Coping in Stressful Episodes: The Role of Individual Differences, Environmental Factors, and Situational Characteristics

Transcription

1 Journal of Personality and Social Psychology Copyright 1986 by the American Psychological Association, Inc. 1986, Vol. 51, No. 6, /86/$00.75 Coping in Stressful Episodes: The Role of Individual Differences, Environmental Factors, and Situational Characteristics Katharine R. Parkes University of Oxford, England Theoretical models emphasize the importance of person and environmental variables in stress and coping processes. This article examines individual differences (extraversion and neuroticism), environmental factors (social support and work demand), and situational characteristics (type of stressful episode and its perceived importance) as predictors of three self-report measures of coping (general coping, direct coping, and suppression) derived from the Ways of Coping Questionnaire. The data analyzed were collected from 135 first-year female student nurses. Individual differences were assessed prior to exposure to the ward environment, and information about stressful episodes was obtained during the initial period of nursing practice. Multiple regression analyses showed that individual differences and environmental and situational factors were significant predictors of the coping scores and that patterns of main and interactive effects were different for each type of coping. For direct coping and suppression, predicted interactions across person, environmental, and situational variables contributed significantly to the explained variance. Curvilinear interactions between work demand and neuroticism were significant for both direct coping and suppression; interactions of social support and extraversion with perceived importance predicted direct coping; and interactions between neuroticism and extraversion and between work demand and importance predicted suppression. These findings are discussed in relation to current substantive and methodological issues in the study of coping and adaptation. Process-oriented models conceptualize stress in terms of a relation between person and environment, emphasizing the dynamic, interactive nature of stressful transactions. Cognitive appraisal and coping are seen as the central constructs in this model (Lazarus, 1966; Lazarus & Folkman, 1984). This approach implies that specific stressful events and the way that individuals perceive and respond to them, rather than generalized perceptions of stress, are the focus of interest. Drawing on this framework, empirical studies have examined relations between the characteristics of the stressful situation, how it is perceived and appraised by the individual concerned, the affective responses associated with it, and the coping strategies reported (Coyne, Aldwin, & Lazarus, 1981; Folkman & Lazarus, 1980; McCrae, 1984; Parkes, 1984; Stone & Neale, 1984). However, coping may be influenced not only by the nature of the stressful episode but also by the resources, both intraindividual and environmental, available to the person concerned (Mops & Billings, 1982; Rosenbaum, 1983; Roskies & Lazarus, 1980). Thus, The work described in this article was funded by the Health and Safety Executive, and its support is gratefully acknowledged. I would also like to thank the staff and students of the hospitals concerned for their cooperation in this work. Thanks are also due to Richard S. Lazarus, who is at the Department of Psychology, University of California, Berkeley, for making available the Ways of Coping Questionnaire. I am also grateful to the anonymous reviewers of a previous version of this article for their helpful comments, to Davina Rendall, who assisted with the collection and processing of the data, and to several additional interviewers. Correspondence concerning this article should be addressed to Katharine R. Parkes, Department of Experimental Psychology, University of Oxford, South Parks Road, Oxford OX1 3UD, England. individual capacities and abilities as well as the nature of the environment in which the episode occurs are of potential importance in the study of coping processes. In the most recent formulation of their transactional model, Lazarus and Folkman (1984) viewed the person and environment as being in a "mutually reciprocal, bi-directional relationship" (p. 325) and suggested that "separate person and environment elements join together to form new meanings through appraisal" (p. 326). Thus, in the research approach advocated by Lazarus and Folkman, individual differences and environmental factors are subsumed under the global construct of appraisal, rather than treated as separate entities. In contrast, other researchers have adopted structural models in which relations between measures of life stress and health-related outcomes are seen as moderated by stable personality characteristics, coping styles, or the psychosocial environment (e.g., Billings & Mops, 1981; Lefcourt, Martin, & Saleh, 1984; Mitchell, Cronkite, & Mops, 1983; Wheaton, 1983). In these studies, no account is taken of the nature or time course of particular stressful transactions; general categories of stressors, or overall severity ratings, rather than specific episodes form the basis of the analysis. Thus, neither transactional nor structural approaches provide evidence as to the role of situational factors in coping while simultaneously taking into account environmental and intraindividual factors as separate and identifiable sources of influence. However, evidence reviewed in the following sections shows that these three types of factors are each of relevance in relation to coping. Situational Characteristics In studying coping in relation to specific stressful episodes, situational characteristics may either be assessed in subjective 1277

2 1278 KATHARINE R. PARKES terms or independently classified on a rational basis. Consistent with the emphasis on cognitive appraisal in transactional models, reported work has focused primarily on relations between coping and subjective perceptions of the stressful situation; for instance, the degree to which the individual concerned appraises the situation as controllable, desirable, unexpected, challenging, or threatening (Folkman & Lazarus, 1980; Mc- Crae, 1984; Parkes, 1984; Stone & Neale, 1984). These studies consistently find significant relations between situational appraisals and reported coping strategies. In McCrae's study, for example, threat appraisals were associated with the use of faith, fatalism, and wishful thinking, whereas challenge appraisals elicited strategies such as rational action, positive thinking, and self-restraint. One problem with this approach, noted by Folkman and Lazarus (1985) in relation to their own study, is the degree of conceptual overlap between self-reported situational perceptions, coping strategies, and emotional responses. In the second approach, stressful situations or events are classified independently into rational categories according to content or domain of concern. Thus, differences have been found in the patterns of problem-focused and emotion-focused coping reported for different types of situations or events, assigned by independent raters either to content categories, for example, illness, interpersonal conflicts, or financial problems (Billings & Mops, 1981), or to appraisal categories such as loss, challenge, or threat (McCrae, 1984). If data are collected at several different times during a prolonged stressful experience, within-subjects comparisons of coping in different situations can be made. Using this approach, Folkman and Lazarus (1985) found that problem-focused coping was more salient during preparation for an examination and that distancing strategies were more salient while awaiting the results. Krantz (1983) also studied coping in the context of examinations. In the laboratory, situational effects in coping have been investigated by systematically manipulating type of threat (Pittner & Houston, 1980). Environmental Factors The environment, both psychosocial and physical, has significant implications for behavior and affect (see Mops, 1976, for an extensive review of this literature). In the study of coping, the nature of the environment in which a particular stressful episode occurs can be regarded as a potential resource (or, in some circumstances, a constraint) that may influence the types of coping used. Thus, measures of the psychosocial environment, particularly social support, have been found to be related to the levels of coping reported (Billings & Mops, 1981; Mitchell et al., 1983). Further evidence comes from comparisons of coping responses for stressful episodes occurring in qualitatively different environments. Thus, higher levels of problem-focused coping were found in work settings than were found in family environments (Folkman & Lazarus, 1980). Similarly, Pearlin and Schooler (1978) reported differences between work and domestic settings in the extent to which coping moderated stressstrain relations. The influence of the work environment on individual coping behaviors is of particular relevance to the present study. Newton and Keenan (1985) found that coping by withdrawal was less likely in supportive environments; this appears to be the only empirical study to have examined relations between coping and work environment characteristics. However, case studies of particular organizations (such as Menzies's (1960) study of a London hospital and Mechanic's (1962/1978) study of doctoral students) illustrate ways in which institutional environments may influence coping patterns. For instance, Menzies described how the social structure of the ward encourages use of defenses such as detachment, projection, and denial but constrains potentially valuable coping behaviors (e.g., the exercise of autonomy and discretion). More generally, the influence of the work setting on affective and behavioral responses, including physical and mental health, job satisfaction, performance, and turnover (see, for instance, Alfredsson, Karasek, & Theorell, 1982; House, 1981; Jackson, 1983; Karasek, 1979; Karasek, Baker, Marxer, Ahlbom, & Theorell, 1981; Mops, 1981; O'Connor et al., 1984; Parkes, 1982) may be mediated by the influence of the work environment on individual coping behaviors. Individual Differences In a stressful situation, an individual attempts to evaluate the problem, to appraise and implement possible courses of action, and to regulate his or her emotional responses. Thus, individual qualities and capacities and the constellation of coping skills, which Rosenbaum (1983) referred to as "learned resourcefulness," influence the strategies available for managing a particular stressful episode. Lazarus and Folkman (1984) suggested that coping and appraisal are influenced by individual differences in psychological vulnerability, in personal resources and capacities, and in commitments and values. More specifically, Chan (1977) emphasized self-esteem, helplessness, and chronic anxiety as predictors of stress responses. Some relevant aspects of individual differences are assessed by personality inventories. For instance, relations have been found between Type A behavior and patterns of coping and defense (Pittner & Houston, 1980; Vickers, Hervig, Rahe, & Rosenman, 1981; Vingerhoets & Flohr, 1984), between internal control and problem-oriented coping (Anderson, 1977; Parkes, 1984), and between trait anxiety and maladaptive coping (Parasuraman & Cleek, 1984). A more extensive study of personality characteristics and coping was reported by Fleishman (1984), who further analyzed Pearlin and Schooler's (1978) data. He found that mastery and selfesteem were only weakly related to coping, but that self-denial (the tendency to avoid thinking about negative aspects of one's life) and nondisclosure (the tendency to avoid revealing problems to others) were reflected in predictable ways in the coping patterns reported. A more recent study, by McCrae and Costa (I 986), demonstrates the influence ofneuroticism and extraversion on coping mechanisms. Individual differences (e.g., neuroticism, flexibility, and internal control) have also been found to act as moderators of stress-strain relations (Denney & Frisch, 1981; Pearlin & Schooler, 1978; Wheaton, 1983), and these effects may be mediated through appraisal and coping processes. Present Study: Person, Environment, and Situation as Predictors of Coping Lazarus and Cohen (1977) emphasized the importance of studying interactions between person and environmental variables as predictors of coping behavior and recommended "a

