Search

The structure of coping was examined in three studies by means of Wherry's approach to hierarchical factor analysis. A hierarchical model with three levels was identified that included eight primary factors, four secondary factors, and two tertiary factors. The eight primary factors (problem solving, cognitive restructuring, emotional expression, social support, problem avoidance, wishful thinking, self-criticism, and social withdrawal) identified dimensions of coping found in previous empirical research and theoretical writing. The emergence of the four secondary and two tertiary factors provided empirical support for two theoretical hypotheses concerning the structure of coping. Support for the constructs of problem- and emotion-focused coping hypothesized by Lazarus was obtained at the secondary level, and support for the constructs of approach and avoidance coping hypothesized by many theorists was obtained at the tertiary level. These findings suggest that both formulations may describe the structure of coping, albeit at different levels of analysis.

The effectiveness of two primarily self-administered treatments for chronic tension headache were compared. Twenty-four recurrent tension headache sufferers received either relaxation therapy alone or relaxation training plus cognitive-behavioral therapy in a primarily self-administered treatment format. Both treatments yielded substantial reductions in headache activity and smaller but significant reductions in depression. However, patients who received the combined treatment recorded significantly larger reductions in headache activity than patients receiving relaxation training alone. In addition, high pretreatment levels of headache activity and daily life stress were associated with a poor response to relaxation training but were unrelated to patients' response to the combined treatment. These results suggest that cognitive-behavioral interventions may enhance the effectiveness of primarily self-administered relaxation training, particularly with selected subgroups of patients.