Springer Series on Stress and Coping – serie

This book examines new developments in the area of human competence and coping behavior. It sets forth a conceptual framework that considers the interplay between environmental contexts and personal resources and their impact on how indi­ viduals cope with life transitions and crises. The selections cover the tasks confronted in varied life crises and describe the coping strategies employed in managing them. The material identifies the long-term effects of such life events as divorce and bereave­ ment as well as the way in which these stressors can promote personal growth and maturity. The book contains a broad selec­ tion of recent literature on coping and adaptation, integrative commentaries that provide the background for each of the areas as well as conceptual linkages among them, and an introductory overview that presents a general perspective on human compe­ tence and coping. Illustrative case examples are included. The first part of the book is organized chronologically ac­ cording to developmental life transitions confronted by many people-from the childhood years through adolescence, career choice and parenthood, divorce and remarriage, middle age and retirement, and death and bereavement. The second part covers unusual life crises and other hazards that typically involve ex­ treme stress such as man-made and natural disasters and terrorism. The book highlights effective coping behavior among healthy individuals rather than psychological breakdown and psychiatric symptoms. The emphasis is on successful adaptation, the ability to cope with life transitions and crises, and the process by which such ix x PREFACf. ".

This book examines new developments in the area of human competence and coping behavior. It sets forth a conceptual framework that considers the interplay between environmental contexts and personal resources and their impact on how indi­ viduals cope with life transitions and crises. The selections cover the tasks confronted in varied life crises and describe the coping strategies employed in managing them. The material identifies the long-term effects of such life events as divorce and bereave­ ment as well as the way in which these stressors can promote personal growth and maturity. The book contains a broad selec­ tion of recent literature on coping and adaptation, integrative commentaries that provide the background for each of the areas as well as conceptual linkages among them, and an introductory overview that presents a general perspective on human compe­ tence and coping. Illustrative case examples are included. The first part of the book is organized chronologically ac­ cording to developmental life transitions confronted by many people-from the childhood years through adolescence, career choice and parenthood, divorce and remarriage, middle age and retirement, and death and bereavement. The second part covers unusual life crises and other hazards that typically involve ex­ treme stress such as man-made and natural disasters and terrorism. The book highlights effective coping behavior among healthy individuals rather than psychological breakdown and psychiatric symptoms. The emphasis is on successful adaptation, the ability to cope with life transitions and crises, and the process by which such ix x PREFACf. ".

"Like a Bridge over Troubled Waters" The surge of current interest in the interface between clinical and social psychology is well illustrated by the publication of a number of general texts and journals in this area, and the growing emphasis in graduate programs on providing training in both disciplines. Although the bene­ fits of an integrated clinical-social approach have been recognized for a number of years, the recent work in this area has advanced from the­ oretical extrapolations of social psychological models to clinical issues to theory and research that is based on social principles and conducted in clinical domains. It is becoming increasingly common to find social psy­ chologists pursuing research with clinical populations and clinical psy­ chologists investigating variables that have traditionally been in the realm of social psychology. A major area of interface between the two disciplines is in research and theory concerned with how individuals respond to negative events. In addition to the trend toward an integrated clinical-social approach, the growing body of literature in this area reflects the explosion of cur­ rent interest in the area of health psychology; work by clinical and social psychologists on the topics of stress and coping has been one of the major facets of this burgeoning field. The purpose of the present volume is to provide a common forum for recent advances in the clinical and social literature on responses to negative life outcomes.

This book is one additional indication that a new field of study is emerging within the social sciences, if it has not emerged already. Here is a sampling of the fruit of a field whose roots can be traced to the earliest medical writings in Kahun Papyrus in 1900 B.C. In this document, according to Ilza Veith, the earliest medical scholars described what was later identified as hysteria. This description was long before the 1870s and 1880s when Char­ cot speculated on the etiology of hysteria and well before the first use of the term traumatic neurosis at the turn of this Century. Traumatic stress studies is the investigation of the immediate and long-term psychosocial consequences of highly stressful events and the factors that affect those consequences. This definition includes three primary elements: event, conse­ quences, and causal factors affecting the perception of both. This collection of papers addresses all three elements and collectively contributes to our understanding and appreciation of the struggles of those who have en­ dured so much, often with little recognition of their experiences.

