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Coping with Stress Essay

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Psychology Discussion

Essay on stress: it’s meaning, effects and coping with stress.

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Essay on Stress: It’s Meaning, Effects and Coping with Stress!

Stress is a very common problem being faced today. Every individual will experience stress in one or the other time.

The term stress has many definitions, Lazarus and Folkman (1984) have defined stress as “an internal state which can be caused by physical demands of body or by environmental and social situations, which are evaluated as potentially harmful, uncontrollable, or exceeding our resources for coping”.

According to David Fontana “stress is a demand made upon the adaptive capacities of the mind and body”.

These definitions indicate that stress represents those conditions under which individuals have demand made upon them, that they cannot physically or psychologically meet, leading to breakdown at one or other of these levels.

Stress is usually thought of in negative terms. But ii can manifest itself in both positive and negative way. It is said to be positive when the situation offers an opportunity for one, to gain something.

Eustress (the Greek word ‘eu’ means good) is the term used to describe positive stress. It is often viewed as motivator, since in its absence the individual lacks the spirit necessary for peak performance. Distress is the term used to indicate negative stress.

Almost any change in the environment- even a pleasant change such as a joyful trip- demands some coping, and a little stress is useful in helping us to adapt. But beyond some point, stress becomes a ‘distress’.

What acts to produce distress varies from person to person, but some events seem to be stressors for every person.

Examples of stressors are:

1. Injury or infections of the body, dangers in environment, major changes or transitions in life which force us to cope in new ways.

2. Physical stressors like noise, pollutions, climatic changes, etc.

3. Hustles of everyday life centering on work, family, social activities, health and finances.

4. Frustrations and conflicts.

The physical, environmental and social causes of the stress state are termed stressors. Once induced by stressors the internal stress state can then lead to various responses. On the other hand, psychological responses such as anxiety, hopelessness, depression, irritability, and a general feeling of not being able to cope with the world, can result from the stress state.

Stress cycles:

Stress has a number of immediate effects. If the stressors are maintained, long-term behavioural, physiological, emotional and cognitive effects occur. If these effects hinder adaptation to the environment or create discomfort and distress, they themselves become stressors and, tend to perpetuate a ‘cycle’ of distress.

Example, a patient spends more money on treatment, may experience continued stress even after the cure of the disease, because repayment of debt cause stress for long time in him or a patient whose leg is amputated after accident may continue to worry about it.

On the other hand, many people have developed ways of coping with stressors, so that they are able to respond adaptively. This is the ‘wellness cycle’. Teaching people adaptive ways of handling stress, so as to promote the wellness cycle is an important part of the newly emerging field of behavioural medicine.

Effects of stress:

Stress is not always harmful. In fact, it is recognised that low levels of stress can even helps for better performance. For example, a student can prepare well for forthcoming examination only if he has some stress. However, excess level of stress is undoubtedly harmful.

The effects of stress are divided into three categories:

a. Physiological effects:

Commonly appearing stress related bodily disorders are-peptic ulcers, hypertension, chronic fatigue, hormonal changes, increased heart rate, difficulty in breathing, numbness of limbs, heart disease and reduction in immunity, etc.

b. Psychological effects:

Anxiety, depression, hopelessness, helplessness, anger, nervousness, irritability, tension and boredom may be experienced.

c. Behavioural changes:

Decreasing efficiency, making mistakes, inability to take decisions, under eating or overeating, sleeplessness, increased smoking, develop addiction to alcohol and drugs, forgetfulness, hypersensitivity or passiveness, accident proneness and interpersonal difficulties are seen.

Stress is linked to disorders such as cancer and heart disorders. There are several mediating variables that determine whether stress becomes dangerous or not. For example, good coping mechanisms which can help to reduce stress, having good social support, often help in reducing stress.

Perception of stress or how a person views stress is also very important. For example, a person may not perceive a situation as stressful whereas the same situation may be perceived as highly stressful by some other person.

People with personality type ‘A’ are more prone to be affected by stress related disorders like cardiovascular diseases. Personality character like hardiness or emotional stability helps to withstand effects of stress.

Hans Selye, a renowned biological scientist defines stress as the nonspecific response of the body to any demand upon it. He termed the body’s response to stressors the “General Adaptation Syndrome” (GAS).

The GAS consists of 3 stages:

1. Alarm reaction:

It is an emergency response of the body. In this stage prompt responses of the body, many of them mediated by the sympathetic nervous system, prepare us to cope with the stressor here and now.

2. Stage of resistance:

If the stressor continues to be present, the stage of resistance begins, wherein the body resists the effects of the continuous stressor. During this stage certain hormonal responses of the body are an important line of defence in resisting the effects of stressors (For example, release of ACTH).

3. Stage of exhaustion:

In this stage, the body’s capacity to respond to both continuous and new stressors has been seriously compromised. The person will no longer be able to face stressor and he will finally succumb to it. The person may develop psychosomatic illness.

The stress leads to many psychosomatic diseases. Treatment for such diseases involves medical help for the physical problems and, at the same time, attention to the psychological factors producing the stress.

Coping with Stress :

There are different ways of coping with stress such as: confronting (facing), distancing (remoteness), self-control, seeking social support, accepting responsibility, escape or avoid (from the stressor), plan a problem solving strategy and positive reappraisal.

Usually two broad type of coping types are seen- Instrumental coping and Emotional coping.

In instrumental coping, a person focuses on the problem and tries to solve it. In emotional coping, the focus is more on the feelings generated by the problem.

Today, self- help remedies, Do to yourself approaches, weight loss clinics and diets, health foods and physical exercise are being given much attention in mass media. People are actually taking more responsibility to maintain good health.

However, some specific techniques to eliminate or to manage more effectively the inevitable, prolonged stress are as follows:

Good physical exercise like walking, jogging, swimming, riding bicycle, playing soft ball, tennis are necessary to cope with stress.

Relaxation:

Whether a person simply takes it easy once in a while or uses specific relaxation techniques such as bio-feedback, or meditation, the intent is to eliminate the immediately stressful situation or manage a prolonged stressful situation more effectively.

Taking it easy may mean curling up with a good book on an easy chair or watching some light programme on television or listening to a light music. Meditation is scientifically proved to be very useful, both physically and mentally to cope with stress.

Behavioural self-control:

By deliberately managing the antecedents and the consequence of their own behaviour, people can achieve self-control. Besides managing their own behaviour to reduce stress, people can also become more aware of their limits and of ‘red flags’ that signal trouble ahead. They can avoid people or situations that they know will put them under stress.

Maladaptive strategies, rigid strategies or relying on one type of coping method lead to increase in the stress. Social support helps reduce the effect of stress. People may provide help, advice, material support or moral support that helps to reduce stress.

In addition to the above, psychotherapy (Beck’s cognitive therapy, Ellis’s rational emotive therapy and Meichenbaum’s stress- inoculation training), skill training, environmental changes, Bio-feedback (control of physical signs such as Blood pressure, headache, etc), family therapy, group therapy, hypnosis, yoga, are found to be very useful. Finally, uses of drugs are some of the other strategies adopted in coping with stress.

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What Is Stress?

Your Body's Response to a Situation That Requires Attention or Action

Elizabeth Scott, PhD is an author, workshop leader, educator, and award-winning blogger on stress management, positive psychology, relationships, and emotional wellbeing.

• Identifying
• Next in How Stress Impacts Your Health Guide How to Recognize Burnout Symptoms

Stress can be defined as any type of change that causes physical , emotional, or psychological strain. Stress is your body's response to anything that requires attention or action. 

Everyone experiences stress to some degree. The way you respond to stress, however, makes a big difference to your overall well-being.

Verywell / Brianna Gilmartin

Sometimes, the best way to manage your stress involves changing your situation. At other times, the best strategy involves changing the way you respond to the situation.

Developing a clear understanding of how stress impacts your physical and mental health is important. It's also important to recognize how your mental and physical health affects your stress level.

Watch Now: 5 Ways Stress Can Cause Weight Gain

Signs of stress.

Stress can be short-term or long-term. Both can lead to a variety of symptoms, but chronic stress can take a serious toll on the body over time and have long-lasting health effects.

Some common signs of stress include:

• Changes in mood
• Clammy or sweaty palms
• Decreased sex drive
• Difficulty sleeping
• Digestive problems
• Feeling anxious
• Frequent sickness
• Grinding teeth
• Muscle tension, especially in the neck and shoulders
• Physical aches and pains
• Racing heartbeat

Identifying Stress

What does stress feel like? What does stress feel like? It often contributes to irritability, fear, overwork, and frustration. You may feel physically exhausted, worn out, and unable to cope.

Stress is not always easy to recognize, but there are some ways to identify some signs that you might be experiencing too much pressure. Sometimes stress can come from an obvious source, but sometimes even small daily stresses from work, school, family, and friends can take a toll on your mind and body.

If you think stress might be affecting you, there are a few things you can watch for:

• Psychological signs such as difficulty concentrating, worrying, anxiety, and trouble remembering
• Emotional signs such as being angry, irritated, moody, or frustrated
• Physical signs such as high blood pressure, changes in weight, frequent colds or infections, and changes in the menstrual cycle and libido
• Behavioral signs such as poor self-care, not having time for the things you enjoy, or relying on drugs and alcohol to cope

Stress vs. Anxiety

Stress can sometimes be mistaken for anxiety, and experiencing a great deal of stress can contribute to feelings of anxiety. Experiencing anxiety can make it more difficult to cope with stress and may contribute to other health issues, including increased depression, susceptibility to illness, and digestive problems.

Stress and anxiety contribute to nervousness, poor sleep, high blood pressure , muscle tension, and excess worry. In most cases, stress is caused by external events, while anxiety is caused by your internal reaction to stress. Stress may go away once the threat or the situation resolves, whereas anxiety may persist even after the original stressor is gone.

Causes of Stress

There are many different things in life that can cause stress. Some of the main sources of stress include work, finances, relationships, parenting, and day-to-day inconveniences.

Stress can trigger the body’s response to a perceived threat or danger, known as the fight-or-flight response .   During this reaction, certain hormones like adrenaline and cortisol are released. This speeds the heart rate, slows digestion, shunts blood flow to major muscle groups, and changes various other autonomic nervous functions, giving the body a burst of energy and strength.

Originally named for its ability to enable us to physically fight or run away when faced with danger, the fight-or-flight response is now activated in situations where neither response is appropriate—like in traffic or during a stressful day at work.

When the perceived threat is gone, systems are designed to return to normal function via the relaxation response .   But in cases of chronic stress, the relaxation response doesn't occur often enough, and being in a near-constant state of fight-or-flight can cause damage to the body.

Stress can also lead to some unhealthy habits that have a negative impact on your health. For example, many people cope with stress by eating too much or by smoking. These unhealthy habits damage the body and create bigger problems in the long-term.  

