Emotional approach coping

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Emotional approach coping is a psychological construct that involves the use of emotional processing and emotional expression in response to a stressful situation. [1] [2] As opposed to emotional avoidance, in which emotions are experienced as a negative, undesired reaction to a stressful situation, emotional approach coping involves the conscious use of emotional expression and processing to better deal with a stressful situation. [3] The construct was developed to explain an inconsistency in the stress and coping literature: emotion-focused coping was associated with largely maladaptive outcomes while emotional processing and expression was demonstrated to be beneficial. [3]

Contents

History of the construct

Coping is a conscious attempt to address and alleviate demands perceived as stressful. [4] Research examining coping has suggested two broad categories of coping: emotion-focused and problem-focused coping. [5] [6] Emotion-focused coping involves attempts to regulate the negative emotional response to stress. Whereas problem-focused coping involves attempts to directly modify the stressor. [5] [7] Coping processes have also been defined instead on whether they involve approaching the stressful situation or avoiding it. [8] [9] [10]

The experience of powerful emotions has been characterized by researchers as disruptive and dysfunctional, particularly for cognitive processes. [11] Moreover, research also suggests links between emotion-focused coping and poor psychological outcomes. A review of over 100 studies found associations between emotion-focused coping and negative outcomes such as poor life satisfaction, greater depressive and anxious symptoms and neuroticism. [1]

However, there is some evidence in the empirical literature that emotional expression can be functional and adaptive. Experimental research on expressive writing, involving emotional disclosure, has been shown to have benefits for performance on cognitive tasks and for psychological outcomes, such as depressive symptoms. [12] Emotion regulation has also illustrated the importance of emotional processing and expression for well-being. [13] Therapeutic approaches have also demonstrated the important role of emotions in coping with difficult situations. Emotion-focused therapy is a clinical psychology approach that emphasizes the importance of acknowledging and tolerating negative emotions and enjoying positive emotions for healthy psychological adjustment. [14]

Researchers have attempted to disentangle the maladaptive and functional aspects of emotion-focused coping by examining the measurements of emotion-focused coping. Several studies have found that emotion-focused measurements of coping often aggregate approach and avoidance strategies. [1] [3] A second reason emotion-focused coping has been construed as maladaptive is that measures of emotion-focused coping are confounded with measures of distress. [15] In an attempt to rectify these difficulties with the operationalization of emotion-focused coping, a new scale for assessing emotional approach coping was proposed. [3] [16]

In the context of natural disaster and crisis, mental health and supporting emotional coping styles has been found to be often be neglected by first responders. Research suggests that those experiencing crisis and trauma do better when they are able to engage with their emotional experiences by reflecting on them in order to make meaning of them. This process leads to an increase in tolerance of emotion, resilience, psychological flexibility, and community engagement. Furthermore, this process leads to greater growth when a collective approach to emotional processing is taken. [17]

Assessment of coping through emotional approach

Emotional approach coping can be assessed using the emotional approach coping scales developed by Stanton, Kirk, Cameron, and Danoff-Burg in 2000. [16] The scales involve two distinct subscales of items: emotional processing and emotional expression. [16] Emotional processing and emotional expression scales are positively correlated but distinct. [16] The emotional processing items reflect an attempt to understand, consider and examine emotions in response to a stressful event. For example, “I acknowledge my feelings” and “I take time to figure out what I’m really feeling.” Emotional expression items assess attempts to verbally and non-verbally communicate and share emotions. [16] Sample items include: “I allow myself to express my feelings” and “I feel free to express my emotions.” [16] The emotional approach coping scales have been tested and validated using situational (i.e., what do you do in response to a specific stressor) and dispositional (i.e., what do you do in general) instruction sets. [18] The scales are uncorrelated with social desirability. [19] In addition to English, the emotional approach coping scale has also been validated in Norwegian [20] and Turkish. [21]

Empirical support

Longitudinal research

Infertility

Among heterosexual couples coping with infertility, emotional approach coping predicted decreased depressive symptoms for both members of the couple after an unsuccessful insemination attempt. [22] Emotional approach coping may also confer benefits for partners. Having a male partner high in emotional approach coping was protective against depressive symptoms for female partners low in emotional approach coping. [22]

Sexual assault

Emotional approach coping may confer some benefits to victims of sexual assault. Among sexual assault survivors, increases in emotional expression were associated with greater perceived control over the recovery process and feelings of control were associated with decreased distress after the assault. [23]

