This document discusses coping strategies and styles. It defines coping and outlines different types of coping strategies, including problem-focused, emotion-focused, meaning-focused, and social coping. It describes the physiology behind different coping styles and the clinical significance of understanding patients' coping mechanisms. Both positive and negative coping techniques are explained, as well as gender differences. Issues of concern around coping and common coping scales are also summarized.

1. COPING STRATEGIES
HOD DEPT OF PSYCHIATRY
DR RAKESH YADUVANSHI
MODERATORS
DR RAIES AHMED,AP,DEPARTMENT OF PSYCHIATRY
DR GAJAL GUPTA,SR,DEPARTMENT OF PSYCHIATRY
PRESENTED BY:
DR RAKESH RANJAN PADHI

3. OVERVIEW OF THE TOPIC
• i)Introduction
• ii)Coping-Psychology
• iii)Types of Coping Strategies
• iv)Physiology behind different Coping Strategies
• v)Clinical Significance
• vi)Positive Techniques
• vii)Negative Techniques
• viii) Gender Differences in Coping Strategies
• ix) Issues of Concern
• x) Coping Scales

4. INTRODUCTION
• Coping is defined as the thoughts and behaviors mobilized to manage internal
and external stressful situations.
• It is a term used distinctively for conscious and voluntary mobilization of
acts, different from 'defense mechanisms' that are subconscious or
unconscious adaptive responses, both of which aim to reduce or tolerate
stress.
• When individuals are subjected to a stressor, the varying ways of dealing with
it are termed 'coping styles,' which are a set of relatively stable traits that
determine the individual's behavior in response to stress.
• These are consistent over time and across situations.

5. COPING-PSYCHOLOGY
• In psychology, Coping is expending conscious effort to solve personal and
interpersonal problems and seeking to master,minimize or tolerate stress or
conflict.
• Psychological coping mechanisms are commonly termed as Coping
Strategies or Coping Skills.
• Generally, coping is divided into:
(i) reactive coping (a reaction following the stressor)
(ii) proactive coping (aiming to neutralize future stressors)

6. • Proactive individuals excel in stable environments because they are more
routinized, rigid, and are less reactive to stressors, while reactive individuals
perform better in a more variable environment.

7. TYPES OF COPING STRATEGIES
a)Problem-focused- which addresses the problem causing the distress:
Examples of this style include active coping, planning, restraint coping, and
supression of competing activities.
-The three problem focussed coping strategies identified by Folkman and
Lazarus are taking control,information seeking, and evaluating the pros and
cons.
b)Emotion-focused- which aims to reduce the negative emotions associated
with the problem: Examples of this style include positive reframing,
acceptance, turning to religion, and humor.
-Involve releasing pent-up emotions,distracting oneself,managing hostile
feelings,mediating or using systemic relaxing procedures.

9. c)Meaning-focused- in which an individual uses cognitive strategies to
derive and manage the meaning of the situation
d)Social Coping (support-seeking)- in which an individual reduces stress
by seeking emotional or instrumental support from their community.

10. PHYSIOLOGY BEHIND DIFFERENT COPING
STYLES
• The physiology behind different coping styles is related to the serotonergic
and dopaminergic input of the medial prefrontal cortex and the nucleus
accumbens.
• The neuropeptides vasopressin and oxytocin also have an important
implication relative to coping styles.
• Neuroendocrinology involving the level of activity of the hypothalamic-
pituitary-adrenocortical axis, corticosteroids, and plasma catecholamines
have a relationship with an individual's coping style.

11. • Cortisol- A stress hormone ,was found to be elevated in males during stressful
situations.
• In females, cortisol levels were found to be decreased in stressful situations
and instead an increase in limbic activity was seen.

12. • The importance of coping styles does not only affect the patients alone but
also their physicians and nurses.
• Healthcare workers are more likely to choose a problem-oriented coping
mechanism while the tendency to choose avoidance decreases with age and
employment duration.
• The incidence of burnout syndrome decreases with the use of problem-
oriented coping mechanisms, social integration, and the use of religion.

13. CLINICAL SIGNIFICANCE
• Understanding coping mechanisms is a cornerstone in choosing the best
approach to the patient to build an effective doctor-patient relationship.
• The need to monitor the patient's level of distress and coping mechanisms
arise because patients who adopt maladaptive mechanisms are more likely to
perceive their doctors as being disengaged and less supportive.
• This perception is clinically significant because about one out of four cancer
patients use a maladaptive coping mechanism.
• The relation between maladaptive coping mechanisms and numerous
disorders has been established.

