Coping with chronic illness: A study of illness controllability and the influence of coping strategies on psychological adjustment.

Abstract

Longitudinal data on the coping strategies used by middle-aged and older adults faced with one of four different chronic illnesses (N ~ 151) were used to evaluate the role of coping in the explanation of psychological adjustment. The study distinguished between illnesses that offer few opportunities for control (rheumatoid arthritis and cancer) and those more responsive to individual and medical efforts at control (hypertension and diabetes) and evaluated the emotional consequences of two coping strategies, information seeking and wish-fulfilling fantasy, expected to play different roles in adjustment. Results showed information seeking to have salubrious effects on adjustment and wish-fulfilling fantasy to have deleterious consequences; contrary to expectation, neither strategy's effects were modified by illness controllability. Analyses of the direction of causation between coping and adjustment suggest that wish-fulfilling fantasy is linked to poor adjustment in a mutually reinforcing causal cycle. The modesty of the effects of coping, however, demand replication of results to confirm the conclusions drawn here. Physical health is closely related to emotional and mental health, particularly among middle-aged and older adults, a fact documented by a multitude of studies (see reviews by Larson, 1978; Palmore & Luikart, 1972). Individuals differ in their adjustment to both acute and chronic illness, however. Coping efforts have been proposed as one means of accounting for these differences in adaptation, and numerous studies have documented the importance of individual coping efforts in helping ill adults maintain reasonable levels of emotional well-being (e.g., Cohen & Lazarus, 1979; Moos, 1982). These studies have found typical coping strategies to include: denial, selective ignoring, information seeking, taking refuge in activity, avoidance, learning specific illness-related procedures, engaging in wish-fulfilling fantasy, blaming others, and seeking comfort from others. Unfortunately, many of the studies arguing the importance

Cites (2)

1. The structure of coping
   Pearlin, Leonard I., Schooler, Carmi · 1978 · Journal of Health and Social Behavior
2. The Stress Process
   Pearlin, Leonard I., Menaghan, Elizabeth G., Lieberman, Morton A., Mullan, Joseph T. · 1981 · Journal of Health and Social Behavior

Show all 2 references

Cited by (29)

1. Multidimensional assessment of coping: a critical evaluation
   Endler, Norman S., Parker, James D. · 1990 · Journal of Personality and Social Psychology
2. Does coping help? A reexamination of the relation between coping and mental health
   Aldwin, Carolyn M., Revenson, Tracey A. · 1987 · Journal of Personality and Social Psychology
3. Modeling cognitive adaptation: A longitudinal investigation of the impact of individual differences and coping on college adjustment and performance.
   Aspinwall, Lisa G., Taylor, Shelley E. · 1992 · Journal of Personality and Social Psychology
4. The association of coping to physical and psychological health outcomes: a meta-analytic review.
   Penley, Julie A., Tomaka, Joe, Wiebe, John S. · 2002 · Journal of Behavioral Medicine
5. Assessment of multidimensional coping: Task, emotion, and avoidance strategies.
   Norman S. Endler, James D. A. Parker · 1994 · Psychological Assessment

See all 594