Breast cancer

There is mixed evidence for the utility of emotional approach coping in samples of women with breast cancer. In a longitudinal study of women with breast cancer, for women who perceived their social environments to be receptive, emotional expression predicted improved quality of life. [24] Coping through emotional expression among women with breast cancer has also been found to predict an increase in post-traumatic growth. [25] However, other studies have not found the same link between emotional expression and post-traumatic growth. [26]

Cross-sectional research

Student and community samples

Cross-sectional studies illustrate the link between emotional approach coping and positive psychological adjustment, under certain conditions in student and community samples. In a cross-sectional study of undergraduate women, women who scored more highly on emotional approach coping reported more positive and less negative valenced repetitive thoughts. [27] In a community sample of African-American adults, emotional approach coping has also been found to be negatively associated with anger, trait anxiety and depressive symptoms. [28] In addition, women who reported higher dispositional emotional processing also reported fewer depressive and anxious symptoms and greater life satisfaction; while for men, higher dispositional emotional expression was linked to greater life satisfaction. [16]

Clinical samples

There is some evidence to suggest associations between emotional approach coping and psychological well-being. In a study of individuals who met DSM-IV criteria for anxiety disorder and healthy controls, levels of emotional approach coping were lower in those individuals who met the criteria than in controls. [29] Another study examined veterans and found that higher levels emotional expression (but not emotional processing) were associated with lower depressive symptoms and decreased post-traumatic stress disorder, even when statistically controlling for age, gender, and race. [30]

Cancer samples

Cross-sectional research of cancer samples reveals some positive, negative and mixed links with emotional approach coping. Higher emotional processing and emotional expression in female cancer survivors was associated with higher positive emotions and lower negative emotions. [31] In male cancer survivors, higher emotional processing has been linked to higher positive emotions and higher emotional expression has been linked with lower negative emotions and fewer intrusive thoughts. [31] However, the links between emotional approach coping and psychological adjustment are not all positive some are negative or mixed. In one study of women who had received an abnormal result on an ovarian cancer screen, higher emotional processing was associated with higher intrusive thoughts and neither emotional processing nor emotional expression were associated with cancer-related post-traumatic growth. [32]

Diabetes samples

There is from cross-sectional research that suggests the benefits of emotional processing for patients with diabetes. Among patients with type 2 diabetes, higher emotional processing was associated with greater diabetes-related knowledge, medication adherence and relevant self-care behaviors such as diet, physical activity and blood glucose monitoring. [33] Similarly, in adolescent patients with Type 1 diabetes, emotional processing was revealed to be associated with better metabolic control. [34]

Factors that determine effectiveness

Stressor-coping strategy fit

The stressor and the individual's appraisal of the stressor may determine the effectiveness of emotional approach coping as a mechanism for managing stress. [5] An appraisal of a stressful situation as uncontrollable may make emotional approach coping an advantageous coping mechanism. [1] In fact, one study of undergraduates shows that when faced with a stressor individuals appraise as more uncontrollable, they are more likely to endorse using emotional approach coping to manage it. [35]

Gender

There is some evidence to suggest that the utility of emotional approach coping varies by gender. [1] In a longitudinal study, emotional approach coping was found to predict increased life satisfaction and decreased depressive symptoms over time in women; however, in men, emotional approach coping predicted poorer adjustment over time. [15] Some samples have also found that women report using emotional processing and expression more than men. [18] [29] [31] However, research of infertile couples found no differences in the utility of emotional approach coping for men and women. [22]

Individual differences

Individual differences, such as skill at engaging active coping techniques and comfort with expressing emotions, may modify the tendency to successfully employ emotional approach coping. [1] Individuals high in perceived emotional intelligence may also be more likely to use emotional approach coping skillfully. [1] Holding unrealistic perceptions of control may make the use of coping through emotional approach less likely because expressing and processing emotions could lead to evaluations that result in acknowledgement of illusions of control. [36] Personality attributes, such as hope, can also moderate the effectiveness of emotional approach coping. Women with breast cancer who were high in hope and reported coping with emotional expression, had fewer medical appointments for cancer-related complaints, enhanced physical health and decreased distress compared to women who did not cope using emotional expression. [24]

Mechanisms

Goal identification and pursuit

The effects of emotional approach coping could be the result of identifying goals, understanding barriers to achieving those goals, and finding new pathways to achieve them. [1] Emotional expression and processing could help individuals direct attention to identify the most important goals in their lives. [1]

Habituation to the stressor and cognitive appraisal

The effects of emotional approach coping could also be due to exposure to stressful stimuli when actively processing and expressing emotions. [1] The repeated exposure to the stressor could result in physiological habituation. [2] Repeated exposure to a stressor through emotional expression and processing could also lead to cognitive reappraisal of the stressor and related self-affirmations. [16] [37]

