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Practice of stress management behaviors and associated factors among undergraduate students of Mekelle University, Ethiopia: a cross-sectional study

  • Gebrezabher Niguse Hailu 1  

BMC Psychiatry volume  20 , Article number:  162 ( 2020 ) Cite this article

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Stress is one of the top five threats to academic performance among college students globally. Consequently, students decrease in academic performance, learning ability and retention. However, no study has assessed the practice of stress management behaviors and associated factors among college students in Ethiopia. So the purpose of this study was to assess the practice of stress management behaviors and associated factors among undergraduate university students at Mekelle University, Tigray, Ethiopia, 2019.

A cross-sectional study was conducted on 633 study participants at Mekelle University from November 2018 to July 2019. Bivariate analysis was used to determine the association between the independent variable and the outcome variable at p  < 0.25 significance level. Significant variables were selected for multivariate analysis.

The study found that the practice of stress management behaviors among undergraduate Mekelle university students was found as 367(58%) poor and 266(42%) good. The study also indicated that sex, year of education, monthly income, self-efficacy status, and social support status were significant predictors of stress management behaviors of college students.

This study found that the majority of the students had poor practice of stress management behaviors.

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Stress is the physical and emotional adaptive response to an external situation that results in physical, psychological and behavioral deviations [ 1 ]. Stress can be roughly subdivided into the effects and mechanisms of chronic and acute stress [ 2 ]. Chronic psychological stress in early life and adulthood has been demonstrated to result in maladaptive changes in both the HPA-axis and the sympathetic nervous system. Acute and time-limited stressors seem to result in adaptive redistribution of all major leukocyte subpopulations [ 2 ].

Stress management behaviors are defined as behaviors people often use in the face of stress /or trauma to help manage painful or difficult emotions [ 3 ]. Stress management behaviors include sleeping 6–8 h each night, Make an effort to monitor emotional changes, Use adequate responses to unreasonable issues, Make schedules and set priorities, Make an effort to determine the source of each stress that occurs, Make an effort to spend time daily for muscle relaxation, Concentrate on pleasant thoughts at bedtime, Feel content and peace with yourself [ 4 ]. Practicing those behaviors are very important in helping people adjust to stressful events while helping them maintain their emotional wellbeing [ 3 ].

University students are a special group of people that are enduring a critical transitory period in which they are going from adolescence to adulthood and can be one of the most stressful times in a person’s life [ 5 ]. According to the American College Health Association’s National College Health Assessment, stress is one of the top five threats to academic performance among college students [ 6 ]. For instance, stress is a serious problem in college student populations across the United States [ 7 ].

I have searched literatures regarding stress among college students worldwide. For instance, among Malaysian university students, stress was observed among 36% of the respondents [ 8 ]. Another study reported that 43% of Hong Kong students were suffered from academic stress [ 9 ]. In western countries and other Middle Eastern countries, including 70% in Jordan [ 10 ], 83.9% in Australia [ 11 ]. Furthermore, based on a large nationally representative study the prevalence of stress among college students in Ethiopia was 40.9% [ 12 ].

Several studies have shown that socio-demographic characteristics and psychosocial factors like social support, health value and perceived self-efficacy were known to predict stress management behaviors [ 13 , 14 , 15 , 16 , 17 ].

Although the prevalence of stress among college students is studied in many countries including Ethiopia, the practice of stress management behaviors which is very important in promoting the health of college students is not studied in Ethiopia. Therefore this study aimed to assess the practice of stress management behaviors and associated factors among undergraduate students at Mekelle University.

The study was conducted at Mekelle university colleges from November 2018 to July 2019 in Mekelle city, Tigray, Ethiopia. Mekelle University is a higher education and training public institution located in Mekelle city, Tigray at a distance of 783 Kilometers from the Ethiopian capital ( http://www.mu.edu.et/ ).

A cross-sectional study was conducted on 633 study participants. Students who were ill (unable to attend class due to illness), infield work and withdrawal were not included in the study.

The actual sample size (n) was computed by single population proportion formula [n = [(Za/2)2*P (1 − P)]/d2] by assuming 95% confidence level of Za/2 = 1.96, margin of error 5%, proportion (p) of 50% and the final sample size was estimated to be 633. A 1.5 design effect was used by considering the multistage sampling technique and assuming that there was no as such big variations among the students included in the study.

Multi-stage random sampling was used. Three colleges (College of health science, college of business and Economics and College of Natural and Computational Science) were selected from a total of the seven Colleges from Mekelle University using a simple random sampling technique in which proportional sample allocation was considered from each college.

Data were collected using a self-administered questionnaire by trained research assistants at the classes.

The questionnaire has three sections. The first section contained questions on demographic characteristics of the study participants. The second section contained questions to assess the practice of stress management of the students. The tool to assess the practice of stress management behaviors for college students was developed by Walker, Sechrist, and Pender [ 4 ]. The third section consisted of questions for factors associated with stress management of the students divided into four sub-domains, including health value used to assess the value participants place on their health [ 18 ]. The second subdomain is self-efficacy designed to assess optimistic self-beliefs to cope with a variety of difficult demands in life [ 19 ] and was adapted by Yesilay et al. [ 20 ]. The third subdomain is perceived social support measures three sources of support: family, friends, and significant others [ 21 ] and was adapted by Eker et al. [ 22 ]. The fourth subscale is perceived stress measures respondents’ evaluation of the stressfulness of situations in the past month of their lives [ 23 ] and was adapted by Örücü and Demir [ 24 ].

The entered data were edited, checked visually for its completeness and the response was coded and entered by Epi-data manager version 4.2 for windows and exported to SPSS version 21.0 for statistical analysis.

Bivariate analysis was used to determine the association between the independent variable and the outcome variable. Variables that were significant at p  < 0.25 with the outcome variable were selected for multivariable analysis. And odds ratio with 95% confidence level was computed and p -value <= 0.05 was described as a significant association.

Operational definition

Good stress management behavior:.

Students score above or equal to the mean score.

Poor stress management behavior:

Students score below the mean score [ 4 ].

Seciodemographic characteristics

Among the total 633 study participants, 389(61.5%) were males, of those 204(32.2%) had poor stress management behavior. The Median age of the respondents was 20.00 (IQR = ±3). More ever, this result showed that 320(50.6%) of the students came from rural areas, 215(34%) of them had poor stress management behavior.

The result revealed that 363(57.35%) of the study participants were 2nd and 3rd year students, of them 195 (30.8%) had poor stress management.

This result indicated that 502 (79.3%) of the participants were in the monthly support category of > = 300 ETB with a median income of 300.00 ETB (IQR = ±500), from those, 273(43.1%) students had poor stress management behavior (Table  1 ).

figure 1

Status of practice of stress management behaviors of under graduate students at Mekelle University, Ethiopia

Psychosocial factors

This result indicated that 352 (55.6%) of the students had a high health value status of them 215 (34%) had good stress management behavior. It also showed that 162 (25.6%) of the students had poor perceived self-efficacy, from those 31(4.9%) had a good practice of stress management behavior. Moreover, the result showed that 432(68.2%) of the study participants had poor social support status of them 116(18.3%) had a good practice of stress management behavior (Table  1 ).

Practice of stress management behaviors

The result showed that the majority (49.8%) of the students were sometimes made an effort to spend time daily for muscle relaxation. Whereas only 28(4.4%) students were routinely concentrated on pleasant thoughts at bedtime.

According to this result, only 169(26.7%) of the students were often made an effort to determine the source of stress that occurs. It also revealed that the majority (40.1%) of the students were never made an effort to monitor their emotional changes. Similarly, the result indicated that the majority (42.5%) of the students were never made schedules and set priorities.

The result revealed that only 68(10.7%) of the students routinely slept 6–8 h each night. More ever, the result showed that the majority (34.4%) of the students were sometimes used adequate responses to unreasonable issues (Table  2 ).

Status of the practice of stress management behaviors

The result revealed that the practice of stress management behaviors among regular undergraduate Mekelle university students was found as 367(58%) poor and 266(42%) good. (Fig  1 )

Factors associated with stress management behaviors

In the bivariate analysis sex, college, year of education, student’s monthly income’, perceived-self efficacy, perceived social support and perceived stress were significantly associated with stress management behavior at p < =0.25. Whereas in the multivariate analysis sex, year of education, student’s monthly income’, perceived-self efficacy and perceived social support were significantly associated with stress management behavior at p < =0.05.

Male students were 3.244 times more likely to have good practice stress management behaviors than female students (AOR: 3.244, CI: [1.934–5.439]). Students who were in the age category of less than 20 years were 70% less to have a good practice of stress management behaviors than students with the age of greater or equal to 20 year (AOR: 0.300, CI:[0.146–0.618]).

Students who had monthly income less than300 ETB were 64.4% less to have a good practice of stress management behaviors than students with monthly income greater or equal to 300 ETB (AOR: 0.356, CI:[0.187–0.678]).

Students who had poor self- efficacy status were 70.3% less to have a good practice of stress management behaviors than students with good self-efficacy status (AOR: 0.297, CI:[0.159–0.554]). Students who had poor social support were 70.5% less to have a good practice of stress management behaviors than students with good social support status (AOR: 0.295[0.155–0.560]) (Table  3 ).

The present study showed that the practice of stress management behaviors among regular undergraduate students was 367(58%) poor and 266(42%) good. The study indicated that sex, year of education, student’s monthly income, social support status, and perceived-self efficacy status were significant predictors of stress management behaviors of students.

The current study revealed that male students were more likely to have good practice of stress management behaviors than female students. This finding is contradictory with previous studies conducted in the USA [ 13 , 25 ], where female students were showed better practice of stress management behaviors than male students. This difference might be due to socioeconomic and measurement tool differences.

The current study indicated that students with monthly income less than 300 ETB were less likely to have good practice of stress management behaviors than students with monthly income greater than or equal to 300 ETB. This is congruent with the recently published book which argues a better understanding of our relationship with money (income). The book said “the people with more money are, on average, happier than the people with less money. They have less to worry about because they are not worried about where they are going to get food or money for their accommodation or whatever the following week, and this has a positive effect on their health” [ 26 ].

The present study found that first-year students were less likely to have good practice of stress management behaviors than senior students. This finding is similar to previous findings from Japan [ 27 ], China [ 28 ] and Ghana [ 29 ]. This might be because freshman students may encounter a multitude of stressors, some of which they may have dealt with in high school and others that may be a new experience for them. With so many new experiences, responsibilities, social settings, and demands on their time. As a first-time, incoming college freshman, experiencing life as an adult and acclimating to the numerous and varied types of demands placed on them can be a truly overwhelming experience. It can also lead to unhealthy amounts of stress. A report by the Anxiety and Depression Association of America found that 80% of freshman students frequently or sometimes experience daily stress [ 30 ].

The current study showed that students with poor self-efficacy status were less likely to have good practice of stress management behaviors. This is congruent with the previous study that has demonstrated quite convincingly that possessing high levels of self-efficacy acts to decrease people’s potential for experiencing negative stress feelings by increasing their sense of being in control of the situations they encounter [ 14 ]. More ever this study found that students with poor social support were less likely to have a good practice of stress management behaviors. This finding is similar to previous studies that found good social support, whether from a trusted group or valued individual, has shown to reduce the psychological and physiological consequences of stress, and may enhance immune function [ 15 , 16 , 17 ].

Ethics approval and consent to participate

Ethical clearance and approval obtained from the institutional review board of Mekelle University. Moreover, before conducting the study, the purpose and objective of the study were described to the study participants and written informed consent was obtained. The study participants were informed as they have full right to discontinue during the interview. Subject confidentiality and any special data security requirements were maintained and assured by not exposing the patient’s name and information.

Limitation of the study

There is limited literature regarding stress management behaviors and associated factors. There is no similar study done in Ethiopia previously. More ever, using a self-administered questionnaire, the respondents might not pay full attention to it/read it properly.

This study found that the majority of the students had poor practice of stress management behaviors. The study also found that sex, year of education, student’s monthly income, social support status, and perceived-self efficacy status were significant predictors of stress management behaviors of the students.

Availability of data and materials

The datasets used during the current study is available from the corresponding author on reasonable request.


Adjusted Odd Ratio

College of Business& Economics

College of health sciences

Confidence interval

College of natural and computational sciences

Crud odds ratio

Ethiopian birr

Master of Sciences

United States of America

United kingdom

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Hailu, G.N. Practice of stress management behaviors and associated factors among undergraduate students of Mekelle University, Ethiopia: a cross-sectional study. BMC Psychiatry 20 , 162 (2020). https://doi.org/10.1186/s12888-020-02574-4

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Recent developments in stress and anxiety research

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Stress and anxiety are virtually omnipresent in today´s society, pervading almost all aspects of our daily lives. While each and every one of us experiences “stress” and/or “anxiety” at least to some extent at times, the phenomena themselves are far from being completely understood. In stress research, scientists are particularly grappling with the conceptual issue of how to define stress, also with regard to delimiting stress from anxiety or negative affectivity in general. Interestingly, there is no unified theory of stress, despite many attempts at defining stress and its characteristics. Consequently, the available literature relies on a variety of different theoretical approaches, though the theories of Lazarus and Folkman ( 1984 ) or McEwen ( 1998 ) are relatively pervasive in the literature. One key issue in conceptualizing stress is that research has not always differentiated between the perception of a stimulus or a situation as a stressor and the subsequent biobehavioral response (often called the “stress response”). This is important, since, for example, psychological factors such as uncontrollability and social evaluation, i.e. factors that may influence how an individual perceives a potentially stressful stimulus or situation, have been identified as characteristics that elicit particularly powerful physiological stressful responses (Dickerson and Kemeny 2004 ). At the core of the physiological stress response is a complex physiological system, which is located in both the central nervous system (CNS) and the body´s periphery. The complexity of this system necessitates a multi-dimensional assessment approach involving variables that adequately reflect all relevant components. It is also important to consider that the experience of stress and its psychobiological correlates do not occur in a vacuum, but are being shaped by numerous contextual factors (e.g. societal and cultural context, work and leisure time, family and dyadic systems, environmental variables, physical fitness, nutritional status, etc.) and dispositional factors (e.g. genetics, personality, resilience, regulatory capacities, self-efficacy, etc.). Thus, a theoretical framework needs to incorporate these factors. In sum, as stress is considered a multi-faceted and inherently multi-dimensional construct, its conceptualization and operationalization needs to reflect this (Nater 2018 ).