3 INDIVIDUAL, ENVIRONMENTAL, AND SITUATIONAL FACTORS IN COPING 1279 mode of analysis in which the sets of variables of person and environment are separately measured as antecedents, and their mutual influences are observed" (p. 113). An extension of this approach forms the basis of the work reported in this article. Thus, in the present study, the model used to predict coping responses distinguished between three separate sources of influence: situational, environmental, and person variables. Situational factors are related to the immediate nature of the stressful transaction, which was the specific focus of the individual's coping attempts. Environmental factors (which were assessed independently) represent the relatively stable psychosocial characteristics of the work environment in which the episode occurred. Intraindividual differences, orperson factors, are represented by personality characteristics assessed prior to the occurrence of the episode. On the basis of the theoretical and empirical work reviewed earlier, it was predicted that variables within each of these three domains would influence the coping strategies individuals adopt in particular situations. Thus, the extent to which particular forms of coping are used would depend not only on the nature of the episode that is the focus of the coping attempts but also on environmental constraints and resources and on the personality, needs, and capacities of the individual concerned. Furthermore, transactional theories predict that these factors combine interactively to influence coping. For instance, exposure to chronically high work demand may be particularly detrimental to the coping attempts of anxious individuals, and subjects with a high need for affiliation may be disproportionately affected by lack of social support. However, there have been no empirical studies that compare additive and interactive models of coping; indeed, there have been no studies in which person, environmental, and situational variables have been examined simultaneously in relation to particular types of coping responses. Lazarus and Folkman (1984) conceptualized the combined influence of person and environment on coping as being mediated by cognitive appraisal, but there are inherent methodological problems in interpreting relations between self-reported coping and appraisal variables (in which person, situation, and environment are confounded). In effect, the present study avoids some of the problems involved in testing Lazarus and Folkman's theory by independently assessing variables representing the major determinants of cognitive appraisal and directly evaluating their main and interactive effects on coping. The data that formed the basis of this study were collected from student nurses. During their first period of hospital ward experience, descriptions of stressful episodes were obtained from interviews and questionnaires, and information about coping responses was collected by means of a preliminary version of the Ways of Coping Questionnaire, subsequently published with minor revision by Folkman and Lazarus, The scores derived from this checklist assessed two specific forms of coping, direct coping and suppression, which were the main focus of interest, as well as a third general coping dimension, which represented the overall repertoire of strategies reported (Parkes, 1984). The independent variables represented the three domains of interest (individual differences, situational factors, and environmental factors); in each domain, measures were chosen to predict coping on the basis of the literature reviewed earlier. The following measures were used in this study: 1. Individual differences: Measures of extraversion (sociable, easygoing, active, and optimistic tendencies) and neuroticism (vulnerable, anxious, moody, and rigid tendencies) were used to assess person variables. These traits have been found to have wide-ranging implications for behavior and mental health (Eysenck, 1970; Eysenck & Eysenck, 1975; Lynn, 1981) and, more specifically, for coping (McCrae & Costa, 1986). 2. Environmental factors: Measures of work demand and social support, two dimensions known to represent salient characteristics of work settings (Karasek, 1979; Moos, 1976, 1981), were used to assess the environment in which the episode occurred. 3. Situational factors: These related specifically to the nature of the particular stressful transaction reported (the individual's own assessment of the importance of the episode and the type of episode as classified by independent assessors). Formulation of the Predictive Models The additive model that was tested included the first-order effects of each of the specified independent variables, together with an additional factor that represented overall differences between the two hospitals in which data were collected. In order to test interactions between different types of independent variables, it was necessary to specify a priori the particular interaction terms to be included in the model. Previous empirical studies of coping as a dependent measure were, in general, not directly relevant in this context. As reviewed earlier, few studies have examined both person and environmental variables as predictors of coping, have examined interactive effects, or have investigated coping in work settings. However, it was possible to formulate predictions, albeit more tentatively, from studies of individual and environmental factors as moderators of relations between stress and well-being. Theoretically, coping is regarded as a mediator of stress-outcome relations; hence, it was reasonable to assume that factors that interact to influence psychological outcomes under conditions of life stress would also be likely to interact as predictors of coping responses. This assumption is consistent with evidence directly relating coping to mental and physical health outcomes (for instance, Billings & Moos, 1981; McCrae & Costa, 1986; Parasuraman & Cleek, 1984). On this basis, it was possible to predict particular interactions between the person, environmental, and situational variables used in the present study. However, interactions involving hospital and type of episode were not predicted a priori; these variables were specific to the present study and could not be related to the general literature on stress and coping. The evidence on which the predictions were based is outlined in the following sections. Person-Environment Interactions Neuroticism and Work Demand Individuals with high neuroticism scores respond less adaptively to demanding circumstances and are more vulnerable to emotional distress than are those with low scores (Eysenck, 1970). Moreover, anxiety (a major component of neuroticism) has been found to interact with work demand to predict stress reactions (Parasuraman & Cleek, 1984). Therefore, in the present study, it was predicted that the effects of work demand on

4 1280 KATHARINE R. PARKES coping would differ for high- and low-neurotic subjects. However, it was also necessary to consider the nature of the relation between work demand and coping; it has been argued on theoretical grounds that work demand is related to outcome variables in a curvilinear manner, both overload and underload being less favorable than moderate levels (Welford, 1973). Empirical studies of work settings provide some support for this view (Coburn, 1975; Frankenhauser & Gardell, 1976; Mowday & Spencer, 1981). Therefore, in order to take into account possible curvilinear effects, both linear and quadratic components of work demand were included in the predictive model as independent terms and in interaction with neuroticism. Extraversion and Social Support Extraverts show a heightened sensitivity to variations in social support. Under conditions of high social support, they report less distress than do introverts, and under conditions of low support, they report greater distress than do introverts (Duckitt, 1984). In addition, need for affiliation (a measure conceptually linked to extraversion) interacts with social support to predict mood disturbance in response to life stress (Lefcourt et al., 1984). These findings suggest that the coping strategies adopted by introverts and extraverts may be differentially influenced by the level of social support available. Therefore, an interaction between extraversion and social support was included in the predictive model tested in the present study. Person-Situation Interactions Extensive evidence shows that individual differences moderate relations between life stress and well-being, personality differences having more marked effects at more severe levels of stress. Both extraversion and neuroticism have been found to act in this way, individuals high in neuroticism and/or low in extraversion showing poorer adaptation to severe life stress (Denney & Frisch, 1981; Duckitt & Broil, 1982). In the present study, the perceived importance of the episode could be regarded as analogous to life-event severity. Therefore, it was appropriate (assuming, as noted earlier, that variables that interact to predict outcome may also interact to predict coping) to include Importance X Extraversion and Importance X Neuroticism interactions in the model used to predict coping scores. Environment-Situation Interactions Arguments analogous to those outlined earlier led to the inclusion of interactions between environmental variables and episode importance in the predictive model. The role of social support in moderating the adverse effects of life stress has been widely demonstrated (for a review of this literature, see Cohen & Wills, 1985). In the context of the present work, this led to the prediction of an interaction between social support and importance. Although there is little direct empirical evidence of an interaction between work demand and episode importance, such an interaction is implied by Jacobson (1978), who noted that a chronically high level of work load impairs the ability of nurses to cope with unexpected demands and sudden crises. More generally, the work of Parasuraman and Cleek (1984) demonstrates the interactive effects of quantitative work demand and maladaptive coping in predicting stress responses. Thus, the interactive model included terms representing interactions between extraversion and social support, between neuroticism and work demand, and between each of these variables and the episode importance. These interactions were tested for each of the specific coping measures. It was not appropriate to formulate different models for direct coping and suppression because the evidence on which the predictive model was based was potentially applicable to each measure: Direct coping and suppression both represent specific types of coping responses, both are potentially adaptive forms of coping, and both include strategies found to predict outcome in previous studies (e.g., Billings & Moos, 1981; Felton & Revenson, 1984; Folkman & Lazarus, 1985; Newton & Keenan, 1985). Furthermore, in view of the indirect nature of the predictions and the absence of specific information relating to coping in work settings, no attempt was made to predict the particular form of the interaction effects. The only difference between the interactive models tested for direct coping and suppression was that an Extraversion Neuroticism interaction term was included in the suppression model. This prediction was derived from the conceptual similarity between the suppression items and the description of low-neurotic introverts as controlled, low in emotionality, and reserved in interpersonal relationships (Eysenck & Eysenck, 1975), and it was also consistent with findings inversely linking the personality trait of nondisclosure with coping behaviors that involve interpersonal communication, particularly advice seeking (Fleishman, 1984). In summary, the main interest in formulating and testing interactive models as predictors of direct coping and suppression was threefold: (a) to establish whether, as predicted by transactional theories, models including interactions across person, situational, and environmental variables accounted for a significantly higher proportion of variance in coping than did the corresponding additive models; (b) to determine, within the framework of an interactive model, the relative importance of person, environment, and situation as predictors of coping; and (c) to examine the patterns of main and interactive effects for each coping measure in relation to the predictions made earlier. For the general coping measure, it was considered that person and environmental variables would combine additively rather than interactively. This measure represents the overall number of cognitive and behavioral strategies reported in relation to the stressful situation. Thus, it is most appropriately regarded as an index of the repertoire of strategies that an individual calls into play in a particular context. Interactive effects, which are seen as operating through appraisal processes to influence specific coping responses, would not be expected to determine the extent of the overall coping repertoire available to an individual. Thus, the prediction made in the present study was that constraints and resources associated with the person and environment would contribute independently to the reported repertoire of strategies. Method Subjects Three successive entry groups (1978 to 1980) of female student nurses participated in this research. Almost all the students were in the

