Coping with chronic stress : an investigation of the social context

Social relationships are important for physical and mental health, but the specific mechanisms involved are much less clear. The stress and coping process is one pathway through which social relationships could influence health and wellbeing. Drawing on a social contextual model of stress and coping, I investigated specific ways that social relationships shape and are shaped by adjustment to chronic stress. Study 1 examined the role of perceived social support availability in a sample of people living with spinal cord injury (SCI) who were coping with chronic pain symptoms. Pain catastrophizing has been consistently associated with worse adjustment to chronic pain, therefore Study 1 focused on understanding the role of support in mitigating the extent and impact of this maladaptive coping response. This intensive longitudinal study found that tangible support was associated with less pain catastrophizing overall and smaller increases in pain when catastrophizing did occur. Implications for people living with SCI and other chronic pain populations are discussed. Study 2 examined the role of stress appraisals in long-term relationship outcomes. Although traditional cognitive models of stress predict that those who appraise stressors as very serious are at greatest risk of poor outcomes, findings in Study 2 support a social contextual model in which shared appraisals have a protective effect on marital outcomes. In this study of stepfamily couples, a joint view of their most serious family problems was associated with a reduced risk of separation or divorce across the next 20 years. Implications for preventive interventions for highly stressed families are discussed. Finally, Study 3 examined how adjustment to chronic stress in one family member affects others in the family system. In this longitudinal study of families caring for a child with a complex chronic health condition, mothers’ experiences of posttraumatic growth were found to predict fewer behavioural problems in their healthy children over time. These findings support a family systems approach in which the benefits of posttraumatic growth in the face of adversity can also extend from mothers to children. Together these studies underscore some of the mechanisms through which social relationships may promote better health and wellbeing.