Coping, defined as the thoughts and behaviors used to manage the internal and external demands of situations that are appraised as stressful, has been a focus of research in the social sciences for more than three decades. The dramatic proliferation of coping research has spawned healthy debate and criticism and offered insight into the question of why some individuals fare better than others do when encountering stress in their lives. We briefly review the history of contemporary coping research with adults. We discuss three primary challenges for coping researchers (measurement, nomenclature, and effectiveness), and highlight recent developments in coping theory and research that hold promise for the field, including previously unaddressed aspects of coping, new measurement approaches, and focus on positive affective outcomes.

Although research on coping over the past 30 years has produced convergent evidence about the functions of coping and the factors that influence it, psychologists still have a great deal to learn about how coping mechanisms affect diverse outcomes. One of the reasons more progress has not been made is the almost exclusive focus on negative outcomes in the stress process. Coping theory and research need to consider positive outcomes as well. The authors focus on one such outcome, positive affect, and review findings about the co-occurrence of positive affect with negative affect during chronic stress, the adaptive functions of positive affect during chronic stress, and a special class of meaning-based coping processes that support positive affect during chronic stress.

BACKGROUND-Physicians, particularly trainees and those in surgical subspecialties, are at risk for burnout. Mistreatment (i.e., discrimination, verbal or physical abuse, and sexual harassment) may contribute to burnout and suicidal thoughts.METHODS-A cross-sectional national survey of general surgery residents administered with the 2018 American Board of Surgery In-Training Examination assessed mistreatment, burnout (evaluated with the use of the modified Maslach Burnout Inventory), and suicidal thoughts during the past year. We used multivariable logistic-regression models to assess the association of mistreatment with burnout and suicidal thoughts. The survey asked residents to report their gender.RESULTS-Among 7409 residents (99.3% of the eligible residents) from all 262 surgical residency programs, 31.9% reported discrimination based on their self-identified gender, 16.6% reported racial discrimination, 30.3% reported verbal or physical abuse (or both), and 10.3% reported sexual harassment. Rates of all mistreatment measures were higher among women; 65.1% of the women reported gender discrimination and 19.9% reported sexual harassment. Patients and patients' families were the most frequent sources of gender discrimination (as reported by 43.6% of residents) and racial discrimination (47.4%), whereas attending surgeons were the most frequent sources of sexual harassment (27.2%) and abuse (51.9%).

There is growing interest in positive aspects of the stress process, including positive outcomes of stress and antecedents that dispose individuals to appraise stressful situations more as a challenge than as a threat. Less attention has been given to the adaptational significance of positive emotions during stress or to the coping processes that sustain positive emotions. We review evidence for the occurrence of positive emotions under conditions of stress, discuss the functional role that positive emotions play under such conditions, and present three types of coping that are associated with positive emotion during chronic stress. These findings point to new research questions about the role of positive emotions during stress and the nature of the coping processes that generate these positive emotions.