outcomes in the same study so that we can learn more about how coping works
both in the short- and long-term. Menaghan (1982), for example, used distress as
an indicator of emotional well-being in the near term and numbers of life problems
as an indicator of longer-term effectiveness.
Second, coping responses that are effective with respect to one outcome may
have a negative impact on another (Folkman 1992, Zeidner & Saklofske 1996). In a
study of physicians’ mistakes, for example, Wu et al. (1993) found that physicians
who coped by accepting responsibility for the mistake made constructive changes
in their practice (problem-solving), but also experienced more distress.
A third point has to do with an assumption that a successful goal outcome
involves mastery or resolution. Zeidner & Saklofske (1996, p. 158) for example,
state that adaptive coping “should lead to a permanent problem resolution with no
additional conflict or residual outcomes while maintaining a positive emotional
state.” This approach does a disservice to the chronic, inherently unresolvable
situations and conditions that characterize the stress most people are most troubled
by such as chronic illness, caregiving, unemployment, and bereavement, and which
are the most challenging in terms of coping (Mattlin et al. 1990). Gignac & Gottlieb
COPING 755
(1997) make the interesting observation that research on coping effectiveness is

virtually nonexistent in the area of chronic stress.
A fourth issue has to do with who evaluates the status of the goal. Is it an
observer or is it the person doing the coping? A number of investigators (e.g.,
Aldwin & Revenson 1987, Gignac & Gottlieb 1996, Ntoumanis & Biddle 1998)
ask participants to appraise the efficacy of their own coping efforts. In their study
of caregivers of patients with dementia, for example, Gignac & Gottlieb (1996),
assessed caregivers’ appraisals of their coping efficacy in response to the symptom
of their family member’s dementia they found most upsetting. Importantly, these
efficacy appraisals were made in terms of progress toward goal outcomes identified
in qualitative analysis of interview data (a problem-solving/instrumental goal, the

maintenance of self-esteem, the regulation of emotional and physiological arousal,
the development of greater self-understanding, and the preservation of harmonious
relations with relatives) rather than in terms of mastery or resolution. Observer rat-
ings of coping efficacy are used less frequently, and usually in relation to behavioral
outcomes such as performance on an exam (Carver & Scheier 1994, Folkman &
Lazarus 1985) or on a laboratory-based task (Aspinwall & Richter 1999), or to
biological outcomes, such as immune markers of HIV disease progression (e.g.,
Ironson et al. 2002).
COPING-ENVIRONMENT FIT A full account of coping effectiveness must consider

characteristics of the context and the fit between those characteristics and various
types of coping. Several approaches have been taken to characterize situations.
One is to classify stressful situations in terms of what they are about in objective
terms, such as illness, death, or children (Billings & Moos 1981, Mattlin et al.
1990). This approach ignores psychological dimensions that are theoretically rel-
evant to a contextual approach to coping. The approach in which the investigator
characterizes situations as a threat, loss, or challenge (McCrae 1984) is closer to
the contextual theory in that it uses dimensions to classify situations that reflect dif-
ferent kinds of stress and that suggest different coping approaches (e.g., approach
versus avoidance; problem versus emotion-focused). However, the classification
is made by someone who may not share the individual’s history, dispositions, or
goals, all of which are relevant to the appraisal of threat, loss, and challenge.
The approach to characterizing the context most consistent with a contextual
formulation is to obtain the individual’s own appraisal of the situation, event, or
condition in relation to a theoretically relevant dimension. The most frequently
assessed dimension is the opportunity for personal control, or the appraisal of con-
trol or changeability. The fit between the appraisal of controllability and coping
is sometimes referred to as the goodness of fit (Conway & Terry 1992, Folkman
1984, Zeidner & Saklofske 1996). Theoretically, appraisals of control call for
greater proportions of active, instrumental problem-focused forms of coping, and
appraisals of lack of control call for more active or passive emotion-focused cop-
ing. Presumably, people who choose coping strategies that fit the appraised con-
trollability of a task will have better outcomes than people who do not. There
is mixed support for this hypothesis. In a study of hemodialysis patients and
adherence, Christensen et al. (1995) found that coping involving planful problem
solving was associated with more favorable adherence when the stressor involved
a relatively controllable aspect of the hemodialysis context. For stressors that were
less controllable, emotional self-control, a form of emotion-focused coping, was
associated with more favorable adherence. Terry & Hynes (1998) made distinctions
among problem- and emotion-focused kinds of coping in a study of women coping
with a medical procedure, in vitro fertilization, which they considered uncontrol-
lable. Direct attempts to manage the problem were related to poorer adjustment,
which supported the goodness-of-fit hypothesis. They also found that emotion-
focused approach to coping was better related to adjustment. Escape, another form
of emotion-focused coping, was not. Park et al. (2001) found support for the fit
between problem-focused coping and controllability in a sample of HIV+ men,
but the evidence for a fit between emotion-focused coping and lack of control
was less strong. Conversely, Macrodimitris & Endler (2001) found evidence for
a fit between lower perceived control and high emotion-oriented coping for the
psychological adjustment of people with type 2 diabetes, but did not find evidence
for the fit between higher perceived control and instrumental coping.
People’s ability to modify their coping according to the situational demands
is sometimes referred to as coping flexibility, which involves the systematic use
of a variety of strategies across different situations rather than the more rigid
application of a few coping strategies (Lester et al. 1994). Flexibility has been
measured in three different ways: through a card sorting procedure in which the
individual places cards containing descriptions of coping into categories that range
from “most like me” to “least like me” (Schwartz & Daltroy 1991), by counting
the number of coping options selected from a coping inventory for each of several
scenarios (Lester et al. 1994), and by examining the flexibility of appraisals of
controllability and the flexibility of coping in relation to the appraisal (Cheng
2001). The study by Lester et al. suggested coping flexibility using the card sort
method and the inventory count method is associated with greater well-being.
Cheng tested her hypotheses about appraisal in a laboratory study and found that
the results predicted flexible appraisal processes in a real-life setting. However,
Cheng did not relate flexibility to relevant outcomes.
Theoretically, the concept of goodness of fit and the related notion of coping
flexibility make sense. The studies to date suggest, however, that these concepts
need to be tested with more refined categories of coping. It also may be necessary
to take into account additional situational characteristics, such as whether or not
it involves a goal of such significance that it cannot be easily relinquished (Carver
& Scheier 1998, Stein et al. 1997).
NEW DEVELOPMENTS
Coping research is itself dynamic and new directions are emerging that are help-
ing the field move forward, including future-oriented proactive coping, a dual-
process model of coping, social aspects of coping, and three new directions that
COPING 757
are tied closely to emerging emotion research: emotion-approach coping, emotion-