The goal of the World Association for Stress Related and Anxiety Disorders (WASAD) is to promote and make available basic and clinical research on stress-related and anxiety disorders. Coinciding with WASAD’s 3rd International Congress held in September 2021 in Vienna, Austria, this journal publishes a Special Issue encompassing state-of-the art research in the field of stress and anxiety. This special issue collects answers to a number of important questions that need to be addressed in current and future research. Among the most relevant issues are (1) the multi-dimensional assessment that arises as a consequence of a multi-faceted consideration of stress and anxiety, with a particular focus on doing so under ecologically valid conditions. Skoluda et al. 2021 (in this issue) argue that hair as an important source of the stress hormone cortisol should not only be taken as a complementary stress biomarker by research staff, but that lay persons could be also trained to collect hair at the study participants’ homes, thus increasing the ecological validity of studies incorporating this important measure; (2) the incongruence between psychological and biological facets of stress and anxiety that has been observed both in laboratory and field research (Campbell and Ehlert 2012 ). Interestingly, there are behavioral constructs that do show relatively high congruence. As shown in the paper of Vatheuer et al. ( 2021 ), gaze behavior while exposed to an acute social stressor correlates with salivary cortisol, thus indicating common underlying mechanisms; (3) the complex dynamics of stress-related measures that may extend over shorter (seconds to minutes), medium (hours and diurnal/circadian fluctuations), and longer (months, seasonal) time periods. In particular, momentary assessment studies are highly qualified to examine short to medium term fluctuations and interactions. In their study employing such a design, Stoffel and colleagues (Stoffel et al. 2021 ) show ecologically valid evidence for direct attenuating effects of social interactions on psychobiological stress. Using an experimental approach, on the other hand, Denk et al. ( 2021 ) examined the phenomenon of physiological synchrony between study participants; they found both cortisol and alpha-amylase physiological synchrony in participants who were in the same group while being exposed to a stressor. Importantly, these processes also unfold over time in relation to other biological systems; al’Absi and colleagues showed in their study (al’Absi et al. 2021 ) the critical role of the endogenous opioid system and its relation to stress-related analgesia; (4) the influence of contextual and dispositional factors on the biological stress response in various target samples (e.g., humans, animals, minorities, children, employees, etc.) both under controlled laboratory conditions and in everyday life environments. In this issue, Sattler and colleagues show evidence that contextual information may only matter to a certain extent, as in their study (Sattler et al. 2021 ), the biological response to a gay-specific social stressor was equally pronounced as the one to a general social stressor in gay men. Genetic information is probably the most widely researched dispositional factor; Kuhn et al. show in their paper (Kuhn et al. 2021 ) that the low expression variant of the serotonin transporter gene serves as a risk factor for increased stress reactivity, thus clearly indicating the important role of dispositional factors in stress processing. An interesting factor combining both aspects of dispositional and contextual information is maternal care; Bentele et al. ( 2021 ) in their study are able to show that there was an effect of maternal care on the amylase stress response, while no such effect was observed for cortisol. In a similar vein, Keijser et al. ( 2021 ) showed in their gene-environment interaction study that the effects of FKBP5, a gene very closely related to HPA axis regulation, and early life stress on depressive symptoms among young adults was moderated by a positive parenting style; and (5) the role of stress and anxiety as transdiagnostic factors in mental disorders, be it as an etiological factor, a variable contributing to symptom maintenance, or as a consequence of the condition itself. Stress, e.g., as a common denominator for a broad variety of psychiatric diagnoses has been extensively discussed, and stress as an etiological factor holds specific significance in the context of transdiagnostic approaches to the conceptualization and treatment of mental disorders (Wilamowska et al. 2010 ). The HPA axis, specifically, is widely known to be dysregulated in various conditions. Fischer et al. ( 2021 ) discuss in their comprehensive review the role of this important stress system in the context of patients with post-traumatic disorder. Specifically focusing on the cortisol awakening response, Rausch and colleagues provide evidence for HPA axis dysregulation in patients diagnosed with borderline personality disorder (Rausch et al. 2021 ). As part of a longitudinal project on ADHD, Szep et al. ( 2021 ) investigated the possible impact of child and maternal ADHD symptoms on mothers’ perceived chronic stress and hair cortisol concentration; although there was no direct association, the findings underline the importance of taking stress-related assessments into consideration in ADHD studies. As the HPA axis is closely interacting with the immune system, Rhein et al. ( 2021 ) examined in their study the predicting role of the cytokine IL-6 on psychotherapy outcome in patients with PTSD, indicating that high reactivity of IL-6 to a stressor at the beginning of the therapy was associated with a negative therapy outcome. The review of Kyunghee Kim et al. ( 2021 ) also demonstrated the critical role of immune pathways in the molecular changes due to antidepressant treatment. As for the therapy, the important role of cognitive-behavioral therapy with its key elements to address both stress and anxiety reduction have been shown in two studies in this special issue, evidencing its successful application in obsessive–compulsive disorder (Ivarsson et al. 2021 ; Hollmann et al. 2021 ). Thus, both stress and anxiety are crucial transdiagnostic factors in various mental disorders, and future research needs elaborate further on their role in etiology, maintenance, and treatment.

In conclusion, a number of important questions are being asked in stress and anxiety research, as has become evident above. The Special Issue on “Recent developments in stress and anxiety research” attempts to answer at least some of the raised questions, and I want to invite you to inspect the individual papers briefly introduced above in more detail.

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Nater, U.M. Recent developments in stress and anxiety research. J Neural Transm 128 , 1265–1267 (2021). https://doi.org/10.1007/s00702-021-02410-3

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Article contents

Work, stress, coping, and stress management.

  • Sharon Glazer Sharon Glazer University of Baltimore
  •  and  Cong Liu Cong Liu Hofstra University
  • https://doi.org/10.1093/acrefore/9780190236557.013.30
  • Published online: 26 April 2017

Work stress refers to the process of job stressors, or stimuli in the workplace, leading to strains, or negative responses or reactions. Organizational development refers to a process in which problems or opportunities in the work environment are identified, plans are made to remediate or capitalize on the stimuli, action is taken, and subsequently the results of the plans and actions are evaluated. When organizational development strategies are used to assess work stress in the workplace, the actions employed are various stress management interventions. Two key factors tying work stress and organizational development are the role of the person and the role of the environment. In order to cope with work-related stressors and manage strains, organizations must be able to identify and differentiate between factors in the environment that are potential sources of stressors and how individuals perceive those factors. Primary stress management interventions focus on preventing stressors from even presenting, such as by clearly articulating workers’ roles and providing necessary resources for employees to perform their job. Secondary stress management interventions focus on a person’s appraisal of job stressors as a threat or challenge, and the person’s ability to cope with the stressors (presuming sufficient internal resources, such as a sense of meaningfulness in life, or external resources, such as social support from a supervisor). When coping is not successful, strains may develop. Tertiary stress management interventions attempt to remediate strains, by addressing the consequence itself (e.g., diabetes management) and/or the source of the strain (e.g., reducing workload). The person and/or the organization may be the targets of the intervention. The ultimate goal of stress management interventions is to minimize problems in the work environment, intensify aspects of the work environment that create a sense of a quality work context, enable people to cope with stressors that might arise, and provide tools for employees and organizations to manage strains that might develop despite all best efforts to create a healthy workplace.

  • stress management
  • organization development
  • organizational interventions
  • stress theories and frameworks


Work stress is a generic term that refers to work-related stimuli (aka job stressors) that may lead to physical, behavioral, or psychological consequences (i.e., strains) that affect both the health and well-being of the employee and the organization. Not all stressors lead to strains, but all strains are a result of stressors, actual or perceived. Common terms often used interchangeably with work stress are occupational stress, job stress, and work-related stress. Terms used interchangeably with job stressors include work stressors, and as the specificity of the type of stressor might include psychosocial stressor (referring to the psychological experience of work demands that have a social component, e.g., conflict between two people; Hauke, Flintrop, Brun, & Rugulies, 2011 ), hindrance stressor (i.e., a stressor that prevents goal attainment; Cavanaugh, Boswell, Roehling, & Boudreau, 2000 ), and challenge stressor (i.e., a stressor that is difficult, but attainable and possibly rewarding to attain; Cavanaugh et al., 2000 ).

Stress in the workplace continues to be a highly pervasive problem, having both direct negative effects on individuals experiencing it and companies paying for it, and indirect costs vis à vis lost productivity (Dopkeen & DuBois, 2014 ). For example, U.K. public civil servants’ work-related stress rose from 10.8% in 2006 to 22.4% in 2013 and about one-third of the workforce has taken more than 20 days of leave due to stress-related ill-health, while well over 50% are present at work when ill (French, 2015 ). These findings are consistent with a report by the International Labor Organization (ILO, 2012 ), whereby 50% to 60% of all workdays are lost due to absence attributed to factors associated with work stress.

The prevalence of work-related stress is not diminishing despite improvements in technology and employment rates. The sources of stress, such as workload, seem to exacerbate with improvements in technology (Coovert & Thompson, 2003 ). Moreover, accessibility through mobile technology and virtual computer terminals is linking people to their work more than ever before (ILO, 2012 ; Tarafdar, Tu, Ragu-Nathan, & Ragu-Nathan, 2007 ). Evidence of this kind of mobility and flexibility is further reinforced in a June 2007 survey of 4,025 email users (over 13 years of age); AOL reported that four in ten survey respondents reported planning their vacations around email accessibility and 83% checked their emails at least once a day while away (McMahon, 2007 ). Ironically, despite these mounting work-related stressors and clear financial and performance outcomes, some individuals are reporting they are less “stressed,” but only because “stress has become the new normal” (Jayson, 2012 , para. 4).

This new normal is likely the source of psychological and physiological illness. Siegrist ( 2010 ) contends that conditions in the workplace, particularly psychosocial stressors that are perceived as unfavorable relationships with others and self, and an increasingly sedentary lifestyle (reinforced with desk jobs) are increasingly contributing to cardiovascular disease. These factors together justify a need to continue on the path of helping individuals recognize and cope with deleterious stressors in the work environment and, equally important, to find ways to help organizations prevent harmful stressors over which they have control, as well as implement policies or mechanisms to help employees deal with these stressors and subsequent strains. Along with a greater focus on mitigating environmental constraints are interventions that can be used to prevent anxiety, poor attitudes toward the workplace conditions and arrangements, and subsequent cardiovascular illness, absenteeism, and poor job performance (Siegrist, 2010 ).

Even the ILO has presented guidance on how the workplace can help prevent harmful job stressors (aka hindrance stressors) or at least help workers cope with them. Consistent with the view that well-being is not the absence of stressors or strains and with the view that positive psychology offers a lens for proactively preventing stressors, the ILO promotes increasing preventative risk assessments, interventions to prevent and control stressors, transparent organizational communication, worker involvement in decision-making, networks and mechanisms for workplace social support, awareness of how working and living conditions interact, safety, health, and well-being in the organization (ILO, n.d. ). The field of industrial and organizational (IO) psychology supports the ILO’s recommendations.

IO psychology views work stress as the process of a person’s interaction with multiple aspects of the work environment, job design, and work conditions in the organization. Interventions to manage work stress, therefore, focus on the psychosocial factors of the person and his or her relationships with others and the socio-technical factors related to the work environment and work processes. Viewing work stress from the lens of the person and the environment stems from Kurt Lewin’s ( 1936 ) work that stipulates a person’s state of mental health and behaviors are a function of the person within a specific environment or situation. Aspects of the work environment that affect individuals’ mental states and behaviors include organizational hierarchy, organizational climate (including processes, policies, practices, and reward structures), resources to support a person’s ability to fulfill job duties, and management structure (including leadership). Job design refers to each contributor’s tasks and responsibilities for fulfilling goals associated with the work role. Finally, working conditions refers not only to the physical environment, but also the interpersonal relationships with other contributors.

Each of the conditions that are identified in the work environment may be perceived as potentially harmful or a threat to the person or as an opportunity. When a stressor is perceived as a threat to attaining desired goals or outcomes, the stressor may be labeled as a hindrance stressor (e.g., LePine, Podsakoff, & Lepine, 2005 ). When the stressor is perceived as an opportunity to attain a desired goal or end state, it may be labeled as a challenge stressor. According to LePine and colleagues’ ( 2005 ), both challenge (e.g., time urgency, workload) and hindrance (e.g., hassles, role ambiguity, role conflict) stressors could lead to strains (as measured by “anxiety, depersonalization, depression, emotional exhaustion, frustration, health complaints, hostility, illness, physical symptoms, and tension” [p. 767]). However, challenge stressors positively relate with motivation and performance, whereas hindrance stressors negatively relate with motivation and performance. Moreover, motivation and strains partially mediate the relationship between hindrance and challenge stressors with performance.

Figure 1. Organizational development frameworks to guide identification of work stress and interventions.

In order to (1) minimize any potential negative effects from stressors, (2) increase coping skills to deal with stressors, or (3) manage strains, organizational practitioners or consultants will devise organizational interventions geared toward prevention, coping, and/or stress management. Ultimately, toxic factors in the work environment can have deleterious effects on a person’s physical and psychological well-being, as well as on an organization’s total health. It behooves management to take stock of the organization’s health, which includes the health and well-being of its employees, if the organization wishes to thrive and be profitable. According to Page and Vella-Brodrick’s ( 2009 ) model of employee well-being, employee well-being results from subjective well-being (i.e., life satisfaction and general positive or negative affect), workplace well-being (composed of job satisfaction and work-specific positive or negative affect), and psychological well-being (e.g., self-acceptance, positive social relations, mastery, purpose in life). Job stressors that become unbearable are likely to negatively affect workplace well-being and thus overall employee well-being. Because work stress is a major organizational pain point and organizations often employ organizational consultants to help identify and remediate pain points, the focus here is on organizational development (OD) frameworks; several work stress frameworks are presented that together signal areas where organizations might focus efforts for change in employee behaviors, attitudes, and performance, as well as the organization’s performance and climate. Work stress, interventions, and several OD and stress frameworks are depicted in Figure 1 .

The goals are: (1) to conceptually define and clarify terms associated with stress and stress management, particularly focusing on organizational factors that contribute to stress and stress management, and (2) to present research that informs current knowledge and practices on workplace stress management strategies. Stressors and strains will be defined, leading OD and work stress frameworks that are used to organize and help organizations make sense of the work environment and the organization’s responsibility in stress management will be explored, and stress management will be explained as an overarching thematic label; an area of study and practice that focuses on prevention (primary) interventions, coping (secondary) interventions, and managing strains (tertiary) interventions; as well as the label typically used to denote tertiary interventions. Suggestions for future research and implications toward becoming a healthy organization are presented.

Defining Stressors and Strains

Work-related stressors or job stressors can lead to different kinds of strains individuals and organizations might experience. Various types of stress management interventions, guided by OD and work stress frameworks, may be employed to prevent or cope with job stressors and manage strains that develop(ed).

A job stressor is a stimulus external to an employee and a result of an employee’s work conditions. Example job stressors include organizational constraints, workplace mistreatments (such as abusive supervision, workplace ostracism, incivility, bullying), role stressors, workload, work-family conflicts, errors or mistakes, examinations and evaluations, and lack of structure (Jex & Beehr, 1991 ; Liu, Spector, & Shi, 2007 ; Narayanan, Menon, & Spector, 1999 ). Although stressors may be categorized as hindrances and challenges, there is not yet sufficient information to be able to propose which stress management interventions would better serve to reduce those hindrance stressors or to reduce strain-producing challenge stressors while reinforcing engagement-producing challenge stressors.

Organizational Constraints

Organizational constraints may be hindrance stressors as they prevent employees from translating their motivation and ability into high-level job performance (Peters & O’Connor, 1980 ). Peters and O’Connor ( 1988 ) defined 11 categories of organizational constraints: (1) job-related information, (2) budgetary support, (3) required support, (4) materials and supplies, (5) required services and help from others, (6) task preparation, (7) time availability, (8) the work environment, (9) scheduling of activities, (10) transportation, and (11) job-relevant authority. The inhibiting effect of organizational constraints may be due to the lack of, inadequacy of, or poor quality of these categories.

Workplace Mistreatment

Workplace mistreatment presents a cluster of interpersonal variables, such as interpersonal conflict, bullying, incivility, and workplace ostracism (Hershcovis, 2011 ; Tepper & Henle, 2011 ). Typical workplace mistreatment behaviors include gossiping, rude comments, showing favoritism, yelling, lying, and ignoring other people at work (Tepper & Henle, 2011 ). These variables relate to employees’ psychological well-being, physical well-being, work attitudes (e.g., job satisfaction and organizational commitment), and turnover intention (e.g., Hershcovis, 2011 ; Spector & Jex, 1998 ). Some researchers differentiated the source of mistreatment, such as mistreatment from one’s supervisor versus mistreatment from one’s coworker (e.g., Bruk-Lee & Spector, 2006 ; Frone, 2000 ; Liu, Liu, Spector, & Shi, 2011 ).

Role Stressors

Role stressors are demands, constraints, or opportunities a person perceives to be associated, and thus expected, with his or her work role(s) across various situations. Three commonly studied role stressors are role ambiguity, role conflict, and role overload (Glazer & Beehr, 2005 ; Kahn, Wolfe, Quinn, Snoek, & Rosenthal, 1964 ). Role ambiguity in the workplace occurs when an employee lacks clarity regarding what performance-related behaviors are expected of him or her. Role conflict refers to situations wherein an employee receives incompatible role requests from the same or different supervisors or the employee is asked to engage in work that impedes his or her performance in other work or nonwork roles or clashes with his or her values. Role overload refers to excessive demands and insufficient time (quantitative) or knowledge (qualitative) to complete the work. The construct is often used interchangeably with workload, though role overload focuses more on perceived expectations from others about one’s workload. These role stressors significantly relate to low job satisfaction, low organizational commitment, low job performance, high tension or anxiety, and high turnover intention (Abramis, 1994 ; Glazer & Beehr, 2005 ; Jackson & Schuler, 1985 ).

Excessive workload is one of the most salient stressors at work (e.g., Liu et al., 2007 ). There are two types of workload: quantitative and qualitative workload (LaRocco, Tetrick, & Meder, 1989 ; Parasuraman & Purohit, 2000 ). Quantitative workload refers to the excessive amount of work one has. In a summary of a Chartered Institute of Personnel & Development Report from 2006 , Dewe and Kompier ( 2008 ) noted that quantitative workload was one of the top three stressors workers experienced at work. Qualitative workload refers to the difficulty of work. Workload also differs by the type of the load. There are mental workload and physical workload (Dwyer & Ganster, 1991 ). Excessive physical workload may result in physical discomfort or illness. Excessive mental workload will cause psychological distress such as anxiety or frustration (Bowling & Kirkendall, 2012 ). Another factor affecting quantitative workload is interruptions (during the workday). Lin, Kain, and Fritz ( 2013 ) found that interruptions delay completion of job tasks, thus adding to the perception of workload.