Affect labeling

The process of labeling the emotions (i.e., putting them into words) may lessen the intensity of the emotional experience. Studies have shown the process of affective labeling leads to decreases in brain regions such as the amygdala and increases in activation of the prefrontal cortex, possibly indicating beneficial emotion regulation. [38]

Regulation of social environment

The use of emotional approach coping may signal to the social environment that an individual is in need of support. [1] The responsiveness of the social environment will determine the adaptiveness of emotional approach coping. Emotional expression that is met with empathetic concern may lead to better adjustment than emotional expression met by rejection. [2] Some evidence from the research suggests this could be a potential mechanism. For women with breast cancer who perceive their social environment to be highly receptive, coping through emotional expression predicts improved quality of life. [24]

See also

Related Research Articles

Coping refers to conscious strategies used to reduce unpleasant emotions. Coping strategies can be cognitions or behaviors and can be individual or social. To cope is to deal with and overcome struggles and difficulties in life. It is a way for people to maintain their mental and emotional well-being. Everybody has ways of handling difficult events that occur in life, and that is what it means to cope. Coping can be healthy and productive, or destructive and unhealthy. It is recommended that an individual cope in ways that will be beneficial and healthy. "Managing your stress well can help you feel better physically and psychologically and it can impact your ability to perform your best."

<span class="mw-page-title-main">Social support</span> Support systems for individuals

Social support is the perception and actuality that one is cared for, has assistance available from other people, and most popularly, that one is part of a supportive social network. These supportive resources can be emotional, informational, or companionship ; tangible or intangible. Social support can be measured as the perception that one has assistance available, the actual received assistance, or the degree to which a person is integrated in a social network. Support can come from many sources, such as family, friends, pets, neighbors, coworkers, organizations, etc.

Psychological resilience is the ability to cope mentally and emotionally with a crisis, or to return to pre-crisis status quickly.

Caring in intimate relationships is the practice of providing care and support to an intimate relationship partner. Caregiving behaviours are aimed at reducing the partner's distress and supporting their coping efforts in situations of either threat or challenge. Caregiving may include emotional support and/or instrumental support. Effective caregiving behaviour enhances the care-recipient's psychological well-being, as well as the quality of the relationship between the caregiver and the care-recipient. However, certain suboptimal caregiving strategies may be either ineffective or even detrimental to coping.

Psycho-oncology is an interdisciplinary field at the intersection of physical, psychological, social, and behavioral aspects of the cancer experience for both patients and caregivers. Also known as psychiatric oncology or psychosocial oncology, researchers and practitioners in the field are concerned with aspects of individuals' experience with cancer beyond medical treatment, and across the cancer trajectory, including at diagnosis, during treatment, transitioning to and throughout survivorship, and approaching the end-of-life. Founded by Jimmie Holland in 1977 via the incorporation of a psychiatric service within the Memorial Sloan Kettering Cancer Center in New York, the field has expanded drastically since and is now universally recognized as an integral component of quality cancer care. Cancer centers in major academic medical centers across the country now uniformly incorporate a psycho-oncology service into their clinical care, and provide infrastructure to support research efforts to advance knowledge in the field.

<span class="mw-page-title-main">Emotional exhaustion</span> Chronic state of physical and emotional depletion

Emotional exhaustion is symptom of burnout, a chronic state of physical and emotional depletion that results from excessive work or personal demands, or continuous stress. It describes a feeling of being emotionally overextended and exhausted by one's work. It is manifested by both physical fatigue and a sense of feeling psychologically and emotionally "drained".

<span class="mw-page-title-main">Determination</span> Positive emotional feeling

Determination is a positive emotional feeling that promotes persevering towards a difficult goal in spite of obstacles. Determination occurs prior to goal attainment and serves to motivate behavior that will help achieve one's goal.

Emotional self-regulation or emotion regulation is the ability to respond to the ongoing demands of experience with the range of emotions in a manner that is socially tolerable and sufficiently flexible to permit spontaneous reactions as well as the ability to delay spontaneous reactions as needed. It can also be defined as extrinsic and intrinsic processes responsible for monitoring, evaluating, and modifying emotional reactions. Emotional self-regulation belongs to the broader set of emotion regulation processes, which includes both the regulation of one's own feelings and the regulation of other people's feelings.

Positive affectivity (PA) is a human characteristic that describes how much people experience positive affects ; and as a consequence how they interact with others and with their surroundings.

