II Article search
III Literature review
IV Adolescent coping strategies
VI Understanding the ecological framework
This feature originally ran in OHPE's 11 July 2014 issue, but it feels apropos to resurface it this week.
Submitted by Cameron Montgomery1,2, David Trumpower1, Angus McMurtry1, Shehzad Ghani1, Alix Daubney1, Eva Guerin 2 (1Faculty of Education, University of Ottawa; 2 Institut de recherche de l’Hôpital Montfort)
Coping with stress during adolescence is a thoroughly documented phenomenon, and there is a growing understanding of its relationship with adolescent mental health and illnesses. The scientific literature on adolescent stress and coping has evolved, cementing the proposition that the two concepts are inextricably linked. For example, Lazarus and Folkman’s (1984) frame of reference on stress and coping is applied widely in the scientific literature on adolescent stress and coping. According to this framework, stress is conceptualized as a perception of daily hassles and events. Hassles or events are appraised by an individual as threatening or harmful and thus they are considered to be stress factors. Resources are then appraised within the immediate environment to cope with the stress factor, and finally, one uses identified resources to cope with the perceived threat or harm.
Coping is typically referred to as a strategy rather than a mechanism. Semantically, the terms strategy and mechanism can be differentiated in that a strategy is more purposeful, planned and conscious, whereas a mechanism is an unconscious “mental and emotional pattern that shapes behaviour in a given situation or environment” (The Free Online Dictionary, n.d.). Coping can take several forms, such as problem-focused and emotion-focused coping (Lazarus & Folkman, 1984). In addition, coping strategies can be either functional or dysfunctional, or similarly conceptualized as adaptive versus maladaptive (O’Connor et al, 2010). Examples of applicable functional coping strategies include social support, parental support, and the above-mentioned problem-focused coping. Dysfunctional coping strategies typically encompass avoidance, wishful thinking, and blame (Carver, Scheier & Weintraub, 1989).
Given the vast scientific literature on adolescent stress and coping, it was deemed worthwhile to create a comprehensive framework of adolescent stress and coping in order to capture the vast quantity of research and synthesize it. The objectives were to:
- Categorize the various concepts related to adolescent stress and coping that can be found in quantitative articles in the scientific literature in order to develop an over-arching, comprehensive framework of adolescent stress and coping strategies.
- Test the over-arching, comprehensive framework on adolescent stress and coping strategies through meta-analytic procedures.
II Article search
To identify relevant articles, the following databases were searched: ERIC, Sociological Abstracts, PsycINFO, SCOPUS, PUBMED, and Erudit. Keywords for the search were “adolescent”, “stress” and “coping” across databases in order to maintain consistency. As well, searches in all databases were restricted to peer reviewed articles published between 1991 and 2013.
III Literature review
Socioeconomic status, low-income or poverty more specifically, can give rise to adolescents experiencing feelings of hopelessness (Landis et al., 2007). In fact, studies have shown that youth from lower-income families display less optimism in general (Finkelstein, Kubzanski, Capitman, & Goodman, 2007). Ayerst (1999) purports that street youth experience augmented levels of depression compared with youth who are not living on the street due to lack of food, money, shelter and family stress. Homelessness is more difficult for adolescents as opposed to their adult counterparts due to the lack of life skills upon which they can draw (Dalton & Packenham, 2002).
Ethnicity can also play a role in the types of stress experienced by youth and the way in which they experience them. For example, Latino youth report discrimination as a major cause of depression (Stein, Gonzalez & Huq, 2012) compared to Caucasian youth. Furthermore, contrary to results in Caucasian samples, adolescent African American males report higher levels of stress than African American females as the road to adulthood for this male population is extremely arduous, especially in low-income families (Carlson & Grant, 2008). In terms of cultural norms, Chinese American youth versus European American youth experience higher levels of stress due in part to the academic demands placed upon them as well as parental stress due to demands for conformance (Jose & Huntsinger, 2005). This phenomenon of academic pressure is evident more so in Eastern societies (Asian) and less in Western (North American) societies (Lee, 2003, Ang et al., 2009). Studies have shown that North American parents and adolescents do not rate academic success high on a level of importance because in their culture, one's academic prowess is not a determinant of one's self worth, whereas in Eastern families, it is typically of the utmost importance (Ang et al., 2009). Moreover, Ang et al. (2009) purport that in Eastern societies, one's academic standings reflects the entire family. Furthermore, adolescents in schools for gifted children also report high stress levels due to academic stress (Suldo, Shaunessy, & Handesty, 2008) and girls in general report feeling more academic pressure than boys (Moksnes, Moljord, Espnes & Byrne, 2010).