Work-Family Conflict

Work-family conflict is a form of inter-role conflict in which demands from one’s work domain and one’s family domain are incompatible to some extent (Greenhaus & Beutell, 1985 ). Work can interfere with family (WIF) and/or family can interfere with work (FIW) due to time-related commitments to participating in one domain or another, incompatible behavioral expectations, or when strains in one domain carry over to the other (Greenhaus & Beutell, 1985 ). Work-family conflict significantly relates to work-related outcomes (e.g., job satisfaction, organizational commitment, turnover intention, burnout, absenteeism, job performance, job strains, career satisfaction, and organizational citizenship behaviors), family-related outcomes (e.g., marital satisfaction, family satisfaction, family-related performance, family-related strains), and domain-unspecific outcomes (e.g., life satisfaction, psychological strain, somatic or physical symptoms, depression, substance use or abuse, and anxiety; Amstad, Meier, Fasel, Elfering, & Semmer, 2011 ).

Individuals and organizations can experience work-related strains. Sometimes organizations will experience strains through the employee’s negative attitudes or strains, such as that a worker’s absence might yield lower production rates, which would roll up into an organizational metric of organizational performance. In the industrial and organizational (IO) psychology literature, organizational strains are mostly observed as macro-level indicators, such as health insurance costs, accident-free days, and pervasive problems with company morale. In contrast, individual strains, usually referred to as job strains, are internal to an employee. They are responses to work conditions and relate to health and well-being of employees. In other words, “job strains are adverse reactions employees have to job stressors” (Spector, Chen, & O’Connell, 2000 , p. 211). Job strains tend to fall into three categories: behavioral, physical, and psychological (Jex & Beehr, 1991 ).

Behavioral strains consist of actions that employees take in response to job stressors. Examples of behavioral strains include employees drinking alcohol in the workplace or intentionally calling in sick when they are not ill (Spector et al., 2000 ). Physical strains consist of health symptoms that are physiological in nature that employees contract in response to job stressors. Headaches and ulcers are examples of physical strains. Lastly, psychological strains are emotional reactions and attitudes that employees have in response to job stressors. Examples of psychological strains are job dissatisfaction, anxiety, and frustration (Spector et al., 2000 ). Interestingly, research studies that utilize self-report measures find that most job strains experienced by employees tend to be psychological strains (Spector et al., 2000 ).

Leading Frameworks

Organizations that are keen on identifying organizational pain points and remedying them through organizational campaigns or initiatives often discover the pain points are rooted in work-related stressors and strains and the initiatives have to focus on reducing workers’ stress and increasing a company’s profitability. Through organizational climate surveys, for example, companies discover that aspects of the organization’s environment, including its policies, practices, reward structures, procedures, and processes, as well as employees at all levels of the company, are contributing to the individual and organizational stress. Recent studies have even begun to examine team climates for eustress and distress assessed in terms of team members’ homogenous psychological experience of vigor, efficacy, dedication, and cynicism (e.g., Kożusznik, Rodriguez, & Peiro, 2015 ).

Each of the frameworks presented advances different aspects that need to be identified in order to understand the source and potential remedy for stressors and strains. In some models, the focus is on resources, in others on the interaction of the person and environment, and in still others on the role of the person in the workplace. Few frameworks directly examine the role of the organization, but the organization could use these frameworks to plan interventions that would minimize stressors, cope with existing stressors, and prevent and/or manage strains. One of the leading frameworks in work stress research that is used to guide organizational interventions is the person and environment (P-E) fit (French & Caplan, 1972 ). Its precursor is the University of Michigan Institute for Social Research’s (ISR) role stress model (Kahn, Wolfe, Quinn, Snoek, & Rosenthal, 1964 ) and Lewin’s Field Theory. Several other theories have since evolved from the P-E fit framework, including Karasek and Theorell’s ( 1990 ), Karasek ( 1979 ) Job Demands-Control Model (JD-C), the transactional framework (Lazarus & Folkman, 1984 ), Conservation of Resources (COR) theory (Hobfoll, 1989 ), and Siegrist’s ( 1996 ) Effort-Reward Imbalance (ERI) Model.

Field Theory

The premise of Kahn et al.’s ( 1964 ) role stress theory is Lewin’s ( 1997 ) Field Theory. Lewin purported that behavior and mental events are a dynamic function of the whole person, including a person’s beliefs, values, abilities, needs, thoughts, and feelings, within a given situation (field or environment), as well as the way a person represents his or her understanding of the field and behaves in that space. Lewin explains that work-related strains are a result of individuals’ subjective perceptions of objective factors, such as work roles, relationships with others in the workplace, as well as personality indicators, and can be used to predict people’s reactions, including illness. Thus, to make changes to an organizational system, it is necessary to understand a field and try to move that field from the current state to the desired state. Making this move necessitates identifying mechanisms influencing individuals.

Role Stress Theory

Role stress theory mostly isolates the perspective a person has about his or her work-related responsibilities and expectations to determine how those perceptions relate with a person’s work-related strains. However, those relationships have been met with somewhat varied results, which Glazer and Beehr ( 2005 ) concluded might be a function of differences in culture, an environmental factor often neglected in research. Kahn et al.’s ( 1964 ) role stress theory, coupled with Lewin’s ( 1936 ) Field Theory, serves as the foundation for the P-E fit theory. Lewin ( 1936 ) wrote, “Every psychological event depends upon the state of the person and at the same time on the environment” (p. 12). Researchers of IO psychology have narrowed the environment to the organization or work team. This narrowed view of the organizational environment is evident in French and Caplan’s ( 1972 ) P-E fit framework.

Person-Environment Fit Theory

The P-E fit framework focuses on the extent to which there is congruence between the person and a given environment, such as the organization (Caplan, 1987 ; Edwards, 2008 ). For example, does the person have the necessary skills and abilities to fulfill an organization’s demands, or does the environment support a person’s desire for autonomy (i.e., do the values align?) or fulfill a person’s needs (i.e., a person’s needs are rewarded). Theoretically and empirically, the greater the person-organization fit, the greater a person’s job satisfaction and organizational commitment, the less a person’s turnover intention and work-related stress (see meta-analyses by Assouline & Meir, 1987 ; Kristof-Brown, Zimmerman, & Johnson, 2005 ; Verquer, Beehr, & Wagner, 2003 ).

Job Demands-Control/Support (JD-C/S) and Job Demands-Resources (JD-R) Model

Focusing more closely on concrete aspects of work demands and the extent to which a person perceives he or she has control or decision latitude over those demands, Karasek ( 1979 ) developed the JD-C model. Karasek and Theorell ( 1990 ) posited that high job demands under conditions of little decision latitude or control yield high strains, which have varied implications on the health of an organization (e.g., in terms of high turnover, employee ill-health, poor organizational performance). This theory was modified slightly to address not only control, but also other resources that could protect a person from unruly job demands, including support (aka JD-C/S, Johnson & Hall, 1988 ; and JD-R, Bakker, van Veldhoven, & Xanthopoulou, 2010 ). Whether focusing on control or resources, both they and job demands are said to reflect workplace characteristics, while control and resources also represent coping strategies or tools (Siegrist, 2010 ).

Despite the glut of research testing the JD-C and JD-R, results are somewhat mixed. Testing the interaction between job demands and control, Beehr, Glaser, Canali, and Wallwey ( 2001 ) did not find empirical support for the JD-C theory. However, Dawson, O’Brien, and Beehr ( 2016 ) found that high control and high support buffered against the independent deleterious effects of interpersonal conflict, role conflict, and organizational politics (demands that were categorized as hindrance stressors) on anxiety, as well as the effects of interpersonal conflict and organizational politics on physiological symptoms, but control and support did not moderate the effects between challenge stressors and strains. Coupled with Bakker, Demerouti, and Sanz-Vergel’s ( 2014 ) note that excessive job demands are a source of strain, but increased job resources are a source of engagement, Dawson et al.’s results suggest that when an organization identifies that demands are hindrances, it can create strategies for primary (preventative) stress management interventions and attempt to remove or reduce such work demands. If the demands are challenging, though manageable, but latitude to control the challenging stressors and support are insufficient, the organization could modify practices and train employees on adopting better strategies for meeting or coping (secondary stress management intervention) with the demands. Finally, if the organization can neither afford to modify the demands or the level of control and support, it will be necessary for the organization to develop stress management (tertiary) interventions to deal with the inevitable strains.

Conservation of Resources Theory

The idea that job resources reinforce engagement in work has been propagated in Hobfoll’s ( 1989 ) Conservation of Resources (COR) theory. COR theory also draws on the foundational premise that people’s mental health is a function of the person and the environment, forwarding that how people interpret their environment (including the societal context) affects their stress levels. Hobfoll focuses on resources such as objects, personal characteristics, conditions, or energies as particularly instrumental to minimizing strains. He asserts that people do whatever they can to protect their valued resources. Thus, strains develop when resources are threatened to be taken away, actually taken away, or when additional resources are not attainable after investing in the possibility of gaining more resources (Hobfoll, 2001 ). By extension, organizations can invest in activities that would minimize resource loss and create opportunities for resource gains and thus have direct implications for devising primary and secondary stress management interventions.

Transactional Framework

Lazarus and Folkman ( 1984 ) developed the widely studied transactional framework of stress. This framework holds as a key component the cognitive appraisal process. When individuals perceive factors in the work environment as a threat (i.e., primary appraisal), they will scan the available resources (external or internal to himself or herself) to cope with the stressors (i.e., secondary appraisal). If the coping resources provide minimal relief, strains develop. Until recently, little attention has been given to the cognitive appraisal associated with different work stressors (Dewe & Kompier, 2008 ; Liu & Li, 2017 ). In a study of Polish and Spanish social care service providers, stressors appraised as a threat related positively to burnout and less engagement, but stressors perceived as challenges yielded greater engagement and less burnout (Kożusznik, Rodriguez, & Peiro, 2012 ). Similarly, Dawson et al. ( 2016 ) found that even with support and control resources, hindrance demands were more strain-producing than challenge demands, suggesting that appraisal of the stressor is important. In fact, “many people respond well to challenging work” (Beehr et al., 2001 , p. 126). Kożusznik et al. ( 2012 ) recommend training employees to change the way they view work demands in order to increase engagement, considering that part of the problem may be about how the person appraises his or her environment and, thus, copes with the stressors.

Effort-Reward Imbalance

Siegrist’s ( 1996 ) Model of Effort-Reward Imbalance (ERI) focuses on the notion of social reciprocity, such that a person fulfills required work tasks in exchange for desired rewards (Siegrist, 2010 ). ERI sheds light on how an imbalance in a person’s expectations of an organization’s rewards (e.g., pay, bonus, sense of advancement and development, job security) in exchange for a person’s efforts, that is a break in one’s work contract, leads to negative responses, including long-term ill-health (Siegrist, 2010 ; Siegrist et al., 2014 ). In fact, prolonged perception of a work contract imbalance leads to adverse health, including immunological problems and inflammation, which contribute to cardiovascular disease (Siegrist, 2010 ). The model resembles the relational and interactional psychological contract theory in that it describes an employee’s perception of the terms of the relationship between the person and the workplace, including expectations of performance, job security, training and development opportunities, career progression, salary, and bonuses (Thomas, Au, & Ravlin, 2003 ). The psychological contract, like the ERI model, focuses on social exchange. Furthermore, the psychological contract, like stress theories, are influenced by cultural factors that shape how people interpret their environments (Glazer, 2008 ; Thomas et al., 2003 ). Violations of the psychological contract will negatively affect a person’s attitudes toward the workplace and subsequent health and well-being (Siegrist, 2010 ). To remediate strain, Siegrist ( 2010 ) focuses on both the person and the environment, recognizing that the organization is particularly responsible for changing unfavorable work conditions and the person is responsible for modifying his or her reactions to such conditions.

Stress Management Interventions: Primary, Secondary, and Tertiary

Remediation of work stress and organizational development interventions are about realigning the employee’s experiences in the workplace with factors in the environment, as well as closing the gap between the current environment and the desired environment. Work stress develops when an employee perceives the work demands to exceed the person’s resources to cope and thus threatens employee well-being (Dewe & Kompier, 2008 ). Likewise, an organization’s need to change arises when forces in the environment are creating a need to change in order to survive (see Figure 1 ). Lewin’s ( 1951 ) Force Field Analysis, the foundations of which are in Field Theory, is one of the first organizational development intervention tools presented in the social science literature. The concept behind Force Field Analysis is that in order to survive, organizations must adapt to environmental forces driving a need for organizational change and remove restraining forces that create obstacles to organizational change. In order to do this, management needs to delineate the current field in which the organization is functioning, understand the driving forces for change, identify and dampen or eliminate the restraining forces against change. Several models for analyses may be applied, but most approaches are variations of organizational climate surveys.

Through organizational surveys, workers provide management with a snapshot view of how they perceive aspects of their work environment. Thus, the view of the health of an organization is a function of several factors, chief among them employees’ views (i.e., the climate) about the workplace (Lewin, 1951 ). Indeed, French and Kahn ( 1962 ) posited that well-being depends on the extent to which properties of the person and properties of the environment align in terms of what a person requires and the resources available in a given environment. Therefore, only when properties of the person and properties of the environment are sufficiently understood can plans for change be developed and implemented targeting the environment (e.g., change reporting structures to relieve, and thus prevent future, communication stressors) and/or the person (e.g., providing more autonomy, vacation days, training on new technology). In short, climate survey findings can guide consultants about the emphasis for organizational interventions: before a problem arises aka stress prevention, e.g., carefully crafting job roles), when a problem is present, but steps are taken to mitigate their consequences (aka coping, e.g., providing social support groups), and/or once strains develop (aka. stress management, e.g., healthcare management policies).

For each of the primary (prevention), secondary (coping), and tertiary (stress management) techniques the target for intervention can be the entire workforce, a subset of the workforce, or a specific person. Interventions that target the entire workforce may be considered organizational interventions, as they have direct implications on the health of all individuals and consequently the health of the organization. Several interventions categorized as primary and secondary interventions may also be implemented after strains have developed and after it has been discerned that a person or the organization did not do enough to mitigate stressors or strains (see Figure 1 ). The designation of many of the interventions as belonging to one category or another may be viewed as merely a suggestion.

Primary Interventions (Preventative Stress Management)

Before individuals begin to perceive work-related stressors, organizations engage in stress prevention strategies, such as providing people with resources (e.g., computers, printers, desk space, information about the job role, organizational reporting structures) to do their jobs. However, sometimes the institutional structures and resources are insufficient or ambiguous. Scholars and practitioners have identified several preventative stress management strategies that may be implemented.

Planning and Time Management

When employees feel quantitatively overloaded, sometimes the remedy is improving the employees’ abilities to plan and manage their time (Quick, Quick, Nelson, & Hurrell, 2003 ). Planning is a future-oriented activity that focuses on conceptual and comprehensive work goals. Time management is a behavior that focuses on organizing, prioritizing, and scheduling work activities to achieve short-term goals. Given the purpose of time management, it is considered a primary intervention, as engaging in time management helps to prevent work tasks from mounting and becoming unmanageable, which would subsequently lead to adverse outcomes. Time management comprises three fundamental components: (1) establishing goals, (2) identifying and prioritizing tasks to fulfill the goals, and (3) scheduling and monitoring progress toward goal achievement (Peeters & Rutte, 2005 ). Workers who employ time management have less role ambiguity (Macan, Shahani, Dipboye, & Philips, 1990 ), psychological stress or strain (Adams & Jex, 1999 ; Jex & Elaqua, 1999 ; Macan et al., 1990 ), and greater job satisfaction (Macan, 1994 ). However, Macan ( 1994 ) did not find a relationship between time management and performance. Still, Claessens, van Eerde, Rutte, and Roe ( 2004 ) found that perceived control of time partially mediated the relationships between planning behavior (an indicator of time management), job autonomy, and workload on one hand, and job strains, job satisfaction, and job performance on the other hand. Moreover, Peeters and Rutte ( 2005 ) observed that teachers with high work demands and low autonomy experienced more burnout when they had poor time management skills.

Person-Organization Fit

Just as it is important for organizations to find the right person for the job and organization, so is it the responsibility of a person to choose to work at the right organization—an organization that fulfills the person’s needs and upholds the values important to the individual, as much as the person fulfills the organization’s needs and adapts to its values. When people fit their employing organizations they are setting themselves up for experiencing less strain-producing stressors (Kristof-Brown et al., 2005 ). In a meta-analysis of 62 person-job fit studies and 110 person-organization fit studies, Kristof-Brown et al. ( 2005 ) found that person-job fit had a negative correlation with indicators of job strain. In fact, a primary intervention of career counseling can help to reduce stress levels (Firth-Cozens, 2003 ).