regulation, and positive emotion and coping.
Future-Oriented Proactive Coping

Although the concept of threat—anticipated harm or loss—is central to cognitive
theories of stress, most studies of coping focus on how people cope with events
that occurred in the past or that are occurring in the present. One of the new
developments in coping has to do with ways people cope in advance to prevent or
mute the impact of events that are potential stressors, such as a pending lay-off, a
medical procedure that has been scheduled, or having to deal with the results of a
test that is scheduled in the near future (Aspinwall & Taylor 1997).
Aspinwall & Taylor (1997) refer to these responses to potential stressors as
“proactive coping.” Their model defines five interrelated components of the proac-
tive coping process: (a) the importance of building a reserve of resources (includ-
ing temporal, financial, and social resources) that can be used to prevent or offset
future net losses (see also Hobfoll 1989), (b) recognition of potential stressors,
(c) initial appraisals of potential stressors, (d) preliminary coping efforts, (e) and
the elicitation and use of feedback about the success of one’s efforts (Aspinwall
2003).
Schwarzer & Knoll (2003) distinguish among reactive coping, which alludes to
harm or loss experienced in the past; anticipatory coping, which refers to efforts
to deal with a critical event that is certain or fairly certain to occur in the near
future (e.g., preparing for an exam); preventive coping, which foreshadows an
uncertain threat potential in the distant future (e.g., beginning an exercise program
to prevent an age-related medical condition such as osteoporosis); and proactive
coping, which involves upcoming challenges that are potentially self-promoting.
According to Schwarzer & Knoll the proactive person creates opportunities for
growth, and though like Aspinwall & Taylor (1997), they emphasize the importance
of accumulating resources, the purpose of these resources is to enable the individual
to move toward positively valanced goals that are challenging and associated with
personal growth.
Future-oriented coping, including anticipatory, preventive, and proactive cop-
ing, deserves attention. This type of coping may be a particularly good candidate
for inclusion in cognitive-behavioral or psychoeducational interventions. Measures
need to be developed that tap coping methods that are distinctly future-oriented so
we can learn how people manage to reduce the potential adverse impact of future
events and maximize opportunities for benefit.
Dual Process Model of Coping

In general, we are not highlighting models of coping that are condition-specific in
this review, but we have chosen to discuss Stroebe & Schut’s (1999, 2001) Dual
Process Model of Coping (DPM) because it illustrates a theoretically based cog-
nitive model of coping designed for an important context that has broad relevance
in the social, behavioral, and health sciences, namely, bereavement.
The DPM specifies a dynamic process of coping whereby the bereaved person
oscillates between two orientations: loss and restoration. Loss-oriented coping
includes grief work, breaking bonds and thinking of the deceased person in a
different place, and denying and avoiding changes associated with restoration.
Restoration-oriented coping includes attending to secondary stressors that come
about as a consequence of the bereavement, such as changing identity and role from
“wife” to “widow,” or mastering new skills and responsibilities that had previously
been the provenance of the deceased. Each of these orientations can be thought of
as a set of related goals. Importantly, the DPM defines adaptive coping as involving
oscillation between loss- and future-orientations, between approach and avoidant
coping, and between positive and negative reappraisals. Thus, the DPM specifies
the major adaptive tasks associated with bereavement, specific cognitive processes
associated with each adaptive task, and describes what “effective” coping might
look like in this context. Several studies have tested various aspects of the model,
and findings suggest that the DPM, with its characteristic pattern of oscillation, is
helpful in explaining adjustment to bereavement (for review see M.S. Stroebe, H.
Schut, & W. Stroebe, under review).
Social Aspects of Coping

Although most models of coping view the individual as embedded in a social
context, the literature on coping is dominated by individualistic approaches that
generally give short shrift to social aspects. Themes of personal control, personal
agency, and direct action are central to most theories of coping (e.g., Lazarus &
Folkman 1984, Pearlin & Schooler 1978), all of which reflect the emphasis on the
individual. Dunahoo et al. (1998) have described these individualistic approaches
as “Lone Ranger, ‘man against the elements’ perspective,” but as they point out,
“Even the Lone Ranger had Tonto” (p. 137).
Recent discussions of social aspects of coping include the impact of individual
coping on social relationships and vice versa (e.g., Berghuis & Stanton 2002,
Coyne & Smith 1991, DeLongis & O’Brien 1990, O’Brien & DeLongis 1997) and
the notion of communal, prosocial coping (e.g., Wells et al. 1997).
INDIVIDUAL COPING AND SOCIAL RELATIONSHIPS O’Brien & DeLongis (1997)