Mental Health in the Workplace Webinar

On May 19, 2022, Verywell Mind hosted a virtual Mental Health in the Workplace webinar, hosted by Amy Morin, LCSW. If you missed it, check out  this recap  to learn ways to foster supportive work environments and helpful strategies to improve your well-being on the job.

Types of Stress

Not all types of stress are harmful or even negative. Some of the different types of stress that you might experience include:

• Acute stress : Acute stress is a very short-term type of stress that can either be positive or more distressing; this is the type of stress we most often encounter in day-to-day life.
• Chronic stress : Chronic stress is stress that seems never-ending and inescapable, like the stress of a bad marriage or an extremely taxing job; chronic stress can also stem from traumatic experiences and childhood trauma.
• Episodic acute stress : Episodic acute stress is acute stress that seems to run rampant and be a way of life, creating a life of ongoing distress.
• Eustress : Eustress is fun and exciting. It's known as a positive type of stress that can keep you energized. It's associated with surges of adrenaline, such as when you are skiing or racing to meet a deadline. 

4 Main Types of Stress:

The main harmful types of stress are acute stress, chronic stress, and episodic acute stress. Acute stress is usually brief, chronic stress is prolonged, and episodic acute stress is short-term but frequent. Positive stress, known as eustress, can be fun and exciting, but it can also take a toll.

Impact of Stress

Stress can have several effects on your health and well-being. It can make it more challenging to deal with life's daily hassles, affect your interpersonal relationships, and have detrimental effects on your health. The connection between your mind and body is apparent when you examine stress's impact on your life.

Feeling stressed over a relationship, money, or living situation can create physical health issues. The inverse is also true. Health problems, whether you're dealing with high blood pressure or diabetes , will also affect your stress level and mental health. When your brain experiences high degrees of stress , your body reacts accordingly.

Serious acute stress, like being involved in a natural disaster or getting into a verbal altercation, can trigger heart attacks, arrhythmias, and even sudden death. However, this happens mostly in individuals who already have heart disease.

Stress also takes an emotional toll. While some stress may produce feelings of mild anxiety or frustration, prolonged stress can also lead to burnout , anxiety disorders , and depression.

Chronic stress can have a serious impact on your health as well. If you experience chronic stress, your autonomic nervous system will be overactive, which is likely to damage your body.

Stress-Influenced Conditions

• Heart disease
• Hyperthyroidism
• Sexual dysfunction
• Tooth and gum disease

Treatments for Stress

Stress is not a distinct medical diagnosis and there is no single, specific treatment for it. Treatment for stress focuses on changing the situation, developing stress coping skills , implementing relaxation techniques, and treating symptoms or conditions that may have been caused by chronic stress.

Some interventions that may be helpful include therapy, medication, and complementary and alternative medicine (CAM).

Press Play for Advice On Managing Stress

Hosted by therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast featuring professor Elissa Epel, shares ways to manage stress. Click below to listen now.

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Psychotherapy

Some forms of therapy that may be particularly helpful in addressing symptoms of stress including cognitive behavioral therapy (CBT) and mindfulness-based stress reduction (MBSR) . CBT focuses on helping people identify and change negative thinking patterns, while MBSR utilizes meditation and mindfulness to help reduce stress levels.

Medication may sometimes be prescribed to address some specific symptoms that are related to stress. Such medications may include sleep aids, antacids, antidepressants, and anti-anxiety medications.

Complementary and Alternative Medicine

Some complementary approaches that may also be helpful for reducing stress include acupuncture, aromatherapy, massage, yoga, and meditation .

Coping With Stress

Although stress is inevitable, it can be manageable. When you understand the toll it takes on you and the steps to combat stress, you can take charge of your health and reduce the impact stress has on your life.

• Learn to recognize the signs of burnout. High levels of stress may place you at a high risk of burnout. Burnout can leave you feeling exhausted and apathetic about your job.   When you start to feel symptoms of emotional exhaustion, it's a sign that you need to find a way to get a handle on your stress.
• Try to get regular exercise. Physical activity has a big impact on your brain and your body . Whether you enjoy Tai Chi or you want to begin jogging, exercise reduces stress and improves many symptoms associated with mental illness.  
• Take care of yourself. Incorporating regular self-care activities into your daily life is essential to stress management. Learn how to take care of your mind, body, and spirit and discover how to equip yourself to live your best life.  
• Practice mindfulness in your life. Mindfulness isn't just something you practice for 10 minutes each day. It can also be a way of life. Discover how to live more mindfully throughout your day so you can become more awake and conscious throughout your life.  

If you or a loved one are struggling with stress, contact the  Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline  at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our  National Helpline Database .

Cleveland Clinic. Stress .

National institute of Mental Health. I'm so stressed out! Fact sheet .

Goldstein DS. Adrenal responses to stress .  Cell Mol Neurobiol . 2010;30(8):1433–1440. doi:10.1007/s10571-010-9606-9

Stahl JE, Dossett ML, LaJoie AS, et al. Relaxation response and resiliency training and its effect on healthcare resource utilization [published correction appears in PLoS One . 2017 Feb 21;12 (2):e0172874].  PLoS One . 2015;10(10):e0140212. doi:10.1371/journal.pone.0140212

American Heart Association. Stress and Heart Health.

Chi JS, Kloner RA. Stress and myocardial infarction .  Heart . 2003;89(5):475–476. doi:10.1136/heart.89.5.475

Salvagioni DAJ, Melanda FN, Mesas AE, González AD, Gabani FL, Andrade SM. Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies .  PLoS One . 2017;12(10):e0185781. Published 2017 Oct 4. doi:10.1371/journal.pone.0185781

Bitonte RA, DeSanto DJ 2nd. Mandatory physical exercise for the prevention of mental illness in medical students .  Ment Illn . 2014;6(2):5549. doi:10.4081/mi.2014.5549

Ayala EE, Winseman JS, Johnsen RD, Mason HRC. U.S. medical students who engage in self-care report less stress and higher quality of life .  BMC Med Educ . 2018;18(1):189. doi:10.1186/s12909-018-1296-x

Richards KC, Campenni CE, Muse-Burke JL. Self-care and well-being in mental health professionals: The mediating effects of self-awareness and mindfulness .  J Ment Health Couns . 2010;32(3):247. doi:10.17744/mehc.32.3.0n31v88304423806.

American Psychological Association. 2015 Stress in America .

Krantz DS, Whittaker KS, Sheps DS.  Psychosocial risk factors for coronary heart disease: Pathophysiologic mechanisms .  In R. Allan & J. Fisher,  Heart and mind: The practice of cardiac psychology. American Psychological Association; 2011:91-113. doi:10.1037/13086-004

By Elizabeth Scott, PhD Elizabeth Scott, PhD is an author, workshop leader, educator, and award-winning blogger on stress management, positive psychology, relationships, and emotional wellbeing.

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Chapter 16. Stress, Health, and Coping

16.2 Stress and Coping

Jennifer Walinga

Learning Objectives

• Define coping and adaptation.
• Understand the various conceptualizations of stress as stimulus, response, and transactional process.
• Understand the role of cognition and physiology in coping with stress.
• Recognize emotion-focused and problem-focused coping strategies.
• Understand the relationships and interactions between health, stress, and coping.

In order to understand how people learn to cope with stress, it is important to first reflect on the different conceptualizations of stress and how the coping research has emerged alongside distinct approaches to stress. Stress has been viewed as a response , a stimulus, and a transaction . How an individual conceptualizes stress determines his or her response, adaptation, or coping strategies.

Stress As a Response

Stress as a  response model, initially introduced by Hans Selye (1956), describes stress as a physiological response pattern and was captured within his  general adaptation syndrome (GAS) model (Figure 16.3). This  model describes stress as a dependent variable and includes three concepts :

• Stress is a defensive mechanism.
• Stress follows the three stages of alarm, resistance, and exhaustion.
• If the stress is prolonged or severe, it could result in diseases of adaptation or even death.

Later, in The Stress Concept: Past, Present and Future (1983), Selye introduced the idea that the stress response could result in positive or negative outcomes based on cognitive interpretations of the physical symptoms or physiological experience (Figure 16.3, “The General Adaptation to Stress Model “) . In this way, stress could be experienced as eustress (positive) or dystress (negative). However, Selye always considered stress to be a physiologically based construct or response.  Gradually, other researchers expanded the thinking on stress to include and involve psychological concepts earlier in the stress model.

The response model of stress incorporates coping within the model itself. The idea of adaptation or coping is inherent to the GAS model at both the alarm and resistance stages. When confronted with a negative stimulus, the alarm response initiates the sympathetic nervous system to combat or avoid the stressor (i.e., increased heart rate, temperature, adrenaline, and glucose levels). The resistance response then initiates physiological systems with a  fight or flight  reaction to the stressor, returning the system to homeostasis, reducing harm, or more generally accommodating the stressor, which can lead to adaptive diseases such as sleep deprivation, mental illness, hypertension, or heart disease. Thus, along with the early conceptualization of stress as a physiological response, early research on coping was also born. As early as 1932, Walter Cannon described the notion of self-regulation in his work The Wisdom of the Body.

Stress As a Stimulus

The theory of stress as a stimulus   was introduced in the 1960s, and viewed stress as a significant life event or change that demands response, adjustment, or adaptation.  Holmes  and   Rahe   (1967) created the Social Readjustment Rating Scale (SRRS) consisting of 42 life events scored according to the estimated degree of adjustment they would each demand of the person experiencing them (e.g., marriage, divorce, relocation, change or loss of job, loss of loved one). Holmes and Rahe theorized that stress was an independent variable in the health-stress-coping equation — the cause of an experience rather than the experience itself. While some correlations emerged between SRRS scores and illness (Rahe, Mahan, & Arthur, 1970; Johnson & Sarason, 1979), there were problems with the stress as stimulus theory. The stress as stimulus theory assumes:

• Change is inherently stressful.
• Life events demand the same levels of adjustment across the population.
• There is a common threshold of adjustment beyond which illness will result.

Rahe and Holmes initially viewed the human subject as a passive recipient of stress, one who played no role in determining the degree, intensity, or valence of the stressor. Later, Rahe introduced the concept of interpretation into his research (Rahe & Arthur, 1978), suggesting that a change or life event could be interpreted as a positive or negative experience based on cognitive and emotional factors. However, the stress as stimulus model still ignored important variables such as prior learning, environment, support networks, personality, and life experience.