Job Redesign

The Job Demands-Control/Support (JD-C/S), Job Demands-Resources (JD-R), and transactional models all suggest that factors in the work context require modifications in order to reduce potential ill-health and poor organizational performance. Drawing on Hackman and Oldham’s ( 1980 ) Job Characteristics Model, it is possible to assess with the Job Diagnostics Survey (JDS) the current state of work characteristics related to skill variety, task identity, task significance, autonomy, and feedback. Modifying those aspects would help create a sense of meaningfulness, sense of responsibility, and feeling of knowing how one is performing, which subsequently affects a person’s well-being as identified in assessments of motivation, satisfaction, improved performance, and reduced withdrawal intentions and behaviors. Extending this argument to the stress models, it can be deduced that reducing uncertainty or perceived unfairness that may be associated with a person’s perception of these work characteristics, as well as making changes to physical characteristics of the environment (e.g., lighting, seating, desk, air quality), nature of work (e.g., job responsibilities, roles, decision-making latitude), and organizational arrangements (e.g., reporting structure and feedback mechanisms), can help mitigate against numerous ill-health consequences and reduced organizational performance. In fact, Fried et al. ( 2013 ) showed that healthy patients of a medical clinic whose jobs were excessively low (i.e., monotonous) or excessively high (i.e., overstimulating) on job enrichment (as measured by the JDS) had greater abdominal obesity than those whose jobs were optimally enriched. By taking stock of employees’ perceptions of the current work situation, managers might think about ways to enhance employees’ coping toolkit, such as training on how to deal with difficult clients or creating stimulating opportunities when jobs have low levels of enrichment.

Participatory Action Research Interventions

Participatory action research (PAR) is an intervention wherein, through group discussions, employees help to identify and define problems in organizational structure, processes, policies, practices, and reward structures, as well as help to design, implement, and evaluate success of solutions. PAR is in itself an intervention, but its goal is to design interventions to eliminate or reduce work-related factors that are impeding performance and causing people to be unwell. An example of a successful primary intervention, utilizing principles of PAR and driven by the JD-C and JD-C/S stress frameworks is Health Circles (HCs; Aust & Ducki, 2004 ).

HCs, developed in Germany in the 1980s, were popular practices in industries, such as metal, steel, and chemical, and service. Similar to other problem-solving practices, such as quality circles, HCs were based on the assumptions that employees are the experts of their jobs. For this reason, to promote employee well-being, management and administrators solicited suggestions and ideas from the employees to improve occupational health, thereby increasing employees’ job control. HCs also promoted communication between managers and employees, which had a potential to increase social support. With more control and support, employees would experience less strains and better occupational well-being.

Employing the three-steps of (1) problem analysis (i.e., diagnosis or discovery through data generated from organizational records of absenteeism length, frequency, rate, and reason and employee survey), (2) HC meetings (6 to 10 meetings held over several months to brainstorm ideas to improve occupational safety and health concerns identified in the discovery phase), and (3) HC evaluation (to determine if desired changes were accomplished and if employees’ reports of stressors and strains changed after the course of 15 months), improvements were to be expected (Aust & Ducki, 2004 ). Aust and Ducki ( 2004 ) reviewed 11 studies presenting 81 health circles in 30 different organizations. Overall study participants had high satisfaction with the HCs practices. Most companies acted upon employees’ suggestions (e.g., improving driver’s seat and cab, reducing ticket sale during drive, team restructuring and job rotation to facilitate communication, hiring more employees during summer time, and supervisor training program to improve leadership and communication skills) to improve work conditions. Thus, HCs represent a successful theory-grounded intervention to routinely improve employees’ occupational health.

Physical Setting

The physical environment or physical workspace has an enormous impact on individuals’ well-being, attitudes, and interactions with others, as well as on the implications on innovation and well-being (Oksanen & Ståhle, 2013 ; Vischer, 2007 ). In a study of 74 new product development teams (total of 437 study respondents) in Western Europe, Chong, van Eerde, Rutte, and Chai ( 2012 ) found that when teams were faced with challenge time pressures, meaning the teams had a strong interest and desire in tackling complex, but engaging tasks, when they were working proximally close with one another, team communication improved. Chong et al. assert that their finding aligns with prior studies that have shown that physical proximity promotes increased awareness of other team members, greater tendency to initiate conversations, and greater team identification. However, they also found that when faced with hindrance time pressures, physical proximity related to low levels of team communication, but when hindrance time pressure was low, team proximity had an increasingly greater positive relationship with team communication.

In addition to considering the type of work demand teams must address, other physical workspace considerations include whether people need to work collaboratively and synchronously or independently and remotely (or a combination thereof). Consideration needs to be given to how company contributors would satisfy client needs through various modes of communication, such as email vs. telephone, and whether individuals who work by a window might need shading to block bright sunlight from glaring on their computer screens. Finally, people who have to use the telephone for extensive periods of time would benefit from earphones to prevent neck strains. Most physical stressors are rather simple to rectify. However, companies are often not aware of a problem until after a problem arises, such as when a person’s back is strained from trying to move heavy equipment. Companies then implement strategies to remediate the environmental stressor. With the help of human factors, and organizational and office design consultants, many of the physical barriers to optimal performance can be prevented (Rousseau & Aubé, 2010 ). In a study of 215 French-speaking Canadian healthcare employees, Rousseau and Aubé ( 2010 ) found that although supervisor instrumental support positively related with affective commitment to the organization, the relationship was even stronger for those who reported satisfaction with the ambient environment (i.e., temperature, lighting, sound, ventilation, and cleanliness).

Secondary Interventions (Coping)

Secondary interventions, also referred to as coping, focus on resources people can use to mitigate the risk of work-related illness or workplace injury. Resources may include properties related to social resources, behaviors, and cognitive structures. Each of these resource domains may be employed to cope with stressors. Monat and Lazarus ( 1991 ) summarize the definition of coping as “an individual’s efforts to master demands (or conditions of harm, threat, or challenge) that are appraised (or perceived) as exceeding or taxing his or her resources” (p. 5). To master demands requires use of the aforementioned resources. Secondary interventions help employees become aware of the psychological, physical, and behavioral responses that may occur from the stressors presented in their working environment. Secondary interventions help a person detect and attend to stressors and identify resources for and ways of mitigating job strains. Often, coping strategies are learned skills that have a cognitive foundation and serve important functions in improving people’s management of stressors (Lazarus & Folkman, 1991 ). Coping is effortful, but with practice it becomes easier to employ. This idea is the foundation for understanding the role of resilience in coping with stressors. However, “not all adaptive processes are coping. Coping is a subset of adaptational activities that involves effort and does not include everything that we do in relating to the environment” (Lazarus & Folkman, 1991 , p. 198). Furthermore, sometimes to cope with a stressor, a person may call upon social support sources to help with tangible materials or emotional comfort. People call upon support resources because they help to restructure how a person approaches or thinks about the stressor.

Most secondary interventions are aimed at helping the individual, though companies, as a policy, might require all employees to partake in training aimed at increasing employees’ awareness of and skills aimed at handling difficult situations vis à vis company channels (e.g., reporting on sexual harassment or discrimination). Furthermore, organizations might institute mentoring programs or work groups to address various work-related matters. These programs employ awareness-raising activities, stress-education, or skills training (cf., Bhagat, Segovis, & Nelson, 2012 ), which include development of skills in problem-solving, understanding emotion-focused coping, identifying and using social support, and enhancing capacity for resilience. The aim of these programs, therefore, is to help employees proactively review their perceptions of psychological, physical, and behavioral job-related strains, thereby extending their resilience, enabling them to form a personal plan to control stressors and practice coping skills (Cooper, Dewe, & O’Driscoll, 2011 ).

Often these stress management programs are instituted after an organization has observed excessive absenteeism and work-related performance problems and, therefore, are sometimes categorized as a tertiary stress management intervention or even a primary (prevention) intervention. However, the skills developed for coping with stressors also place the programs in secondary stress management interventions. Example programs that are categorized as tertiary or primary stress management interventions may also be secondary stress management interventions (see Figure 1 ), and these include lifestyle advice and planning, stress inoculation training, simple relaxation techniques, meditation, basic trainings in time management, anger management, problem-solving skills, and cognitive-behavioral therapy. Corporate wellness programs also fall under this category. In other words, some programs could be categorized as primary, secondary, or tertiary interventions depending upon when the employee (or organization) identifies the need to implement the program. For example, time management practices could be implemented as a means of preventing some stressors, as a way to cope with mounting stressors, or as a strategy to mitigate symptoms of excessive of stressors. Furthermore, these programs can be administered at the individual level or group level. As related to secondary interventions, these programs provide participants with opportunities to develop and practice skills to cognitively reappraise the stressor(s); to modify their perspectives about stressors; to take time out to breathe, stretch, meditate, relax, and/or exercise in an attempt to support better decision-making; to articulate concerns and call upon support resources; and to know how to say “no” to onslaughts of requests to complete tasks. Participants also learn how to proactively identify coping resources and solve problems.

According to Cooper, Dewe, and O’Driscoll ( 2001 ), secondary interventions are successful in helping employees modify or strengthen their ability to cope with the experience of stressors with the goal of mitigating the potential harm the job stressors may create. Secondary interventions focus on individuals’ transactions with the work environment and emphasize the fit between a person and his or her environment. However, researchers have pointed out that the underlying assumption of secondary interventions is that the responsibility for coping with the stressors of the environment lies within individuals (Quillian-Wolever & Wolever, 2003 ). If companies cannot prevent the stressors in the first place, then they are, in part, responsible for helping individuals develop coping strategies and informing employees about programs that would help them better cope with job stressors so that they are able to fulfill work assignments.

Stress management interventions that help people learn to cope with stressors focus mainly on the goals of enabling problem-resolution or expressing one’s emotions in a healthy manner. These goals are referred to as problem-focused coping and emotion-focused coping (Folkman & Lazarus, 1980 ; Pearlin & Schooler, 1978 ), and the person experiencing the stressors as potential threat is the agent for change and the recipient of the benefits of successful coping (Hobfoll, 1998 ). In addition to problem-focused and emotion-focused coping approaches, social support and resilience may be coping resources. There are many other sources for coping than there is room to present here (see e.g., Cartwright & Cooper, 2005 ); however, the current literature has primarily focused on these resources.

Problem-Focused Coping

Problem-focused or direct coping helps employees remove or reduce stressors in order to reduce their strain experiences (Bhagat et al., 2012 ). In problem-focused coping employees are responsible for working out a strategic plan in order to remove job stressors, such as setting up a set of goals and engaging in behaviors to meet these goals. Problem-focused coping is viewed as an adaptive response, though it can also be maladaptive if it creates more problems down the road, such as procrastinating getting work done or feigning illness to take time off from work. Adaptive problem-focused coping negatively relates to long-term job strains (Higgins & Endler, 1995 ). Discussion on problem-solving coping is framed from an adaptive perspective.

Problem-focused coping is featured as an extension of control, because engaging in problem-focused coping strategies requires a series of acts to keep job stressors under control (Bhagat et al., 2012 ). In the stress literature, there are generally two ways to categorize control: internal versus external locus of control, and primary versus secondary control. Locus of control refers to the extent to which people believe they have control over their own life (Rotter, 1966 ). People high in internal locus of control believe that they can control their own fate whereas people high in external locus of control believe that outside factors determine their life experience (Rotter, 1966 ). Generally, those with an external locus of control are less inclined to engage in problem-focused coping (Strentz & Auerbach, 1988 ). Primary control is the belief that people can directly influence their environment (Alloy & Abramson, 1979 ), and thus they are more likely to engage in problem-focused coping. However, when it is not feasible to exercise primary control, people search for secondary control, with which people try to adapt themselves into the objective environment (Rothbaum, Weisz, & Snyder, 1982 ).

Emotion-Focused Coping

Emotion-focused coping, sometimes referred to as palliative coping, helps employees reduce strains without the removal of job stressors. It involves cognitive or emotional efforts, such as talking about the stressor or distracting oneself from the stressor, in order to lessen emotional distress resulting from job stressors (Bhagat et al., 2012 ). Emotion-focused coping aims to reappraise and modify the perceptions of a situation or seek emotional support from friends or family. These methods do not include efforts to change the work situation or to remove the job stressors (Lazarus & Folkman, 1991 ). People tend to adopt emotion-focused coping strategies when they believe that little or nothing can be done to remove the threatening, harmful, and challenging stressors (Bhagat et al., 2012 ), such as when they are the only individuals to have the skills to get a project done or they are given increased responsibilities because of the unexpected departure of a colleague. Emotion-focused coping strategies include (1) reappraisal of the stressful situation, (2) talking to friends and receiving reassurance from them, (3) focusing on one’s strength rather than weakness, (4) optimistic comparison—comparing one’s situation to others’ or one’s past situation, (5) selective ignoring—paying less attention to the unpleasant aspects of one’s job and being more focused on the positive aspects of the job, (6) restrictive expectations—restricting one’s expectations on job satisfaction but paying more attention to monetary rewards, (7) avoidance coping—not thinking about the problem, leaving the situation, distracting oneself, or using alcohol or drugs (e.g., Billings & Moos, 1981 ).

Some emotion-focused coping strategies are maladaptive. For example, avoidance coping may lead to increased level of job strains in the long run (e.g., Parasuraman & Cleek, 1984 ). Furthermore, a person’s ability to cope with the imbalance of performing work to meet organizational expectations can take a toll on the person’s health, leading to physiological consequences such as cardiovascular disease, sleep disorders, gastrointestinal disorders, and diabetes (Fried et al., 2013 ; Siegrist, 2010 ; Toker, Shirom, Melamed, & Armon, 2012 ; Willert, Thulstrup, Hertz, & Bonde, 2010 ).

Comparing Coping Strategies across Cultures

Most coping research is conducted in individualistic, Western cultures wherein emotional control is emphasized and both problem-solving focused coping and primary control are preferred (Bhagat et al., 2010 ). However, in collectivistic cultures, emotion-focused coping and use of secondary control may be preferred and may not necessarily carry a negative evaluation (Bhagat et al., 2010 ). For example, African Americans are more likely to use emotion-focused coping than non–African Americans (Knight, Silverstein, McCallum, & Fox, 2000 ), and among women who experienced sexual harassment, Anglo American women were less likely to employ emotion focused coping (i.e., avoidance coping) than Turkish women and Hispanic American women, while Hispanic women used more denial than the other two groups (Wasti & Cortina, 2002 ).

Thus, whereas problem-focused coping is venerated in Western societies, emotion-focused coping may be more effective in reducing strains in collectivistic cultures, such as China, Japan, and India (Bhagat et al., 2010 ; Narayanan, Menon, & Spector, 1999 ; Selmer, 2002 ). Indeed, Swedish participants reported more problem-focused coping than did Chinese participants (Xiao, Ottosson, & Carlsson, 2013 ), American college students engaged in more problem-focused coping behaviors than did their Japanese counterparts (Ogawa, 2009 ), and Indian (vs. Canadian) students reported more emotion-focused coping, such as seeking social support and positive reappraisal (Sinha, Willson, & Watson, 2000 ). Moreover, Glazer, Stetz, and Izso ( 2004 ) found that internal locus of control was more predominant in individualistic cultures (United Kingdom and United States), whereas external locus of control was more predominant in communal cultures (Italy and Hungary). Also, internal locus of control was associated with less job stress, but more so for nurses in the United Kingdom and United States than Italy and Hungary. Taken together, adoption of coping strategies and their effectiveness differ significantly across cultures. The extent to which a coping strategy is perceived favorably and thus selected or not selected is not only a function of culture, but also a person’s sociocultural beliefs toward the coping strategy (Morimoto, Shimada, & Ozaki, 2013 ).

Social Support

Social support refers to the aid an entity gives to a person. The source of the support can be a single person, such as a supervisor, coworker, subordinate, family member, friend, or stranger, or an organization as represented by upper-level management representing organizational practices. The type of support can be instrumental or emotional. Instrumental support, including informational support, refers to that which is tangible, such as data to help someone make a decision or colleagues’ sick days so one does not lose vital pay while recovering from illness. Emotional support, including esteem support, refers to the psychological boost given to a person who needs to express emotions and feel empathy from others or to have his or her perspective validated. Beehr and Glazer ( 2001 ) present an overview of the role of social support on the stressor-strain relationship and arguments regarding the role of culture in shaping the utility of different sources and types of support.

Meaningfulness and Resilience

Meaningfulness reflects the extent to which people believe their lives are significant, purposeful, goal-directed, and fulfilling (Glazer, Kożusznik, Meyers, & Ganai, 2014 ). When faced with stressors, people who have a strong sense of meaning in life will also try to make sense of the stressors. Maintaining a positive outlook on life stressors helps to manage emotions, which is helpful in reducing strains, particularly when some stressors cannot be problem-solved (Lazarus & Folkman, 1991 ). Lazarus and Folkman ( 1991 ) emphasize that being able to reframe threatening situations can be just as important in an adaptation as efforts to control the stressors. Having a sense of meaningfulness motivates people to behave in ways that help them overcome stressors. Thus, meaningfulness is often used in the same breath as resilience, because people who are resilient are often protecting that which is meaningful.