summarize some of the main issues related to the coping of couples. Their re-
view indicates that strategies that may be beneficial to the individual’s well-being
are not necessarily beneficial to the individual’s spouse, and vice versa. Further,
an individual’s strategies that may be beneficial to the spouse may be hurtful to the
individual. For example, Coyne & Smith (1991) studied coping strategies intended
to buffer or protect another person from stress. In a study of myocardial infarction
patients, they found that the use of such strategies by wives resulted in improved
self-efficacy for the husbands, but diminished self-efficacy for the wives.
Berghuis & Stanton (2002) evaluated infertile couples’ coping with a failed
attempt to inseminate. They found that the individual’s level of distress was
COPING 759
influenced both by the individual and the spouse. The pattern of findings suggests
that women and men tend to experience each other’s coping strategies differently.
Women, for example, benefited from their male partner’s problem-focused cop-
ing, but the converse was not true, and avoidance by female partners contributed
to distress in men, but the converse was not true.
COMMUNAL COPING As a counterpoise to the emphasis on individualistic cop-

ing, Hobfoll and his colleagues have developed a multiaxial coping model that
takes both individualistic and communal perspectives into account. It includes a

prosocial-antisocial dimension and a passive-active dimension (Wells et al. 1997).
The communal perspective is contained in the prosocial-antisocial dimension and

refers to coping responses that are influenced by and in reaction to the social con-
text. Thus, a person may delay or not engage in a direct action to solve a problem
if that action is perceived as causing distress to another member of the social en-
vironment. Communal coping can be prosocial (e.g., “Join together with others to
deal with the situation together,” “Think carefully about how others feel before
deciding what to do”), or antisocial (e.g., “Assert your dominance quickly,” “Be
firm, hold your ground”) (Monnier et al. 1998). In a series of studies, Hobfoll
and his colleagues found that active prosocial coping was associated with better
emotional outcomes (Wells et al. 1997), and that women use more prosocial and
men use more antisocial coping (Dunahoo et al. 1998).
Religious Coping
Religious coping received little attention until relatively recently. Now it has be-
come one of the most fertile areas for theoretical consideration and empirical
research. The interest in religious coping is spurred in part by evidence that reli-
gion plays an important role in the entire stress process, ranging from its influence
on the ways in which people appraise events (Park & Cohen 1993) to its influence
on the ways in which they respond psychologically and physically to those events
over the long term (Seybold & Hill 2001). But people also use religion specifically
to help cope with the immediate demands of stressful events, especially to help
find the strength to endure and to find purpose and meaning in circumstances that
can challenge the most fundamental beliefs.
The recent interest in religious coping has been fueled by increasing evidence
that religious involvement affects mental and physical health (Seybold & Hill
2001). Religious involvement is not synonymous with religious coping. Religious
involvement can be a part of an individual’s life independent of stress in that
person’s life. However, some people do become involved with religion as a way
of coping with stress. Further, studies by Holland et al. (1999) and Baider et al.
(1999) show a relationship between a measure of religious and spiritual beliefs
and practices and active forms of coping.
Kenneth Pargament (1997) has articulated complicated conceptual issues inher-
ent in the study of religious coping in his seminal book, The Psychology of Religion
and Coping, and in subsequent publications. One issue is the need to distinguish
religious coping from religious dispositions and psychological and religious out-
comes (Smith et al. 2000) that parallel similar issues in the conceptualization and
measurement of coping more generally (cf. Lazarus & Folkman 1984, Stanton
et al. 1994). A second issue is the need to define methods of religious coping that
are distinct from methods of secular coping. Pargament et al. (1988), for example,
defined three such methods: the self-directing approach, in which people rely on
their God-given resources in coping; the deferring approach, in which people pas-
sively defer the responsibility for problem solving to God; and the collaborative
approach, in which people work together with God as partners in the problem-
solving process (preprint, ms pp. 6–7). A third issue has to do with the potential
confounding between religious and nonreligious coping. Religious methods of
gaining control, for example, could be just a reflection of a basic nonreligious
desire for control. A fourth issue has to do with the fuzzy boundaries between con-
cepts of religiosity and spirituality (Zinnbauer et al. 1997). Many diverse points
of view are expressed in the literature on this issue. Spirituality can exist outside
the boundaries of formal religion, but spirituality is also a part of religion. In this
section, when we refer to religious coping, we also include spiritual coping, such
as efforts to find meaning and purpose, or efforts to connect with a higher order or
divine being that may or may not be religious.
Until the late 1990s, most measures of religious coping relied on just one or two
items that asked about religious involvement, religiosity, or prayer. For example,
one of the earliest coping measures, the Ways of Coping (Folkman & Lazarus 1980,
1988), has just one item that is clearly religious, “I prayed.” The COPE (Carver
et al. 1989), another widely used measure of coping, has a religious coping subscale
that consists of four items: “I seek God’s help,” “I put my trust in God,” “I try to
find comfort in my religion,” and “I prayed.”
In the late 1990s, Pargament and his colleagues developed the RCOPE, an
important contribution to the measurement of religious coping (Pargament et al.
2000). The RCOPE is designed to assess five religious coping functions: (a) find-
ing meaning in the face of suffering and baffling life experiences, (b) providing an
avenue to achieve a sense of mastery and control, (c) finding comfort and reducing
apprehension by connecting with a force that goes beyond the individual, (d) fos-
tering social solidarity and identity, and (e) assisting people in giving up old objects
of value and finding new sources of significance. Specific religious coping methods
were defined for each of these religious functions, and subscales were created. In
other work, Pargament and his colleagues grouped religious coping methods into
positive and negative patterns (Pargament et al. 1998). Positive religious coping
methods are an expression of “a sense of spirituality, a secure relationship with
God, a belief that there is meaning to be found in life, and a sense of spiritual
connectedness with others” (Pargament et al., p. 712). Benevolent religious reap-
praisals, collaborative religious coping, and seeking spiritual support are examples
of coping methods that fall within this category. Negative religious coping is an
expression of “a less secure relationship with God, a tenuous and ominous view of
COPING 761
the world, and a religious struggle in the search for significance” (Pargament et al.,
p. 712). It includes punitive religious reappraisals, demonic religious reappraisals,
reappraisals of God’s powers, and spiritual discontent.
Pargament et al. (2001) conducted one of the few studies to examine religious
coping (as opposed to religious involvement) as a predictor of mortality. The study
produced mixed findings. The authors used items from the RCOPE (Pargament
et al. 2000) to measure positive religious coping and religious struggle in a two-
year longitudinal study of 596 hospitalized persons 55 years of age or older. They
found that religious struggle items (e.g., “Wondered whether God had abandoned
me,” “Questioned God’s love for me”), but not positive religious coping, predicted
mortality after controlling for demographic, physical health, and mental health
variables. The authors point out that their study was the first empirical study to
identify religious variables that increase the risk of mortality. Their study shows
the importance of using measures of religious coping that include methods that
are potentially maladaptive as well as those that are potentially adaptive.
Emotional Approach Coping