Stress As a Transaction

In attempting to explain stress as more of a dynamic process, Richard Lazarus developed the transactional theory of stress and coping (TTSC) (Lazarus, 1966; Lazarus & Folkman, 1984), which presents stress as a product of a transaction between a person (including multiple systems: cognitive, physiological, affective, psychological, neurological) and his or her complex environment .  Stress as a transaction   was introduced with the most impact when Dr. Susan Kobasa first used the concept of hardiness (Kobasa, 1979). Hardiness refers to a pattern of personality characteristics that distinguishes people who remain healthy under life stress compared with those who develop health problems. In the late 1970s, the concept of hardiness was further developed by Salvatore Maddi, Kobasa, and their graduate students at the University of Chicago (Kobasa, 1982; Kobasa & Maddi, 1981; Kobasa, Maddi, & Kahn, 1982; Kobasa, Maddi, Puccetti, & Zola, 1985; Maddi & Kobasa, 1984). Hardiness has some notable similarities with other personality constructs in psychology, including locus of control (Rotter, 1966), sense of coherence (Antonovsky, 1987), self-efficacy (Bandura, 1997),  and dispositional optimism (Scheier & Carver, 1985), all of which will be discussed in the next section. Researchers introduced multiple variables to the stress-as-transaction model, expanding and categorizing various factors to account for the complex systems involved in experiencing a stressor (Werner, 1993). The nature of stress was described in multiple ways: acute, episodic or intermittent, and chronic. Different types of stressors emerged, such as event, situation, cue, and condition, which then fell into categories based on locus of control, predictability, tone, impact, and duration. Figure 16.4 illustrates theories of stress  as a response, stimulus, and transaction.

In his book Psychological Stress and the Coping Process (1966), Lazarus presented an elegant integration of previous research on stress, health, and coping that placed a person’s appraisal of a stressor at the centre of the stress experience. How an individual appraises a stressor determines how he or she copes with or responds to the stressor. Whether or not a stressor is experienced as discomforting is influenced by a variety of personal and contextual factors including capacities, skills and abilities, constraints, resources, and norms (Mechanic, 1978). Lazarus and Folkman (1984) unpacked the concept of interpretation further in their model of stress appraisal, which includes primary, secondary, and reappraisal components (see Figure 16.5, “ The Transactional Theory of Stress and Coping”). Primary appraisal involves determining whether the stressor poses a threat . Secondary appraisal involves the individual’s evaluation of the resources or coping strategies at his or her disposal for addressing any perceived threats . The process of reappraisal is ongoing and involves continually reappraising both the nature of the stressor and the resources available for responding to the stressor .

Coping with Stress

There are many ways that people strive to cope with stressors and feelings of stress in their lives. A host of literature, both popular and academic, extols the practice of stress management and whole industries are devoted to it. Many techniques are available to help individuals cope with the stresses that life brings. Some of the techniques listed in Figure 16.6, “Stress Management Techniques,”  induce a lower than usual stress level temporarily to compensate the biological tissues involved; others face the stressor at a higher level of abstraction. Stress management techniques are more general and range from cognitive (mindfulness, cognitive therapy, meditation) to physical (yoga, art, natural medicine, deep breathing) to environmental (spa visits, music, pets, nature).

Stress coping , as described by researchers such as Lazarus and Folkman, implies a more specific process of cognitive appraisal to determine whether an individual believes he or she has the resources to respond effectively to the challenges of a stressor or change (Folkman & Lazarus, 1988; Lazarus & Folkman, 1987). The appraisal literature explains the response or coping process in terms of problem-focused coping or emotion-focused coping (Folkman & Lazarus, 1980; Lazarus & Folkman, 1984), also referred to as active and passive coping styles (Jex, Bliese, Buzzell, & Primeau, 2001). As well, approach and avoidance-style measures of coping exist involving assertiveness or withdrawal (Anshel, 1996; Anshel & Weinberg, 1999; Roth & Cohen, 1986). When faced with a challenge, an individual primarily appraises the challenge as either threatening or non-threatening, and secondarily in terms of whether he or she has the resources to respond to or cope with the challenge effectively. If the individual does not believe he or she has the capacity to respond to the challenge or feels a lack of control, he or she is most likely to turn to an emotion-focused coping response such as wishful thinking (e.g., I wish that I could change what is happening or how I feel), distancing (e.g., I’ll try to forget the whole thing), or emphasizing the positive (e.g., I’ll just look for the silver lining) (Lazarus & Folkman, 1987). If the person has the resources to manage the challenge, he or she will usually develop a problem-focused coping response such as analysis (e.g., I try to analyze the problem in order to understand it better; I’m making a plan of action and following it). It is theorized and empirically demonstrated that a person’s secondary appraisal then determines coping strategies (Lazarus & Folkman, 1987). Coping strategies vary from positive thinking to denial (see Figure 16.7, “COPE Inventory”) and are measured and tested using a variety of instruments and scales such as the COPE inventory (Carver, Scheier, & Weintraub, 1989).

Research Focus: Stress and Playing Soccer

Walinga (2008), in her work with a university soccer team that was undergoing several stressful changes in addition to the usual performance stressors, recently elaborated upon the appraisal model by suggesting that reappraisal more specifically involves a reiteration of the primary-secondary appraisal process. Once a person determines that a stressor is indeed a threat, and secondarily appraises resources as lacking, he or she then primarily appraises the secondary appraisal. In other words, the person determines whether having a lack of resources indeed poses some sort of threat. If lack of resources is deemed not to be a threat, the person is much more likely to generate creative solutions to the initial stressor and therefore cope effectively. But if a lack of resources is deemed to be a threat, then the person tends to focus on finding resources rather than addressing the initial stressor, and arrives at ineffective control-focused coping strategies.

In the case of the university soccer players, some initial stressors were identified as “a particularly challenging or sizable opponent,” “rainy conditions,” “the cold,” “not connecting with the coach,” or “negative attitudes on the field.” Typical emotion- or control-focused coping strategies included “working harder” and “sucking it up,” as well as avoidance or passivity. One player who struggled with her opponent’s size felt that she had little control over the fact that her opponent was taller and thus “beat her to the header balls.” She explained how she would “just kinda fade away when we play that team…get passive and just fade into the background.” Her coping response signified a withdrawal subscale on the emotion-focused coping scale, and when asked about her degree of satisfaction with her chosen path of response, she replied that she was “unhappy but could see no other alternative.” However, generally the team and several of the key leaders expressed alternative coping strategies not accounted for in the transactional theory of stress and coping. While several members of the team had a negative secondary appraisal, believing themselves to be lacking in the resources required to deal with the changes that occurred to the team, during the interviews it became apparent that such powerlessness did not, as was expected, lead only to emotion-focused coping, such as defensiveness, blame, or withdrawal; an acknowledged lack of control often resulted in an ability to move on and solve the challenges of change effectively.

Many of the team members believed “hitting rock bottom” accounted for their successful transformation, acting as a sort of “trigger” or “restart” and enabling them to gain greater clarity about their goals, as well as strategies for achieving these goals. Rather than focusing on increasing control or controlling the barrier or threat itself, the tolerant individual accepts the barrier as reality and accepts the lack of control as a reality. This person can now attend to and identify the challenges that the barrier poses to attaining her goals. For instance, the goalkeeper focused not on regretting or blaming herself for a missed save, or even trying harder next time, but instead focused on the challenges that a difficult shot posed for her and how she might resolve an unexpected spin on the ball. When faced with rainy conditions, the tolerant player focused not on denying or pushing through the rain, but on the problems the rain creates for her and how to resolve the resulting lack of ball control or slippery field conditions:

• “I guess the spin on the ball was out of my control, but I had total control in terms of adjusting to it.”
• “I was not in control of what my opponent did with the ball or could have done to ensure that I did not win the ball, but I was in control of making sure I did not dive into the tackle, I held my check up so we could get numbers back and avoid a counterattack.”
• “I went forward when I probably shouldn’t have and I left our defenders outnumbered in the back, so I made sure I won the ball so that we would not be faced with a 3-on-2.”
• “Despite my fatigue, I decided to make better decisions on when to commit myself and made sure I communicated when I needed help so that my opponent wouldn’t get a breakaway.”
• “The lights in my eyes were beyond my control, but I could control my focus on the ball and my positioning.”
• “I was not in control of the fact that they were fast; I was in control of my positioning and my decision making.”

By extending the theory of stress and coping, it is hypothesized here that when an individual perceives that he or she is lacking in resources to manage a threat, the perceived lack of control, and not necessarily anxiety, becomes the new challenge and focal point. If the person deems the perceived lack of control to be threatening or problematic for any reason, this would hypothetically cause him or her to fixate on increasing resources for managing the threat (control-focused coping), and impede any kind of response to the particular threats the challenge itself generates. If, on the other hand, the person accepts the lack of control, deeming the lack of resources to be a benign reality, he or she would be able to move the focus to the problems this threat creates and consider options for resolution and goal achievement (problem-focused coping). Control-focused coping seems to be a more generalizable construct for explaining an individual’s inability to focus on the problem at hand. The readiness model proposes that the appraisal process continues to cycle through the primary and secondary phases to determine an individual’s coping response (i.e., primary appraisal = Is it a threat?; secondary appraisal = Do I have the resources to change or control the threat?; if not, we find ourselves back at primary appraisal = Is my lack of control a threat?), and it is this cyclical process of appraisal that offers leverage for facilitating effective coping.

Related concepts to stress coping include locus of control (Rotter, 1966), sense of coherence (Antonovsky, 1987), self-efficacy (Bandura, 1997), and stress-related growth (Scheier & Carver, 1985). Rotter posited that a person with an internal locus of control believes that their achievements and outcomes are determined by their own decisions and efforts. If they do not succeed, they believe it is due to their own lack of effort. Whereas, a person with an external locus of control believes that achievements and outcomes are determined by fate, luck, or other . If the person does not succeed, he or she believes it is due to external forces outside of the person’s control. Aaron Antonovsky (1987) defined sense of coherence as:

a global orientation that expresses the extent to which one has a pervasive, enduring though dynamic feeling of confidence that (1) the stimuli deriving from one’s internal and external environments in the course of living are structured, predictable and explicable; (2) the resources are available to one to meet the demands posed by these stimuli; and (3) these demands are challenges, worthy of investment and engagement (pg. 19).

Self-efficacy is often confused with self-confidence, but in fact confidence is merely one of the many factors that make up a strong sense of self-efficacy. Albert Bandura (1997) defined self-efficacy as the extent or strength of one’s belief in one’s own ability to complete tasks and reach goals . Self-confidence is a trait measure (a quality that is built over time) whereas self-efficacy is a state measure (a capacity experienced at a specific point in time and concerning a specific task). Stress-related growth or thriving is a dispositional response to stress that enables the individual to see opportunities for growth as opposed to threat or debilitation . Spreitzer and colleagues (2005) offered a preliminary definition of thriving as a “psychological state in which individuals experience both a sense of vitality and a sense of learning at work” (p. 538). Carver (1998) described thriving as being “better off after adversity” (p. 247). There are many examples of individuals surpassing previous performances when faced with particularly stressful scenarios, showing increased growth and strength in the face of adversity.