Another cause of stress in adolescents is peer pressure. Peer hassles can be a cause of depression for some adolescents, or psychological arousal (i.e., anxiety) for others; for example, physical fights would cause anxiety as opposed to depression, but bullying would most likely lead to depression rather than anxiety (Gaylord-Harden, Elmore, Campbell, & Wethington, 2011). However, peer-related stress can be interceded by high levels of self-esteem (Moksnes et al., 2010).
With their ups and downs and break-ups, romantic relationships can be a source of stress leading to depression, especially in females who are at risk of depression in general (Davila et al., 2009). Furthermore, adolescents suffering from emotional distress tend to become involved in romantic relationships as a way of increasing their status with peers (Zimmer-Gembeck, Siebenbruner & Collins, 2001).
Family/marital conflict has proven to be another source of stress leading to depression for adolescent females, however not for males (Mazza et al., 2009). Moreover, parent/adolescent disagreements or arguments tend to cause depressive symptoms and internalizing of emotions for adolescents, which can be a cause of internalizing disorders such as anxiety and depression (Reuter, Scaramella, Wallace & Conger, 1999). On the whole, conflict within the family environment can be another source of increased stress leading to depressive symptoms in adolescents (Auerbach & Ringo Ho, 2012).
According to Davila et al. (2009) adolescents who experience parental stress tend to have increased depressive symptoms and females, as a result, are more likely to become involved in romantic and/or sexual relationships. Moreover, over-controlling father figures have been found to greatly contribute to adolescents suffering from anxiety (Verhoeven, Bogels & van der Bruggen, 2012).
Parenting styles can range between two extremes, one being a lack of support from parents as being withdrawn and the other being parents who are highly critical. Notably, depressed youth have self-reported higher levels of parental criticism (Asarnow, Tompson, Woo & Cantwell, 2001). Furthermore, in a study performed by Jaser et al. (2005), adolescents self-reported that parental intrusiveness was related to increased levels of anxiety/depression and aggression.
IV Adolescent coping strategies
Seeking social support is a functional coping method and it can be used for example by those living in low-income households in order to find reliable resources as a means to improved coping. However a lack of social support can augment feelings of hopelessness (Landis et al., 2007). According to Landis et al., 2007, another coping strategy is the use of distraction which may lead to increased clarity, but it can also be difficult since getting out for a walk can be dangerous in certain low-income areas. Active coping/engagement (attempting to improve the situation) can increase feelings of hopelessness when it proves to be fruitless (Landis et al., 2007). Moreover, youth from low-income families tend to exhibit fewer signs of depression (Gaylord-Harden, Taylor, Kesselring, & Grant, 2009), and one theory is that they opt for more destructive coping strategies such as aggression and/or delinquency to disguise their depression/vulnerability (Cassidy & Stevenson, 2005). Several other dysfunctional coping strategies that are used by adolescents include self harm (cutting/scraping) and substance abuse (Ayerst, 1999).
Scott Jr. (2004) claims that racial-related-socialization is a functional coping method instilled in adolescents from their upbringing wherein family members attempt to moderate stress by advising youth of the risks of discrimination in advance. Moreover, African Americans tend to use more spiritual coping as a functional coping strategy and this involves an element of social support (Constantine, Donnelly, & Myers, 2002).
One investigation looked at students facing academic stress (Suldo et al., 2008). They found that adolescents who used functional coping strategies such as positive appraisal (focusing on the good things) and peer/family support reported experiencing less stress than those who resort to anger coping such as yelling at others. In addition, for gifted youth dysfunctional coping strategies include negative avoidance (substance abuse) and anger coping (yelling, blaming others, venting) (Suldo et al., 2008).
With regards to peer hassles as a source of stress, adolescent males tend to experience greater anxiety and resort to dysfunctional coping methods such as aggressive behaviour (fighting). Females on the other hand tend to suffer more from depressive mood states (Gaylord-Harden et al., 2011), and one dysfunctional coping strategy that is often used is disengagement (denial, wishful thinking, etc.). (Sontag, Graber, Gunn, & Warren, 2008). Interestingly, higher levels of self-esteem appear to reduce the effects of peer-pressure situations for adolescents (Moksnes et al., 2010).
According to Plunkett and Henry (1999), in times of family conflict some adolescents choose dysfunctional coping strategies such as avoidance (venting, blaming and substance abuse). Moreover, parental conflict can also be the cause of youth choosing to engage in risky behaviour such as dating someone who is already married (Steinberg, Davila & Finchmann, 2006). In extreme cases, familial stress can lead to extreme distancing and avoidance by running away; indeed, “street kids” report experiencing more stress at home (Ayerst, 1999). However, adequate peer support can serve as a functional coping strategy for youth experiencing family conflict (Gore & Aseltine, 1995). Talking with a friend, a family member, or a teacher constitutes different types of social support (Plunkett & Henry, 1999).