5 INDIVIDUAL, ENVIRONMENTAL, AND SITUATIONAL FACTORS IN COPING 1281 age range of 18 to 25 years. For each group, an initial psychometric assessment was carried out in a classroom setting during the final week of an introductory nursing course and prior to the first ward assignment. Participation was voluntary, but the confidentiality of all individual data was guaranteed, and none of the students declined to take part. However, some students were not available at the time of the interviews (6 to 7 weeks after the initial assessment) because of illness, leave, or premature termination of training. Of the 177 students for whom initial assessment data were available, 150 (approximately equally divided between the two hospitals) were interviewed. Comparison of the initial measures showed no significant differences between those who were and who were not interviewed. Individual Differences Procedure The Eysenck Personality Questionnaire (Eysenck & Eysenck, 1975) was administered during the initial assessment to assess extraversion and neuroticism. The subject group did not differ in neuroticism from the normative data for women of their age, but they were higher in extraversion (Z = 4.17,p <.001). Work Environment Hospitals. The students were based at two general hospitals in the Greater London area. There was no contact between students at the two locations: Classroom teaching, nursing practice, and residences were separately provided for each hospital. At both hospitals, initial nursing experience was gained in medical and surgical wards, as described by Parkes (1982). Between four and eight first-year students were assigned to each ward during this initial training period. Perceived work environment. At the end of the first ward allocation, each student's perceptions of social support in the ward to which she had been allocated were assessed using the Work Relationships Index derived from the Work Environment Scale (Moos, 1981). This measure assesses work-related social support. It is a composite scale summed over three 9-item subscales (Involvement, Peer Cohesion, and StaffSupport) with a dichotomous (0-1) response format. Coefficient alpha for this scale was.79. Perceived work demand was assessed twice during the first ward allocation (after 6 weeks and after 12 weeks) using a set of seven items with a 4-point response scale (scored 1 to 4) derived from the work demand dimension reported by Karasek (1979). Coefficient alpha for this scale was.77. In order to obtain assessments of the work environment that were independent of the student's own responses to these scales, the following procedure, derived from that used by Hoiberg and Berry (1978), was adopted. For each ward, the work-demand scores of students assigned to that ward were averaged, with the scores of one particular student excluded. This average score was then assigned to the excluded subject. Thus, if students A, B, C, D, and E were assigned to a particular ward, the work-demand scores obtained from B, C, D, and E were averaged to give a work-demand score for A; the scores from A, C, D, and E were averaged to give a score for B, and so forth. This process was repeated for each ward separately. The scores for the social support measure were treated in the same way. By this means, scores were assigned to each student independent of her own perceptions of her work situation. The product-moment correlations between the students' own scores and the mean peer scores assigned to them were.39 for work demand and.42 for social support. The peer group means, rather than the student's own scores, were used throughout this study as measures of the levels of work demand and social support to which the each student was exposed. Characteristics of the Stressful Episode and Coping The combined interview and questionnaire method used to obtain information about a recent stressful episode, and the coping strategies used in response to iti was similar to that reported by Coyne et al. (1981). Of the 150 students interviewed, 5 were unable to recall a relevant episode. For a further 10 students, part of the questionnaire data was missing. Thus, complete data were obtained for 135 subjects, 68 students at one hospital and 67 at the other. Interview procedure. In individual interviews, carried out halfway through the first ward assignment, students were asked to describe an episode that had occurred in the course of their work and that had imposed particular demands on them or had disturbed or upset them in some way. A few students, who could not recall episodes related directly to their work on the wards, deseribed events that had occurred in the Nurses' Home or during their off-duty hours. The interview was semistructured. The student initially described the episode in her own way; if necessary, certain specific questions were then asked to elicit additional information. Ways of Coping Questionnaire. Following the interview the students were asked to complete the Ways of Coping Questionnaire. The present study reports data from two parts of this questionnaire: 1. Importance of episode: Subjects were asked to indicate on a 4- point scale ranging from not at all important (0) to very important indeed (3), how important the episode had been to them at the time it occurred. 2. Coping strategies: In completing the coping checklist, subjects were asked to indicate which strategies they had used in the episode described. These responses were scored 1 if the strategy was endorsed and 0 if it was not endorsed. Three measures of coping, derived from 44 of the total of 67 items, were obtained from these data: the general coping score (the mean of 39 positive-loading items representing a wide variety of cognitive and behavioral strategies), and two specific coping scores, direct coping (the mean of 22 items, 10 positive loading and 12 negative loading, reflecting direct attempts to change the stressful circumstances and avoidance of maladaptive cognitive distortions) and suppression (the mean of 12 items, 8 positive loading and 4 negative loading, reflecting attempts to ignore the situation, to avoid talking or thinking about it, and not to act impulsively). The coefficient alpha values for these scales were.89,.71, and.56, respectively. Details of this bifactor model (in which the direct coping and suppression items loaded positively on the General Coping scale and either positively or negatively on one or other specific scale) are given by Parkes (1984). The model was derived by means of the Very Simple Structure (VSS) method, which allows an optimum factor solution (for the purposes of scale construction) to be identified on the basis of a quantitative goodness-of-fit index (Revelle & Rocklin, 1979). Thus, the three scales of the bifactor model jointly provided a best-fit representation of the original correlation matrix. In contrast to the scales derived from conventional varimax rotations of data from the Ways of Coping Questionnaire (e.g., Folkman & Lazarus, 1985), the scales derived by the VSS method were uncorrelated, thus eliminating problems associated with significance testing when there is overlap between independent variables used in a series of similar regression analyses (Schaefer, 1981). Classification of Episodes The interview records were examined by two independent clinical assessors. Working separately, without seeing the questionnaire responses, they classified the episodes into six categories on the basis of content. Agreement between the two assessors was 87%. Episodes about which the two judgments did not agree were reexamined jointly by the raters, and a consensus decision was reached. For the present analysis, four major areas of work-related content were derived by combining related categories within the original classification. These areas were as follows: problems relating to the care of dying patients, 33.3%; interpersonal problems with other nurses, (e.g., reprimands from senior nurses, lack of support, arguments with other nurses), 25.2%; insecurity about knowledge or skills and fear of failure, 19.3%; problems with difficult or hostile patients, 10.4%. A fifth category (11.9% of the total) covered

