The present follow-up study investigated the differential effects of dispositional coping styles on change in nine clinical syndromes of the Axis I spectrum of the DSM-III-R. Subjects were 155 psychiatric outpatients who were examined 6 and 7 years after their enrollment in the study. Coping accounted for up to 9% of the variance of symptom change over 1 year. As hypothesized, the effects of different coping styles varied considerably across the clinical syndromes. Active goal-oriented coping improved symptoms of the anxiety and the dependency spectrum; seeking social support had beneficial effects on symptoms of the depressive spectrum. The effects of the coping styles distraction, use of alcohol and other drugs, and focusing on and venting of emotions were detrimental, but again in a specific way. The results suggest that the differentiation of outcome criteria for coping is important.
According to Lazarus' theory of stress and coping (Lazarus & Folkman, 1984), the outcome of stressful events depends largely on our coping efforts. However, coping is not restricted to the successful mastery of stressful encounters, but, rather, encompasses all behaviors and thoughts aimed at the management of the actual situation (problemfocused coping) and the concomitant emotional reactions (emotion-focused coping). A third category, avoidance coping, is partly considered to belong to the latter spectrum (Aldwin & Revenson, 1987; Lazarus & Folkman, 1984), partly as an entirely different category (Amirkhan, 1990; Endler & Parker, 1990).
One of the main foci in research on coping has been the identification of strategies with a beneficial impact on adjustment to stress. Countless cross-sectional and fewer prospective studies have been conducted with this aim. Among the many different coping strategies that were examined, three kinds of strategies have emerged as being significant for mental health, namely, problem-focused coping, seeking social support, and avoidance coping.
Problemfocused coping appears to have a beneficial potential because, according to several studies, it shows a negative relation to concurrent symptoms of mental disorders (Billings, Cronkite,