For hundreds of years, the human response to personal and collective catastrophe has been recognized. Major historical events of the twen­ tieth century have highlighted the reality of the human response to extreme traumatization, especially the experience of persons exposed to the concentration camps of Nazi Germany, the dropping of atomic bombs on Hiroshima and Nagasaki, and the unique features of the Vietnam conflict. However, it was not until1980, with the publication of the third edition of the Diagnostic and Statistical Manual (DSM-111), that post-traumatic stress disorder (PTSD) was fully recognized as a distinct and valid diagnostic category with a permanency not hitherto afforded post-trauma stress syndromes. Consequently, a formidable PTSD literature has emerged since the late 1970s. Included among the wealth of research and clinical papers are a variety of edited books containing contributions from the major authorities in the field (e.g., Figley, 1978, 1985; van der Kolk, 1984; Kelly, 1985; Sonnenberg, Blank, & Talbott, 1985; Milgram, 1986; Ochberg, 1988). However, to date no publication has brought together and integrated the variety of theoretical and therapeutic perspectives in a form readily accessible to clinicians. It is to this gap in the literature that this contribution is addressed.

I am very pleased to have been asked to do abrief foreword to this second CRISP volume, The Social Context o[ Coping. I know most of the participants and their work, and respect them as first-rate and influen­ tial research scholars whose research is at the cusp of current concerns in the field of stress and coping. Psychological stress is central to human adaptation. It is difficult to visualize the study of adaptation, health, illness, personal soundness, and psychopathology without recognizing their dependence on how weil people cope with the stresses of living. Since the editor, John Eckenrode, has portrayed the themes of each of the chapters in his introduction, I can limit myself to a few general comments about stress and coping. Stress research began, as unexplored fields often do, with very sim­ ple-should I say simplistic?-ideas about how to define the concept. Early approaches were unidimensional and input-output in outlook, modeled implicitly on Hooke's late-17th-century engineering analysis in which external load was an environmental stressor, stress was the area over wh ich the load acted, and strain was the deformation of the struc­ tu re such as a bridge or building.

Over 100 researchers from 16 countries contribute to the first comprehensive handbook on post-traumatic stress disorder. Eight major sections present information on assessment, measurement, and research protocols for trauma related to war veterans, victims of torture, children, and the aged. Clinicians and researchers will find it an indispensible reference, touching on such disciplines and psychiatry, psychology, social work, counseling, sociology, neurophysiology, and political science.

As a researcher whose work focuses largely on the causes and conse­ quences of unwanted pregnancy, I may appear to be an unlikely candidate to write a foreword to a book on infertility. Yet, many of the themes that emerge in the study of unwanted pregnancy are also apparent in the study of infertility. Moreover, this volume is an important contribution to the literature on fertility, women's health issues, and health psychology in general, all topics with which I have been closely involved over the past two decades. Neither pregnancy nor its absence is inherently desirable: The occurrence of a pregnancy can be met with joy or despair, and its absence can be a cause of relief or anguish. Whether or not these states are wanted, the conscious and unconscious meanings attached to pregnancy and in­ fertility, the responses of others, the perceived implications of these states, and one's expectations for the future all are critical factors in determining an individual's response. In addition, both unwanted pregnancy and failure to conceive can be socially stigmatized, evoking both overt and subtle social disapproval. Fur­ ther, they involve not only the woman, but her partner, and potentially the extended family. Finally, both of these reproductive issues have been poorly researched. Because both are emotionally charged and socially stigmatized events, they are difficult to study. Much of the early literature relied on anecdotal or case reports.

In this highly readable text, the author details the findings of an exhaustive series of studies of Isreali combat veterans, documenting the effects of combat stress reaction on mental and physical health, social interaction, and military effectiveness. In addition to providing mental health professionals, trauma victims, and military personnel with an unparalleled source of information, the work's exploration of the cultural, social, and political processes affecting recovery from combat stress reaction offers a unique perspective of contemporary Isreali culture.

This book is a research mono graph reporting empirical results, but we have tried to place the data in a very broad national perspective. Our intent is a volume on mental health policy in the United States, most notably our de facto policies, as indicated by empirical data. The book gives a broad perspective of mental disorders and mental disorder treatment in general hospitals in the United States. The audi­ ence that we ho pe to reach is those interested in mental health policy, planning, and treatment alternatives. The issues raised in this book are germane to anyone who is concerned with the problems that beset those see king treatment for mental or substance abuse disorders. We address the foUowing types of issues: (1) the history of health policy in the United States; (2) the history of our mental health policy as a eomponent of our health poliey; (3) the effeets of ehanges in payment policies; (4) mental disorders among special populations (children, the elderly, the disabled); (5) the cost of treatment; (6) changes in labeling of diagnosis; (7) the effectiveness of treatment; and (8) evolving public policy issues.