6 1282 KATHARINE R. PARKES episodes occurring outside the ward, mostly in the nurses' residence or with personal relationships. The content of the episodes is discussed in detail elsewhere (Parkes, 1985). Statistical Treatment Multiple regression, in which the coping scores were treated as dependent variables in separate regression analyses, was the main statistical technique used. The initial analyses examined additive effects for each of the three measures of coping. Subsequent analyses tested the predicted interactive effects for the two specific coping measures. Additive effects. The independent variables were entered into the analyses hierarchically in four predetermined steps: the hospital at which the student was based, which was decided several months prior to the students' enrollment (Step 1); the individual difference measures, assessed prior to exposure to the ward setting (Step 2); the work environment measures, calculated as described earlier (Step 3); and the two variables relating specifically to the particular stressful episode described (Step 4). Within each step, except the first, variables were entered simultaneously, each corrected for the other. This order was appropriate to the time sequence of data collection, and it allowed individual differences and environmental factors to be evaluated before the specific situational characteristics. In each analysis, hospital was coded as a single dichotomous variable, and episode type was entered as four dichotomous dummy variables (D,-D4); other factors were entered as quantitative ordinal scores. Interactive effects. Following the normal procedure for testing the significance of interaction effects in regression analyses, interactions were represented by product terms, which were entered hierarchically after both the variables forming the product had been entered as main factors (Cohen, 1978). Only predicted interactions were included in the regression analyses, and interactions across person, environment, and situation levels were entered only after all within-level terms had been entered. In order to examine the nature of significant interactions in more detail, regression coefficients were calculated from the final regression equation in which all terms were corrected for all others. In this type of simultaneous regression analysis, problems may arise in interpreting main effects in the presence of interactions between the variables concerned, because the magnitude and significance of main effects are dependent on the value of the moderating variable at which they are evaluated (Cleary & Kessler, 1982; Finney, Mitchell, Cronkite, & Mops, 1984). Several different methods of estimating main effects are possible in these circumstances. Finney et al. advocated the average-effect method, in which the main effect is evaluated at the average observed score on the moderator variable. The average-effect method was used in the present analysis, raw scores on the independent variables (except type of episode) being transformed by subtracting their respective means prior to the regression analysis. This transformation does not change the magnitude and significance of the interaction terms, but it does influence the magnitude of the main effects for variables that are components of interactions. It also changes the values of standardized regression coefficients for both constituent variables and interaction terms; thus, standardized coefficients do not indicate the relative importance of variables in a multiplicative regression analysis, and use of unstandardized coefficients is preferable. Results Means, Standard Deviations, and Intercorrelations of Measures All of the following analyses relate to the group of 135 subjects for whom complete data were available. The means, standard deviations, and intercorrelations ofhos- pital (coded 0 or 1), work environment scores, individual difference scores, the perceived importance of the episode, and the coping scale scores are shown in Table 1. Hospital, extraversion, neurotieism, work demand, social support, and the importance of the episode (the independent variables in the regression analyses) were not highly intercorrelated, all the coefficients being below.20 with the exception of the correlation between neuroticism and the perceived importance of the episode, r(135) =.30, p <.01. The three coping scale scores, the dependent variables in the regression analyses, were almost uncorrelated. However, there were significant zero-order correlations between the independent variables and the coping scores. General coping was positively related to importance and to work demand and negatively related to social support; direct coping was positively related to extraversion and negatively related to neuroticism and perceived importance of episode; and suppression was negatively related to importance. There were no significant differences between subjects in the two hospitals in mean levels of extraversion or neuroticism, in the perceived importance of the episodes reported, or in the mean levels of work demand. There were also no differences between the hospitals in the frequencies with which the five different types of episodes were reported, x2(4, N = 135) = 7.03, ns. However, the two hospitals did differ in mean social support scores, F(I, 133) = 4.79, p <.05. Type of episode was not significantly related to social support, F(4, 130) = 1.65, ns, but it was significantly related to work demand, F(4, 130) = 3.58, p <.01. Episodes classified as "interpersonal problems with other nurses" were associated with significantly higher work demand scores than were other types of problems. The five types of episodes also differed significantly in overall importance ratings, F(4, 130) = 3.11, p <.02. Regression Analysis of Coping Scores in Relation to Individual Differences, Environmental Factors, and Situational Characteristics The rationale underlying the regression approach is outlined in the Method section. The coping measures were treated as dependent variables in separate regression analyses, carried out in three parts. (a) Additive effects analyses: Hierarchical regression analyses were carried out in which the independent variables were entered into the regression equation in four predetermined steps (hospital, individual differences, environmental factors, situational characteristics), no interaction terms being included. (b) Interactive effects analyses: For the direct coping and suppression measures, extended hierarchical analyses were carried out to test the interactive model and to the evaluate the relative importance of person, environmental, and situational factors within this overall model. (c) Regression coefficients derived from the final predictive equations were used to examine the nature of main and interactive effects. Additive Effects For each coping measure, the cumulative squared multiple correlation values, the successive increments to the squared multiple correlations at each level of the analysis, and their significance levels are given in Table 2. The overall significance of each additive model is also shown.

7 INDIVIDUAL, ENVIRONMENTAL, AND SITUATIONAL FACTORS IN COPING 1283 Table 1 Means, Standard Deviations, and Pearson Intercorrelations of Measures Measure M SD Hospital a Extraversion Neuroticism * Work demand Social support ".19" " 6. Importance of episode ** General coping " ** 8. Direct coping " -.18" Suppression m ".20* ** ** Note. N= 135. Hospitals were coded 0 and 1. * p <.05. ** p <.01. General coping. For the general coping scores, the squared multiple correlation increments were significant at all four steps of the analysis; hospital setting, individual differences, work environment, and situational characteristics all contributed significantly to the explained variance. When corrected for variables entered at the same level or at higher levels, all individual variables were significant except for type of episode. Neuroticism, extraversion, work demand, and importance were positively related to general coping scores; social support showed a negative relationship. The largest proportion of explained variance was that due to the work environment; hospital differences contributed least. The overall multiple correlation was.52. Direct coping. In this analysis, hospital was not significant, but the two individual difference variables jointly resulted in a significant increment to the squared multiple correlation. The work environment variables were not significant, but the two situational variables did produce a significant increment in the squared multiple correlation. However, when these variables were evaluated separately, only the type of episode was found to be significant, F(4, 124) = 3.94, p <.005. The overall multiple correlation was.48, situational factors accounting for the largest proportion of the explained variance. Suppression. For the suppression scores, the hierarchical regression analysis showed that only the situational variables entered at the last stage produced a significant increment in the squared multiple correlation; all other variables were nonsignificant. Separate evaluations of the effects of importance and type of episode showed that importance was significant (p <.02), but type of episode was not. The overall multiple correlation in this analysis,.37, was lower than for the other coping scores, and overall, the additive model only just reached the.05 level of significance, F(10, 124) = 1.93, p =.047. Interactive Effects For the direct coping and suppression scores, the predicted interactive model was tested by including the appropriate product terms in the hierarchical analyses. Hospital differences were not taken into account in these analyses because they accounted for little or no variance in the specific coping scores, and no interactions with hospital had been predicted a priori. Person, environmental, and situational variables were entered hierarchically in three sets, the predicted interactions within levels being entered immediately after the component main factors. Table 2 Hierarchical Regression Analyses on Coping Scale Scores: Additive Effects of Hospital, Person, Environmental, and Situational Variables General coping Direct coping Suppression % of % of % of R 2 explained R 2 explained R 2 explained Source df R 2 increment F variance R 2 increment F variance R 2 increment F variance Hospital * < <1 -- Individual differences * ** Environmental characteristics "* < Situational factors " ** ** 84.4 Note. Overall significance of additive models: general coping, F( 10, 124) = 4.54, p <.001; direct coping, F( 10, 124) = 3.74, p <.001; suppression, F(10, 124) = 1.93,p <.05. * p <.05. **p <.01.

8 1284 KATHARINE R. PARKES Table 3 Hierarchical Regression Analysis of Individual Differences, Work Environment Measures, and Situational Characteristics in Relation to Direct Coping Scores % of Cumulative R 2 explained Source R ~ increment F df p variance B a ,132 < "* Extraversion Neuroticism , 132 < *** + Social support , 130 ns Work demand (linear) , 130 < Work demand (quadratic) , 129 ns Importance of episode , 124 ns Episode type , 124 < Extraversion X Social Support ,122 ns Neuroticism x Work Demand (linear) ,122 ns Neuroticism X Work Demand (quadratic) , 121 < * + Extraversion x Importance of Episode , 119 < "* Neuroticism X Importance of Episode , 119 ns Social Support X Importance of Episode Work Demand (linear) X , 117 < *** Importance of Episode , 117 ns Note. Plus (+) indicates a new step in the hierarchical analysis. a The B values are the unstandardized coefficients from the final regression equation, each term being corrected for all other terms. *p <.05. **p <.025. ***p <.01. Predicted interactions across levels were entered, also hierarchically, after the main factors, in the following order: person by environment, person by situation, and environment by situation. Direct coping. Analysis of the direct coping scores, shown in Table 3, confirmed that two main factors, extraversion and type of episode, were significant overall predictors of direct coping. In addition, three of the predicted interactions were significant when entered after their component terms in the hierarchical analysis. These significant interactions reflected the combined influence of person by environment (Neuroticism X Work Demand, quadratic term), person by situation (Extraversion X Importance), and Environment X Situation (Social Support Importance). The remaining three predicted interactions were not significant, although there was weak evidence of the expected interaction between social support and extraversion (. 10 < p <.15). Compared with an additive model including only main factors, the interactive model shown in Table 3 resulted in a highly significant increase in the proportion of variance explained, F(8, 117) = 2.89, p =.006. Interactions across person, environmental, and situational factors accounted for 36.4% of the total explained variance. Suppression. As shown in Table 4, neither neuroticism nor extraversion was a significant predictor of suppression scores, but the interaction between these variables (entered hierarchically after the main factor terms) was highly significant. Of the other main factors, only importance was significant. However, two predicted interactions across person, environment, and situation were significant: that between neuroticism and the quadratic component of work demand and that between work demand and episode importance. None of the predicted interactions involving social support were significant. The interactive model resulted in a significant increase in the squared multiple correlation, as compared with the corresponding additive model, F(9, ll6) = 2.31, p =.02. The within-level interaction (Extraversion X Neuroticism) accounted for 18.9% of the explained variance; interactions across levels accounted for 32.8%. Relative importance of person, environmental, and situational variables. In order to investigate the relative importance of the different types of predictor variables, three analyses were carried out in which main terms and interactions involving, respectively, situational, environmental, and person variables were dropped from the analysis, and the squared multiple correlations were determined for the reduced models that included variables of only two types. For direct coping, the squared multiple correlations and significance levels of the overall models were as follows: person and environment,.147, F(8, 126) = 2.72, p <.01; person and situation,.220, F(9, 125) = 3.91, p <.001; environment and situation,.201, F(10, 124) = 3.12, p <.002. Thus, the reduced models accounted for a significantly smaller proportion of the variance than did the model shown in

