Coping-Stress-Tolerance Pattern
Ineffective Coping (Specify)* (1978, 1998)
DEFINITION
Impairment of adaptive behaviors (valid appraisal, choice of response, and/or inability to use resources). Methods of handling stressful life situations are insufficient to prevent or control anxiety, fear, or anger. Specify stressor(s) (e.g., situational or maturational crises, uncertainty)
DEFINING CHARACTERISTICS
Diagnostic Cues
Reports presence of life stress or problems (specify)
Reports feeling anxious, apprehensive, fearful, angry, and/or depressed
Expresses inability to cope or ask for help
Ineffective or inappropriate use of defense mechanisms (forms of coping that impede adaptive behavior [e.g., see Avoidance Coping, Denial])
Supporting Cues
Disturbance in pattern of tension release
Disturbance in pattern of threat appraisal
Inadequate resources (financial, etc.)
Change in usual communication patterns
Decrease in use of social support
Poor concentration
Lack of goal-directed behavior and resolution of problem (e.g., inability to attend to problem; difficulty organizing information)
Inability to meet role expectations
Inability to meet basic needs
Destructive behavior toward self or others
Sleep disturbance
Fatigue
Risk taking
High illness rate
Abuse of chemical agents
High degree of perceived or actual threat
OUTCOME
Coping
Employs personal actions to manage stressors that tax resources
Psychosocial Adjustment: Life Change
Adaptive psychosocial response to a significant life change
ETIOLOGICAL OR RELATED FACTORS
Inadequate problem solving
Inadequate confidence in coping ability
Inadequate perception of control
Social support deficit or characteristics of relationships
Inability to conserve adaptive energies
HIGH-RISK POPULATIONS
Inadequate opportunity to prepare for stressor
Readiness for Enhanced Coping (2002)
DEFINITION
Pattern of cognitive and behavioral efforts to manage demands that is sufficient for well-being and can be strengthened
DEFINING CHARACTERISTICS
Defines stressors as manageable
Seeks social support
Uses a broad range of problem-oriented and emotion-oriented strategies
Uses spiritual resources
Acknowledges power
Seeks knowledge of new strategies
Is aware of possible environmental changes
OUTCOME
Coping
Employs personal actions to manage stressors that tax resources
Avoidance Coping*
DEFINITION
Prolonged minimization or denial of information (facts, meanings, consequences) when a situation requires active coping
DEFINING CHARACTERISTICS
Diagnostic Cues
Presence of perceived threat to health, self-image, values, lifestyle, or relationships
Minimizes, ignores, or forgets information following clear communication or observation
Mislabels events
Absence of problem solving, information seeking, incorporation of new information into future planning
Supporting Cues
Regressive dependency
Anxiety, depression, passivity, or anger
OUTCOME
Coping
Employs personal actions to manage stressors that tax resources
ETIOLOGICAL OR RELATED FACTORS
Perceived incompetency
Perceived powerlessness
Support system deficit
Independence-dependence conflict (adolescent)
Defensive Coping (1988)
DEFINITION
Repeated projection of falsely positive self-evaluation based on a self-protective pattern that defends against underlying perceived threats to positive self-regard
DEFINING CHARACTERISTICS
Diagnostic Cues
One or more of the following:
Denial of obvious problems or weaknesses
Projection of blame or responsibility
Rationalization of failures
Hypersensitivity to a slight or a criticism
Grandiosity
Supporting Cues
Superior attitude toward others
Difficulty establishing or maintaining relationships
Hostile laughter or ridicule of others
Difficulty in reality testing of perceptions; reality distortion
Lack of follow-through or participation in treatment or therapy
OUTCOME
Coping
Employs personal actions to manage stressors that threaten self-esteem
Ineffective Denial* (1988)
DEFINITION
Conscious or unconscious attempt to reduce anxiety or fear by disavowing the knowledge or meaning of an event (to the detriment of health)
DEFINING CHARACTERISTICS
Diagnostic Cues
Unable to admit impact of disease or event on life pattern as manifested by
one or more of the following:
Delays seeking or refuses health care to the detriment of health; does not admit fear of death or invalidism; displaces fear of impact of the condition; unrealistic plans
Selectively integrates information
Does not perceive danger or personal relevance of symptoms; minimizes symptoms or event
Supporting Cues
Makes dismissive gestures or comments when speaking of distressing events
Displaces source of symptoms to other organs
Inconsistent expression of fear or anxiety
Displays inappropriate affect
Uses home remedies (e.g., self-treatment) to relieve symptoms
OUTCOME
Anxiety Level
Absence of apprehension, tension, or uneasiness
Discusses distressing events/impact of disease
Impaired Resilience (Individual) (2008)
DEFINITION
Decreased ability to sustain a pattern of positive responses to an adverse situation or crisis
DEFINING CHARACTERISTICS
Decreased interest in academic activities
Decreased interest in vocational activities
Depression
Guilt
Isolation
Low self-esteem
Lower perceived health status
Renewed elevation of distress
Shame
Social isolation
Using maladaptive coping skills (e.g., drug use, violence)
OUTCOME
Positive coping responses to adverse situations or crises
ETIOLOGICAL OR RELATED FACTORS
Demographics that increase chance of maladjustment
Drug use
Inconsistent parenting
Low intelligence
Parental mental illness
Poor impulse control
Poverty
Psychological disorders
Vulnerability factors that encompass indices that exacerbate the negative effects of the risk condition
Violence
Violence in neighborhood
HIGH-RISK POPULATIONS
Minority status
Large family size
Gender
Low maternal education
Risk for Compromised Resilience (2008)
DEFINITION
At risk for decreased ability to sustain a pattern of positive responses to an adverse situation or crisis
RISK FACTORS
Chronicity of existing crises
Multiple coexisting adverse situations
Presence of an additional new crisis (e.g., unplanned pregnancy, death of a spouse, loss of job, illness, loss of housing, death of family member)
OUTCOME
Consistently uses positive coping responses to adverse situations or crises
Readiness for Enhanced Resilience* (2008)
DEFINITION
A pattern of positive responses to an adverse situation or crisis that can be strengthened to optimize human potential
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