purpose of the assignment is to discuss and evaluate the role of
representation in the process of coping and the psychological adjustment to
living with a chronic illness/disease.
When an individual is diagnosed with a chronic illness or disease their life is
changed in many ways. The individual’s physical, mental health, personal and
social aspects of their lives are affected by the illness/disease. The chronic condition
also ruins the individual’s quality of life and wellbeing. Human beings learn to
cope with emotional and physical issues at a very young age by learning from
previous events which initiate the coping response. The assignment will describe the different psychologist’s theories on
coping and explore their effectiveness in chronic illnesses. There will
be brief definitions throughout the paper and discussions and evaluations on different
research papers related to the chronic illnesses HIV and AIDS.
Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome (HIV/AIDS) is a
worldwide epidemic, over 70 million people have been affected and 35 million
have died from the disease. (Fajardo-Ortiz et al., 2017). A Chronic illness/disease
is a disorder that persist for an extended amount of time (over 3 months) or
has no potential cure. (de Ridder, Geenen, Kuijer & van Middendorp, 2008). Arthritis,
diabetes, cancer and HIV/AIDS are a few illustrations of chronic illnesses/disease
that are long lasting and have no cure. When diagnosed with a chronic illness
many try and find ways to cope with the illness and the consequences that occur
with the illness.
Coping refers to the
thoughts and behaviours individuals use to manage the internal and external demands
of stressful events. (Folkman, 2010). Coping is the response to diminish the
emotional, physical and psychological effects that are linked with everyday
stresses. (Snyder, 1999). Coping determines how an individual adapts to a
stressful event using cognitive and behavioural efforts. (Meade, Wang, Lin, Wu
& Poppen, 2010). Stress can be defined as a feeling which arises when
an individual perceives a disagreement between the social, physical or
psychological demands of a situation and the resources of an individual’s
biological, psychological or social systems. (Berto, 2014).
There have been various psychological
models developed on an individual’s response to a chronic illness. Such models include,
the stress-coping model, the illness representation model and the adjustment
model. (Dekker & de Groot, 2016). In 1984, psychologists Richard Lazarus
and Susan Folkman proposed the Theory of Cognitive Appraisal model also known
as the Stress Theory, the theory explained the mental process which influence
stressors. (Lazarus and Folkman, 1984). Lazarus and
Folkman (1984) Theory
of Cognitive Appraisal suggests that there are two types of coping responses. (Lazarus
and Folkman, 1984). Emotion-focused coping is used to regulate negative emotion
using strategies such as, seeking emotional support, distancing and
escape-avoidance, and problem-focused coping, which consists
of painful problem-solving, addressing the problem causing distress using
strategies such as information gathering and decision making. (Folkman, 2010).
Additionally, when faced with stress, individuals typically use both emotion-focused
and problem-focused coping strategies to manage their stress, as they can both
be applied in any stressful situation. (Jensen, Forlini, Partridge & Hall,
2016). Nevertheless, individuals are dependent on the assessment of the situation
(i.e., as a threat and or a challenge) to decide on which coping mechanism to adopt.
(Berjot & Gillet, 2011).
strategies involve trying to reduce the negative emotional responses associated
with stressful events (i.e. embarrassment, fear, anxiety, depression and frustration).
(Lazarus and Folkman, 1984). However, emotion-focused coping (i.e. eating,
drinking and taking drugs) are often less effective than using problem-focused
methods in relation to health outcomes. (Penley,
Tomaka, & Weibe, 2012). Emotion-focused coping does not provide a long
term solution. (Dijkstra & Homan, 2016). Although emotion-focused coping is
the better option when the cause of stress is out of an individual’s control.
Problem-focused coping aims
to target the causes of stress in constructive ways, such as managing, tackling
or altering the cause of the stressful situation. (Jensen,
Forlini, Partridge & Hall, 2016). Unlike emotion-focused coping,
problem-focused coping can provide a long-term solution, as it removes the
stressor, and deals with the cause of the problem. (Jensen, Forlini, Partridge
& Hall, 2016).
However, there are
potential weaknesses with problem focused approaches as they do not work in any
situation where it is beyond the individual’s control in removing the source of
stress (i.e. sudden death), as problem-focused approaches work better when the
person can control the source of stress.
Chronic disease such as HIV/AIDS
provides an appropriate testing ground for Lazarus and Folkman (1984) coping
theory because some HIV-related stressors are either changeable or unchangeable.
(Chesney, Chambers, Taylor, Johnson & Folkman, 2003). Individuals who are
diagnosed and living with chronic disease such as HIV/AIDS experience a series
of stressors, the stressors are caused by the diseases effects such as physical
symptoms, medical treatments, medication side-effects, social difficulties and
discrimination. (Meade, Wang, Lin, Wu & Poppen,
2010). Individuals who are diagnosed with HIV/AIDS reported having negative
reactions towards the diagnosis, such as being shocked, scared or tense,
depressed, and feeling suicidal after HIV diagnosis. (Chandra, Ravi, Desai
& Subbakrishna, 1998).
A research study explored
the stress and coping of HIV-positive individuals and the effectiveness of
Lazarus and Folkman’s (1984) coping strategies.
Participants had reported
a range of HIV-related stressors, participants who had experienced more severe
stress viewed HIV/AIDS as a threat to their overall health and well-being, whereas
some participants viewed HIV/AIDS as less threatening to them. (Meade, Wang,
Lin, Wu & Poppen, 2010). Although participants had reported using all types
of coping strategies, they were more likely to use problem-focused strategies (i.e.
problem solving, seeking support) rather than emotion-focused strategies (i.e. avoidance,
wishful thinking, and self-blaming). (Meade, Wang, Lin, Wu & Poppen,
2010). The participants choice of the coping response was influenced by the individual’s
judgement of the situation as either changeable (i.e. controllable) or unchanging
(i.e. uncontrollable) thus, selecting the appropriate coping strategies that is
specific for the stressful situation. (Chesney, Chambers, Taylor, Johnson &