9 INDIVIDUAL, ENVIRONMENTAL, AND SITUATIONAL FACTORS IN COPING 1285 Table 4 Hierarchical Regression Analysis of Individual Differences, Work Environment Measures, and Situational Characteristics in Relation to Suppression Scores % of Cumulative R 2 explained Source R 2 increment F df p variance B a Extraversion , 132 ns Neuroficism ,132 ns Extraversion X Neuroticism , 131 < " + Social support < 1 1, 129 ns Work demand (linear) < 1 1, 129 ns Work demand (quadratic) < 1 1, 128 ns Importance of episode ,123 < * Episode type , 123 ns -- + Extraversion x Social Support < 1 1, 121 ns Neuroticism X Work Demand (linear) <1 1,121 ns ** + Neuroticism X Work Demand (quadratic) ,120 < "* + Extraversion X Importance of Episode < 1 1, 118 ns Neuroticism X Importance of Episode <1 1, 118 ns Social Support Importance of Episode , 116 ns Work Demand (linear) X Importance of Episode 4.78 l, 116 < * Note. Plus (+) indicates a new step in the hierarchical analysis. a The B values are the unstandardized coefficients from the final regression equation, each term being corrected for all other terms. * p <.05. ** p <.025. Table 3. Even the best reduced model (person/situational variables) resulted in a highly significant decrement, F(8, 117) = 2.82, p <.007, relative to the full model. The same analyses were carried out for the suppression scores. The squared multiple correlations and significance levels of the reduced models were as follows: person and environment,.127, F(9, 125) = 2.02, p <.05; person and situation, 9 174, F(I 0, 124) = 2.61, p <.007; and environment and situation,. 165, F(10, 124) = 2.44, p =.01. Again, the person/situational variables produced the best reduced model; however, relative to the full model in Table 4, the decrement was only marginally significant, F(8, 116) = 1.79, p <.09, indicating the relative weakness of environmental effects for this measure. Exploratory analyses. Three further analyses were carried out post hoe. The first analysis was conducted in order to check whether the two-way interactions shown in Tables 3 and 4 concealed significant higher order terms. Three-way interactions (Extraversion Social Support x Importance and Neuroticism X Work Demand x Importance) were tested as the final term in each analysis. In each case, the F values were less than 1.0; thus, there was no evidence of Person Environment X Situation interactions. The predicted model for suppression accounted for a smaller proportion of variance than did the model for direct coping; this difference was partly due to the fact that type of episode was not significant for suppression. The second post hoe analysis showed that the two hospitals differed in the extent to which suppression was reported in relation to particular types of episodes. When hospital and the Hospital Type of Episode interaction were included as the last two terms in the overall model, the Hospital Episode term was found to be significant, F(4, 111) = 2.68, p =.035, and the squared multiple correlation increased to.332, comparable to that for the direct coping scores. In the third post hoc analysis, the interactive model predicted for the specific coping measures was applied to the general coping scores. The squared multiple correlation increased only marginally (from.268 to.281); the increment was nonsignificant, F(8, 116) = 0.26, ns. Determination of Regression Coefficients In order to examine the nature of the significant interaction effects for the two specific coping measures, regression coefficients were determined from simultaneous regression analyses in which each term was corrected for all other terms. Following the recommendations offinney et al. (1984), the regression coefficients were calculated from the complete predictive model

10 1286 KATHARINE R. PARKES being reported by extraverts responding to low-importance episodes. For the suppression scores, Figure 3 shows the interaction between neuroticism and extraversion, determined from the regression coefficients in Table 4. As predicted, low-neurotic introverts reported high levels of suppression, but this was also true of high-neurotic extraverts; the more marked feature of the data was that low-neurotic extraverts had low suppression scores. Thus, among extraverts, neuroticism had a strong positive effect on suppression, whereas for introverts the tendency was in the opposite direction. The curvilinear interaction between neuroticism and work demand for suppression is shown in Figure 4. It can be seen that marked differences between the high- and low-neurotic groups occurred only at higher levels of work demand, low-neurotic subjects showing high-suppression and high-neurotic subjects showing low suppression. The form of the interaction between importance and work demand for the suppression scores showed that at low levels of work demand, importance of the episode had a marked effect on suppression, particularly low levels of suppression being reported for high-importance episodes. In contrast, at high levels of work demand, the importance of the episode was unrelated to suppression scores. Figure 1. The relation between work demand and direct coping for high (1 SD) and low (-1 SD) levels of neuroticism. (The Direct Coping scale shows adjusted scores derived from the regression coefficients in Table 3.) Discussion The results show that coping responses, as assessed by scales derived from the Ways of Coping Questionnaire, are signifi- rather than from a reduced model (in which nonsignificant interactions are dropped from the analysis). The coefficients shown in Tables 3 and 4 were used to determine the regression equations. For direct coping scores, the effect of episode type was significant overall; interpersonal problems with patients and interpersonal problems with other nurses resulted in the highest and lowest scores, respectively. The other main factors were components of significant interactions; specifically, Neuroticism Work Demand (a curvilinear relation), Extroversion Importance, and Social Support Importance. The curvilinear relations between work demand and direct coping for high (1 SD above the mean) and low (1 SD below the mean) levels of neuroticism are shown in Figure 1. For low-neurotic subjects, the curve was of the predicted form, that is, an inverted O-shape with the highest levels of direct coping occurring at moderate levels of work demand. In contrast, for high-neurotic subjects, the overall level of scores was lower, and the effect of work demand was much less marked. The interaction between social support and importance of the episode is shown in Figure 2. At low levels of support (1 SD below the mean), direct coping decreased as importance increased, whereas at high levels of support (1 SD above the mean) the tendency was for direct coping to increase with increases in importance. The highest levels of direct coping were for low-importance episodes occurring in conditions of low social support. The interaction between extraversion and importance was generally similar in form to that between social support and importance, with the highest levels of direct coping Figure 2. The relation between importance and direct coping for high (1 SD) and low (- 1 SD) levels of social support. (The Direct Coping scale shows adjusted scores derived from the regression coefficients in Table 3.)