Resilience is a personality state that can be fortified and enhanced through varied experiences. People who perceive their lives are meaningful are more likely to find ways to face adversity and are therefore more prone to intensifying their resiliency. When people demonstrate resilience to cope with noxious stressors, their ability to be resilient against other stressors strengthens because through the experience, they develop more competencies (Glazer et al., 2014 ). Thus, fitting with Hobfoll’s ( 1989 , 2001 ) COR theory, meaningfulness and resilience are psychological resources people attempt to conserve and protect, and employ when necessary for making sense of or coping with stressors.

Tertiary Interventions (Stress Management)

Stress management refers to interventions employed to treat and repair harmful repercussions of stressors that were not coped with sufficiently. As Lazarus and Folkman ( 1991 ) noted, not all stressors “are amenable to mastery” (p. 205). Stressors that are unmanageable and lead to strains require interventions to reverse or slow down those effects. Workplace interventions might focus on the person, the organization, or both. Unfortunately, instead of looking at the whole system to include the person and the workplace, most companies focus on the person. Such a focus should not be a surprise given the results of van der Klink, Blonk, Schene, and van Dijk’s ( 2001 ) meta-analysis of 48 experimental studies conducted between 1977 and 1996 . They found that of four types of tertiary interventions, the effect size for cognitive-behavioral interventions and multimodal programs (e.g., the combination of assertive training and time management) was moderate and the effect size for relaxation techniques was small in reducing psychological complaints, but not turnover intention related to work stress. However, the effects of (the five studies that used) organization-focused interventions were not significant. Similarly, Richardson and Rothstein’s ( 2008 ) meta-analytic study, including 36 experimental studies with 55 interventions, showed a larger effect size for cognitive-behavioral interventions than relaxation, organizational, multimodal, or alternative. However, like with van der Klink et al. ( 2001 ), Richardson and Rothstein ( 2008 ) cautioned that there were few organizational intervention studies included and the impact of interventions were determined on the basis of psychological outcomes and not physiological or organizational outcomes. Van der Klink et al. ( 2001 ) further expressed concern that organizational interventions target the workplace and that changes in the individual may take longer to observe than individual interventions aimed directly at the individual.

The long-term benefits of individual focused interventions are not yet clear either. Per Giga, Cooper, and Faragher ( 2003 ), the benefits of person-directed stress management programs will be short-lived if organizational factors to reduce stressors are not addressed too. Indeed, LaMontagne, Keegel, Louie, Ostry, and Landsbergis ( 2007 ), in their meta-analysis of 90 studies on stress management interventions published between 1990 and 2005 , revealed that in relation to interventions targeting organizations only, and interventions targeting individuals only, interventions targeting both organizations and individuals (i.e. the systems approach) had the most favorable positive effects on both the organizations and the individuals. Furthermore, the organization-level interventions were effective at both the individual and organization levels, but the individual-level interventions were effective only at the individual level.

Individual-Focused Stress Management

Individual-focused interventions concentrate on improving conditions for the individual, though counseling programs emphasize that the worker is in charge of reducing “stress,” whereas role-focused interventions emphasize activities that organizations can guide to actually reduce unnecessary noxious environmental factors.

Individual-Focused Stress Management: Employee Assistance Programs

When stress become sufficiently problematic (which is individually gauged or attended to by supportive others) in a worker’s life, employees may utilize the short-term counseling services or referral services Employee Assistance Programs (EAPs) provide. People who utilize the counseling services may engage in cognitive behavioral therapy aimed at changing the way people think about the stressors (e.g., as challenge opportunity over threat) and manage strains. Example topics that may be covered in these therapy sessions include time management and goal setting (prioritization), career planning and development, cognitive restructuring and mindfulness, relaxation, and anger management. In a study of healthcare workers and teachers who participated in a 2-day to 2.5-day comprehensive stress management training program (including 26 topics on identifying, coping with, and managing stressors and strains), Siu, Cooper, and Phillips ( 2013 ) found psychological and physical improvements were self-reported among the healthcare workers (for which there was no control group). However, comparing an intervention group of teachers to a control group of teachers, the extent of change was not as visible, though teachers in the intervention group engaged in more mastery recovery experiences (i.e., they purposefully chose to engage in challenging activities after work).

Individual-Focused Stress Management: Mindfulness

A popular therapy today is to train people to be more mindful, which involves helping people live in the present, reduce negative judgement of current and past experiences, and practicing patience (Birnie, Speca, & Carlson, 2010 ). Mindfulness programs usually include training on relaxation exercises, gentle yoga, and awareness of the body’s senses. In one study offered through the continuing education program at a Canadian university, 104 study participants took part in an 8-week, 90 minute per group (15–20 participants per) session mindfulness program (Birnie et al., 2010 ). In addition to body scanning, they also listened to lectures on incorporating mindfulness into one’s daily life and received a take-home booklet and compact discs that guided participants through the exercises studied in person. Two weeks after completing the program, participants’ mindfulness attendance and general positive moods increased, while physical, psychological, and behavioral strains decreased. In another study on a sample of U.K. government employees, study participants receiving three sessions of 2.5 to 3 hours each training on mindfulness, with the first two sessions occurring in consecutive weeks and the third occurring about three months later, Flaxman and Bond ( 2010 ) found that compared to the control group, the intervention group showed a decrease in distress levels from Time 1 (baseline) to Time 2 (three months after first two training sessions) and Time 1 to Time 3 (after final training session). Moreover, of the mindfulness intervention study participants who were clinically distressed, 69% experienced clinical improvement in their psychological health.

Individual-Focused Stress Management: Biofeedback/Imagery/Meditation/Deep Breathing

Biofeedback uses electronic equipment to inform users about how their body is responding to tension. With guidance from a therapist, individuals then learn to change their physiological responses so that their pulse normalizes and muscles relax (Norris, Fahrion, & Oikawa, 2007 ). The therapist’s guidance might include reminders for imagery, meditation, body scan relaxation, and deep breathing. Saunders, Driskell, Johnston, and Salas’s ( 1996 ) meta-analysis of 37 studies found that imagery helped reduce state and performance anxiety. Once people have been trained to relax, reminder triggers may be sent through smartphone push notifications (Villani et al., 2013 ).

Smartphone technology can also be used to support weight loss programs, smoking cessation programs, and medication or disease (e.g., diabetes) management compliance (Heron & Smyth, 2010 ; Kannampallil, Waicekauskas, Morrow, Kopren, & Fu, 2013 ). For example, smartphones could remind a person to take medications or test blood sugar levels or send messages about healthy behaviors and positive affirmations.

Individual-Focused Stress Management: Sleep/Rest/Respite

Workers today sleep less per night than adults did nearly 30 years ago (Luckhaupt, Tak, & Calvert, 2010 ; National Sleep Foundation, 2005 , 2013 ). In order to combat problems, such as increased anxiety and cardiovascular artery disease, associated with sleep deprivation and insufficient rest, it is imperative that people disconnect from their work at least one day per week or preferably for several weeks so that they are able to restore psychological health (Etzion, Eden, & Lapidot, 1998 ; Ragsdale, Beehr, Grebner, & Han, 2011 ). When college students engaged in relaxation-type activities, such as reading or watching television, over the weekend, they experienced less emotional exhaustion and greater general well-being than students who engaged in resources-consuming activities, such as house cleaning (Ragsdale et al., 2011 ). Additional research and future directions for research are reviewed and identified in the work of Sonnentag ( 2012 ). For example, she asks whether lack of ability to detach from work is problematic for people who find their work meaningful. In other words, are negative health consequences only among those who do not take pleasure in their work? Sonnetag also asks how teleworkers detach from their work when engaging in work from the home. Ironically, one of the ways that companies are trying to help with the challenges of high workload or increased need to be available to colleagues, clients, or vendors around the globe is by offering flexible work arrangements, whereby employees who can work from home are given the opportunity to do so. Companies that require global interactions 24-hours per day often employ this strategy, but is the solution also a source of strain (Glazer, Kożusznik, & Shargo, 2012 )?

Individual-Focused Stress Management: Role Analysis

Role analysis or role clarification aims to redefine, expressly identify, and align employees’ roles and responsibilities with their work goals. Through role negotiation, involved parties begin to develop a new formal or informal contract about expectations and define resources needed to fulfill those expectations. Glazer has used this approach in organizational consulting and, with one memorable client engagement, found that not only were the individuals whose roles required deeper re-evaluation happier at work (six months later), but so were their subordinates. Subordinates who once characterized the two partners as hostile and akin to a couple going through a bad divorce, later referred to them as a blissful pair. Schaubroeck, Ganster, Sime, and Ditman ( 1993 ) also found in a three-wave study over a two-year period that university employees’ reports of role clarity and greater satisfaction with their supervisor increased after a role clarification exercise of top managers’ roles and subordinates’ roles. However, the intervention did not have any impact on reported physical symptoms, absenteeism, or psychological well-being. Role analysis is categorized under individual-focused stress management intervention because it is usually implemented after individuals or teams begin to demonstrate poor performance and because the intervention typically focuses on a few individuals rather than an entire organization or group. In other words, the intervention treats the person’s symptoms by redefining the role so as to eliminate the stimulant causing the problem.

Organization-Focused Stress Management

At the organizational level, companies that face major declines in productivity and profitability or increased costs related to healthcare and disability might be motivated to reassess organizational factors that might be impinging on employees’ health and well-being. After all, without healthy workers, it is not possible to have a healthy organization. Companies may choose to implement practices and policies that are expected to help not only the employees, but also the organization with reduced costs associated with employee ill-health, such as medical insurance, disability payments, and unused office space. Example practices and policies that may be implemented include flexible work arrangements to ensure that employees are not on the streets in the middle of the night for work that can be done from anywhere (such as the home), diversity programs to reduce stress-induced animosity and prejudice toward others, providing only healthy food choices in cafeterias, mandating that all employees have physicals in order to receive reduced prices for insurance, company-wide closures or mandatory paid time off, and changes in organizational visioning.

Organization-Focused Stress Management: Organizational-Level Occupational Health Interventions

As with job design interventions that are implemented to remediate work characteristics that were a source of unnecessary or excessive stressors, so are organizational-level occupational health (OLOH) interventions. As with many of the interventions, its placement as a primary or tertiary stress management intervention may seem arbitrary, but when considering the goal and target of change, it is clear that the intervention is implemented in response to some ailing organizational issues that need to be reversed or stopped, and because it brings in the entire organization’s workforce to address the problems, it has been placed in this category. There are several more case studies than empirical studies on the topic of whole system organizational change efforts (see example case studies presented by the United Kingdom’s Health and Safety Executive). It is possible that lack of published empirical work is not so much due to lack of attempting to gather and evaluate the data for publication, but rather because the OLOH interventions themselves never made it to the intervention stage, the interventions failed (Biron, Gatrell, & Cooper, 2010 ), or the level of evaluation was not rigorous enough to get into empirical peer-review journals. Fortunately, case studies provide some indication of the opportunities and problems associated with OLOH interventions.

One case study regarding Cardiff and Value University Health Board revealed that through focus group meetings with members of a steering group (including high-level managers and supported by top management) and facilitated by a neutral, non-judgemental organizational health consultant, ideas for change were posted on newsprint, discussed, and areas in the organization needing change were identified. The intervention for giving voice to people who initially had little already had a positive effect on the organization, as absence decreased by 2.09% and 6.9% merely 12 and 18 months, respectively, after the intervention. Translated in financial terms, the 6.9% change was equivalent to a quarterly savings of £80,000 (Health & Safety Executive, n.d. ). Thus, focusing on the context of change and how people will be involved in the change process probably helped the organization realize improvements (Biron et al., 2010 ). In a recent and rare empirical study, employing both qualitative and quantitative data collection methods, Sørensen and Holman ( 2014 ) utilized PAR in order to plan and implement an OLOH intervention over the course of 14 months. Their study aimed to examine the effectiveness of the PAR process in reducing workers’ work-related and social or interpersonal-related stressors that derive from the workplace and improving psychological, behavioral, and physiological well-being across six Danish organizations. Based on group dialogue, 30 proposals for change were proposed, all of which could be categorized as either interventions to focus on relational factors (e.g., management feedback improvement, engagement) or work processes (e.g., reduced interruptions, workload, reinforcing creativity). Of the interventions that were implemented, results showed improvements on manager relationship quality and reduced burnout, but no changes with respect to work processes (i.e., workload and work pace) perhaps because the employees already had sufficient task control and variety. These findings support Dewe and Kompier’s ( 2008 ) position that occupational health can be reinforced through organizational policies that reinforce quality jobs and work experiences.

Organization-Focused Stress Management: Flexible Work Arrangements

Dewe and Kompier ( 2008 ), citing the work of Isles ( 2005 ), noted that concern over losing one’s job is a reason for why 40% of survey respondents indicated they work more hours than formally required. In an attempt to create balance and perceived fairness in one’s compensation for putting in extra work hours, employees will sometimes be legitimately or illegitimately absent. As companies become increasingly global, many people with desk jobs are finding themselves communicating with colleagues who are halfway around the globe and at all hours of the day or night (Glazer et al., 2012 ). To help minimize the strains associated with these stressors, companies might devise flexible work arrangements (FWA), though the type of FWA needs to be tailored to the cultural environment (Masuda et al., 2012 ). FWAs give employees some leverage to decide what would be the optimal work arrangement for them (e.g., part-time, flexible work hours, compressed work week, telecommuting). In other words, FWA provides employees with the choice of when to work, where to work (on-site or off-site), and how many hours to work in a day, week, or pay period (Kossek, Thompson, & Lautsch, 2015 ). However, not all employees of an organization have equal access to or equitable use of FWAs; workers in low-wage, hourly jobs are often beholden to being physically present during specific hours (Swanberg McKechnie, Ojha, & James, 2011 ). In a study of over 1,300 full-time hourly retail employees in the United States, Swanberg et al. ( 2011 ) showed that employees who have control over their work schedules and over their work hours were satisfied with their work schedules, perceived support from the supervisor, and work engagement.

Unfortunately, not all FWAs yield successful results for the individual or the organization. Being able to work from home or part-time can have problems too, as a person finds himself or herself working more hours from home than required. Sometimes telecommuting creates work-family conflict too as a person struggles to balance work and family obligations while working from home. Other drawbacks include reduced face-to-face contact between work colleagues and stakeholders, challenges shaping one’s career growth due to limited contact, perceived inequity if some have more flexibility than others, and ambiguity about work role processes for interacting with employees utilizing the FWA (Kossek et al., 2015 ). Organizations that institute FWAs must carefully weigh the benefits and drawbacks the flexibility may have on the employees using it or the employees affected by others using it, as well as the implications on the organization, including the vendors who are serving and clients served by the organization.

Organization-Focused Stress Management: Diversity Programs

Employees in the workplace might experience strain due to feelings of discrimination or prejudice. Organizational climates that do not promote diversity (in terms of age, religion, physical abilities, ethnicity, nationality, sex, and other characteristics) are breeding grounds for undesirable attitudes toward the workplace, lower performance, and greater turnover intention (Bergman, Palmieri, Drasgow, & Ormerod, 2012 ; Velez, Moradi, & Brewster, 2013 ). Management is thus advised to implement programs that reinforce the value and importance of diversity, as well as manage diversity to reduce conflict and feelings of prejudice. In fact, managers who attended a leadership training program reported higher multicultural competence in dealing with stressful situations (Chrobot-Mason & Leslie, 2012 ), and managers who persevered through challenges were more dedicated to coping with difficult diversity issues (Cilliers, 2011 ). Thus, diversity programs can help to reduce strains by directly reducing stressors associated with conflict linked to diversity in the workplace and by building managers’ resilience.

Organization-Focused Stress Management: Healthcare Management Policies

Over the past few years, organizations have adopted insurance plans that implement wellness programs for the sake of managing the increasing cost of healthcare that is believed to be a result of individuals’ not managing their own health, with regular check-ups and treatment. The wellness programs require all insured employees to visit a primary care provider, complete a health risk assessment, and engage in disease management activities as specified by a physician (e.g., see frequently asked questions regarding the State of Maryland’s Wellness Program). Companies believe that requiring compliance will reduce health problems, although there is no proof that such programs save money or that people would comply. One study that does, however, boast success, was a 12-week workplace health promotion program aimed at reducing Houston airport workers’ weight (Ebunlomo, Hare-Everline, Weber, & Rich, 2015 ). The program, which included 235 volunteer participants, was deemed a success, as there was a total weight loss of 345 pounds (or 1.5 lbs per person). Given such results in Houston, it is clear why some people are also skeptical over the likely success of wellness programs, particularly as there is no clear method for evaluating their efficacy (Sinnott & Vatz, 2015 ).