In psychology, posttraumatic growth (PTG) is positive psychological change experienced as a result of struggling with highly challenging, highly stressful life circumstances. These circumstances represent significant challenges to the adaptive resources of the individual, and pose significant challenges to the individual's way of understanding the world and their place in it. Posttraumatic growth involves "life-changing" psychological shifts in thinking and relating to the world and the self, that contribute to a personal process of change, that is deeply meaningful.

In psychology, avoidance coping is a coping mechanism and form of experiential avoidance. It is characterized by a person's efforts, conscious or unconscious, to avoid dealing with a stressor in order to protect oneself from the difficulties the stressor presents. Avoidance coping can lead to substance abuse, social withdrawal, and other forms of escapism. High levels of avoidance behaviors may lead to a diagnosis of avoidant personality disorder, though not everyone who displays such behaviors meets the definition of having this disorder. Avoidance coping is also a symptom of post-traumatic stress disorder and related to symptoms of depression and anxiety. Additionally, avoidance coping is part of the approach-avoidance conflict theory introduced by psychologist Kurt Lewin.

Social undermining is the expression of negative emotions directed towards a particular person or negative evaluations of the person as a way to prevent the person from achieving their goals.

Psychological hardiness, alternatively referred to as personality hardiness or cognitive hardiness in the literature, is a personality style first introduced by Suzanne C. Kobasa in 1979. Kobasa described a pattern of personality characteristics that distinguished managers and executives who remained healthy under life stress, as compared to those who developed health problems. In the following years, the concept of hardiness was further elaborated in a book and a series of research reports by Salvatore Maddi, Kobasa and their graduate students at the University of Chicago.

<span class="mw-page-title-main">Psychological stress</span> Feeling of strain and pressure

In psychology, stress is a feeling of emotional strain and pressure. Stress is a type of psychological pain. Small amounts of stress may be beneficial, as it can improve athletic performance, motivation and reaction to the environment. Excessive amounts of stress, however, can increase the risk of strokes, heart attacks, ulcers, and mental illnesses such as depression and also aggravation of a pre-existing condition.

Interpersonal emotion regulation is the process of changing the emotional experience of one's self or another person through social interaction. It encompasses both intrinsic emotion regulation, in which one attempts to alter their own feelings by recruiting social resources, as well as extrinsic emotion regulation, in which one deliberately attempts to alter the trajectory of other people's feelings.

Social problem-solving, in its most basic form, is defined as problem solving as it occurs in the natural environment. More specifically it refers to the cognitive-behavioral process in which one works to find adaptive ways of coping with everyday situations that are considered problematic. This process in self-directed, conscious, effortful, cogent, and focused. Adaptive social problem-solving skills are known to be effective coping skills in an array of stressful situations. Social problem-solving consists of two major processes. One of these processes is known as problem orientation. Problem orientation is defined as the schemas one holds about problems in everyday life and ones assessment of their ability to solve said problems.

Expressive suppression is defined as the intentional reduction of the facial expression of an emotion. It is a component of emotion regulation.

Self-blame is a cognitive process in which an individual attributes the occurrence of a stressful event to oneself. The direction of blame often has implications for individuals’ emotions and behaviors during and following stressful situations. Self-blame is a common reaction to stressful events and has certain effects on how individuals adapt. Types of self-blame are hypothesized to contribute to depression, and self-blame is a component of self-directed emotions like guilt and self-disgust. Because of self-blame's commonality in response to stress and its role in emotion, self-blame should be examined using psychology's perspectives on stress and coping. This article will attempt to give an overview of the contemporary study on self-blame in psychology.

Suzanne C. Segerstrom is a professor of Psychology and biostatistician at the University of Kentucky. She is known for her clinical research on optimism and pessimism in relation to health, stress, and general well-being.

Social constraints are a psychological term that can be defined as "any social condition that causes a trauma survivor to feel unsupported, misunderstood, or otherwise alienated from their social network when they are seeking social support or attempting to express trauma-related thoughts, feelings, or concerns." Social constraints are most commonly defined as negative social interactions which make it difficult for an individual to speak about their traumatic experiences. The term is associated with the social-cognitive processing model, which is a psychological model describing ways in which individuals cope and come to terms with trauma they have experienced. Social constraints have been studied in populations of bereaved mothers, individuals diagnosed with cancer, and suicide-bereaved individuals. There is evidence of social constraints having negative effects on mental health. They have been linked to increased depressive symptoms as well as post-traumatic stress disorder symptoms in individuals who have experienced traumatic events. There seems to be a positive association between social constraints and negative cognitions related to traumatic events. Social constraints have also been linked to difficulties in coping with illness in people who have been diagnosed with terminal illness such as cancer.

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