11 INDIVIDUAL, ENVIRONMENTAL, AND SITUATIONAL FACTORS IN COPING 1287 Figure 3. The relation between extroversion and suppression for high (1 SD) and low (- 1 SD) levels of neuroticism. (The Suppression scale shows adjusted scores derived from the regression coefficients in Table 4.) dom group of students whose work situation was essentially similar to that of the subject herself. This approach, which draws on Pngh's (1977) analysis of situational and unique components in environmental perceptions, ensured that the environmental measures used were free from the direct influence of the personality, coping behaviors, and self-report biases of the individual concerned. There remained the possibility that the social support and work demand scores applied to a particular subject might be indirectly affected by her behavior and interactions with her peer group. However, it is reasonable to infer a primary direction of effect from the nature of the work environment, as assessed by the peer-group ratings, to the coping scores, particularly as the students on each ward were assigned to different shift schedules and, therefore, did not regularly work together. Of the two situational characteristics analyzed, the importance of the episode was self-reported concurrently with the reporting of coping strategies, and information about stressful episodes was obtained retrospectively. Therefore, in this case, no directional inferences can be drawn. There was also a significant correlation between perceived importance and neuroticism, possibly reflecting an underlying vulnerability expressed in both measures; Martin and Clark (1985) reported similar findings. Some problems of inference also apply to the second situational variable, episode type, although this classification was made independently by clinical raters. The classifications were derived from interview material, which may have been influenced by the subject's perceptions of the situation and by the coping responses adopted. Thus, causal inferences about re- cantly related to individual differences, to the characteristics of the environment in which the stressful episode occurs, and to the specific nature of the episode. Thus, the study shows that intraindividual, environmental, and situational factors are each of importance as predictors of coping responses and that, consistent with initial predictions, both main and interactive effects contribute significantly to the explained variance in coping scores. These findings will be discussed later, together with theoretical and methodological aspects of work. First, however, some issues of causal inference and interpretation must be considered. In the present study, individual differences were assessed prior to the occurrence of the stressful episodes and, indeed, prior to the initial ward assignment. Thus, relations between extraversion/neuroticism and coping scores can be interpreted as the influence of individual differences on coping and are not open to interpretation in the opposite direction. However, the possibility of one or more unmeasured variables influencing both individual difference scores and subsequent reports of coping strategies cannot be excluded. For the work environment measures, the basis of inference was different. These measures related to the ward period during which the stressful episode occurred, but they were not self-report data in that the scores applied to each subject represented the consensus view of her peers on the same ward, not her own responses. Students were preassigned to wards with no element of selection or choice; therefore, the peer ratings were derived from the scores of a ran- Figure 4. The relation between work demand and suppression for high (1 SD) and low (-1 SD) levels of neuroticism. (The Suppression scale shows adjusted scores derived from the regression coefficients in Table 4.)

12 1288 KATHARINE R. PARKES lations between episode type and coping cannot be made unambiguously. The nature of the coping measures used is also of relevance in interpreting the present findings. Lazarus and Folkman (1984) defined coping as "all efforts to manage, regardless of outcome" (p. 178), and the Ways of Coping Questionnaire lists a variety of cognitive and behavioral strategies derived from the literature on coping and defense and from other sources. This definition of coping encompasses not only potentially effective strategies, but also some forms of coping and defense (wishful thinking, fantasy, and self-blame) that are usually associated with adaptive problems (Andrews, Tennant, Hewson, & Vaillant, 1978; Felton & Revenson, 1984; Folkman & Lazarus, 1985; Frydman, 1981; Kobasa, 1982; McCrae & Costa, 1986). In the present study, these reality-distorting strategies loaded negatively on the Direct Coping scale. Thus, both direct coping and suppression represented potentially adaptive coping attempts. Empirical studies confirm the general effectiveness of these types of coping (Anderson, 1977; Billings & Moos, 1981, 1984; Felton & Revenson, 1984; Vaillant, 1976), although the extent to which either approach is effective in any particular circumstance will be influenced by the nature of the stressful transaction concerned. On the General Coping scale, all items, including those describing maladaptive strategies, loaded positively. Thus, higher scores on the General Coping scale should not necessarily be interpreted as representing more effective coping, but only as implying that a wider repertoire of cognitive and behavioral strategies was called into play. It was nonetheless of interest to analyze the general coping scores, as evidence suggests that a more extensive coping repertoire and the use of combinations of cognitive and behavioral strategies is potentially advantageous (Peadin & Schooler, 1978; Schiffman, 1984). Person, Environment, and Situation as Predictors of Coping The main findings of the present study can be summarized as follows. First, predicted interactions between variables representing person, environment, and situation made significant contributions to the explained variance in the scores for direct coping and suppression. Consistent with transactional theories, for each of these specific coping measures the interactive model accounted for a significantly greater proportion of variance than did the corresponding additive model. Also in accordance with initial predictions, general coping was determined by an additive rather than an interactive model. Second, analysis of reduced models, restricted to two of the three types of variables, showed that person and situational variables were the most important influences on both direct coping and suppression. However, for direct coping, all three types of variables contributed significantly to the explained variance, whereas for suppression, environmental variables made only a marginally significant contribution to the overall model. In contrast, for general coping, environmental factors accounted for the largest proportion of the explained variance. Finally, not all the individual interactions predicted a priori were significant, and the pattern of interactions was different for the two measures of specific coping. Direct coping was predicted mainly by interactions between extraversion, social support, and importance and by the main effect of type of episode. Suppression was predicted by interactions between neuroticism, work demand, and importance and by the extraversion/ neuroticism interaction. Only the interaction between neuroticism and the quadratic component of work demand was a significant predictor of both direct coping and suppression. These findings are of both empirical and theoretical relevance. Empirically, the study extends the existing literature by simultaneously taking into account person, environmental, and situational factors as predictors of coping and examining their relative importance. The study also allowed the different patterns of main and interactive effects that influence the various forms of coping to be examined in relation to initial predictions derived from the life-stress literature and the nature and direction of interaction effects to be evaluated. Theoretically, the study demonstrates that coping is not determined solely by intraindividual processes related to individual differences and perceptions of particular episodes, but is also determined by external factors, particularly the nature of the environment in which the episode occurs. It also provides support for transactional models of stress and coping by showing that interactions between person, environmental, and situational variables account for significant proportions of the variance in coping scores. Empirical Findings Person, environmental, and situational variables were each found to be important predictors of direct coping. The active, problem-focused approach to managing stress that characterized this form of coping was reflected in the overall effect of extraversion, extraverts reporting significantly more direct coping strategies than did introverts. Type of episode also had a significant effect on direct coping, consistent with the fact that in some stressful episodes (e.g., public reprimands from senior ward staff) students had little opportunity for problem-focused forms of coping, whereas they were able to respond directly to other kinds of problems (e.g., those involving difficult or uncooperative patients) in spite of their limited authority and experience. For suppression, individual differences (in the form of an interaction between neuroticism and extraversion) and the perceived importance of the episode were the major determinants, environmental factors (particularly social support) being less relevant; this emphasis on internal processes is consistent with the intrapsychie nature of suppression as a form of coping. In contrast, environmental constraints and resources were the major determinants of general coping, with more difficult circumstances (i.e., high work load and low support) eliciting a greater number of strategies. However, person and situational characteristics also made significant contributions. The more detailed findings will be discussed later in relation to specific interactive effects predicted a priori. Person~Environment Interactions Neuroticism and work demand. The interactions between neuroticism and work demand were of a different form for direct coping and suppression, but consistent with initial predictions and with other reported findings (McCrae & Costa, 1986), the low-neurotic group responded more adaptively than did the