Coping and Health

The capacity for thriving, resilience, or stress-related growth has been associated with improved health outcomes. For example, building on Carver’s work on dispositional optimism and thriving, Shepperd, Maroto, and Pbert (1996) found, in their longitudinal study of cardiac patients, that optimism predicts success in making health changes associated with lower risk of cardiac disease. Optimism was significantly and directly correlated with improved health outcomes, including lower levels of saturated fat, body fat, and global coronary risk, and positively associated with success in increasing aerobic capacity. Billings and colleagues (2000) showed that coping affected positive and negative affect among men who were caregiving for AIDS patients. Social support coping predicted increases in positive affect, which in turn were related to fewer physical symptoms. Avoidant coping, however, was related to increases in negative affect, which were related to more physical symptoms.

Research Focus: Coping with Melanoma

Perhaps the most dramatic of stress coping interventions studies was conducted by Fawzy and his colleagues (Fawzy, Cousins, Fawzy, Kemeny, & Morton, 1990; Fawzy, Kemeny, et al., 1990; Fawzy, et al., 1993; Fawzy & Fawzy, 1994), who did specific coping skills interventions with melanoma patients. During a six-week structured program, participants experienced multiple program components including health education, psychological support, problem-solving, and stress management training. In the short term, the experimental subjects were more likely to use active behaviour coping than the controls, and also had more positive affect. Differences in immune functioning were evident between the two groups at the six-month assessment. Specifically, experimental subjects had a greater percentage of large granular lymphocytes, more NK cells, and better NK cytotoxicity.  While coping strategies were not directly associated with immune cell changes, they were correlated with affect, which in turn was associated with immune functioning. The studies supported the hypothesis that effects of coping on biomedical outcomes may be mediated through affect. At a five-year follow-up, a third of the control group had died, compared with less than 10% of the experimental group. Longer survival was associated with more active coping at baseline.

Key Takeaways

• Stress has been conceived of in different ways: as a response, as a stimulus, and as a transaction.
• Stress as response treats stress as the physiological dependent variable.
• Stress as stimulus treats stress as a life event or change that acts as an independent variable.
• Stress as transaction considers the myriad personal, social, and environmental factors that come into play in determining the nature, degree, and impact of the stress experience.
• There are a variety of stress management techniques deriving from a multitude of theoretical derivations and philosophies.
• Coping with stress can be a trait or state-based process — an inherent quality or ability or a learned skill or capacity.
• How people appraise a stressor determines how they will attempt to cope with the stressor.
• Appraisal hinges on multiple human, social, and environmental factors.
• Concepts related to coping include optimism, thriving, hardiness, locus of control, and self-efficacy, all qualities and capacities that can influence the coping strategies an individual chooses to apply to a stressor.

Exercises and Critical Thinking

• Reflect on a recent emotionally or physiologically impactful stressor that you perceived to be threatening or negative. What social, environmental, and personal factors contributed to your appraisal of the stressor? Referencing the list of coping items on the COPE inventory, what types of coping strategies did you apply?
• Imagine a stressful situation that you believe you coped with positively. Can you identify some coping strategies you used? Can you determine whether you were able to grow through the experience? What factors facilitated a positive outcome for you?
• What are some major life events you have experienced? Can you identify differences in how you appraised these events? How you coped with these events?

Anshel, M.H. (1996). Coping styles among adolescent competitive athletes.  The Journal of Social Psychology, 136, 311-323.

Anshel, M.H. & Weinberg, R.T. (1999). Re-examining coping among basketball referees following stressful events: Implications for coping interventions. Journal of Sport Behavior, 22, 144-161.

Antonovsky, A. (1987).  Unraveling the mystery of health: How people manage stress and stay well . San Francisco: Jossey Bass.

Bandura, A. (1997 ). Self-efficacy: The exercise of control. New York: Freeman.

Billings, D. W., Folkman, S., Acree, M., & Moskowitz, J. T. (2000). Coping and physical health during caregiving: The roles of positive and negative affect. Journal of Personality and Social Psychology, 79 , 131–142.

Carver, C. S. (1998). Resilience and thriving: Issues, models, and linkages. Journal of Social Issues, 54 , 245–266.

Carver, C. S., Scheier, M. F., & Weintraub, J. K.  (1989).  Assessing coping strategies:  A theoretically based approach .   Journal of Personality and Social Psychology, 56 , 267–283.

Cannon, W. B. (1932). The Wisdom of the Body. New York: W.W. Norton.

Fawzy, F., & Fawzy, N. (1994). Psychoeducational interventions and health outcomes. In R. Glaser and J. K. Kiecolt-Glaser (Eds.). Handbook of human stress and immunity (pp. 365–402). San Diego: Academic Press.

Fawzy, F. I., Fawzy, N. W., Hyun, C., Elashoff, R., Guthrie, D., Fahey, J. L., & Moron, D. L. (1993). Malignant melanoma: Effects on early structured psychiatric intervention, coping, and affective state on recurrence and survival six years later. Archives of General Psychiatry, 50 , 681–689.

Fawzy, F. I., Cousins, N., Fawzy, N. W., Kemeny, M., & Morton, D. I. (1990). A structured psychiatric intervention for cancer patients: I. Changes over time in methods of coping and affective disturbance. Archives of General Psychiatry, 47 , 720–725.

Fawzy, F. I., Kemeny, M., Fawzy, N. W., Elashoff, R., Morton, D., Cousins, N., & Fahey, J. L. (1990). A structured psychiatric intervention for cancer patients: II. Changes over time in immunological measures. Archives of General Psychiatry, 47 , 729–235.

Folkman, S. & Lazarus, R.S. (1980). An analysis of coping in a middle-aged community sample. Journal of Health & Social Behavior, 21 (3), 219-239.

Folkman, S., Lazarus, R. S. (1988). Coping as a mediator of emotion. Journal of Personal and Social Psycholog,. 54, 466-75.

Holmes, T., & Rahe, R. (1967). The Social Reajustment Rating Scale. Journal of Psychosomatic Research, 12, (4), p. 213–233.

Jex,  S.M.,  Bliese,  P.D.,  Buzzell,  S., &    Primeau.  J.  (2001). The impact of self-efficacy on stressor–strain relations: Coping style as an explanatory mechanism.  Journal of Applied Psychology 86 (3), 401.

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Kobasa, S. C., Maddi, S. R., & Kahn, S. (1982). Hardiness and health: A prospective study. Journal of Personality and Social Psychology 42 (1), 168–177.

Kobasa, S. C., Maddi, S. R., Puccetti, M. C., & Zola, M. A. (1985). Effectiveness of hardiness, exercise and social support as resources against illness. Journal of Psychosomatic Research 29 (5), 525–533.

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Lazarus, R. S. (1999). Stress and emotion: A new synthesis. New York: Springer.

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping . New York: Springer.

Lazarus, R. S., & Folkman, S. (1987). Transactional theory and research on emotions and coping. European Journal of Personality, 1, 141–169 .

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Image Attributions

Figure 16.3: A diagram of the General Adaptation syndrome model by David G. Myers (http://commons.wikimedia.org/wiki/File:General_Adaptation_Syndrome.jpg) used under the CC-BY 3.0 (http://creativecommons.org/licenses/by/3.0/deed.en).

Figure 16.4: by J. Walinga.

Figure 16.5: by J. Walinga.

Figure 16.6: by J. Walinga.

Figure 16.7: Adapted by J. Walinga from Carver, Scheier, & Weintraub, 1989.

Long Descriptions

[Return to Figure 16.6] Figure 16.7 long description: COPE Inventory scale of coping techniques

• positive reinterpretation and growth
• mental disengagement
• focus on and venting of emotions
• use of instrumental social support
• active coping
• religious coping
• behavioural disengagement
• use of emotional social support
• substance use
• suppression of competing activities

[Return to Figure 16.7]

Introduction to Psychology - 1st Canadian Edition Copyright © 2014 by Jennifer Walinga is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Coping with Stress

Many of us are facing challenges that can be stressful and overwhelming. Learning to cope with stress in a healthy way will help you, the people you care about, and those around you become more resilient.

Stress can cause the following:

• Feelings of fear, anger, sadness, worry, numbness, or frustration.
• Changes in appetite, energy, desires, and interests.
• Trouble concentrating and making decisions.
• Nightmares or problems sleeping.
• Physical reactions, such as headaches, body pains, stomach problems, or skin rashes.
• Worsening of chronic health problems and mental health conditions.
• Increased use of  alcohol , illegal drugs (like heroin , cocaine , or methamphetamine ), and misuse of prescription drugs (like opioids).
• Healthy Ways to Cope with Stress
• If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org
• Disaster Distress Helpline : CALL or TEXT 1-800-985-5990 (press 2 for Spanish)

Here are some ways you can manage stress, anxiety, grief, or worry:

• Take breaks from news stories, including those on social media. It’s good to be informed, but constant information about negative events can be upsetting. Consider limiting news to just a couple times a day and disconnecting from phone, TV, and computer screens for a while.
• Eat healthy. Have fruits and vegetables, lean protein, whole grains, and low-fat or no-fat dairy. Limit foods with unhealthy fats, salt, and added sugars. See Healthy Eating Tips .
• Get enough sleep.  Go to bed and wake up at the same time each day to help you sleep better . Adults need 7 or more hours per night.
• Move more and sit less. Every little bit of physical activity helps. Start small and build up to 2 ½ hours a week. You can break it into smaller amounts such as 20 to 30 minutes a day.
• Limit alcohol  intake. Choose not to drink, or drink in moderation on days you drink alcohol. Moderation means having 2 drinks or less a day for men or 1 drink or less for women. Find out more at Drink Less, Be Your Best .
• Avoid using illegal drugs or prescription drugs in ways other than prescribed. Don’t take someone else’s prescription. Substance use treatment is available, and recovery starts with asking for help.
• Avoid smoking , vaping, and the use of other tobacco products. People can and do quit smoking for good.
• Continue with regular health appointments, tests, screenings, and vaccinations.
• Take deep breaths, stretch, or meditate .
• Try to do some other activities you enjoy.
• Talk with people you trust about your concerns and how you are feeling.
• Connect with your community-based or faith-based organizations.

For Everyone

• How Right Now — Finding What Helps
• Coping with a Disaster or Traumatic Event
• Suicide Prevention
• I’m So Stressed Out! Fact Sheet (NIMH)
• Mindfulness Coach – PTSD: National Center for PTSD (va.gov)

For Families and Children

• Helping Children Cope with Emergencies
• Adolescent Mental Health
• Tools for Supporting Emotional Wellbeing in Children and Youth

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• The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
• Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
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• CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.