Moreover, for some, such a program is too paternalistic and intrusive, as well as punishes anyone who chooses not to actively participate in disease management programs (Sinnott & Vatz, 2015 ). The programs put the onus of change on the person, though it is a response to the high costs of ill-health. The programs neglect to consider the role of the organization in reducing the barriers to healthy lifestyle, such as cloaking exempt employment as simply needing to get the work done, when it usually means working significantly more hours than a standard workweek. In fact, workplace health promotion programs did not reduce presenteeism (i.e., people going to work while unwell thereby reducing their job performance) among those who suffered from physical pain (Cancelliere, Cassidy, Ammendolia, & Côte, 2011 ). However, supervisor education, worksite exercise, lifestyle intervention through email, midday respite from repetitive work, a global stress management program, changes in lighting, and telephone interventions helped to reduce presenteeism. Thus, emphasis needs to be placed on psychosocial aspects of the organization’s structure, including managers and overall organizational climate for on-site presence, that reinforces such behavior (Cancelliere et al., 2011 ). Moreover, wellness programs are only as good as the interventions to reduce work-related stressors and improve organizational resources to enable workers to improve their overall psychological and physical health.

Concluding Remarks

Future research.

One of the areas requiring more theoretical and practical attention is that of the utility of stress frameworks to guide organizational development change interventions. Although it has been proposed that the foundation for work stress management interventions is in organizational development, and even though scholars and practitioners of organization development were also founders of research programs that focused on employee health and well-being or work stress, there are few studies or other theoretical works that link the two bodies of literature.

A second area that requires additional attention is the efficacy of stress management interventions across cultures. In examining secondary stress management interventions (i.e., coping), some cross-cultural differences in findings were described; however, there is still a dearth of literature from different countries on the utility of different prevention, coping, and stress management strategies.

A third area that has been blossoming since the start of the 21st century is the topic of hindrance and challenge stressors and the implications of both on workers’ well-being and performance. More research is needed on this topic in several areas. First, there is little consistency by which researchers label a stressor as a hindrance or a challenge. Researchers sometimes take liberties with labels, but it is not the researchers who should label a stressor but the study participants themselves who should indicate if a stressor is a source of strain. Rodríguez, Kozusznik, and Peiró ( 2013 ) developed a measure in which respondents indicate whether a stressor is a challenge or a hindrance. Just as some people may perceive demands to be challenges that they savor and that result in a psychological state of eustress (Nelson & Simmons, 2003 ), others find them to be constraints that impede goal fulfillment and thus might experience distress. Likewise, some people might perceive ambiguity as a challenge that can be overcome and others as a constraint over which he or she has little control and few or no resources with which to cope. More research on validating the measurement of challenge vs. hindrance stressors, as well as eustress vs. distress, and savoring vs. coping, is warranted. Second, at what point are challenge stressors harmful? Just because people experiencing challenge stressors continue to perform well, it does not necessarily mean that they are healthy people. A great deal of stressors are intellectually stimulating, but excessive stimulation can also take a toll on one’s physiological well-being, as evident by the droves of professionals experiencing different kinds of diseases not experienced as much a few decades ago, such as obesity (Fried et al., 2013 ). Third, which stress management interventions would better serve to reduce hindrance stressors or to reduce strain that may result from challenge stressors while reinforcing engagement-producing challenge stressors?

A fourth area that requires additional attention is that of the flexible work arrangements (FWAs). One of the reasons companies have been willing to permit employees to work from home is not so much out of concern for the employee, but out of the company’s need for the focal person to be able to communicate with a colleague working from a geographic region when it is night or early morning for the focal person. Glazer, Kożusznik, and Shargo ( 2012 ) presented several areas for future research on this topic, noting that by participating on global virtual teams, workers face additional stressors, even while given flexibility of workplace and work time. As noted earlier, more research needs to be done on the extent to which people who take advantage of FWAs are advantaged in terms of detachment from work. Can people working from home detach? Are those who find their work invigorating also likely to experience ill-health by not detaching from work?

A fifth area worthy of further research attention is workplace wellness programing. According to Page and Vella-Brodrick ( 2009 ), “subjective and psychological well-being [are] key criteria for employee mental health” (p. 442), whereby mental health focuses on wellness, rather than the absence of illness. They assert that by fostering employee mental health, organizations are supporting performance and retention. Employee well-being can be supported by ensuring that jobs are interesting and meaningful, goals are achievable, employees have control over their work, and skills are used to support organizational and individual goals (Dewe & Kompier, 2008 ). However, just as mental health is not the absence of illness, work stress is not indicative of an absence of psychological well-being. Given the perspective that employee well-being is a state of mind (Page & Vella-Brodrick, 2009 ), we suggest that employee well-being can be negatively affected by noxious job stressors that cannot be remediated, but when job stressors are preventable, employee well-being can serve to protect an employee who faces job stressors. Thus, wellness programs ought to focus on providing positive experiences by enhancing and promoting health, as well as building individual resources. These programs are termed “green cape” interventions (Pawelski, 2016 ). For example, with the growing interests in positive psychology, researchers and practitioners have suggested employing several positive psychology interventions, such as expressing gratitude, savoring experiences, and identifying one’s strengths (Tetrick & Winslow, 2015 ). Another stream of positive psychology is psychological capital, which includes four malleable functions of self-efficacy, optimism, hope, and resilience (Luthans, Youssef, & Avolio, 2007 ). Workplace interventions should include both “red cape” interventions (i.e., interventions to reduce negative experiences) and “green cape” interventions (i.e., workplace wellness programs; Polly, 2014 ).

A Healthy Organization’s Pledge

A healthy workplace requires healthy workers. Period. Among all organizations’ missions should be the focus on a healthy workforce. To maintain a healthy workforce, the company must routinely examine its own contributions in terms of how it structures itself; reinforces communications among employees, vendors, and clients; how it rewards and cares for its people (e.g., ensuring they get sufficient rest and can detach from work); and the extent to which people at the upper levels are truly connected with the people at the lower levels. As a matter of practice, management must recognize when employees are overworked, unwell, and poorly engaged. Management must also take stock of when it is doing well and right by its contributors’ and maintain and reinforce the good practices, norms, and procedures. People in the workplace make the rules; people in the workplace can change the rules. How management sees its employees and values their contribution will have a huge role in how a company takes stock of its own pain points. Providing employees with tools to manage their own reactions to work-related stressors and consequent strains is fine, but wouldn’t it be grand if organizations took better notice about what they could do to mitigate the strain-producing stressors in the first place and take ownership over how employees are treated?

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The Impact of Stress Management Within Organizations and Its Effects on Employees’ Performance

97 Pages Posted: 18 Nov 2020

Ya Adam Jallow

American International University West Africa

Date Written: May 1, 2020

The purpose of this study is to examine the Impact of Stress Management within Organizations and its Effects on Employees’ Performance. Stress is an unavoidable factor in everyone’s lives. People deal with it more than once in their lifetime. Stress may be defined as a feeling of physical, psychological or emotional tension which is developed by different circumstances or events that occur in our lives. In every organization, employees are the backbone that ensures the smooth running of the business. But as a matter of fact, these employees are ordinary people who are vulnerable to any and all threats, be it physical, emotional and psychological and this includes stress. It can cause them to lose focus in their activities and accumulate low yield or performance in most or all their functions seeing as they will be too distracted thinking about their own problems to do their work. Despite that, stress can also be positive because it pushes people to do more and fulfill their obligations. It can add an extra boost to your way of thinking and their pace of doing their work. Moreover, stress is not uncontrollable. It can be managed in order to protect any sort of negative impacts/ effects. This is what is called stress management. It is defined as the method or techniques of handling or controlling stress. Stress management has a huge effect on employees and their performance as it brings about positivity and competence, therefore, it has an even greater impact on the organization because if their employees are stress free, they are at least 95% focused in their duties, thus the businesses advantages increase. This study therefor is undertaken to investigate what impact stress and stress management has on organizations and its effects on employees’ performance, to determine what causes stress, to identify the different types or dimensions of stress and how to handle or manage stress. Questionnaires will be used the primary method of data gathering and desk research will also be used as secondary method of collecting data which will be analysed and put together for summary, recommendations and conclusion.

Keywords: Stress Management, Human Resources, Research

Suggested Citation: Suggested Citation

Ya Adam Jallow (Contact Author)

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Stress management.

Mary Worthen ; Elizabeth Cash .


Last Update: August 14, 2023 .

  • Introduction

Effective techniques for stress management are varied. They typically include behaviors that improve physical health, such as nutrition and exercise, but may also incorporate strategies that improve cognitive and emotional functioning. The stress-reduction approach based on mindfulness practices has recently enjoyed an explosion of interest from a variety of healthcare and epidemiological researchers. [1] [2] [3] The concept of mindfulness, which originates from practices of Buddhism, is defined as a focused awareness of one’s experience, and purposeful and nonjudgmental focus on the present moment. [4] Structured interventions, such as the Mindfulness-Based Stress Reduction (MBSR) program, provide participants with the opportunity to learn breathing meditation, body scanning techniques, and gentle, yoga-inspired physical exercises. [5] With practice, individuals learn to process emotions, thoughts, and sensations as they arise. Individuals learn to modify their reflexive conditioning from automatically reacting or worrying about the future to a more adaptive, measured response with greater awareness of the present moment. [6] The literature is replete with evidence suggesting that, with practice, individuals can become more mindful, increasing their capacity to fully process emotions, thoughts, and sensations as they arise. [7] [8] [9] [10] [11] [12] MBSR interventions have been adapted to a wide variety of individuals, from those suffering from chronic or debilitating health conditions to healthy undergraduate or medical students. Randomized controlled trials of MBSR interventions have demonstrated improvements to psychological and physiological processes with relevance to health outcomes and improved stress management.

Some individuals have a greater innate, or trait, capacity for mindfulness. These individuals, who have not participated in mindfulness-training interventions, tend to experience better physical health, report fewer physiological symptoms such as pain, and utilize fewer healthcare resources. [13] Trait mindfulness has been associated with lower ratings of anxiety and depression in a variety of medical and non-medical populations. [14] Trait mindfulness may emerge from a genetic predisposition. A recent epidemiological study of adolescent twins revealed that trait mindfulness was 32% heritable. [15] The same study also revealed that 66% of the variance in trait mindfulness was due to environmental factors, suggesting that is also a skill that can be learned. In fact, an MBSR study in university undergraduates revealed that, while increases in mindfulness and psychological outcomes can be observed in participants as a whole, effects may be more pronounced among individuals higher in trait mindfulness at study entry. [16] These data substantiate the utility of mindfulness training, even for high-trait individuals.

  • Issues of Concern

Standard MBSR Programs

Standard MBSR programs have demonstrated potential to ameliorate physiological dysregulation, including attenuated hypothalamic-pituitary-adrenal (HPA) axis activation, autonomic activation, and inflammation. [17] [18] A study of healthy adult males who endorsed a higher capacity for present-moment focus found they also exhibited reduced emotional distress and autonomic (heart rate) reactivity when exposed to hypoxic conditions. [19] Neural correlates may underlie relationships between mindfulness practices and central nervous system (CNS) function reported in the literature. Higher trait mindfulness positively correlates with activity in the anterior cingulate and prefrontal cortices in healthy adults, both of which demonstrate reduced activity in studies of individuals suffering from anxiety and depressive disorders. [20] Levels of trait mindfulness also correlate with grey matter volume reductions in the amygdala and caudate in healthy adults and greater volume in bilateral gyri of adults with generalized anxiety disorder. [20] Likewise, studies also demonstrate that mindfulness training results in increased blood flow in the amygdala and hippocampal regions among breast cancer patients and increased grey matter concentrations in the norepinephrine and serotonin systems in the brain of in healthy adults. [21] [22] This evidence for shared neural circuitry suggests at least partial mechanisms by which mindful approaches may be beneficial for individuals who are experiencing prolonged psychological distress or difficulty managing stress.

Mindfulness-Based Stress Reduction

Mindfulness-Based Stress Reduction (MBSR) was initially designed to relieve suffering among chronic pain patients by teaching skills that cultivate present moment-focused, non-judgmental awareness. [5] Three formal mindfulness techniques are taught over eight weeks: The “body scan,” an attention-focusing technique; gentle yoga; and sitting meditation. The body scan is performed supine with attention directed systematically and non-judgmentally through regions of the body, encouraging relaxed awareness and acceptance of proprioceptive and interoceptive sensation. Hatha yoga consists of gentle movement and stretching sequences that promote awareness of movement and position. Sitting meditation helps develop a stable cognitive perspective from which to observe mental events with openness and acceptance without becoming caught up in distressing thoughts or feelings. Informal mindfulness practice is also encouraged: Participants cultivate an awareness of the present moment, whether perceived as pleasant or unpleasant. The intent is to help participants become engaged with the experiences of each moment as they arise and learn to face stressful events in a way that is skillfully responsive rather than habitually reactive. With practice, individuals learn to modify their reflexive conditioning from automatically reacting or worrying about the future to a more adaptive, measured response with greater awareness of the present moment.

Traditional MBSR Interventions

Traditional MBSR interventions can easily be performed without the use of specialized equipment. Many group administrators and practitioners prefer to have materials handy to help modify movement-based exercises and yoga poses for those with physical limitations. Typically a yoga mat, blocks, and strap are sufficient. Studies of MBSR group interventions have suggested that limiting group size to less than 20 individuals is preferable to build a cohesive dynamic between practitioners (see Lehrer, Woolfolk, and Sime, Principles and practice of stress management. New York: Guilford). [23] Guided practices, including the body scan and sitting meditations, are available on electronic media or for download from several sources. There is also an abundance of freely available apps and podcasts that offer mindfulness teachings, guided and unguided timed sitting and supine meditations, and guided mindfulness practices to listen to during activities such as exercising or cleaning. Most are available for free or for a range of modest costs. Some offer free trials, while some apps and many quality podcasts are totally free. Encourage interested individuals to try out a few different options and find what works best for them. Practitioners also may find that different approaches are more preferable, depending on the day, stress level, and practice time available. We caution individuals to avoid listening to guided sessions or podcasts while driving, as increased drowsiness may occur. 

Mindfulness-based interventions may be optimized to enhance pre-existing practitioner strengths and address specific stress-management needs. Among cancer patients, a benefit was observed after an MBSR program incorporated a shortened length of meditation assignments, reduced frequency of group meetings, and adjustments of the physical movements taught (e.g., yoga poses). Similar modifications have been considered for other cancer patient samples, including changing the usual mindful (raisin) eating exercise to utilize a liquid for those who have trouble eating or swallowing, omitting the day-long silent retreat if thought to be too taxing or inappropriate for the population, adjusting physical movements to account for any injury or pain that may be present, and employing an individual (versus group) format to better incorporate session scheduling with medical appointments. [24] Given the similar improvements to psychological measures when compared to standard MBSR program outcomes, modified interventions may not be an inferior approach to increasing mindfulness practices among participants. These strategies may be advantageous with regard to implementation and utilization by practitioners who are experiencing busy daily activities and have limited flexibility to facilitate adding a new routine to their daily lives. 

  • Clinical Significance

Several authors have offered thoughtful conceptualizations of mechanisms by which mindfulness may reduce stress and ameliorate illness symptoms. [25] Theoretical models focus on metacognitive factors, explore mindfulness in the context of a widely accepted model of stress and coping, and contrast this practice, which stems from Eastern tradition and includes Western psychology. [26] [27] Other recent work has highlighted the need to examine process variables related to the techniques used, individual meditation practice, social factors, and other aspects of MBSR. [28]

Novice mindfulness practitioners also engage in "informal" practice as they learn to observe their own thoughts and sensations and explore a new stance as a nonjudgmental observer of their own life. Attending to one’s own experience may set up a dynamic cognitive interaction that can facilitate a capacity to respond to ongoing experiences as if they are occurring for the first time, typically referred to as "beginner’s mind." This interrupts the automatic processes of relying on previously conditioned stress reactions. Paradoxically, positive changes seem especially likely to occur when one can let go of the struggle of trying to change or control the process. This perspective lies at the core of empirically validated acceptance-based intervention model. A focus on the present moment can potentially help decondition habitual reaction patterns and increase response flexibility. From a cognitive perspective, this suggests that viewing present circumstances as new and unique experiences increases one’s capacity for generating multiple alternative response options. Mindfulness also may address cognitive-behavioral factors, such as self-focused attention, experiential avoidance, and perceived control. [29] [30]

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Disclosure: Mary Worthen declares no relevant financial relationships with ineligible companies.

Disclosure: Elizabeth Cash declares no relevant financial relationships with ineligible companies.

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  • Cite this Page Worthen M, Cash E. Stress Management. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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Stress Research Paper

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Coping with Stress

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Get 10% off with 24start discount code, i. concept of coping, a. why is coping important for mental health, b. historical overview, ii. determinants of coping responses, a. personality characteristics as determinants of coping, b. situational specificity in coping, iii. ways of coping with stress, a. problem-focused coping, b. emotion-focused coping, 1. emotional expression, 2. seeking social support, 3. escape-avoidance, 4. positive illusion, 5. social comparison, c. relationship-focused coping, 1. empathic responding, 2. active engagement and protective buffering, iv. conclusion.