13 INDIVIDUAL, ENVIRONMENTAL, AND SITUATIONAL FACTORS IN COPING 1289 high-neurotic group in both respects. Low neurotics showed an inverted-u relation between work demand and direct coping, with highest levels at moderate work demand, consistent with Welford's (1973) theoretical model. In contrast, high neurotics were relatively unresponsive to work demand, showing consistently low levels of direct coping. Thus, individuals characterized by emotional stability, flexibility, and resilience and working under conditions of moderate work load reported the highest levels of direct coping. The types of coping that were represented by high direct coping scores have been found to predict favorable adaptive outcomes in other studies (for instance, Anderson, 1977; Felton & Revenson, 1984; Folkman & Lazarus, 1985). Thus, the present findings underline the importance of both emotional stability and optimal level of work load in facilitating adaptation to a new and demanding work situation. In contrast, if either personal or environmental characteristics are unfavorable (i.e., high neuroticism and/or extreme levels of work load), direct coping is markedly reduced. For the suppression measure, the pattern of response shown by the low neurotics also tended to be more adaptive than that of the high neurotics, although in this case, the difference applied only to conditions of high-work demand. Under high demand, low-neurotic subjects reported high levels of suppression. Using suppression as a coping strategy in these circumstances can be seen as adaptive in allowing students to meet the continuing demands of the work situation without being distracted by distressing thoughts of specific problems. In contrast, neurotic subjects reported low levels of suppression in high-demand environments, suggesting that preoccupation with unresolved problems may have reduced their capacity to work effectively. Thus, for both coping measures, neurotic subjects showed a potentially less adaptive pattern of response than did their low-neurotic peers. This difference could underlie the finding that failure to complete the 3-year course was predicted by neuroticism (unpublished data) and by high levels of psychological symptoms at the start of training (Parkes, 1983). Extraversion and social support. Extraversion was found to have a significant positive effect on direct coping. However, the predicted interaction between extraversion and social support was not significant, although there was evidence of a trend (p <. 15) consistent with Duckitt's (1984) findings. High social support tended to facilitate direct coping among extraverts, but it had the opposite effect among introverts. For suppression, there was no evidence of an interaction between social support and extraversion or of a main effect of social support. Thus, the nature of the support available to nurses in the work setting had no implications for the extent to which suppression was used to reduce distress, regardless of individual differences in extraversion. This finding (and the similar absence of an interaction between importance and social support that will be noted shortly) reflects the fact that the role of senior nurses in relation to students was predominantly one of supervision, guidance, and authority, rather than one of emotional support. In the terms used by House (198 l) in categorizing forms of work-related support, the students received informational and instrumental support given in the context of specific problems; these forms of social support were more relevant to direct coping than to suppression. Emotional support, which would be expected to reduce the use of suppression as a coping response, was largely absent in the work setting. In this respect, the ward environment was similar to that described by Menzies (1960) in her study of student nurses. Person/Situation and Environment/Situation Interactions For direct coping, interactions between episode importance and person and environmental factors, predicted on the basis of the life-stress literature, were only found to be significant for extraversion and for social support. Thus, the negative relation between importance and direct coping was moderated by measures assessing individual differences in sociability and by environmental differences in social resources but not by measures of personal vulnerability or external demands. Low-importance episodes were found to show the positive effect of extraversion on direct coping more strongly than did high-importance episodes; lack of experience and authority common to all students appeared to mask individual difference effects when a serious situation was encountered. However, the availability of guidance and support from senior nurses was also a relevant factor. High levels of direct coping were associated with minor episodes occurring in wards with low levels of support and, to a lesser extent, with major episodes in wards with high levels of support. Thus, in wards with little guidance from senior nurses, students tended to respond to minor episodes with direct attempts to resolve the problem. The availability of support had the effect of impairing attempts at direct coping for minor episodes but increasing direct coping for serious episodes that students had no authority to handle on their own. These findings are consistent with Menzies' (1960) description of the hierarchical structure of the nursing profession and the role of first-year nurses in relation to qualified staff. However, the nature of the work setting and the subjects' role within it were specific to the present study. Thus, the form of the Importance Social Support interaction found in the present study was different from that typically reported in studies of life stress (see Cohen & Wills, 1985), although crossover interactions involving social support have been found by other researchers (e.g., Cohen & Hoberman, 1983). For suppression, the predicted interactions of person and environmental variables with episode importance were nonsignificant, with the one exception of the work demand by importance interaction. In low-demand environments, high levels of suppression were associated with low-importance episodes. Thus, if routine work was relatively undemanding, students reported suppressing minor problems but not more important ones. However, in wards with high levels of work demand, the importance of a particular episode was unrelated to the level of suppression reported. Aside from this interaction, the results of the present study suggest that the significant negative association between importance and suppression was largely independent of person and environmental influences. General Coping The results showed that the overall repertoire of strategies used (as assessed by the General Coping scale) was influenced by capacities, resources, and limitations associated with personal characteristics and environmental constraints, as well as by episode importance. As predicted, these effects were addi-

14 1290 KATHARINE R. PARKES five; there was no evidence of significant interactions. General coping was positively related to both extraversion and neuroticism, whereas direct coping was positively related to extraversion and showed a negative trend with neuroticism. Thus, extraverts selectively endorsed adaptive problem-oriented coping items (which loaded positively on both direct coping and general coping), whereas neurotics tended to endorse items describing maladaptive cognitive distortions (which loaded negatively on direct coping and positively on general coping). These findings are consistent with other studies that show that use of rational action is associated with extraversion, and use of selfblame, withdrawal, and cognitive distortion is associated with neuroticism (McCrae & Costa, 1986). The nature of the work environment accounted for the largest proportion of the variance in general coping scores. In environments characterized by high work demand or low support, or both, a greater number of coping items was endorsed. Use of a wider coping repertoire is generally adaptive (Pearlin & Schooler, 1978; Schiffman, 1984), but in the absence of outcome measures, the present resuits can only be interpreted as showing that a greater number of strategies are reported in more difficult environmental circumstances and in managing more important episodes. The overall influence of hospital setting suggested that ways in which the hospitals differed, over and above the immediate ward environment, also had implications for the extent to which varied coping repertoires were used. This result is consistent with findings reported previously (Parkes, 1983) that showed that the two hospitals concerned in the present study differed in ways that significantly influenced the students' behavior. Theoretical Issues The findings of the present study are of theoretical interest in the context of current transactional models of stress and coping. Substantial proportions of the explained variance in the direct coping and suppression scores (36.4% and 32.8%, respectively) were due to interactions across different types of variables. Interactions between person, environmental, and situational factors are implicit in transactional theories of stress and coping but have not previously been demonstrated empirically. Thus, the present findings provide support for the theoretical arguments of Lazarus and Folkman (1984), although the mediating role of cognitive appraisal, which is a central construct in transactional theories, was not directly examined. Newton and Keenan (1985) have recently questioned whether subjective appraisal of stress is of primary importance in relation to coping; in their study, person and environmental variables were found to be direct predictors of coping of equal importance to appraisal. The present study accords with that of Newton and Keenan in showing that factors that influence appraisal can be treated as direct and identifiable sources of variance in coping and that such studies potentially provide useful information about adaptive processes. In this context, it is of relevance that the proportions of explained variance in the present study compare favorably with the values reported in other studies examining predictors of coping (Felton & Revenson, 1984; Fleishman, 1984; Menaghan & Merves, 1984; Shinn, Rosario, M~rch, & Chestnut, 1984). Furthermore, the design of the present study substantially lessened the problems of self-report methodology and conceptual overlap between independent and dependent variables, which may inflate the proportions of variance explained in studies of appraisal and coping processes. However, further empirical research is required to clarify the importance of appraisal as an influence on coping, over and above that of person, environmental, and situational variables. Theoretically, it was also of interest that scores on the two specific coping measures were determined by different combinations of person, environmental, and situational variables. If these effects are mediated by appraisal, then particular dimensions of appraisal, deriving from different combinations of person, environmental, and situational effects, may lead to particular types of coping. Folkman and Lazarus (1980) found that problem-focused and emotion-focused coping were almost always used together in the same episode; the present findings suggest that different interactions between person and environmental variables, acting through different appraisals, may underly the different types of coping responses with which an individual attempts to manage stressful transactions. Methodological Issues Although the present study draws widely on the work of Lazarus and his colleagues, the research approach does not fall within the process-oriented, transactional model advocated in their most recent discussion of methodological aspects of research into stress and coping (Lazarus & Folkman, 1984). Thus, this article is concerned with situational, environmental, and person variables as direct predictors of coping, rather than with their combined effect as expressed in appraisal measures; and it does not attempt to study the reciprocal interactions between coping, appraisal, and emotional response that take place during the course of a stressful experience. In the terminology used by Lazarus and Folkman to describe a more traditional causeand-effect model, the present findings can be seen as contributing to the study of relations between causal antecedents (which include person, situational, and environmental variables) and self-reported coping strategies, at the psychological level of analysis. In this context, the findings highlight the ways in which not only situational factors, but also stable individual characteristics and the nature of the environment that forms the wider setting of the episode, can be identified as direct predictors of coping behavior. Lazarus and Folkman have rightly drawn attention to the limitations of earlier approaches to stress research and have emphasized the need to adopt a transactional framework in studying stress and coping processes. However, the present work demonstrates that more traditional models still provide a useful basis for research in this field, although such models do not take into account the complex processes of reciprocal causation between appraisal, reappraisal, coping, and affective reactions that occur over time during stressful encounters. Current research methods are not, as yet, adequate to encompass fully the theoretical and empirical complexity of transactional process models. Until further progress in methodology has been made (e.g., in developing longitudinal data collection methods that can accommodate the unpredictable time course of stressful transactions and capture the fluctuating nature of emotions, coping, and cognitive appraisals; in devising reliable and valid assessment instruments; and in applying appropriate statistical techniques for testing transactional models), there is a continu-