In the majority of studies of coping and adjustment, emotion-focused coping has
been associated with higher levels of distress. Stanton and colleagues (Stanton et al.
1994, Stanton et al. 2000, Stanton et al. 2002) suggest that this is due to several
flaws in the way emotion-focused coping is usually measured and analyzed. First,
emotion-focused coping can include many different types of coping depending on
the study. Second, emotion-focused items that indicate approach (e.g., “I get upset
and am really aware of it”) and items that reflect avoidance of emotions (e.g., “I
try not to think about it”) are often combined into a single scale when, in fact, their
effects may be very different and they may actually be inversely correlated. Third,
many of the emotion-focused items on the most commonly used coping scales are
confounded with distress (e.g., “I get upset and let my emotions out,” “I become
very tense”) and therefore the correlations with distress outcomes are likely to be
inflated. Stanton and colleagues set out to address these issues by developing a
scale to assess coping through emotional approach that was uncontaminated by
distress and focused only on emotional approach types of coping.
Coping through emotional approach involves actively processing and express-
ing emotion (Stanton et al. 1994, Stanton et al. 2000). The emotional approach scale
consists of two subscales: emotional processing (e.g., “I realize that my feelings
are valid and important,” “I take time to figure out what I’m really feeling”) and
emotional expression (e.g., “I feel free to express my emotions,” “I let my feelings
come out freely”) (Stanton et al. 2000). The subscales have acceptable reliability
and validity and are relatively distinct from other forms of coping (Stanton et al.
2000).
In one of their earlier studies, Stanton et al. (1994) demonstrated that emo-
tional approach coping (which combined expression and processing items) was
associated with decreased depression and hostility and increased life satisfaction
over a one-month period for women but increased depression and decreased life
satisfaction for men. In a subsequent set of studies in which emotional processing
and expression were analyzed as separate subscales, neither was associated with
depression but emotional expression was associated with life satisfaction for both
men and women. In addition, emotional processing and emotional expression were
associated with hope in women (but not in men). In a study of women with stage
I or II breast cancer (Stanton et al. 2000), coping with cancer through emotional
expression was associated with improved perceptions of health, decreased dis-
tress, fewer medical visits, and increased vigor at a three-month follow up. Coping
through emotional processing, however, was associated with increases in distress
over the three-month study period. Stanton et al. (2000) suggest that although
emotional processing appears to be adaptive in the shorter term, if it continues
over the longer term may become ruminative and therefore less beneficial in terms
of adjustment.
Work by Nolen-Hoeksema and her colleagues supports this possibility. Rumina-
tion, the tendency to passively and repeatedly focus on negative emotions and the
possible consequences of those negative emotions, is associated with increased
symptoms of depression and anxiety and onset of major depressive episodes
(Nolen-Hoeksema 2000, Nolen-Hoeksema & Davis 1999, Nolen-Hoeksema et al.
1999). Future work on emotional approach coping should explore the point at
which emotional approach coping may become rumination.
Emotion Regulation
Emotion regulation is the process “by which individuals influence which emotions
they have, when they have them, and how they experience and express these emo-
tions. Emotion regulatory processes may be automatic or controlled, conscious
or unconscious, and may have their effects at one or more points in the emotion
generative process” (Gross 1998b, p. 275). To the extent that coping is aimed at
ameliorating negative emotions or promoting positive emotions, it falls under the
rubric of emotion regulation. However, emotion regulation also includes noncon-
scious processes that, according to our definition, do not fall under the purview of
coping. In addition, since the coping process is prompted by negative emotion, it
happens after the occurrence of emotion in the stress process, not prior, as with
some forms of emotion regulation (but see our discussion of proactive and antici-
patory coping). Eisenberg et al. (1997) classify both coping and emotion regulation
under the larger category of self-regulation and note that coping involves the regu-
latory processes that occur in stressful contexts. Finally, although problem-focused
coping is initiated by the occurrence of a negative emotion, problem-focused forms
of coping do not fall under the category of emotion regulation in the sense that
they are aimed at changing the source of the stress and, therefore, can be seen as
nonemotional actions (Gross 1998b).
Eisenberg et al. (1997) identify two types of emotion regulation: one that in-
volves regulating the internal feeling states and associated physiological processes
COPING 763
(what they label emotion regulation) and the second that involves regulating the
behavioral concomitants of emotion (labeled emotion-related behavior regulation).
Gross (1998b) distinguishes two general classes of emotion regulation depending
on where they occur in the emotion-generating process. Antecedent-focused regu-
lation includes situation selection, situation modification, attentional deployment,
and cognitive change. Response-focused regulation includes response modulation.
In a series of lab studies (e.g., Butler et al. 2003; Gross 1998a; Gross & John
2003b; Gross & Levenson 1993, 1997). Gross and colleagues have compared
reappraisal, an antecedent-focused form of regulation to suppression, a response-

focused form of regulation. They found that reappraisal and suppression have
different affective, cognitive, social, and physiological consequences (see Gross