Essay on Stress Management

500 words essay on stress management.

Stress is a very complex phenomenon that we can define in several ways. However, if you put them together, it is basically the wear and tear of daily life. Stress management refers to a wide spectrum of techniques and psychotherapies for controlling a person’s stress level, especially chronic stress . If there is effective stress management, we can help one another break the hold of stress on our lives. The essay on stress management will throw light on the very same thing.

Identifying the Source of Stress

The first step of stress management is identifying the source of stress in your life. It is not as easy as that but it is essential. The true source of stress may not always be evident as we tend to overlook our own stress-inducing thoughts and feelings.

For instance, you might constantly worry about meeting your deadline. But, in reality, maybe your procrastination is what leads to this stress than the actual deadline. In order to identify the source of stress, we must look closely within ourselves.

If you explain away stress as temporary, then it may be a problem. Like if you yourself don’t take a breather from time to time, what is the point? On the other hand, is stress an integral part of your work and you acknowledging it like that?

If you make it a part of your personality, like you label things as crazy or nervous energy, you need to look further. Most importantly, do you blame the stress on people around you or the events surrounding you?

It is essential to take responsibility for the role one plays in creating or maintaining stress. Your stress will remain outside your control if you do not do it.

Strategies for Stress Management

It is obvious that we cannot avoid all kinds of stress but there are many stressors in your life which you can definitely eliminate. It is important to learn how to say no and stick to them.  Try to avoid people who stress you out.

Further, if you cannot avoid a stressful situation, try altering it. Express your feelings don’t bottle them up and manage your time better. Moreover, you can also adapt to the stressor if you can’t change it.

Reframe problems and look at the big picture. Similarly, adjust your standards and focus on the positive side. Never try to control the uncontrollable. Most importantly, make time for having fun and relaxing.

Spend some time with nature, go for a walk or call a friend, whatever pleases you.  You can also try working out, listening to music and more. As long as it makes you happy, never give up.

Get the huge list of more than 500 Essay Topics and Ideas

Conclusion of the Essay on Stress Management

All in all, we can control our stress levels with relaxation techniques that evoke the relaxation response of our body. It is the state of restfulness that is the opposite of the stress response. Thus, when you practice these techniques regularly, you can build your resilience and heal yourself.

FAQ of Essay on Stress Management

Question 1: What is the importance of stress management?

Answer 1: Stress management is very efficient as it helps in breaking the hold which stress has on our lives. Moreover, you can also become happy, healthy and more productive because of it. The ultimate goal should be to live a balanced life and have the resilience to hold up under pressure.

Question 2: Give some stress management techniques.

Answer 2: There are many stress management techniques through which one can reduce stress in their lives. One can change their situation or their reaction to it. We can try by altering the situation. If not, we can change our attitudes towards it. Remember, accept things that you cannot change.

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Stress, coping, and hope

Affiliation.

• 1 University of California, San Francisco, CA, USA. [email protected]
• PMID: 20799373
• DOI: 10.1002/pon.1836

Hope is discussed in many literatures and from many perspectives. In this essay hope is discussed from the vantage of psychology and stress and coping theory. Hope and psychological stress share a number of formal properties: both are contextual, meaning-based, and dynamic, and both affect well-being in difficult circumstances. Two assumptions underlie this essay: (1) hope is essential for people who are coping with serious and prolonged psychological stress; and (2) hope is not a perpetually self-renewing resource; it has peaks and valleys and is at times absent altogether. The relationship between hope and coping is dynamic and reciprocal; each in turn supports and is supported by the other. This relationship is illustrated with two adaptive tasks common across situations that threaten physical or psychological well-being-managing uncertainty and coping with a changing reality. The essay describes ways in which coping fosters hope when it is at low ebb as well as ways in which hope fosters and sustains coping over the long term.

(c) 2010 John Wiley & Sons, Ltd.

• Adaptation, Psychological*
• Attitude to Health*
• Neoplasms / psychology*
• Stress, Psychological / psychology*
• Uncertainty

Self Efficacy, Stress & Coping, and Headspace Program Analytical Essay

Stress and coping, self-efficacy, headspace program, works cited, stressors experienced.

Though performing housework chores may appear simple, I find it a major stressing factor. This is, perhaps, because I have to juggle between the chores and my challenging studies, thus making me strain in balancing the activities within the time limited.

Health behavior and the stressors

My unhealthy behavior of avoiding physical exercises is strongly related to the stresses I experience. In particular, during examination period, I am not able to engage in any physical exercise despite being aware that physical activities are therapeutic and help lessen the stress.

I usually perceive physical exercises as a waste of time which could otherwise be used for studying. My thoughts are thus the etiology of the unhealthy behavior of avoiding exercises. Stressors mostly distract me from performing any duties, even predefined ones. When I feel distracted, I have developed a habit of chatting for hours over the phone. I know that chatting does not eliminate the stress, but it provides me with a means of escaping from the stressors, albeit for a little while.

Coping strategies and their effectiveness

Planning and emotional support are the main strategies for coping with the stress factors. In planning, I usually schedule all the tasks I intend to accomplish in writing. This compels me to adhere to the schedule and enables me to prioritize my tasks. Planning is an effective remedy since it gives me an opportunity to appropriately manage my time, hence dispelling the fears of time wastage.

Emotional support is also another effective strategy in managing the stressors. Accompanied with my family members and friends, I do not develop the feelings of boredom and loneliness because I feel encouraged.

Health behavior and coping

By applying the strategies to cope with stress, I am able to allocate time for physical activities. The more I engage in exercises the more I feel relieved from the stressors. This is because the exercises reveal me from boredom and make me feel happy, thus giving me positive feelings. Exercises also provide me with the opportunity of applying the strategies to cope with my stress and enhancing my abilities of dealing with the stressors.

I managed to attain a score of about 78 in all the exercises. I anticipated improving self-efficacy as I put more efforts to improve my workout. My self-efficacy was nevertheless affected by two situations that made me score a zero. The two events happened when I had a lot of work at home, and my friends came to see me.

To increase self-efficacy, I utilized Bandura’s two strategies, which were the vicarious experience and physiological states. In vicarious experiences, I leaned on my mates who encouraged me to follow them as they were studying yet had time to engage in activities like gymnastics.

This helped me avoid becoming depressed. In physiological state strategy, I refined my thoughts to recognize that studies were not exhaustive, so I should have spared energy for other activities. This boosted my ability to handle stressors. Another important strategy that I employed was verbal persuasion when visitors were around. This made me more active and become appreciated with positive remarks. This encouraged me to work hard and boost my confidence.

Headspace is a mental health program developed in response to the need to improve accessibility and effectiveness of healthcare to the youth suffering from cognitive and drug-dependent problems. The program targets at young people aged between 12 and 25 years. The initiative encourages the youth with cognitive disorders to seek professional help. The program also empowers the communities to be able to respond in time to the issues in focus.

This is done through provision of education and trainings. The healthcare concepts of this program are established on the realization that adolescents do not meet mental health needs that must be addressed in their development using the available local resources (McGorry et al. 68). The program works by creating friendly platforms where the suffering youth can seek for help.

McGorry, Patrick, Tanti Chris, Stokes Ryan, Hickie Ian, Carnell Kate, Littlefield Lyndel and Moran John. “Headspace: Australia’s National Youth Mental Health Foundation- Where young minds come first.” The Medical Journal of Australia 187.7 (2007): 68. Web.

• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2023, December 6). Self Efficacy, Stress & Coping, and Headspace Program. https://ivypanda.com/essays/self-efficacy-stress-coping/

"Self Efficacy, Stress & Coping, and Headspace Program." IvyPanda , 6 Dec. 2023, ivypanda.com/essays/self-efficacy-stress-coping/.

IvyPanda . (2023) 'Self Efficacy, Stress & Coping, and Headspace Program'. 6 December.

IvyPanda . 2023. "Self Efficacy, Stress & Coping, and Headspace Program." December 6, 2023. https://ivypanda.com/essays/self-efficacy-stress-coping/.

1. IvyPanda . "Self Efficacy, Stress & Coping, and Headspace Program." December 6, 2023. https://ivypanda.com/essays/self-efficacy-stress-coping/.

Bibliography

IvyPanda . "Self Efficacy, Stress & Coping, and Headspace Program." December 6, 2023. https://ivypanda.com/essays/self-efficacy-stress-coping/.

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• Open access
• Published: 12 December 2023

Examining the role of community resilience and social capital on mental health in public health emergency and disaster response: a scoping review

• C. E. Hall 1 , 2 ,
• H. Wehling 1 ,
• J. Stansfield 3 ,
• J. South 3 ,
• S. K. Brooks 2 ,
• N. Greenberg 2 , 4 ,
• R. Amlôt 1 &
• D. Weston 1  

BMC Public Health volume  23 , Article number:  2482 ( 2023 ) Cite this article

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The ability of the public to remain psychologically resilient in the face of public health emergencies and disasters (such as the COVID-19 pandemic) is a key factor in the effectiveness of a national response to such events. Community resilience and social capital are often perceived as beneficial and ensuring that a community is socially and psychologically resilient may aid emergency response and recovery. This review presents a synthesis of literature which answers the following research questions: How are community resilience and social capital quantified in research?; What is the impact of community resilience on mental wellbeing?; What is the impact of infectious disease outbreaks, disasters and emergencies on community resilience and social capital?; and, What types of interventions enhance community resilience and social capital?

A scoping review procedure was followed. Searches were run across Medline, PsycInfo, and EMBASE, with search terms covering both community resilience and social capital, public health emergencies, and mental health. 26 papers met the inclusion criteria.

The majority of retained papers originated in the USA, used a survey methodology to collect data, and involved a natural disaster. There was no common method for measuring community resilience or social capital. The association between community resilience and social capital with mental health was regarded as positive in most cases. However, we found that community resilience, and social capital, were initially negatively impacted by public health emergencies and enhanced by social group activities.

Several key recommendations are proposed based on the outcomes from the review, which include: the need for a standardised and validated approach to measuring both community resilience and social capital; that there should be enhanced effort to improve preparedness to public health emergencies in communities by gauging current levels of community resilience and social capital; that community resilience and social capital should be bolstered if areas are at risk of disasters or public health emergencies; the need to ensure that suitable short-term support is provided to communities with high resilience in the immediate aftermath of a public health emergency or disaster; the importance of conducting robust evaluation of community resilience initiatives deployed during the COVID-19 pandemic.

