The relative efficacy of avoidant and nonavoidant coping strategies: A meta-analysis.

Abstract

A casual review of the research literature on coping strategies suggests that strategies involving avoidant tactics are effective in reducing pain, stress, and anxiety in some cases, whereas nonavoidant strategies (called here attention), appear to be more effective in others. This article reports the results of a series of meta-analyses to ascertain whether there are systematic patterns in the empirical literature that describe when attention strategies are more or less effective than avoidant strategies. In particular, we consider the role of different kinds of attentional sets and also the role of time--whether some kinds of strategies work best in the early phases of the stress experience, and others are more efficacious in later phases of the stress experience. Results of an overall analysis of studies providing tests of attention versus avoidance indicated little evidence for one strategy's superiority. However, supplementary analyses, motivated by theoretical reasons, suggest there are boundary conditions that define the relative efficacy of a specific strategy. Overall, avoidance was associated with more positive adaptation in the short-run. However, attention was superior to avoidance if the former involved a focus on sensory schemata rather than emotional processing. If attention involved an emotional interpretational set or no explicit set, then it was associated with more negative outcomes than avoidance. In terms of long-term outcomes, avoidance indicates better outcomes initially, but with time, attention was associated with more positive outcomes. A final set of analyses found that both attention and avoidance facilitate adaptation as compared with no instruction controls. The meta-analyses suggest the important role of interpretational set and whether one looks at the immediate or at the long-term effects of coping. Limitations of the analyses and directions for future research are discussed.

Adjustment to a low-control situation: Reexamining the role of coping responses.

“…Thus, despite suggestions that the temporal course of the event needs to be taken into account when making predictions concerning the effects of avoidant-type strategies on adjustment to low-control stress (Folkman & Lazarus, 1988;Lazarus, 1983;Roth & Cohen, 1986;Suls & Fletcher, 1985), the evidence from recent field studies suggests that, irrespective of the stage of the encounter, the use of avoidant-type strategies has detrimental effects on adjustment to low-control stress. The level of effort involved in avoiding the reality of an event and the use of escapist strategies (e.g., drinking more alcohol) may deplete a person's resources (Stanton & Snider, 1993;Wegner, Shortt, Blake, & Page, 1990), interfere with eventual assimilation and acceptance of the situation (Roth & Cohen, 1986), and increase the frequency of undesired intrusions of thoughts about the event (Stanton & Snider, 1993;Wegner et al, 1990).…”

“…In a meta-analysis of 43 studies (mostly studies of adjustment to low-control, laboratory-induced stressors such as cold-pressor tasks), Suls and Fletcher (1985) did find evidence that avoidant strategies had some benefit in the short term, whereas nonavoidant strategies were found to be most beneficial for longer term adaptation. However, the results of this meta-analysis are difficult to generalize to field settings.…”

Anxiété et coping des soignants : la prison est-elle un facteur de protection ?

“…La contradiction concerne les liens entre copings et événements stressants, notamment l'observation que lorsque des sujets évaluent une situation comme incontrôlable ou inchangeable, ils tendent à rapporter une prédominance de copings d'évitement ou centrés sur l'émotion. A contrario, si la situation est évaluée comme modifiable ou contrôlable, les copings centrés sur le problème ou de confrontation sont privilégiés [10,28,47,50]. Si l'on validait l'hypothèse « d'incontrôlabilité » de la prison, on aurait observé une fréquence plus élevée de l'utilisation de copings centrés sur l'émotion dans notre échantillon.…”

“…Nos résultats sont cohérents avec les travaux relatifs aux liens entre santé et copings qui révèlent, de façon consistante, que les copings centrés sur l'émotion ou de fuite-évitement sont associés à un stress plus important que les copings orientés vers le problème ou l'action [17,28,45,47,50]. Ce type de résultat n'est pas récent.…”

“…Ce type de résultat n'est pas récent. Il y a plus de 20 ans, une méta-analyse des études sur le coping chez des personnes malades montrait l'effet adaptatif à court terme des copings d'évitement et l'effet adaptatif à long terme des copings de confrontation à la maladie [47]. On observe donc une association de l'action de copings comme la résolution de problème avec le ralentissement de la progression de certaines maladies ou de certains symptômes, là encore, à l'inverse des copings d'évitement [13,36].…”