& John 2003b for a review). For example, compared to participants in a control
condition who were instructed to simply watch a distressing film clip, participants
who were told to inhibit their emotional expression while watching the clip (the
suppression condition) had poorer recall for details of the clip in an unexpected test
at the end of the session (Richards & Gross 2000). In a second study, one group of
participants was instructed to reappraise a set of emotionally evocative slides by
viewing them as medical professionals would. When compared to the suppression
group, which was instructed to suppress their emotional expression in response to
the slides, the reappraisal group had better performance on a subsequent test in
which they were asked to write down information associated with each slide as
the slides were viewed again (Richards & Gross 2000).
Gross & John (2003a) developed the Emotion Regulation Questionnaire, a
measure of individual differences in the tendency to reappraise or suppress. When
compared to those who report using less suppression, those individuals who re-
port using higher levels of suppression also reported having poorer memory for
conversations and performed more poorly when asked to recall events they had
reported in a daily diary a week earlier. Reappraisal was not related to either form
of memory test.
Butler et al. 2003 examined the social consequences of reappraisal and suppres-
sion by having unacquainted female dyads watch an upsetting film, then discuss
their reactions. One of the pair was given a secret instruction to suppress, reap-
praise, or interact naturally with the other member of the pair. Interestingly, the
partners of the suppressors had greater increases in blood pressure than the partners
of the reappraisers or those who acted naturally. It appears that interacting with a
partner who suppresses emotional reactions is stressful for the person with whom
he or she is interacting.
The work on emotion regulation adds to the coping literature by providing an
in-depth look at the effects of some forms of emotion-focused types of coping.
The forms of emotion regulation that Gross and colleagues are studying in the lab
can be considered emotion-focused coping because they are elicited in response
to the depiction of disturbing, stressful events that the individual is unable to
control or change. One challenge for future work in this area is to delineate the
extent to which these lab studies generalize to more applied stressful contexts. For
example, when receiving frightening news such as the diagnosis of cancer, would
suppressing one’s emotional reaction lead to poorer recall for the information from
the physician than immediate reappraisal of the news?
Coping and Positive Emotion

An exciting new development in the field of coping has to do with the growing
awareness of the presence of positive emotion in the stress process (Bonanno &
Keltner 1997, Folkman 1997, Folkman & Moskowitz 2000). This awareness has
been fueled by growing interest in positive emotion more generally among emotion
researchers (e.g., Danner et al. 2001; Fredrickson & Joiner 2002; Fredrickson &
Levenson 1998; Fredrickson et al. 2000; Haidt 2000; Harker & Keltner 2001; Isen
1993, 2002) and a trend in psychology in general to focus on positive traits and
concepts (e.g., Aspinwall & Clark 2003, Major et al. 1998, O’Leary & Ickovics
1995, Seligman & Csikszentmihalyi 2000). Interest in positive emotion in the
stress process has opened a new avenue for coping research.
A number of studies have documented that positive emotion can occur with
relatively high frequency, even in the most dire stressful context, and can occur
during periods when depression and distress are significantly elevated. Silver &
Wortman (1987; as reported in Wortman 1987), assessed positive and negative
emotions in a sample of people who had severe spinal cord injuries and a sample
of parents who had lost a child to sudden infant death syndrome. In both samples,
despite the severity of the loss and the high levels of negative emotions reported,
positive emotions occurred with surprising frequency. In the sample of people
with spinal cord injury, happiness was reported more frequently than negative
emotions by the third week after injury. In a sample of parents who lost a child
to sudden infant death syndrome, positive and negative emotions were reported
with approximately the same frequency three weeks after the child’s death, and
by three months positive emotions were reported more frequently than negative
emotions.
Westbrook & Viney (1982) interviewed a sample of patients who were hos-
pitalized with a chronic or disabling illness and a comparison group of healthy
adults regarding their “life at the moment, the good things and the bad; what it’s
like for you” (p. 901). As expected, when compared to the control group, patients’
responses revealed significantly more anxiety, depression, anger, and helpless-
ness. However, their responses also showed significantly more positive feelings
than did the responses of the comparison group. Viney et al. (1989) also found
co-occurrence of positive and negative emotions in a sample of chronically ill men.
Although the negative emotions of anxiety, depression, and helplessness were more
frequent in the chronically ill groups when compared to a healthy control group,
the positive emotion of enjoyment was also more frequent in the ill groups.
A similar co-occurrence of positive and negative emotion was found in a sample
of caregiving partners of men with AIDS. Although the depression scores of the
caregivers in the study were in the range that would classify them as at risk for
COPING 765
clinical depression, when asked to report how often they experienced various
positive and negative emotions in the previous week, the participants reported
experiencing positive emotion as least as frequently as they experienced negative
emotion, with the exception of the time immediately surrounding the death of the
partner (Folkman 1997). Three years after the death of the partner, although the
mean depression score of the bereaved caregivers was still significantly higher
than the general population mean, positive emotions were reported significantly
more frequently than negative emotions in the past week (Moskowitz et al. 2003).
The co-occurrence of positive and negative emotion has important implications