Peer Review reports

For the general population, public health emergencies and disasters (e.g., natural disasters; infectious disease outbreaks; Chemical, Biological, Radiological or Nuclear incidents) can give rise to a plethora of negative outcomes relating to both health (e.g. increased mental health problems [ 1 , 2 , 3 , 4 ]) and the economy (e.g., increased unemployment and decreased levels of tourism [ 4 , 5 , 6 ]). COVID-19 is a current, and ongoing, example of a public health emergency which has affected over 421 million individuals worldwide [ 7 ]. The long term implications of COVID-19 are not yet known, but there are likely to be repercussions for physical health, mental health, and other non-health related outcomes for a substantial time to come [ 8 , 9 ]. As a result, it is critical to establish methods which may inform approaches to alleviate the longer-term negative consequences that are likely to emerge in the aftermath of both COVID-19 and any future public health emergency.

The definition of resilience often differs within the literature, but ultimately resilience is considered a dynamic process of adaptation. It is related to processes and capabilities at the individual, community and system level that result in good health and social outcomes, in spite of negative events, serious threats and hazards [ 10 ]. Furthermore, Ziglio [ 10 ] refers to four key types of resilience capacity: adaptive, the ability to withstand and adjust to unfavourable conditions and shocks; absorptive, the ability to withstand but also to recover and manage using available assets and skills; anticipatory, the ability to predict and minimize vulnerability; and transformative, transformative change so that systems better cope with new conditions.

There is no one settled definition of community resilience (CR). However, it generally relates to the ability of a community to withstand, adapt and permit growth in adverse circumstances due to social structures, networks and interdependencies within the community [ 11 ]. Social capital (SC) is considered a major determinant of CR [ 12 , 13 ], and reflects strength of a social network, community reciprocity, and trust in people and institutions [ 14 ]. These aspects of community are usually conceptualised primarily as protective factors that enable communities to cope and adapt collectively to threats. SC is often broken down into further categories [ 15 ], for example: cognitive SC (i.e. perceptions of community relations, such as trust, mutual help and attachment) and structural SC (i.e. what actually happens within the community, such as participation, socialising) [ 16 ]; or, bonding SC (i.e. connections among individuals who are emotionally close, and result in bonds to a particular group [ 17 ]) and bridging SC (i.e. acquaintances or individuals loosely connected that span different social groups [ 18 ]). Generally, CR is perceived to be primarily beneficial for multiple reasons (e.g. increased social support [ 18 , 19 ], protection of mental health [ 20 , 21 ]), and strengthening community resilience is a stated health goal of the World Health Organisation [ 22 ] when aiming to alleviate health inequalities and protect wellbeing. This is also reflected by organisations such as Public Health England (now split into the UK Health Security Agency and the Office for Health Improvement and Disparities) [ 23 ] and more recently, CR has been targeted through the endorsement of Community Champions (who are volunteers trained to support and to help improve health and wellbeing. Community Champions also reflect their local communities in terms of population demographics for example age, ethnicity and gender) as part of the COVID-19 response in the UK (e.g. [ 24 , 25 ]).

Despite the vested interest in bolstering communities, the research base establishing: how to understand and measure CR and SC; the effect of CR and SC, both during and following a public health emergency (such as the COVID-19 pandemic); and which types of CR or SC are the most effective to engage, is relatively small. Given the importance of ensuring resilience against, and swift recovery from, public health emergencies, it is critically important to establish and understand the evidence base for these approaches. As a result, the current review sought to answer the following research questions: (1) How are CR and SC quantified in research?; (2) What is the impact of community resilience on mental wellbeing?; (3) What is the impact of infectious disease outbreaks, disasters and emergencies on community resilience and social capital?; and, (4) What types of interventions enhance community resilience and social capital?

By collating research in order to answer these research questions, the authors have been able to propose several key recommendations that could be used to both enhance and evaluate CR and SC effectively to facilitate the long-term recovery from COVID-19, and also to inform the use of CR and SC in any future public health disasters and emergencies.

A scoping review methodology was followed due to the ease of summarising literature on a given topic for policy makers and practitioners [ 26 ], and is detailed in the following sections.

Identification of relevant studies

An initial search strategy was developed by authors CH and DW and included terms which related to: CR and SC, given the absence of a consistent definition of CR, and the link between CR and SC, the review focuses on both CR and SC to identify as much relevant literature as possible (adapted for purpose from Annex 1: [ 27 ], as well as through consultation with review commissioners); public health emergencies and disasters [ 28 , 29 , 30 , 31 ], and psychological wellbeing and recovery (derived a priori from literature). To ensure a focus on both public health and psychological research, the final search was carried across Medline, PsycInfo, and EMBASE using OVID. The final search took place on the 18th of May 2020, the search strategy used for all three databases can be found in Supplementary file 1 .

Selection criteria

The inclusion and exclusion criteria were developed alongside the search strategy. Initially the criteria were relatively inclusive and were subject to iterative development to reflect the authors’ familiarisation with the literature. For example, the decision was taken to exclude research which focused exclusively on social support and did not mention communities as an initial title/abstract search suggested that the majority of this literature did not meet the requirements of our research question.

The full and final inclusion and exclusion criteria used can be found in Supplementary file 2 . In summary, authors decided to focus on the general population (i.e., non-specialist, e.g. non-healthcare worker or government official) to allow the review to remain community focused. The research must also have assessed the impact of CR and/or SC on mental health and wellbeing, resilience, and recovery during and following public health emergencies and infectious disease outbreaks which affect communities (to ensure the research is relevant to the review aims), have conducted primary research, and have a full text available or provided by the first author when contacted.

Charting the data

All papers were first title and abstract screened by CH or DW. Papers then were full text reviewed by CH to ensure each paper met the required eligibility criteria, if unsure about a paper it was also full text reviewed by DW. All papers that were retained post full-text review were subjected to a standardised data extraction procedure. A table was made for the purpose of extracting the following data: title, authors, origin, year of publication, study design, aim, disaster type, sample size and characteristics, variables examined, results, restrictions/limitations, and recommendations. Supplementary file 3 details the charting the data process.

Analytical method

Data was synthesised using a Framework approach [ 32 ], a common method for analysing qualitative research. This method was chosen as it was originally used for large-scale social policy research [ 33 ] as it seeks to identify: what works, for whom, in what conditions, and why [ 34 ]. This approach is also useful for identifying commonalities and differences in qualitative data and potential relationships between different parts of the data [ 33 ]. An a priori framework was established by CH and DW. Extracted data was synthesised in relation to each research question, and the process was iterative to ensure maximum saturation using the available data.

Study selection

The final search strategy yielded 3584 records. Following the removal of duplicates, 2191 records remained and were included in title and abstract screening. A PRISMA flow diagram is presented in Fig.  1 .

PRISMA flow diagram

At the title and abstract screening stage, the process became more iterative as the inclusion criteria were developed and refined. For the first iteration of screening, CH or DW sorted all records into ‘include,’ ‘exclude,’ and ‘unsure’. All ‘unsure’ papers were re-assessed by CH, and a random selection of ~ 20% of these were also assessed by DW. Where there was disagreement between authors the records were retained, and full text screened. The remaining papers were reviewed by CH, and all records were categorised into ‘include’ and ‘exclude’. Following full-text screening, 26 papers were retained for use in the review.

Study characteristics

This section of the review addresses study characteristics of those which met the inclusion criteria, which comprises: date of publication, country of origin, study design, study location, disaster, and variables examined.

Date of publication

Publication dates across the 26 papers spanned from 2008 to 2020 (see Fig.  2 ). The number of papers published was relatively low and consistent across this timescale (i.e. 1–2 per year, except 2010 and 2013 when none were published) up until 2017 where the number of papers peaked at 5. From 2017 to 2020 there were 15 papers published in total. The amount of papers published in recent years suggests a shift in research and interest towards CR and SC in a disaster/ public health emergency context.

Graph to show retained papers date of publication

Country of origin

The locations of the first authors’ institutes at the time of publication were extracted to provide a geographical spread of the retained papers. The majority originated from the USA [ 35 , 36 , 37 , 38 , 39 , 40 , 41 ], followed by China [ 42 , 43 , 44 , 45 , 46 ], Japan [ 47 , 48 , 49 , 50 ], Australia [ 51 , 52 , 53 ], The Netherlands [ 54 , 55 ], New Zealand [ 56 ], Peru [ 57 ], Iran [ 58 ], Austria [ 59 ], and Croatia [ 60 ].

There were multiple methodological approaches carried out across retained papers. The most common formats included surveys or questionnaires [ 36 , 37 , 38 , 42 , 46 , 47 , 48 , 49 , 50 , 53 , 54 , 55 , 57 , 59 ], followed by interviews [ 39 , 40 , 43 , 51 , 52 , 60 ]. Four papers used both surveys and interviews [ 35 , 41 , 45 , 58 ], and two papers conducted data analysis (one using open access data from a Social Survey [ 44 ] and one using a Primary Health Organisations Register [ 56 ]).

Study location

The majority of the studies were carried out in Japan [ 36 , 42 , 44 , 47 , 48 , 49 , 50 ], followed by the USA [ 35 , 37 , 38 , 39 , 40 , 41 ], China [ 43 , 45 , 46 , 53 ], Australia [ 51 , 52 ], and the UK [ 54 , 55 ]. The remaining studies were carried out in Croatia [ 60 ], Peru [ 57 ], Austria [ 59 ], New Zealand [ 56 ] and Iran [ 58 ].

Multiple different types of disaster were researched across the retained papers. Earthquakes were the most common type of disaster examined [ 45 , 47 , 49 , 50 , 53 , 56 , 57 , 58 ], followed by research which assessed the impact of two disastrous events which had happened in the same area (e.g. Hurricane Katrina and the Deepwater Horizon oil spill in Mississippi, and the Great East Japan earthquake and Tsunami; [ 36 , 37 , 38 , 42 , 44 , 48 ]). Other disaster types included: flooding [ 51 , 54 , 55 , 59 , 60 ], hurricanes [ 35 , 39 , 41 ], infectious disease outbreaks [ 43 , 46 ], oil spillage [ 40 ], and drought [ 52 ].

Variables of interest examined

Across the 26 retained papers: eight referred to examining the impact of SC [ 35 , 37 , 39 , 41 , 46 , 49 , 55 , 60 ]; eight examined the impact of cognitive and structural SC as separate entities [ 40 , 42 , 45 , 48 , 50 , 54 , 57 , 59 ]; one examined bridging and bonding SC as separate entities [ 58 ]; two examined the impact of CR [ 38 , 56 ]; and two employed a qualitative methodology but drew findings in relation to bonding and bridging SC, and SC generally [ 51 , 52 ]. Additionally, five papers examined the impact of the following variables: ‘community social cohesion’ [ 36 ], ‘neighbourhood connectedness’ [ 44 ], ‘social support at the community level’ [ 47 ], ‘community connectedness’ [ 43 ] and ‘sense of community’ [ 53 ]. Table  1 provides additional details on this.