Furthermore, securely attached adolescents (i.e., those from a supportive family) tend to employ more functional coping strategies in times of stress, such as positive reappraisal, as opposed to insecurely attached youth who tend to turn to dysfunctional coping measures such as self-blame (this is all my fault), rumination (constantly thinking about the situation) and catastrophizing (thinking about how incredibly horrible the situation is) (Kraiij et al., 2003). When youth feel a lack of support from their family, they may turn to bullying or stealing as a means of coping (Bal, Crombez, Oost, & Debourdeaudhuij, 2003). Konishi and Hymel (2009), purport that a supportive family may reduce a negative coping strategy like bullying as a means of coping with stress, and can even improve self-esteem. This illustrates a buffering effect.
High self-esteem can also serve as a stress buffer as adolescents possessing greater self-esteem tend to be better equipped to deal with stressful situations and tend to use more functional as opposed to dysfunctional coping strategies (Dumont & Provost, 1999). According to the same authors, youth who were studied and proved to be more resilient to stressful situations, were found to have higher self-esteem, which gives them a feeling of self-efficacy, thus enabling them to better deal with stressful situations.
With regards to gender differences and puberty, Nolen-Hoeksema (1987) states that girls experience increased levels of perceived stress compared with boys. This is consistent with the finding of Doungtran (2011), who found girls reported more stress than boys. Furthermore, girls tend to be more prone to depression due to a higher tendency to use rumination as a coping strategy and a decreased perception of instrumentality (feelings of helplessness) which is made even more difficult when combined with the added stress of the biological (puberty) and social challenges they face during early adolescence (Nolen-Hoeksema and Girgus, 1994).
Girls are more likely than boys to cope with stressors via dysfunctional coping methods such as rumination (Li, DiGiuseppe, & Froh, 2006), which encompasses brooding and self-reflection (Burwell & Shirk, 2007). Furthermore, males and females with low self-esteem are more inclined to engage in dysfunctional coping measures to deal with stress such as illegal and anti-social activities (Dumont & Provost, 1999). Avoidance, although it may ease their pain, does not solve the problem and can lead to states of depression (Dumont & Provost, 1999).
Article selection criteria
The criteria used to select articles were:
- The age range for the adolescent participants fell between 12 and 19 years.
- The articles provided quantitative measures of the relationship between stress and stressor or between stress and coping strategy.
We excluded articles that focused on participants with diagnosed clinical disorders such as bipolar disorder and schizophrenia and other specific medical conditions.
Conceptual overview and synthesis articles as well as qualitative research were excluded given that they would not provide a computable effect size. In addition, articles that reported multivariate relationships between stress and combinations of stress factors and/or coping strategies were eliminated because such effect sizes did not refer to the singular, direct relationship between a given stress factor or coping strategy.
Based on these criteria, 76 articles were selected from a much larger set of 197 articles which represented varying sample sizes and effects sizes. Only three of the articles used a physiological measure of stress; all others used a measure of perceived stress via self-report. In addition, only two of the studies that were included were published in a language other than English (i.e., French, Spanish)
Based on the literature search, 76 quantitative articles met the inclusion criteria and were divided between researchers. Through a process of negotiation and discussion, the authors pooled their interpretations and produced a concept map regarding the main concepts and sub-concepts that were operationalized into categories and sub-categories.
VI Understanding the ecological framework
In most fields of research, researchers face complex problems that have many interrelated causes, for example student diversity and educational challenges. To deeply understand and effectively intervene in these contexts, researchers will often adopt multi-level, multi-factorial frameworks that are described as “ecological”, “biosocial” or “psychosocial”. When it comes to analyzing and conceptualizing stress, alternative approaches do exist and we do not intend to reduce their importance. Examples include biological and environmental influences, causes and coping mechanisms, and functional and dysfunctional coping strategies. We believe, however, that the ecological perspective developed in this paper offers a broad view of the issue that is both novel and useful for research as well as treatment regarding the complex interaction between adolescent stress and coping.
Independent variables in the selected articles were classified into two main categories that reflect the ecology of adolescent stress and coping: 1) stress factors and 2) functional and dysfunctional coping strategies. These two main recurring categories were often used together in the scientific literature on adolescent stress and coping. Based on the analysis of the articles, the two main categories are related to the following four sub-categories with supporting examples:
- sociocultural milieu
- family and friends
These four sub-categories are not hierarchical, and are sometimes simultaneously related to both stress factors and functional/dysfunctional coping strategies.