for coping. On the one hand, if positive and negative emotions are simply bipolar
opposites, then coping that reduces distress should simultaneously increase posi-
tive emotion, and vice versa. On the other, the co-occurrence phenomenon suggests
there may be a degree of independence, in which case different kinds of coping
may be associated with the regulation of positive and negative affect.
There is mounting evidence that although some coping strategies affect both
positive and negative emotion, a number of strategies are related to just one or
the other. Stone et al. (1995) examined the association of distraction, situation
redefinition, direct action, catharsis, acceptance, seeking social support, relaxation,
and religion with positive and negative affect as reported in end-of-day diaries.
They found that relaxation and direct action were uniquely associated with positive
affect, whereas distraction and acceptance were also associated with lower levels
of negative affect.
Carver & Scheier (1994) studied the associations of coping with positive and
negative emotion over the course of an exam. None of the coping responses mea-
sured prior to the exam was associated with positive challenge or benefit emotions
during the postexam, pregrade period. However, use of problem-focused coping
and positive reframing after the exam predicted challenge emotions (e.g., excited,
eager) after the grades were announced.
Prospective data from a study of 110 caregiving partners of men with AIDS
assessed bimonthly pre- and postbereavement indicated problem-focused coping
and positive reappraisal were consistently associated with increases in positive
affect, but only inconsistently related to decreases in negative affect (Moskowitz
et al. 1996).
Analyses of narrative data from the AIDS caregiver study indicated that other
types of coping, not captured by traditional checklist measures of coping, are likely
to be related to positive emotion in the context of ongoing stress (Folkman 1997).
At the conclusion of the interview, participants were asked to describe a positive
meaningful event about “something that you did, or something that happened to
you that made you feel good and that was meaningful to you and helped you get
through the day.”
This question was posed to 1794 participants, and 99.5% were able to report
a positive meaningful event. In an in-depth analysis of 215 events reported by 36
participants, Folkman et al. (1997) found that the events often concerned some-
thing other than caregiving or bereavement (the subject of the focal stressors)
and instead were associated with other roles that participants had (e.g., coworker,
family member). In addition, they often concerned what on the surface appeared to
be comparatively minor events (e.g., a beautiful sunset, a kind word from a friend,
a good grade on a test). These findings suggested that under enduring stressful
conditions such as caregiving or bereavement, people consciously seek out posi-
tive meaningful events or infuse ordinary events with positive meaning to increase
their positive affect, which in turn provides respite from distress and thereby helps
replenish resources and sustain further coping.
COPING, THE SEARCH FOR MEANING, AND POSITIVE EMOTION One of the central
tasks in coping with severe stress is to integrate the occurrence of the stressor with
one’s beliefs about the world and the self (Janoff-Bulman 1989, 1999; Park &
Folkman 1997). A common theme in the coping processes related to positive
emotion is their link to the individual’s important values, beliefs, and goals that
comprise the individual’s sense of meaning (Folkman 1997).
Positive reappraisal, for example, involves a reinterpretation of the event in
terms of benefits to one’s values, beliefs, and goals. Problem-focused coping, when
effective, is associated with feelings of mastery and control, goals that are generally
valued in Western culture. Positive meaningful events are linked to positive emotion
precisely because they reaffirm what one values and help one to focus on those
values while coping with the ongoing stressful event.
PERCEIVING BENEFIT AS A COPING STRATEGY Individuals who have experienced

a severe stressful event such as a tornado or hurricane, being diagnosed with cancer,
or losing a loved one to AIDS, often report that something positive has come out of
the experience, such as closer relationships with family and friends, reprioritizing
of goals, and greater appreciation of life. These benefits and personal changes
have been called stress-related growth (Park et al. 1996), post-traumatic growth
(Tedeschi et al. 1998), and benefit finding (Affleck & Tennen 1996, Tennen &
Affleck 2002).
The perception of growth after a stressful experience is generally examined
as an outcome. Efforts have been made to study the process by which persons
experiencing stress arrive at the conclusion that they have experienced benefits
from the stress. Park et al. (1996) examined stress-related growth in response to
a recent stressful event in a sample of college students. The coping responses of
acceptance (“I get used to the idea that it happened,” “I accept the reality of the fact
that it happened”) and positive reinterpretation (“I look for something good in what
is happening,” “I learn something from the experience”) were cross-sectionally
related to stress-related growth.
Another approach links cognitive processing and the discovery of meaning. In
a qualitative analysis of the bereavement narratives of HIV+ gay men who had
lost a close friend or partner to AIDS, Bower et al. (1998) studied the association
of cognitive processing and finding meaning with the decline of CD4 cells (T-
helper cells that are attacked by the HIV virus) and mortality. Cognitive processing
COPING 767
was defined as “deliberate, effortful, or long-lasting thinking about the death”