How is CR and SC measured or quantified in research?

The measures used to examine CR and SC are presented Table  1 . It is apparent that there is no uniformity in how SC or CR is measured across the research. Multiple measures are used throughout the retained studies, and nearly all are unique. Additionally, SC was examined at multiple different levels (e.g. cognitive and structural, bonding and bridging), and in multiple different forms (e.g. community connectedness, community cohesion).

What is the association between CR and SC on mental wellbeing?

To best compare research, the following section reports on CR, and facets of SC separately. Please see Supplementary file 4  for additional information on retained papers methods of measuring mental wellbeing.

• Community resilience

CR relates to the ability of a community to withstand, adapt and permit growth in adverse circumstances due to social structures, networks and interdependencies within the community [ 11 ].

The impact of CR on mental wellbeing was consistently positive. For example, research indicated that there was a positive association between CR and number of common mental health (i.e. anxiety and mood) treatments post-disaster [ 56 ]. Similarly, other research suggests that CR is positively related to psychological resilience, which is inversely related to depressive symptoms) [ 37 ]. The same research also concluded that CR is protective of psychological resilience and is therefore protective of depressive symptoms [ 37 ].

• Social capital

SC reflects the strength of a social network, community reciprocity, and trust in people and institutions [ 14 ]. These aspects of community are usually conceptualised primarily as protective factors that enable communities to cope and adapt collectively to threats.

There were inconsistencies across research which examined the impact of abstract SC (i.e. not refined into bonding/bridging or structural/cognitive) on mental wellbeing. However, for the majority of cases, research deems SC to be beneficial. For example, research has concluded that, SC is protective against post-traumatic stress disorder [ 55 ], anxiety [ 46 ], psychological distress [ 50 ], and stress [ 46 ]. Additionally, SC has been found to facilitate post-traumatic growth [ 38 ], and also to be useful to be drawn upon in times of stress [ 52 ], both of which could be protective of mental health. Similarly, research has also found that emotional recovery following a disaster is more difficult for those who report to have low levels of SC [ 51 ].

Conversely, however, research has also concluded that when other situational factors (e.g. personal resources) were controlled for, a positive relationship between community resources and life satisfaction was no longer significant [ 60 ]. Furthermore, some research has concluded that a high level of SC can result in a community facing greater stress immediately post disaster. Indeed, one retained paper found that high levels of SC correlate with higher levels of post-traumatic stress immediately following a disaster [ 39 ]. However, in the later stages following a disaster, this relationship can reverse, with SC subsequently providing an aid to recovery [ 41 ]. By way of explanation, some researchers have suggested that communities with stronger SC carry the greatest load in terms of helping others (i.e. family, friends and neighbours) as well as themselves immediately following the disaster, but then as time passes the communities recover at a faster rate as they are able to rely on their social networks for support [ 41 ].

Cognitive and structural social capital

Cognitive SC refers to perceptions of community relations, such as trust, mutual help and attachment, and structural SC refers to what actually happens within the community, such as participation, socialising [ 16 ].

Cognitive SC has been found to be protective [ 49 ] against PTSD [ 54 , 57 ], depression [ 40 , 54 ]) mild mood disorder; [ 48 ]), anxiety [ 48 , 54 ] and increase self-efficacy [ 59 ].

For structural SC, research is again inconsistent. On the one hand, structural SC has been found to: increase perceived self-efficacy, be protective of depression [ 40 ], buffer the impact of housing damage on cognitive decline [ 42 ] and provide support during disasters and over the recovery period [ 59 ]. However, on the other hand, it has been found to have no association with PTSD [ 54 , 57 ] or depression, and is also associated with a higher prevalence of anxiety [ 54 ]. Similarly, it is also suggested by additional research that structural SC can harm women’s mental health, either due to the pressure of expectations to help and support others or feelings of isolation [ 49 ].

Bonding and bridging social capital

Bonding SC refers to connections among individuals who are emotionally close, and result in bonds to a particular group [ 17 ], and bridging SC refers to acquaintances or individuals loosely connected that span different social groups [ 18 ].

One research study concluded that both bonding and bridging SC were protective against post-traumatic stress disorder symptoms [ 58 ]. Bridging capital was deemed to be around twice as effective in buffering against post-traumatic stress disorder than bonding SC [ 58 ].

Other community variables

Community social cohesion was significantly associated with a lower risk of post-traumatic stress disorder symptom development [ 35 ], and this was apparent even whilst controlling for depressive symptoms at baseline and disaster impact variables (e.g. loss of family member or housing damage) [ 36 ]. Similarly, sense of community, community connectedness, social support at the community level and neighbourhood connectedness all provided protective benefits for a range of mental health, wellbeing and recovery variables, including: depression [ 53 ], subjective wellbeing (in older adults only) [ 43 ], psychological distress [ 47 ], happiness [ 44 ] and life satisfaction [ 53 ].

Research has also concluded that community level social support is protective against mild mood and anxiety disorder, but only for individuals who have had no previous disaster experience [ 48 ]. Additionally, a study which separated SC into social cohesion and social participation concluded that at a community level, social cohesion is protective against depression [ 49 ] whereas social participation at community level is associated with an increased risk of depression amongst women [ 49 ].

What is the impact of Infectious disease outbreaks / disasters and emergencies on community resilience?

From a cross-sectional perspective, research has indicated that disasters and emergencies can have a negative effect on certain types of SC. Specifically, cognitive SC has been found to be impacted by disaster impact, whereas structural SC has gone unaffected [ 45 ]. Disaster impact has also been shown to have a negative effect on community relationships more generally [ 52 ].

Additionally, of the eight studies which collected data at multiple time points [ 35 , 36 , 41 , 42 , 47 , 49 , 56 , 60 ], three reported the effect of a disaster on the level of SC within a community [ 40 , 42 , 49 ]. All three of these studies concluded that disasters may have a negative impact on the levels of SC within a community. The first study found that the Deepwater Horizon oil spill had a negative effect on SC and social support, and this in turn explained an overall increase in the levels of depression within the community [ 40 ]. A possible explanation for the negative effect lays in ‘corrosive communities’, known for increased social conflict and reduced social support, that are sometimes created following oil spills [ 40 ]. It is proposed that corrosive communities often emerge due to a loss of natural resources that bring social groups together (e.g., for recreational activities), as well as social disparity (e.g., due to unequal distribution of economic impact) becoming apparent in the community following disaster [ 40 ]. The second study found that SC (in the form of social cohesion, informal socialising and social participation) decreased after the 2011 earthquake and tsunami in Japan; it was suggested that this change correlated with incidence of cognitive decline [ 42 ]. However, the third study reported more mixed effects based on physical circumstances of the communities’ natural environment: Following an earthquake, those who lived in mountainous areas with an initial high level of pre-community SC saw a decrease in SC post disaster [ 49 ]. However, communities in flat areas (which were home to younger residents and had a higher population density) saw an increase in SC [ 49 ]. It was proposed that this difference could be due to the need for those who lived in mountainous areas to seek prolonged refuge due to subsequent landslides [ 49 ].

What types of intervention enhance CR and SC and protect survivors?

There were mixed effects across the 26 retained papers when examining the effect of CR and SC on mental wellbeing. However, there is evidence that an increase in SC [ 56 , 57 ], with a focus on cognitive SC [ 57 ], namely by: building social networks [ 45 , 51 , 53 ], enhancing feelings of social cohesion [ 35 , 36 ] and promoting a sense of community [ 53 ], can result in an increase in CR and potentially protect survivors’ wellbeing and mental health following a disaster. An increase in SC may also aid in decreasing the need for individual psychological interventions in the aftermath of a disaster [ 55 ]. As a result, recommendations and suggested methods to bolster CR and SC from the retained papers have been extracted and separated into general methods, preparedness and policy level implementation.

General methods

Suggested methods to build SC included organising recreational activity-based groups [ 44 ] to broaden [ 51 , 53 ] and preserve current social networks [ 42 ], introducing initiatives to increase social cohesion and trust [ 51 ], and volunteering to increase the number of social ties between residents [ 59 ]. Research also notes that it is important to take a ‘no one left behind approach’ when organising recreational and social community events, as failure to do so could induce feelings of isolation for some members of the community [ 49 ]. Furthermore, gender differences should also be considered as research indicates that males and females may react differently to community level SC (as evidence suggests males are instead more impacted by individual level SC; in comparison to women who have larger and more diverse social networks [ 49 ]). Therefore, interventions which aim to raise community level social participation, with the aim of expanding social connections and gaining support, may be beneficial [ 42 , 47 ].

Preparedness

In order to prepare for disasters, it may be beneficial to introduce community-targeted methods or interventions to increase levels of SC and CR as these may aid in ameliorating the consequences of a public health emergency or disaster [ 57 ]. To indicate which communities have low levels of SC, one study suggests implementing a 3-item scale of social cohesion to map areas and target interventions [ 42 ].

It is important to consider that communities with a high level of SC may have a lower level of risk perception, due to the established connections and supportive network they have with those around them [ 61 ]. However, for the purpose of preparedness, this is not ideal as perception of risk is a key factor when seeking to encourage behavioural adherence. This could be overcome by introducing communication strategies which emphasise the necessity of social support, but also highlights the need for additional measures to reduce residual risk [ 59 ]. Furthermore, support in the form of financial assistance to foster current community initiatives may prove beneficial to rural areas, for example through the use of an asset-based community development framework [ 52 ].

Policy level

At a policy level, the included papers suggest a range of ways that CR and SC could be bolstered and used. These include: providing financial support for community initiatives and collective coping strategies, (e.g. using asset-based community development [ 52 ]); ensuring policies for long-term recovery focus on community sustainable development (e.g. community festival and community centre activities) [ 44 ]; and development of a network amongst cooperative corporations formed for reconstruction and to organise self-help recovery sessions among residents of adjacent areas [ 58 ].

This scoping review sought to synthesise literature concerning the role of SC and CR during public health emergencies and disasters. Specifically, in this review we have examined: the methods used to measure CR and SC; the impact of CR and SC on mental wellbeing during disasters and emergencies; the impact of disasters and emergencies on CR and SC; and the types of interventions which can be used to enhance CR. To do this, data was extracted from 26 peer-reviewed journal articles. From this synthesis, several key themes have been identified, which can be used to develop guidelines and recommendations for deploying CR and SC in a public health emergency or disaster context. These key themes and resulting recommendations are summarised below.