In common parlance, ‘‘coping’’ is often used to suggest that individuals are handling stress well or that they have the situation under control. However, most health psychologists who study stress and coping would define coping broadly to include all thoughts and behaviors that occur in response to a stressful experience, whether the person is handling the situation well or poorly. Coping includes what we do and think in response to a stressor, even if we are unaware of why or what we are doing. This broad definition is important for two reasons. First, if we limit the definition of coping to thoughts and behaviors that the individual purposefully and intentionally engages in as a way of handling the stressful situation, we may exclude a wide array of responses that typically remain outside of awareness. These can include, for example, believing in unrealistically positive illusions, escaping through the use of alcohol and other drugs, or fleeing from stress in one area of life (e.g., family) by immersing oneself in some unrelated activity (e.g., work). Second, this definition of coping does not assume a priori that some forms of coping are bad and others are good. All of the person’s responses to the stressor are considered coping, whether or not they help to resolve the situation. This is important, as in recent years researchers have found that many forms of coping that have traditionally been considered bad coping, such as escape-avoidance, may actually have beneficial effects when coping with certain types of stressors under specific circumstances.

Many disorders of mental health are either directly caused by stress or their expression is triggered by stress. In cases where a person is already experiencing poor health, stress can exacerbate and maintain the problems. However, there are wide individual differences in the effects of stress, and these are thought to be largely due to individual differences in coping with stress. Therefore, many health psychologists have turned their attention in recent years to trying to understand the antecedents and consequences of various ways of coping with stress.

In early models, certain forms of coping (and people who used them) were viewed as immature, dysfunctional, or maladaptive. Many emotion-focused strategies were not even considered forms of coping, but merely defenses. These models lost favor as evidence accumulated that many forms of coping previously assumed to be maladaptive could sometimes have positive effects, at least in certain circumstances. Researchers such as Lazarus conceptualized coping as a process in constant flux, responsive to changes in situational demands. The focus on situational factors as primary determinants of coping responses was welcomed as a correction of previous tendencies to treat coping in trait terms. Claims made by Mischel in 1968 that personality traits are poor predictors of behavior were also influential. Furthermore, the findings of a number of studies suggest that in general, situational factors play a larger role in determining responses to stress than do personality traits. Thus, earlier notions of rigid ‘‘styles’’ of coping have been replaced by an understanding that coping is best conceived in process terms. Given this new understanding of coping that emerged during the 1970s and 1980s, the role of personality in coping was given scant attention during those years. Recently, it has been acknowledged that although personality may not be the single most important determinant of coping responses to stress, its role is nonetheless quite important. In the past few years, health psychologists have again turned their attention to examining personality factors that might determine how people cope with stress. Currently, most researchers in the field would agree that how a person copes with stress will shift over time depending on an array of factors that can be broken down into two broad categories: person and situation.

Clinicians and researchers alike have examined the role of personality in coping in an attempt to predict and explain which individuals are at risk for experiencing psychological maladjustment. The underlying assumption is that personality can influence how one copes with stress, and coping determines whether stress will have deleterious effects on health and well-being. A consistent set of personality traits have emerged as significant predictors of the ways in which people cope and the impact coping has on their health. The following is a brief summary of the various personality traits that have been empirically related to coping.

The last 50 years have seen a growing interest in the role of personality as measured by the big five personality traits of neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness. These five factors are believed by many personality researchers to be the five basic underlying dimensions of personality. Researchers have tended to find that neuroticism (the tendency to experience negative affect) is related to maladaptive coping efforts and poor psychological well-being. In comparison, researchers have tended to find that extraversion (the tendency to be gregarious and to experience positive affect) is related to adaptive coping and better psychological well-being. Individuals high on openness (the tendency to be creative and open to feelings and experiences) remain strong in the face of adversity and are more able to engage in coping that is sensitive to the needs of others. Given that two defining features of openness to experience are originality and creativity, future research may show individuals high on openness to be particularly effective and flexible copers. Those individuals high on agreeableness (the tendency to be good-natured) also appear to cope in an adaptive manner that is sensitive to the needs of others. Individuals high on agreeableness tend to engage in less negative interpersonal coping strategies (e.g., confronting others), more positive interpersonal coping (e.g., seeking social support), and lower levels of maladaptive emotion-focused coping (e.g., escape avoidance). Individuals high on agreeableness may seek to avoid additional conflict and distress when coping. Finally, those individuals high on conscientiousness (the tendency to be careful and reliable) have been found to engage in lower levels of maladaptive emotion-focused coping (e.g., escape avoidance) and higher use of problem-focused coping. Individuals high in conscientiousness may seek to engage in the most responsible and constructive forms of coping.

The way in which one anticipates future events has also been established to have an impact on well-being. The tendency to anticipate positive outcomes for the future is referred to as optimism. Carver, Scheier, and others have reported this trait to be associated with both adaptive coping and good mental health. High levels of optimism may lead to higher levels of constructive coping, which in turn reduce distress, making positive expectations highly adaptive. In contrast, pessimistic individuals (those who do not generally anticipate positive future outcomes) tend to use more maladaptive coping strategies, which in turn are related to higher levels of both anxiety and depression.

An internal locus of control (i.e., feeling a sense of personal control) over the events and experiences in one’s life is often positively related to psychological well-being, whereas an external sense of control (i.e., lacking a sense of personal control and feeling that control over events is external to oneself) is often negatively related to mental health criteria. Research examining locus of control as a stable personality trait has identified several ways in which this trait influences both coping and psychological adjustment. For example, studies have found that an internal locus of control is related to greater use of problem-focused coping. It appears that a belief in one’s ability to impact or change events is related to constructive attempts to alter or change aspects of the environment or oneself under times of duress. Given that such problem-focused coping efforts are generally associated with better psychological outcomes, at least when used with stressors that are controllable, an internal locus of control can have beneficial effects upon mental health.

Currently, there is much interest among researchers in studying the factors within a given situation that determine how an individual will cope, how the chosen coping strategies influence mental health, and how this process varies from situation to situation. In 1984, Lazarus and Folkman identified a number of dimensions of stressful situations that are important determinants of the stress and coping process. Novelty (has the individual coped with this type of stressor in the past?), predictability (are there signs that will alert an individual to the onset of the stressful event /situation?), event uncertainty (how likely is it that the situation will occur?), imminence (is the event likely to occur in the near future?), duration (how long will the experience last?), and temporal uncertainty (is it possible to identify whether the event will occur?) all impact affective, cognitive, and behavioral reactions to stress. That is, these situational factors play a role in determining the extent to which a person experiences a situation as stressful, and in turn, how he or she copes with the stressful situation.

Several researchers have conducted studies that explore a variety of situational determinants of coping. Consistent with the hypothesis that situational factors do influence the coping process, researchers have tended to find that different situations elicit different forms of coping, and similar situations elicit similar modes of coping. In addition, similar coping strategies have been found to have different effects across different situations, in that the effectiveness of any one coping strategy and its impact on well-being varies from situation to situation. This points to the importance of a match between a chosen coping strategy and the situationally specific demands of a stressor to maximize emotional adjustment and minimize ongoing struggles. Thus, the particular characteristics of a stressful situation determine both coping choice and coping effectiveness. For example, positive reappraisal is generally an effective coping strategy related to psychological well-being. However, in 1991, Wethington and Kessler noted that when the stressful situation calls for some form of action to be taken, the use of positive reappraisal alone is related to psychological maladjustment. Likewise, in 1994, Aldwin pointed out that emotion- focused coping is more effective when coping with a situation that is perceived as involving loss, whereas problem-focused coping is more effective when coping with a situation that is appraised as a threat or challenge. Therefore, one must be cautious in making generalizations about the relation of specific coping strategies to mental health, as this relation will vary according to the situational demands.

Empirical evidence supports the hypothesis that individuals will vary their coping efforts and choices systematically to fit a given stressor. General coping styles aggregated over time tend to be poorly correlated with the ways in which one copes in a specific situation. That is, researchers or clinicians cannot accurately predict how an individual will cope with any one specific stressor by relying on the average way in which the same individual copes across a variety of situations over time. To illustrate, an individual may engage in moderately high levels of a particular coping strategy over time but not use this particular strategy at all when coping with a certain type of stressor. Averaging coping responses across multiple situations, therefore, obscures important information about how coping is related to well-being under specific and well-defined circumstances.

Researchers such as Wethington and Kessler have identified several ways in which coping varies from situation to situation. First, the ways in which individuals cope with an acute but short-term stressor often differs from the ways in which they cope with an ongoing chronic stressor. Second, the ways in which individuals cope can also be influenced by the coping responses of others around them. Third, individuals tend to use different strategies depending on the role domain in which stress occurs. Fourth, situations are defined by a multitude of demands and therefore any one stressor may demand multiple coping strategies in order to be resolved effectively. Those with the highest psychological well-being may well be those individuals who can successfully engage in a variety of coping strategies. Rigid adherence to a small set of coping strategies geared toward direct resolution of the stressor, at the expense of those that might help to reduce stress-related negative emotions, could be maladaptive in many circumstances.

Researchers have begun to examine the ways in which situational factors interact with person factors in determining how people cope with stress. Existing evidence suggests that coping varies as a function of both the situation and the person. For example, in 1986, Parkes found that individuals low in neuroticism varied their use of direct action according to the level of work demands. In comparison, those individuals high in neuroticism did not vary their use of direct action in response to changing levels of work demands. Furthermore, although situational factors play a larger role overall in determining coping responses, the more ambiguous a stressful situation is, the greater the influence of person factors on the coping process.

Historically, coping has been seen as serving two basic functions: problem-focused (active attempts to alter and resolve the stressful situation) and emotion-focused (efforts to regulate one’s emotions). Recently, a third function that concerns relationship-focused coping (efforts to manage and maintain social relationships during stressful periods) has been studied as well.

Problem-focused coping includes those forms of coping that are geared directly toward solving the problem or changing the stressful situation. Most of the research examining problem-focused coping has been on planful problem-solving. Coping strategies based on planful problem-solving involve conscious attempts to determine and execute the most appropriate course of action needed to directly prevent, eliminate, or significantly improve a stressful situation. Making a plan of action and following it is an example of the sort of cool deliberate strategy that typifies this form of coping. Although the primary effect of problem-focused modes of coping is to change or eliminate the stressful environment, it is not unusual for such coping to result inadvertently in a reduction in negative affect and/or an increase in positive affect (e.g., devising and carrying out a plan to finish a task that one has felt pressured to complete). The increase in positive affect following the use of planful problem-solving may be the result of an improvement both in the way one perceives the stressful situation and in the direct changes in the stressful situation itself. In general, planful problem-solving tends to be associated with less negative emotion, more positive emotion, positive reappraisals of the stressful situation, and satisfactory outcomes.

Important moderators of this strategy and its influence on psychological well-being have been documented. First, it appears that individuals engage in a higher use of planful problem-solving when they perceive a situation or encounter as one in which something can be changed for the better. Furthermore, the use of this strategy in uncontrollable or unchangeable situations seems to have a negative impact on psychological health. It appears that pursuing a futile course of action can interfere with the adaptive function of accepting those things that cannot be changed or altered. Second, when a loved one has something to lose in a stressful situation, individuals tend to use lower amounts of planful problem-solving than when a loved one does not have something to lose. Individuals seem to experience difficulty formulating a plan of action when coping with the added emotional distress invoked by concern for a loved one’s well-being. Third, when the stress occurs at work, individuals tend to use higher levels of planful problem-solving. In this context, many forms of emotion-focused coping strategies may be viewed as ineffective and socially inappropriate.

In summary, in situations that require a course of action to minimize or reduce stress, the individual may be better off engaging in planful problem-solving efforts rather than in emotion-focused strategies such as denial. Such efforts will more likely improve the interactions between an individual and their environment, and have a positive impact on well-being.

Emotion-focused modes of coping include those forms of coping that are geared toward managing one’s emotions during stressful periods. A larger number of studies have examined emotion-focused modes of coping than either problem- or relationship-focused modes of coping. All of the many forms of emotion-focused coping that have been described in the literature cannot possibly be discussed here. Instead, we focus on those forms that have received the most attention in the scholarly literature.

Emotional expression is the active expression of one’s thoughts and feelings about an experience or event, and is a common way to cope with stress. The expression can take place through a variety of interpersonal, verbal, and artistic means, including talking or corresponding with someone, keeping a diary, and drawing or painting.

Pennebaker reviews the historical relation of emotional expression to mental health, as reflected in Maslow’s notion of self-expression and Freud’s concept of emotional catharsis. However, modern researchers studying this phenomenon have construed emotional expression as more than simply the venting of emotions. Pennebaker and his colleagues suggest that it is the active expression of both thoughts and feelings surrounding experiences that makes emotional expression a beneficial form of coping with stress. Pennebaker suggests that this expression can aid in deriving a sense of meaning, insight, and resolution by initiating a process in which facts, feelings, thoughts, and options can be organized effectively.

Pennebaker and colleagues have found across several studies that emotional expression is positively related to both psychological and physical well-being. These studies used a variety of modes of emotional expression, such as writing essays about one’s experiences, talking out loud into a tape recorder, or talking to another individual. In comparison, active inhibition (i.e., the deliberate and conscious nonexpression of one’s thoughts and feelings) has been found to be negatively related to psychological well-being. In addition, emotional expression that is inappropriately disclosing (e.g., telling a nonreceptive stranger), overly self-absorbed (i.e., disengaging and isolating the listener), overly intellectualized (i.e., lacking acknowledgment and expression of one’s feelings), or done in the presence of an unsupportive and critical person, is less likely to have beneficial effects.

There are individual differences in people’s ability and desire to engage in emotional expression. For example, some people tend to engage in high levels of emotional expression, whereas others do not. This area of research suggests that the degree of emotional expression may reflect a general personality trait. Gender differences in emotional expression have also been found as women tend to report higher levels of emotional expression than men.

There are a variety of contexts in which individuals coping with stress may engage in emotional expression. As Pennebaker points out, support groups, self-help programs (e.g., Alcoholics Anonymous), telephone crisis lines, psychotherapy, pastoral counseling, and even internet discussions all provide a context in which emotional expression is supported, if not actively encouraged. Evidence suggests that emotional expression has a disease-preventative effect.

Another common way of coping with stress is to seek some form of social support. The social support sought may be informational support (e.g., an individual recently diagnosed with HIV contacting a support group to find out more about the virus), tangible support (e.g., a grieving widow asking a friend to help baby-sit her children for an afternoon), or emotional support (e.g., a recently laid-off worker accepting sympathy and understanding from a friend). In general, higher levels of social support are associated with better psychological and physical well-being. However, the quality of available social support is more important to well-being than the absolute amount of available social support. To illustrate, an individual who has a few constructively supportive friends and family members may receive better social support and experience greater health benefits than an individual who has many friends and family members but who do not provide constructive social support. In this context, constructive social support consists of support provision that meets the needs of the individual seeking such support.

In 1988, Fisher and colleagues differentiated between solicited versus unsolicited social support. There are times when members of one’s social support network provide unsolicited social support. Unsolicited support tends to occur when the stressor is highly visible and there exist social norms as to how members of the social network should behave (e.g., a death in the family, loss of a child, dissolution of a marriage). However, individuals often have to cope with stressors that are not readily apparent to those around them. During such times, an individual must actively seek social support in order to receive it. Furthermore, a variety of factors seem to play a role in the extent to which individuals will seek social support as part of their coping with such stressors. For example, if individuals blame themselves for the occurrence of a stigmatizing stressor (e.g., contracting HIV after having unprotected sex), they may be less likely to seek social support because of the potential for embarrassment, stigmatization, judgment, and further blame. Given that nondisclosure of stressful experiences has been associated with threats to psychological well-being, not seeking social support may result in an increase risk for disorders of health and well-being.

Individuals may also resist seeking social support when the support available has the potential to add stress to an already stressful situation. Social support would be feared when the support provider delivers social support in an excessive or inappropriate manner. To illustrate, an individual suffering from a chronic, debilitating illness such as rheumatoid arthritis (RA) may avoid seeking social support if doing so threatens their independence (e.g., a support provider insists on doing everything for the individual with RA rather than simply facilitating the sufferer’s own coping efforts).