(p. 980), which could be considered a form of coping with the friend’s death.
Statements coded as cognitive processing included “I keep thinking about what
lessons are for me, what can I learn,” “I’m muddling through my own feeling of
. . . what could have been, what was, and what is, and . . . I’m more thinking of my
future.” Discovery of meaning was defined as a “major shift in values, priorities, or
perspectives in response to the loss” (p. 980). Statements classified as discovery of
meaning included “In one way I suppose that his passing influenced me to believe
more strongly about the quality of life and living life in a satisfying way as much as
possible,” “I certainly appreciated more the friends that I have and became much
closer with them,” and “I would say that (his) death lit up my faith.”
Sixty-five percent of the sample was classified as having engaged in cognitive
processing about the death and 40% of the sample reported finding meaning in
their bereavement. Cognitive processing was significantly associated with find-
ing meaning, and although the majority of participants who found meaning were
classified as high in cognitive processing, less than half of the participants who
did not find meaning were classified as high in cognitive processing. Furthermore,
participants classified as finding meaning had a less-rapid decrease in CD4 count
compared to participants who did not find meaning. Discovery of meaning was
also associated with lower risk of mortality.
Tennen and Affleck (Affleck & Tennen 1996; Tennen & Affleck 1999, 2002)
examined a slightly different question. They studied a coping response called ben-
efit reminding, which they define as effortful cognitions in which the individual
reminds himself or herself of the possible benefits stemming from the stressful
experience. The assumption is that benefit reminding can only be used as a coping
strategy by those who have already found some benefit or perceived some pos-
itive consequences from the stressor. Thus, rather than being a coping strategy
that precedes finding meaning or perceiving benefits in response to stress, bene-
fit reminding is conceptualized as a form of coping that follows the perception of
benefits. In a study of women with fibromyalgia, an illness associated with chronic
pain, Tennen & Affleck (1999) demonstrated that benefit reminding was uniquely
associated with pleasant mood. Their data, which included daily ratings of pain,
mood, and coping, demonstrated that although benefit reminding was as prevalent
on high-pain days as on lower-pain days, benefit reminding was significantly as-
sociated with increased pleasant mood (e.g., happy, cheerful) but not necessarily
decreased negative mood. “Thus, on days when these chronic pain sufferers made
greater efforts to remind themselves of the benefits that have come from their ill-
ness, they were especially more likely to experience pleasurable mood, regardless
of how intense their pain was on these days” (p. 297).
The emerging interest in positive emotions in the stress process and coping
processes associated with them is one of the most exciting developments in coping
theory and research. What is needed is a clearer delineation of the interplay between
positive and negative emotions and research to identify coping processes associated
with positive emotions during both acute and chronic stress.
CONCLUSIONS
Thirty-five years ago, when coping research was just emerging, the concept of
coping was still somewhat akin to a black box in the stress process. Over subsequent
years, we have begun to see what’s inside the black box. Throughout this period,
there has also been extensive and sometimes contentious debate about the merits
of coping research. Healthy debate and thoughtful criticism are signs that a field is
maturing. At the same time, new methodologies and new ways of thinking about
coping are emerging. Despite the complexities inherent in the study of coping,
the area continues to hold great promise for explaining who thrives under stress
and who does not, and it continues to hold great promise for informing effective
interventions to help people better handle both acute and chronic stress.
The Annual Review of Psychology is online at http://psych.annualreviews.org
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Zeidner M, Endler NS. 1996. Handbook of Cop- Butter EM, et al. 1997. Religion and spiri-
ing. New York: Wiley tuality: unfuzzying the fuzzy. J. Sci. Study
Zeidner M, Saklofske D. 1996. Adaptive and Relig. 36(4):549–64
P1: FDS
December 9, 2003 14:49 Annual Reviews AR207-FM
Annual Review of Psychology

Volume 55, 2004
CONTENTS
Frontispiece—Walter Mischel xvi

PREFATORY
Toward an Integrative Science of the Person, Walter Mischel 1

LEARNING AND MEMORY PLASTICITY
On Building a Bridge Between Brain and Behavior, Jeffrey D. Schall 23
The Neurobiology of Consolidations, Or, How Stable is the Engram?,
Yadin Dudai 51
BRAIN IMAGING/COGNITIVE NEUROSCIENCE
Understanding Other Minds: Linking Developmental Psychology and
Functional Neuroimaging, R. Saxe, S. Carey, and N. Kanwisher 87
SLEEP
Hypocretin (Orexin): Role in Normal Behavior and Neuropathology,
Jerome M. Siegel 125
SPEECH PERCEPTION
Speech Perception, Randy L. Diehl, Andrew J. Lotto, and Lori L. Holt 149
DEPTH, SPACE, AND MOTION
Visual Mechanisms of Motion Analysis and Motion Perception,
Andrew M. Derrington, Harriet A. Allen, and Louise S. Delicato 181
ATTENTION AND PERFORMANCE
Cumulative Progress in Formal Theories of Attention, Gordon D. Logan 207
MEMORY
The Psychology and Neuroscience of Forgetting, John T. Wixted 235
FORM PERCEPTION AND OBJECT RECOGNITION
Object Perception as Bayesian Inference, Daniel Kersten,
Pascal Mamassian, and Alan Yuille 271
ADULTHOOD AND AGING
Development in Midlife, Margie E. Lachman 305
vii
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viii CONTENTS
DEVELOPMENT IN SOCIETAL CONTEXT

The Intergenerational Transfer of Psychosocial Risk: Mediators of
Vulnerability and Resilience, Lisa A. Serbin and Jennifer Karp 333
DEVELOPMENT IN THE FAMILY
Development in the Family, Ross D. Parke 365
SCHIZOPHRENIA AND RELATED DISORDERS
Schizophrenia: Etiology and Course, Elaine Walker, Lisa Kestler,