Firstly, this review established that there is no consistent or standardised approach to measuring CR or SC within the general population. This finding is consistent with a review conducted by the World Health Organization which concludes that despite there being a number of frameworks that contain indicators across different determinants of health, there is a lack of consensus on priority areas for measurement and no widely accepted indicator [ 27 ]. As a result, there are many measures of CR and SC apparent within the literature (e.g., [ 62 , 63 ]), an example of a developed and validated measure is provided by Sherrieb, Norris and Galea [ 64 ]. Similarly, the definitions of CR and SC differ widely between researchers, which created a barrier to comparing and summarising information. Therefore, future research could seek to compare various interpretations of CR and to identify any overlapping concepts. However, a previous systemic review conducted by Patel et al. (2017) concludes that there are nine core elements of CR (local knowledge, community networks and relationships, communication, health, governance and leadership, resources, economic investment, preparedness, and mental outlook), with 19 further sub-elements therein [ 30 ]. Therefore, as CR is a multi-dimensional construct, the implications from the findings are that multiple aspects of social infrastructure may need to be considered.

Secondly, our synthesis of research concerning the role of CR and SC for ensuring mental health and wellbeing during, or following, a public health emergency or disaster revealed mixed effects. Much of the research indicates either a generally protective effect on mental health and wellbeing, or no effect; however, the literature demonstrates some potential for a high level of CR/SC to backfire and result in a negative effect for populations during, or following, a public health emergency or disaster. Considered together, our synthesis indicates that cognitive SC is the only facet of SC which was perceived as universally protective across all retained papers. This is consistent with a systematic review which also concludes that: (a) community level cognitive SC is associated with a lower risk of common mental disorders, while; (b) community level structural SC had inconsistent effects [ 65 ].

Further examination of additional data extracted from studies which found that CR/SC had a negative effect on mental health and wellbeing revealed no commonalities that might explain these effects (Please see Supplementary file 5 for additional information)

One potential explanation may come from a retained paper which found that high levels of SC result in an increase in stress level immediately post disaster [ 41 ]. This was suggested to be due to individuals having greater burdens due to wishing to help and support their wide networks as well as themselves. However, as time passes the levels of SC allow the community to come together and recover at a faster rate [ 41 ]. As this was the only retained paper which produced this finding, it would be beneficial for future research to examine boundary conditions for the positive effects of CR/SC; that is, to explore circumstances under which CR/SC may be more likely to put communities at greater risk. This further research should also include additional longitudinal research to validate the conclusions drawn by [ 41 ] as resilience is a dynamic process of adaption.

Thirdly, disasters and emergencies were generally found to have a negative effect on levels of SC. One retained paper found a mixed effect of SC in relation to an earthquake, however this paper separated participants by area in which they lived (i.e., mountainous vs. flat), which explains this inconsistent effect [ 49 ]. Dangerous areas (i.e. mountainous) saw a decrease in community SC in comparison to safer areas following the earthquake (an effect the authors attributed to the need to seek prolonged refuge), whereas participants from the safer areas (which are home to younger residents with a higher population density) saw an increase in SC [ 49 ]. This is consistent with the idea that being able to participate socially is a key element of SC [ 12 ]. Overall, however, this was the only retained paper which produced a variable finding in relation to the effect of disaster on levels of CR/SC.

Finally, research identified through our synthesis promotes the idea of bolstering SC (particularly cognitive SC) and cohesion in communities likely to be affected by disaster to improve levels of CR. This finding provides further understanding of the relationship between CR and SC; an association that has been reported in various articles seeking to provide conceptual frameworks (e.g., [ 66 , 67 ]) as well as indicator/measurement frameworks [ 27 ]. Therefore, this could be done by creating and promoting initiatives which foster SC and create bonds within the community. Papers included in the current review suggest that recreational-based activity groups and volunteering are potential methods for fostering SC and creating community bonds [ 44 , 51 , 59 ]. Similarly, further research demonstrates that feelings of social cohesion are enhanced by general social activities (e.g. fairs and parades [ 18 ]). Also, actively encouraging activities, programs and interventions which enhance connectedness and SC have been reported to be desirable to increase CR [ 68 ]. This suggestion is supported by a recent scoping review of literature [ 67 ] examined community champion approaches for the COVID-19 pandemic response and recovery and established that creating and promoting SC focused initiatives within the community during pandemic response is highly beneficial [ 67 ]. In terms of preparedness, research states that it may be beneficial for levels of SC and CR in communities at risk to be assessed, to allow targeted interventions where the population may be at most risk following an incident [ 42 , 44 ]. Additionally, from a more critical perspective, we acknowledge that ‘resilience’ can often be perceived as a focus on individual capacity to adapt to adversity rather than changing or mitigating the causes of adverse conditions [ 69 , 70 ]. Therefore, CR requires an integrated system approach across individual, community and structural levels [ 17 ]. Also, it is important that community members are engaged in defining and agreeing how community resilience is measured [ 27 ] rather than it being imposed by system leads or decision-makers.

In the aftermath of the pandemic, is it expected that there will be long-term repercussions both from an economic [ 8 ] and a mental health perspective [ 71 ]. Furthermore, the findings from this review suggest that although those in areas with high levels of SC may be negatively affected in the acute stage, as time passes, they have potential to rebound at a faster rate than those with lower levels of SC. Ongoing evaluation of the effectiveness of current initiatives as the COVID-19 pandemic progresses into a recovery phase will be invaluable for supplementing the evidence base identified through this review.

• Recommendations

As a result of this review, a number of recommendations are suggested for policy and practice during public health emergencies and recovery.

Future research should seek to establish a standardised and validated approach to measuring and defining CR and SC within communities. There are ongoing efforts in this area, for example [ 72 ]. Additionally, community members should be involved in the process of defining how CR is measured.

There should be an enhanced effort to improve preparedness for public health emergencies and disasters in local communities by gauging current levels of SC and CR within communities using a standardised measure. This approach could support specific targeting of populations with low levels of CR/SC in case of a disaster or public health emergency, whilst also allowing for consideration of support for those with high levels of CR (as these populations can be heavily impacted initially following a disaster). By distinguishing levels of SC and CR, tailored community-centred approaches could be implemented, such as those listed in a guide released by PHE in 2015 [ 73 ].

CR and SC (specifically cognitive SC) should be bolstered if communities are at risk of experiencing a disaster or public health emergency. This can be achieved by using interventions which aim to increase a sense of community and create new social ties (e.g., recreational group activities, volunteering). Additionally, when aiming to achieve this, it is important to be mindful of the risk of increased levels of CR/SC to backfire, as well as seeking to advocate an integrated system approach across individual, community and structural levels.

It is necessary to be aware that although communities with high existing levels of resilience / SC may experience short-term negative consequences following a disaster, over time these communities might be able to recover at a faster rate. It is therefore important to ensure that suitable short-term support is provided to these communities in the immediate aftermath of a public health emergency or disaster.

Robust evaluation of the community resilience initiatives deployed during the COVID-19 pandemic response is essential to inform the evidence base concerning the effectiveness of CR/ SC. These evaluations should continue through the response phase and into the recovery phase to help develop our understanding of the long-term consequences of such interventions.

Limitations

Despite this review being the first in this specific topic area, there are limitations that must be considered. Firstly, it is necessary to note that communities are generally highly diverse and the term ‘community’ in academic literature is a subject of much debate (see: [ 74 ]), therefore this must be considered when comparing and collating research involving communities. Additionally, the measures of CR and SC differ substantially across research, including across the 26 retained papers used in the current review. This makes the act of comparing and collating research findings very difficult. This issue is highlighted as a key outcome from this review, and suggestions for how to overcome this in future research are provided. Additionally, we acknowledge that there will be a relationship between CR & SC even where studies measure only at individual or community level. A review [ 75 ] on articulating a hypothesis of the link to health inequalities suggests that wider structural determinants of health need to be accounted for. Secondly, despite the final search strategy encompassing terms for both CR and SC, only one retained paper directly measured CR; thus, making the research findings more relevant to SC. Future research could seek to focus on CR to allow for a comparison of findings. Thirdly, the review was conducted early in the COVID-19 pandemic and so does not include more recent publications focusing on resilience specifically in the context of COVID-19. Regardless of this fact, the synthesis of, and recommendations drawn from, the reviewed studies are agnostic to time and specific incident and contain critical elements necessary to address as the pandemic moves from response to recovery. Further research should review the effectiveness of specific interventions during the COVID-19 pandemic for collation in a subsequent update to this current paper. Fourthly, the current review synthesises findings from countries with individualistic and collectivistic cultures, which may account for some variation in the findings. Lastly, despite choosing a scoping review method for ease of synthesising a wide literature base for use by public health emergency researchers in a relatively tight timeframe, there are disadvantages of a scoping review approach to consider: (1) quality appraisal of retained studies was not carried out; (2) due to the broad nature of a scoping review, more refined and targeted reviews of literature (e.g., systematic reviews) may be able to provide more detailed research outcomes. Therefore, future research should seek to use alternative methods (e.g., empirical research, systematic reviews of literature) to add to the evidence base on CR and SC impact and use in public health practice.

This review sought to establish: (1) How CR and SC are quantified in research?; (2) The impact of community resilience on mental wellbeing?; (3) The impact of infectious disease outbreaks, disasters and emergencies on community resilience and social capital?; and, (4) What types of interventions enhance community resilience and social capital?. The chosen search strategy yielded 26 relevant papers from which we were able extract information relating to the aims of this review.

Results from the review revealed that CR and SC are not measured consistently across research. The impact of CR / SC on mental health and wellbeing during emergencies and disasters is mixed (with some potential for backlash), however the literature does identify cognitive SC as particularly protective. Although only a small number of papers compared CR or SC before and after a disaster, the findings were relatively consistent: SC or CR is negatively impacted by a disaster. Methods suggested to bolster SC in communities were centred around social activities, such as recreational group activities and volunteering. Recommendations for both research and practice (with a particular focus on the ongoing COVID-19 pandemic) are also presented.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

Social Capital

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This study was supported by the National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King’s College London and the University of East Anglia. The views expressed are those of the author(s) and not necessarily those of the NIHR, Public Health England, the UK Health Security Agency or the Department of Health and Social Care [Grant number: NIHR20008900]. Part of this work has been funded by the Office for Health Improvement and Disparities, Department of Health and Social Care, as part of a Collaborative Agreement with Leeds Beckett University.

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DW, JSo and JSt had the main idea for the review. The search strategy and eligibility criteria were devised by CH, DW, JSo and JSt. CH conducted the database searches. CH and DW conducted duplicate, title and abstract and full text screening in accordance with inclusion criteria. CH conducted data extraction, CH and DW carried out the analysis and drafted the initial manuscript. All authors provided critical revision of intellectual content. All authors approved the final manuscript.

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Hall, C.E., Wehling, H., Stansfield, J. et al. Examining the role of community resilience and social capital on mental health in public health emergency and disaster response: a scoping review. BMC Public Health 23 , 2482 (2023). https://doi.org/10.1186/s12889-023-17242-x

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