15 INDIVIDUAL, ENVIRONMENTAL, AND SITUATIONAL FACTORS IN COPING 1291 ing need for studies based on less complex approaches to stress and coping. References Alfredsson, L., Karasek, R., & Thcorcll, T. (1982). Myocardial infarction risk and psychosocial work environment: An analysis of the male Swedish working force. Social Science and Medicine, 16, Anderson, C. R. (1977). Locus of control, coping behaviors, and performance in a stress setting: A longitudinal study. Journal of Applied Psychology, 62, Andrews, G., Tennant, C., Hewson, D. M., & Vaillant, G. E. (1978). Life event stress, social support, coping style, and risk of psychological impairment. Journal of Nervous and Mental Disease, 166, Billings, A. G., & Moos, R. H. (1981). The role of coping responses and social resources in attenuating the stress of life events. Journal of Behavioral Medicine, 4, Billings, A. G., & Moos, R. H. (1984). Coping, stress, and social resources among adults with unipolar depression. Journal of Personality and Social Psychology, 46, Chart, K. B. (1977). Individual differences in reactions to stress and their personality and situational determinants: Some implications for community mental health. Social Science and Medicine, 11, Cleary, P. D., & Kessler, R. C. (1982). The estimation and interpretation of modifier effects. Journal of Health and Social Behavior, 23, Coburn, D. (1975). Job-worker incongruence: Consequences for health. Journal of Health and Social Behavior, 16, Cohen, J. (1978). Partialed products are interactions; partialed powers are curve components. Psychological Bulletin, 85, Cohen, S., & Hoberman, H. (1983). Positive events and social support as buffers of life change stress. Journal of Applied Social Psychology, 13, Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, Coyne, J. C., Aldwin, C., & Lazarus, R. S. (1981). Depression and coping in stressful episodes. Journal of Abnormal Psychology, 90, Denney, D. R., & Frisch, M. B. (1981). The role of neuroticism in relation to life stress and illness. Journal of Psychosomatic Research, 25, Duckitt, J. (1984). Social support, personality, and the prediction of psychological distress. Journal of Clinical Psychology, 40, Duckitt, J., & Broil, T. (1982). Personality factors as moderators of the psychological impact of life stress. South African Journal of Psychology, 12, Eysenck, H. J. (1970). The structure of human personality, London: Methuen. Eysenck, H. J., & Eysenck, S. B. G. (1975). Manual of the Eysenck Personality Questionnaire. London: Hodder & Stoughton. Felton, B. J., & Revenson, T. A. (1984). Coping with chronic illness: A study of illness controllability and the influence of coping strategies on psychological adjustment. Journal of Consulting and Clinical Psychology, 52, Finney, J. W., Mitchell, R. E., Cronkite, R. C., & Moos, R. H. (1984). Methodological issues in estimating main and interactive effects: Examples from coping/social support and stress field. Journal of Health and Social Behavior, 25, Fleishman, J. A. (1984). Personality characteristics and coping patterns. Journal of Health and Social Behavior, 25, Folkman, S., & Lazarus, R. S. (1980). An analysis of coping in a middleaged community sample. Journal of Health and Social Behavior, 21, Folkman, S., & Lazarus, R. S. (1985). If it changes it must be a process: Study of emotion and coping during three stages of a college examination. Journal of Personality and Social Psychology, 48, Frankenhauser, M., & Gardell, B. (1976). Underload and overload in working life: Outline of a multidisciplinary approach. Journal of Human Stress, 2(3), Frydman, M. I. (1981). Social support, life events, and psychiatric symptoms: A study of direct, conditional and interactive effects. Social Psychiatry, 16, Hoiberg, A., & Berry, N. H. (1978). Expectations and perceptions of Navy life. Organizational Behavior and Human Performance, 21, House, J. S. ( 1981). Work stress and social support. Reading, MA: Addison-Wesley. Jackson, S. E. (1983). Participation in decision making as a strategy for reducing job-related strain. Journal of Applied Psychology,, 68, Jacobson, S. P. (1978). Stressful situations for neonatal intensive care nurses. MCN: American Journal of Maternal and Child Nursing, 3, Karasek, R. A. (1979). Job demands, job decision latitude, and mental strain: Implications for job redesign. Administrative Science Quarterly, 24, Karasek, R., Baker, D., Marxer, E, Ahlbom, A., & Theorell, T. (1981). Job decision latitude, job demands, and cardiovascular disease: A prospective study of Swedish men. American Journal of Public Health, 71, Kobasa, S. C. (1982). Commitment and coping in stress resistance among lawyers. Journal of Personality and Social Psychology, 42, Krantz, S. E. (1983). Cognitive appraisals and problem-directed coping: A prospective study of stress. Journal of Personality and Social Psychology, 44, Lazarus, R. S. (1966). Psychological stress and the coping process. New York: McGraw-Hill. Lazarus, R. S., & Cohen, J. B. (1977). Environmental stress. Human Behavior and Environment, 2, Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer. Lefcourt, H. M., Martin, R. A., & Saleh, W. E. (1984). Locus of control and social support: Interactive moderators of stress. Journal of Personality and Social Psychology, 47, Lynn, R. (Ed.). (1981). Dimensions of personality, Oxford, England: Pergamon Press. Martin, M., & Clark, D. M. (1985). Cognitive mediation of depressed mood and neuroticism. IRCS Medical Science, 13, McCrae, R. R. (1984). Situational determinants of coping responses: Loss, threat, and challenge. Journal of Personality and Social Psychology, 46, McCrae, R. R., & Costa, P. T. (1986). Personality, coping, and coping effectiveness in an adult sample. Journal of Personality, 54, Mechanic, D. (1978). Students under stress: A study in the social psychology of adaptation. (Original work published 1962) Madison: University of Wisconsin Press. Menaghan, E. G., & Merves, E. S. (1984). Coping with occupational problems: The limits of individual effort. Journal of Health and Social Behavior, 25, Menzies, I. E. P. (1960). A case-study in the functioning of social systems as a defence against anxiety. Human Relations, 13, Mitchell, R. E., Cronkite, R. C., & Moos, R. H. (1983). Stress, coping, and depression among married couples. Journal of Abnormal Psycholog?A, 92, Moos, R. H. (1976). The human context: Environmental determinants of behavior New York: Wiley. Moos, R. H. (1981). Work Environment Scale manual Palo Alto, CA: Consulting Psychologists Press. Moos, R. H., & Billings, A. G. (1982). Conceptualizing and measuring coping resources and processes. In L. Goldberger & S. Breznitz (Eds.), Handbook of stress: Theoretical and clinical aspects (pp ). New York: Free Press.

16 1292 KATHARINE R. PARKES Mowday, R. T., & Spencer, D. G. (1981). The influence of task and personality characteristics on employee turnover and absenteeism incidents. Academy of Management Journal, 24, Newton, T. J., & Keenan, A. (1985). Coping with work-related stress. Human Relations, 38, O'Connor, E. J., Peters, L. H., Pooyan, A., Weekiey, J., Frank, B., & Erenkrantz, B. (1984). Situational constraint effects on performance, affective reactions, and turnover: A field replication and extension. Journal of Applied Psychology, 69, Parasuraman, S., & Cleek, M. A. (1984). Coping behaviors and managers' affective reactions to role stressors. Journal of Vocational Behavior, 24, Parkes, K. R. ( i 982). Occupational stress among student nurses: A natural experiment. Journal of Applied Psychology, 6 7, Parkes, K. R. (1983). Smoking as a moderator of the relationship between alfective state and absence from work. Journal of Applied Psychology, 68, Parkes, K. R. (1984). Locus of control, cognitive appraisal, and coping in stressful episodes. Journal of Personality and Social Psychology, 46, Parkes, K. R. (1985). Stressful episodes reported by first-year student nurses: A descriptive account. Social Science and Medicine, 20, Pearlin, L. I., & Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 19, Pittner, M. S., & Houston, B. K. (1980). Response to stress, cognitive coping strategies, and the Type A behavior pattern. Journal of Personality and Social Psychology, 39, laugh, W. M. (1977). Assessment of environmental effects: Method and model. Organizational Behavior and Human Performance, 18, Revelle, W., & Rocklin, T. (1979). Very simple structure: An alternative procedure for estimating the optimal number of interpretable factors. Multivariate Behavioral Research, 14, Rosenbaum, M. (1983). Learned resourcefulness as a behavioral reper- toire for the self-regulation of internal events: Issues and speculations. In M. Rosenbaum, C. M. Franks, & Y. Jaffe (Eds.), Perspectives on behavior therapy in the eighties (pp ). New York: Springer. Roskies, E., & Lazarus, R. S. (1980). Coping theory and the teaching of coping skills. In P. Davidson & S. Davidson (Eds.), Behavioral medicine: Changing health life styles. (pp ). New York: Brunner/ Mazel. Schaefer, C. (1981). Shoring up the "buffer" of social support. A comment on LaRocco, House, and French, Journal of Health and Social Behavior, 22, Schiffman, S. (1984). Coping with temptations to smoke. Journal of Consulting and Clinical Psychology, 52, Shinn, M., Rosario, M., March, H., & Chestnut, D. E. (1984). Coping with job stress and burnout in the human services. Journal of Personality and Social Psychology,, 46, Stone, A. A., & Neale, J. M. (1984). New measure of daily coping: Development and preliminary results. Journal of Personality and Social Psychology,, 46, Vaillant, G. E. (1976). Natural history of male psychological health. V. The relation of ego mechanisms of defense to adult adjustment. Archives of General Psychiat~ 33, Vickers, R. R., Hervig, L. K., Rahe, R. H., & Rosenman, R. H. (1981). Type A behavior pattern and coping and defense. Psychomatic Medicine, 43, Vingerhoets, A. J. J. M., & Flohr, H. (1984). Type A behaviour and selfreports of coping preferences. British Journal of Medical Psychology,, 57, Welford, A. T. (1973). Stress and performance. Ergonomics, 16, Wheaton, B. (1983). Stress, personal coping resources, and psychiatric symptoms: An investigation of interactive models. Journal of Health and Social Behavior, 24, Received March 5, 1985 Revision received April 4,