Annie Bollini, and Karen M. Hochman 401
SUBSTANCE ABUSE DISORDERS

Clinical Implications of Reinforcement as a Determinant of Substance
Use Disorders, Stephen T. Higgins, Sarah H. Heil,
and Jennifer Plebani Lussier 431
Motivational Influences on Cigarette Smoking, Timothy B. Baker,
Thomas H. Brandon, and Laurie Chassin 463
INFERENCE, PERSON PERCEPTION, ATTRIBUTION
Self-Knowledge: Its Limits, Value, and Potential for Improvement,
Timothy D. Wilson and Elizabeth W. Dunn 493
GENDER
Gender in Psychology, Abigail J. Stewart and Christa McDermott 519
MASS MEDIA
Mediated Politics and Citizenship in the Twenty-First Century,
Doris Graber 545
NONVERBAL AND VERBAL COMMUNICATION
The Internet and Social Life, John A. Bargh and
Katelyn Y.A. McKenna 573
SOCIAL INFLUENCE
Social Influence: Compliance and Conformity, Robert B. Cialdini
and Noah J. Goldstein 591
SMALL GROUPS
Group Performance and Decision Making, Norbert L. Kerr
and R. Scott Tindale 623
PERSONALITY PROCESSES
Creativity, Mark A. Runco 657
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CONTENTS ix
PSYCHOLOGY AND CULTURE

Psychology and Culture, Darrin R. Lehman, Chi-yue Chiu,
and Mark Schaller 689
TEACHING OF SUBJECT MATTER
Teaching of Subject Matter, Richard E. Mayer 715
PERSONALITY AND COPING STYLES
Coping: Pitfalls and Promise, Susan Folkman and Judith Tedlie Moskowitz 745
SURVEY METHODOLOGY
Survey Research and Societal Change, Roger Tourangeau 775

Human Research and Data Collection via the Internet,
Michael H. Birnbaum 803
INDEXES
Author Index 833
Subject Index 877
Cumulative Index of Contributing Authors, Volumes 45–55 921
Cumulative Index of Chapter Titles, Volumes 45–55 926
ERRATA
An online log of corrections to Annual Review of Psychology chapters
may be found at http://psych.annualreviews.org/errata.shtml

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2 Dec 2003 18:53 AR AR207-PS55-26.tex AR207-PS55-26.

sgm LaTeX2e(2002/01/18) P1: GCE

Annu. Rev. Psychol. 2004. 55:745–74

COPING: Pitfalls and Promise

California 94143-1726; email: folkman@ocim.ucsf.edu, moskj@ocim.ucsf.edu

Key Words coping critique, coping measurement, positive emotion, coping

746 FOLKMAN ¥ MOSKOWITZ

1996). Although defense-focused research continued throughout this period within

The Contextual, Cognitive Model of Coping

What Have We Learned?

748 FOLKMAN ¥ MOSKOWITZ

■ potentially burdensome length (Stone & Neale 1984)

■ unreliability of recall (Coyne & Gottlieb 1996), and

750 FOLKMAN ¥ MOSKOWITZ

such as those that involve finding meaning. Conversely, retrospective accounts

There is no gold standard for the measurement of coping. Momentary accounts

ways they coped.

Coping Nomenclature: Conceptual and Empirical Approaches

752 FOLKMAN ¥ MOSKOWITZ

brushstrokes and it is used extensively in the coping literature. Other conceptu-

Several investigators found that the problem-focused and emotion-focused dis-

Sometimes this kind of distinction is important to retain. If sample size allows,

consistency may have limited applicability in assessing the psychometric adequacy

754 FOLKMAN ¥ MOSKOWITZ

might be considered effective coping at the outset of a stressful situation may be

The evaluation of coping in a contextual model requires a two-pronged ap-

(1997) make the interesting observation that research on coping effectiveness is

in qualitative analysis of interview data (a problem-solving/instrumental goal, the

COPING-ENVIRONMENT FIT A full account of coping effectiveness must consider

756 FOLKMAN ¥ MOSKOWITZ

are tied closely to emerging emotion research: emotion-approach coping, emotion-

Future-Oriented Proactive Coping

Dual Process Model of Coping

758 FOLKMAN ¥ MOSKOWITZ

Social Aspects of Coping

INDIVIDUAL COPING AND SOCIAL RELATIONSHIPS O’Brien & DeLongis (1997)

COMMUNAL COPING As a counterpoise to the emphasis on individualistic cop-

takes both individualistic and communal perspectives into account. It includes a

The communal perspective is contained in the prosocial-antisocial dimension and

760 FOLKMAN ¥ MOSKOWITZ

Emotional Approach Coping

762 FOLKMAN ¥ MOSKOWITZ

reappraisal, an antecedent-focused form of regulation to suppression, a response-

different affective, cognitive, social, and physiological consequences (see Gross

764 FOLKMAN ¥ MOSKOWITZ

Coping and Positive Emotion

The co-occurrence of positive and negative emotion has important implications

766 FOLKMAN ¥ MOSKOWITZ

PERCEIVING BENEFIT AS A COPING STRATEGY Individuals who have experienced

was defined as “deliberate, effortful, or long-lasting thinking about the death”

768 FOLKMAN ¥ MOSKOWITZ

The Annual Review of Psychology is online at http://psych.annualreviews.org

Univ. Press Dunahoo CL, Hobfoll SE, Monnier J, Hulsizer

770 FOLKMAN ¥ MOSKOWITZ

1999, pp. 305–23 rugged individualism in coping. Part 2: Con-

772 FOLKMAN ¥ MOSKOWITZ

Pargament KI, Kennell J, Hathaway W, Greven- hav. Med.. Washington, DC

theoretical advances, and clinical applica- bereavement. In Meaning Reconstruction,

774 FOLKMAN ¥ MOSKOWITZ

Annual Review of Psychology

Frontispiece—Walter Mischel xvi

Toward an Integrative Science of the Person, Walter Mischel 1

DEVELOPMENT IN SOCIETAL CONTEXT