14. • Psychiatric disorders such as PTSD, anxiety, and major depression, and
somatic symptoms were all correlated with coping styles related to
avoidance.
• This scenario holds for other disorders such as hypertension and heart
diseases, where maladaptive coping strategies were used by patients who
had more severe symptoms.

15. POSITIVE TECHNIQUES(Adaptive or
Constructive Coping)
• Proactive Coping- Anticipation is when one reduces the stress of some difficult
challenge by anticipating what it will be like and preparing for how one is going to
cope with it.
• Social Coping- Such as seeking social support from others.
• Meaning-focused coping- In which the person concentrates on deriving meaning
from the stressful experience.
• Avoiding thoughts or circumstances that cause stress
• Adequate nutrition,exercise,sleep contribute to stress management as do physical
fitness and relaxation techniques such as progressive muscle relaxation

16. • One of the most positive methods people use to cope with painful situation
is Humor .
• You feel things to the full but you master them by turning it all into pleasure
and fun.

17. While Dealing with Stress It is Important to
deal with Physical,Mental and Social Well
Being
• Physically,one should maintain one’s health and learn to relax if one finds
oneself under stress.
• Mentally it is important to think positive thoughts,value oneself,demonstrate
good time management,plan and think ahead and express emotions.
• Socially one should communicate with people and seek new activities.

18. NEGATIVE TECHNIQUES(Maladaptive
Coping or Non-Coping)
• Dissociation is the ability of mind to separate and compartmentalize
thoughts,memories and emotions. Often associated with post traumatic
stress syndrome.
• Sensitization is when a person seeks to learn about,rehearse and/or
anticipate fearful events in a protective effort to prevent these events from
occuring in the first place.
• Safety behaviors are demonstrated when individuals with anxiety disorders
come to rely on something or someone as a means of coping with their
excessive anxiety.

19. • Anxious avoidance is when a person avoids anxiety provoking situations by
all means. This is the most common strategy.
• Escape is closely related to avoidance. This technique is often demonstrated
by people who experience panic attacks or have phobias. These people want
to flee the situation at the first sign of anxiety.

20. GENDER DIFFERENCES IN COPING
STRATEGIES
• Gender differences in Coping Strategies are the ways in which men and
women differ in managing psychological stress.
• There is evidence that males often develop stress due to their careers,
whereas females often encounter stress due to issues in interpersonal
relationships.
• Women tend to employ emotion- focused coping and the’ tend-and-befriend
‘response to stress.
• Men tend to use problem focused coping and the fight- or- flight response.
• Perhaps the societal standards encourage men to be more individualistic
while women are often expected to be interpersonal.

21. ISSUES OF CONCERN
• Patients using maladaptive coping mechanisms are more likely to engage in
health-risk behaviors than those with appropriate mechanisms.
• They are also more non-adherent and more likely to use cigarettes or alcohol.
• Coping influences patients' compliance to therapy and the course of the
disease by lifestyle changes.
• In disorders where non-medicinal treatment plays a role in the progression,
coping mechanisms are important in determining the severity of such
conditions.
• Coping styles may be helpful in patients' educational programs or
psychotherapy, and paying attention to them could contribute to the
prevention of sequelae.

22. COPING SCALES
• Coping scales measure the type of coping mechanism a person exhibits. The
most commonly used scales are:
a)COPE (Coping Orientation to Problems Experienced)
b)Ways of Coping Questionnaire
c)Coping Strategies Questionnaire
d)Coping Inventory for Stressful Situations
e)Religious-COPE
f) Coping Response Inventory

23. SUMMARY
• When individuals are subjected to a stressor, the varying ways of dealing
with it are termed coping styles.
• The physiology behind different coping styles is related to the serotonergic
and dopaminergic input of the medial prefrontal cortex and the nucleus
accumbens.
• Teaching patients and their caregivers appropriate coping skills can have a
significant impact on the way they perceive their condition, the severity of
the symptoms, and the psychological distress associated with it.
• Physicians, psychiatrists, physical therapists, nurses, and health educators
share the role of educating patients to become more responsible for their
health.
• Interprofessional involvement can help patients cope better with the
symptoms of their illnesses.