For stress factors, examples of the first sub-category, socio-cultural milieu, are: discrimination (e.g., experiencing hardship due to ethnic background), cultural norms (e.g., performing well at school, good grades), socio-economic status (e.g., lower, middle or upper class based on parental income). Examples of functional coping strategies in this same sub-category are professional support (e.g., access to help from a psychologist or a mentor within the community), engagement (e.g., dealing with the stress factor directly) and development (e.g., what parents have instilled regarding views of racism in society). In terms of dysfunctional coping strategies, resignation is the unique sub-category (e.g., feelings of helplessness towards one’s situation).
The school sub-category is comprised of stress factors such as academic pressure (e.g., scholastic pressure put upon a student from either his/her parents, teachers/tutors or him/herself to perform well at school and obtain good grades) and peer victimization (e.g., peer pressure situations and intimidation with peers).
The sub-category family and friends contains the following examples under stress factors: prenatal smoking, romantic relationships (e.g., holding hands, kissing), family cohesion/conflict (e.g., supportive parents in face of challenges), parental stress (e.g., unemployment, problems or arguments with parents), life events (e.g., death, accidents, suicide), parenting style (e.g., permissive or avoidant). An example of a functional coping strategy is social support (e.g., choosing to talk to friends that are supportive in times of duress or hardship such as exam periods).
The sub-category self is reflected by the following examples of stress factors: drug/substance abuse (e.g., alcohol, marijuana), gender (e.g., female or male), puberty (e.g., physical and psychological changes), self-esteem (e.g., seeing oneself as strong and capable of doing things), perfectionism (e.g., over-diligence to overcome obstacles and perform tasks).
In terms of functional coping strategies, the following six examples were extracted: planning (e.g., looking ahead to fix the situation), active coping (e.g., actively working towards finding a solution), problem solving (e.g., searching for effective solutions such as devising a plan), optimism, religion (e.g., turning to the church for guidance), and using humour (e.g., making light of the situation).
Examples of dysfunctional coping strategies related to self are: distancing/disengagement (engaging oneself in activities unrelated to the stressors), ruminating (e.g., repeating or replaying the same fear over and over in one’s mind), venting, anger (e.g., kicking, punching, fighting, feelings of rage), perfectionism (e.g., it is a stress factor as previously seen under self but is equally a dysfunctional coping strategy because it permeates into other aspects of one’s life and ability to effectively cope), substance abuse, passive coping/avoidance such as wishful thinking, and negative thinking (focusing on the negatives and leading to depression) and religion (e.g., when it is used to avoid a stress factor).
Each of the 76 articles selected for the meta-analysis contributed at least one effect size in the form of a correlation coefficient. More specifically, in some articles more than one correlation was reported between stress, or stress factor or coping strategy thereby contributing more than one effect size.
The overall results of this paper on adolescent stress and coping offer an over-arching, comprehensive ecological framework on adolescent stress and coping strategies delineating both stress factors and functional and dysfunctional coping strategies. Moreover, the fact that the effects were unequal or different provides reasoning for the different sub-categories in our framework. Results indicated that stress factors are more strongly related to dysfunctional coping strategies. In other words, dysfunctional coping strategies played a principal role regarding the relationship between stress factors, functional and dysfunctional coping strategies. This is an important result because health professionals should heed these dysfunctional coping strategies first when trying to understand adolescents’ stress factors. It is therefore a helpful indicator knowing that dysfunctional coping strategies have a greater impact on adolescent stress and they can be used as a stepping stone towards functional coping strategies after they have been identified.
The results regarding the four different levels or sub-categories show the importance of school in regards to adolescent stress and coping. Next, self plays an important role in both stress and coping followed by sociocultural milieu. Family and friends may have a less important relationship with stress and coping strategies but they still tie in to the social aspect that is prevalent.
Future research should continue to consider the bidirectional relationship between adolescent stress factors and dysfunctional coping strategies. Moreover, interventions must specifically heed the interaction between school and self at the forefront of adolescent stress and coping. It seems that this interaction needs to be more closely examined within specific contexts or milieus (such as urban or rural) as the third sub-category suggestions.
Considering the amount of time students spend in school, it is not surprising that this sub-category would have an obvious and notable impact on both adolescent stress and coping strategies. However, it would be important to consider more internal processes such as self-regulation, self-esteem and self-concept when attempting to target and understand adolescent stress factors because these concepts are more internal and difficult to evaluate when trying to diagnose adolescent stress factors. Finally, socialization, as an umbrella concept comprised of school, is prevalent in adolescent stress and coping, and future research should continue to examine this key, uniting component to better understand adolescents’ emotional and cognitive needs.
For more information
Correspondence concerning this article should be addressed to Cameron Montgomery, Faculty of Education, University of Ottawa, 145 Jean Jacques Lussier Street, office 462, Ottawa, Ontario K1N 6N5. E-mail: [email protected]
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