In addition, individual differences have been found in both the extent to which individuals will seek social support and the degree to which they perceive seeking social support to be an effective coping strategy. For example, Thoits, in 1991, found that women engage in higher levels of support seeking than men and perceive seeking social support as a more effective coping strategy than do men. Personality differences also influence the extent to which seeking social support is an effective coping strategy. Recent research has indicated that certain personality traits may explain some of the individual differences in the seeking and receiving of social support. To illustrate, individuals high in neuroticism may tend to elicit negative reactions from others when they seek social support, whereas individuals low in neuroticism may tend to elicit positive reactions. Therefore, different individuals may seek social support to varying degrees and invoke different reactions from others depending on their particular personality and interpersonal style. This suggests that the very individuals most likely to experience threats to their psychological well-being (e.g., those high in neuroticism) and therefore most in need of social support may be those individuals least likely to seek and receive social support in a way that is beneficial to their mental health.

There are times when individuals fail to cope actively with a stressful situation and instead engage in efforts to avoid confronting the stressor. Attempts at escape and avoidance can take a variety of cognitive or behavioral forms, such as wishful thinking, distancing, denial, or engaging in distracting activities. For example, an individual may attempt to repress thoughts of a recently deceased spouse as a cognitive means of escape-avoidance. Likewise, one could immerse oneself in cleaning the house as a way of avoiding a stressful task such as paying bills. As Aldwin noted, certain ways of coping can serve as avoidant coping strategies on one occasion despite serving as approach coping strategies on another. As an example, Aldwin suggests that cognitive reappraisal may function as a constructive approach strategy when used to view a stressful situation more positively and when acting as a catalyst for further action. Conversely, cognitive reappraisal may serve as an avoidant coping strategy when used to rationalize a lack of action or justify engaging in actions that lead to further avoidance (e.g., drinking to make oneself feel better).

Avoidant coping strategies are often a response to the negative affect that results from a stressful situation. For example, some individuals may initially deny that a stressful situation has occurred in an effort to minimize their distress (e.g., not accepting the possibility that a lump in one’s breast may be cancer). Researchers such as Lazarus have suggested that in the early stages of a stressor, such avoidant type strategies may be adaptive in that minimizing distress levels allows one time to adapt and to gather one’s resources. By decreasing levels of distress, short-term escape avoidance may increase one’s ability to engage in active problem-focused coping. Similarly, the use of escape- avoidance may minimize negative affect while one is waiting for a potentially short-term stressor to pass (e.g., reading a magazine to relieve anxiety while waiting to hear the results of an important medical test).

Despite the positive short-term effectiveness of escape- avoidance in reducing psychological distress, the long-term use of escape-avoidance is generally associated with lowered psychological well-being. For example, although distraction is useful when coping with short-term stressors (e.g., medical and dental procedures), long-term use of distraction with an ongoing stressor (e.g., coping with unemployment) is associated with maladjustment. The negative association between the use of escape-avoidance strategies and well-being may result from the lack of constructive action that the continued use of escape-avoidance can entail. That is, when avoiding thoughts or behaviors that are directed at a stressor, one also tends to avoid engaging in constructive efforts that could potentially reduce both the source and degree of one’s distress. In extreme situations, the use of prolonged escape-avoidance can backfire by amplifying a stressful situation and creating added emotional distress (e.g., avoiding obtaining medical attention until it is too late to receive basic treatment).

Historically, it has been assumed that reality-based perceptions are essential to the maintenance of mental health and psychological well-being. However, in 1988, Taylor and Brown suggested that ‘‘positive illusions’’ (i.e., unrealistically positive perceptions) are related to several common criteria of mental health, such as feelings of contentment and the ability to care for others. They argue that a positive misconstrual of experiences over time is beneficial to the psychological adjustment of the individual engaging in such perceptions. Research suggests that more positive views of the self are associated with lower levels of distress, and Taylor and Brown have argued that a relatively unbiased and balanced perception of the self tends to be related to higher levels of distress. Given that distress tends to be related to less constructive forms of coping, a positive view of the self may have beneficial effects through an increase in constructive coping efforts, even if the positive self-view is illusory. For example, individuals fighting life-threatening illnesses such as diabetes may perceive themselves to be higher in personal strength than others, which in turn may lead to more persistent and effective attempts to cope with their disease.

In a similar vein, Taylor reviews research that establishes a positive relation between illusory perceptions of control and mental health. For example, depressed individuals have been found to have perceptions of control closer to reality than nondepressed individuals. Research assessing control has also demonstrated that when coping with a stressful experience, those individuals who feel a greater sense of control will tend to experience better psychological well-being, even when the sense of control is overestimated. For example, a patient dying of AIDS may experience better psychological well-being by choosing to use alternative medicine, thus obtaining some sense of personal control over the treatment of a disease that remains incurable.

Various mechanisms may explain the relation between positive illusions and mental health when individuals are faced with coping with stress in their lives. For example, Taylor hypothesizes that positive illusions are related to positive mood, which in turn is related to social bonding, which in turn is related to higher levels of well-being. Given the adaptive role that constructive social support plays in the coping process, the potential ability of positive illusions to increase social bonding could be highly beneficial. Taylor also suggests that illusions may enhance creative functioning, motivation, persistence, and performance. Higher levels of all of these factors may lead to more effective coping and better well-being (e.g., higher levels of motivation and creativity could increase one’s ability to develop an unusual but highly effective coping strategy).

Recently it has been suggested that conclusions regarding the relation between positive illusions and mental health are an artifact of methodological problems inherent to this area of study. Specifically, Colvin, Block, and Funder, in 1991, argued that previous research has not used valid criteria for establishing objective reality. Without such criteria, it is difficult to verify which individuals are truly engaging in positive illusions. Therefore, conclusions regarding the relation between positive illusions and psychological adjustment may have been premature. These researchers found empirical evidence suggesting that positive illusions can have negative influences on both short-term and long-term mental health.

In 1954, Festinger suggested that individuals are driven to compare themselves to others as a means of obtaining information about oneself and the world during times of threat or ambiguity (i.e., stress). Although the patterns of findings are diverse and sometimes complex, most research in this field suggests that social comparison processes have important implications for psychological well-being. In fact, several researchers have proposed that social comparisons play a central role in the way in which people cope with stressful experiences. For example, social comparisons can help individuals evaluate their resources and provide information relevant to managing emotional reactions to stress. However, the underlying motivation and purpose that each individual has for engaging in this type of coping and the resultant psychological outcomes can be diverse.

In 1989, Wood described three classes of motivational factors that drive a person to engage in social comparisons: self-evaluation, self-improvement, and self-enhancement. All three purposes can be relevant to coping with stress and may aid the individual in striving toward an adaptive outcome. Self-evaluation motivations to engage in social comparison stem from an individual’s desire to obtain information regarding his or her standing on a particular skill or attribute. Self-improvement motivations to engage in social comparison suggest that individuals are interested in deriving information regarding another’s standing on a particular skill or attribute in order to improve their own standing on the same dimension. Self-enhancement motivations to engage in social comparison stem from a need to see oneself in a more positive manner; that is, the results of the social comparison are used to make one feel better about one’s own standing on a particular skill or attribute relative to others.

When an individual seeks a social comparison target as a means of coping with an ambiguous or threatening situation, several options are available. One can select an individual who has a higher or more positive standing than oneself on the dimension in question (i.e., an ‘‘upward social comparison’’). Alternatively, one can select an individual who has a lower or more negative standing than oneself on the relevant dimension (i.e., a ‘‘downward social comparison’’). Presumably, comparisons against others who differ from oneself produce distinctive and discriminating information that has immediate and practical implications for the individual when engaging in coping efforts.

In general, research suggests that when people engage in downward comparisons, they feel more positive and less negative about themselves than when they engage in upward comparisons. Individuals engaging in downward social comparisons because of self-enhancement motivations tend to experience reduced levels of negative affect and feel better about themselves in both field and experimental studies. For example, in their 1985 study of women coping with breast cancer, Wood and her colleagues found that downward comparisons appeared to help women feel better about how they were dealing with their illness by yielding positive evaluations relative to women who were not coping as effectively. However, research has also demonstrated that when individuals are motivated by self-improvement or self-evaluation needs, there is a clear preference for upward comparison information. Under these circumstances, comparisons may help determine what kinds of interventions or efforts are both possible and necessary to cope more effectively with a particular stressor.

Collins proposed in 1996 that the outcomes of social comparisons are not predetermined by the direction in which one makes a comparison. Instead, evidence supports the notion that both upward and downward comparisons can have both positive and negative impacts on psychological well-being. First, upward comparisons can generate negative psychological outcomes through a contrast effect (i.e., one feels inferior to the comparison target). Second, upward comparisons may also yield positive effects through the inspiration and hope they generate. These types of comparisons may be especially helpful for problem-solving activities, as they can provide constructive information that suggests specific coping strategies. Third, downward comparisons can lead to positive outcomes presumably because they allow one to focus on ways in which one is doing well relative to others. Such comparisons may be especially helpful in regulating negative emotions. Finally, downward comparisons can lead to negative outcomes from the fear that one will ‘‘sink’’ to the lower level of the comparison target at some future point in time. Such comparisons may have special significance for individuals coping with illness, where it is feasible that their disease will progress negatively. Given that both downward and upward comparisons contain both positive and negative information relevant to the self, the particular aspect the individual focuses on while coping will determine the valence of the outcome.

A growing number of moderating variables are being identified as important factors in determining the impact social comparison will have as a coping strategy during times of stress, threat, or ambiguity. For example, it appears that individuals with high self-esteem have a greater tendency to derive positive outcomes from either upward or downward social comparisons than individuals with low self-esteem. Other researchers have also noted the important role played by perceived control. Individuals with high degrees of perceived control over the dimension in question may be less likely to experience negative reactions to social comparisons in contrast to those with low levels of control. Individual differences in familiarity with a stressor may also moderate the process of social comparison. For example, an individual who has just discovered they have HIV (unfamiliar dimension)may select different comparison targets for coping than an individual who has been living with the illness for some time (familiar dimension). Presumably, the type of information one needs in order to adapt to threats will vary according to how long one has been dealing with the threat. In addition to individual differences, it appears that the situational context in which the social comparison process takes place is an important determinant of the impact of the comparison itself. For example, different contexts vary in terms of the potential social comparison targets they provide.

At times, individuals will actively self-select when to engage in social comparison and with whom they wish to compare themselves. However, as Collins noted, social comparisons can sometimes be forced on the individual. For example, researchers have found that someone who needs health care services for a serious condition may have no choice but to sit in a waiting room with other individuals who also have the same condition, making social comparisons unavoidable. Such comparisons most likely make it difficult for an individual to avoid the possibility that his or her own illness and condition could get worse. In addition, researchers have suggested that the impact of forced comparisons can be particularly aversive when the comparison target is someone with whom the individual is interdependent (e.g., close friend, co-worker). This suggests that individuals may sometimes have to cope with the stressful nature of the social comparison itself.

Regardless of whether or not one chooses to engage in social comparison, once the social comparison process is underway (i.e., target is compared against), there are some active strategies that individuals can use to maximize the probability of obtaining a positive outcome. First, peripheral dimensions can be used to moderate comparison outcomes. If a comparison produces an unfavorable outcome (e.g., an upward comparison that leaves one feeling inferior), one can always attribute the lower standing to differences between oneself and the target on other related variables (e.g., sex, ethnicity, duration of stressor). Alternatively, as previously discussed, individuals can actively distort information to maintain a more positive perception of reality.

In summary, social comparison processes provide valuable information that individuals can use for a variety of purposes when coping with stress, threat, or ambiguity. The target selected, the situation or context in which the comparison is made, and the unique traits of both the individual and the comparison target have an impact on the outcome of the comparison process. As a result, social comparison may have a positive impact on well-being for particular individuals in certain situations, and a negative impact on well-being for other individuals in different situations. Research has demonstrated the relevance of social comparison to coping with a variety of stressors such as illness and marital problems.

Relationship-focused coping refers to the various attempts made by the individual to manage, regulate, or preserve relationships when coping with stress. Recently, there has been growing interest in the interpersonal dimensions of coping as distinct from the intrapersonal dimensions of emotion- and problem-focused coping.

Empathic coping is one such form of relationship-focused coping. The use of empathy has been related to positive social behaviors such as providing social support and caring for others. Recently, O’Brien and DeLongis have suggested that empathic coping includes the following elements: (a) attempts to see the situation from another’s point of view, (b) efforts to experience personally the emotions felt by the other person, (c) attempts to read between the lines in order to decipher the meaning underlying the other person’s verbal and nonverbal behavior to reach a better understanding of the other person’s experience, (d) attempts to respond in a way that conveys sensitivity and understanding, and (e) efforts to validate and accept the person and their experience while avoiding passing judgment. One may engage in empathic coping either verbally (e.g., telling a spouse that you understand what they are feeling) or nonverbally (e.g., tenderly holding someone’s hand as they talk).

Empathic coping can play a significant role in coping with stress, particularly stress caused by interpersonal problems. Research suggests that empathic coping is related to a decrease in distress caused by interpersonal tension and an increase in relationship satisfaction. The increased understanding gained from empathic coping may result in more appropriate and well-considered coping choices that will maximize the benefits for all involved. Empathic coping may also lead to further benefits for psychological adjustment because of its impact on concurrent or subsequent use of problem- and emotion-focused coping. For example, in 1993, Kramer found that caregivers who engaged in empathic coping strategies were more likely to engage in planful problem-solving than caregivers who did not engage in empathic coping. The greater use of these strategies was related to greater caregiver satisfaction with the care-giving role. In the same study, lower use of empathic coping was related to more maladaptive emotion-focused coping efforts, which were in turn related to depression.

Individuals vary in how often and how effectively they use empathic coping. For example, O’Brien and DeLongis have found that when a close other is involved in a stressful situation, those high in neuroticism are less able to use empathic coping than are those low in neuroticism.

In addition to empathic coping, other forms of relationship- focused coping are also receiving attention. In 1991, Coyne and Smith identified active engagement (e.g., discussing the situation with involved others) and protective buffering (e.g., attempting to hide worries and concerns from involved others) as two forms of relationship-focused coping. They found that higher degrees of protective, relationship-focused coping (e.g., not conveying fears to one’s spouse) among wives of myocardial infarction patients was related to higher degrees of distress among the wives. Note that this is consistent with research suggesting that suppression of emotional expression is related to lowered psychological well-being. However, wives’ use of protective buffering was positively related to self-efficacy among their husbands. It appears that the wives were coping with the stress of their spouse’s illness in a way that maximized the benefits for their sick husbands (i.e., interpersonally adaptive) yet threatened their own well-being (i.e., intrapersonally maladaptive). Such results point to the need to include interpersonal dimensions of coping in addition to the traditional intrapsychic dimensions of coping in order to understand the relation of coping and health outcomes.

In conclusion, there is no one ‘‘good’’ way to cope with stress. Stress takes on many forms, and likewise, so must coping. The most adaptive way to cope with any given stressor depends on both the personality of the stressed individual and the characteristics of the stressful situation. Dimensions of the stressful situation that must be considered in determining the best way to cope with a given stressor include (a) whether others are involved in the situation, how they are coping, and the relationship of these people to the stressed individual; (b) the timing of the stressor and the degree to which it is anticipated or controllable; (c) the types of specific demands inherent to the stressful situation, the duration of such demands, and one’s prior experience with similar stressors; and (d) what is at stake in the stressful situation. Perhaps the key to good coping is flexibility. That is, the ability to vary one’s coping depending on the demands of the situation. What is clear is that no one form of coping will be effective in dealing with all stressors. There are times when attempts at problem-focused coping will be a waste of time and energy that could be better spent engaged in emotion- and relationship-focused coping. At other times, when something can be done directly to prevent or alter the stressful demands, energy may be better spent doing something concrete to solve the problem rather than concentrating on emotion management. Perhaps it is the wisdom to know the difference, and then to act on that knowledge, that is essential to successful coping.


  • Aldwin, C. (1994). Stress, coping, and development: An integrative perspective. New York: Guilford Press.
  • Collins, R. (1996). For better or for worse: The impact of upward social comparison on self-evaluations. Psychological Bulletin, 119, 51–69.
  • Eckenrode, J. (Ed.). (1991). The social context of coping. New York: Plenum Press.
  • Gottlieb, B. (Ed.). (1997). Coping with chronic stress. New York: Plenum Press.
  • Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.
  • Goldberger, L., & Breznitz, S. (Eds.). (1993). Handbook of stress: Theoretical and clinical aspects. New York: Free Press.
  • O’Brien, T. B., & DeLongis, A. (1996). The interactional context of problem-, emotion-, and relationship-focused coping: The role of the Big Five personality factors. Journal of Personality, 64, 775–813.
  • Pennebaker, J. W. (1990). Opening up: The healing power of confiding in others. New York: William Morrow.
  • Taylor, S. E. (1989). Positive illusions: Creative self-deception and the healthy mind. New York: Basic Books.
  • Zeidner, M., & Endler, N. S. (Eds.). (1996). Handbook of coping: Theory, research, applications. New York: John Wiley & Sons.


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