Providing fresh insights into the complex relationship between stress and mental health, internationally recognized contributors identifie emerging conceptual issues, highlight promising avenues for further study, and detail novel methodological techniques for addressing contemporary empirical problems. Specific coverage includes stressful life events, chronic strains, psychosocial resources and mediators, vulnerability to stress, and mental health outcomes-thus providing researchers with a tool to take stock of the past and future of this field.

The nosological roots of post-traumatic stress disorder (PTSD) may be traced back to th~American Psychiatric Association's DSM-I entry of gross stress reaction, as published in 1952. Yet the origins of the current enthusi­ asm with regard to post-traumatic stress can be traced back to 1980, which marked the emergence of the term post-traumatic stress disorder in the DSM­ III. This reflected the American Psychiatric Association's acknowledgment of post-traumatic stress as a discrete, phenomenologically unique, and reli­ able psychopathological entity at a time in American history when such recognition had important social, political, and psychiatric implications. Clearly, prior to DSM-I the lack of a generally accepted terminology did little to augment the disabling effects that psychological traumatization could engender. Nor did the subsequent provision of an official diagnostic label alone render substantial ameliorative qualities. Nevertheless, the post­ Vietnam DSM-III recognition of PTSD did herald a dramatic increase in research and clinical discovery. The American Red Cross acknowledged the need to establish disaster mental health services, the American Psychological Association urged its members to form disaster mental health networks, and the Veterans Administration established a national study center for PTSD.

The nosological roots of post-traumatic stress disorder (PTSD) may be traced back to th~American Psychiatric Association's DSM-I entry of gross stress reaction, as published in 1952. Yet the origins of the current enthusi­ asm with regard to post-traumatic stress can be traced back to 1980, which marked the emergence of the term post-traumatic stress disorder in the DSM­ III. This reflected the American Psychiatric Association's acknowledgment of post-traumatic stress as a discrete, phenomenologically unique, and reli­ able psychopathological entity at a time in American history when such recognition had important social, political, and psychiatric implications. Clearly, prior to DSM-I the lack of a generally accepted terminology did little to augment the disabling effects that psychological traumatization could engender. Nor did the subsequent provision of an official diagnostic label alone render substantial ameliorative qualities. Nevertheless, the post­ Vietnam DSM-III recognition of PTSD did herald a dramatic increase in research and clinical discovery. The American Red Cross acknowledged the need to establish disaster mental health services, the American Psychological Association urged its members to form disaster mental health networks, and the Veterans Administration established a national study center for PTSD.

I n the wake of an earlier book (Solomon, 1993), this new work, Coping with War-Induced Stress: The Gulf War and the Israeli Response, promises to make Zahava Solomon a modern maven with respect to the psychologi­ cal effects of war. Dr. Solomon is a high-ranking officer, serving as a psychiatric epidemiologist in the Mental Health Department of the Is­ raeli Defense Forces Medical Corps. She also teaches at Tel Aviv Univer­ sity. The earlier book dealt with the reactions of the Israeli Defense Forces to the 1982 war in Lebanon, which divided the population of Israel concerning its wisdom and justification. The new book deals with the emotional consequences of the United Nations effort against Iraq after its invasion of Kuwait. Because Israel agreed not to participate actively so as not to endanger the fragile Arab coalition against Iraq, it was in a sense a nonwar-as Solomon refers to it-yet with many fea­ tures of a war. Although they had quite limited casualties, largely in the Tel Aviv area, the Israelis faced the actuality of damaging Scud missile attacks and the threat that these missiles could not only be targeted to much of Israel but also carry poison gas to other Israeli cities. Solomon has written a fascinating book about this crisis in Israeli life.

Renowned scientists and practitioners provide a concise summary of current theory, research, and clinical practice regarding traumatic stress. An integrative biopsychosocial theory of trauma response provides a framework for the book. Chapters consider the frequency and likely mental health consequences of a wide range of traumatic events-including military trauma, violent crime, natural and technological disasters, accidental injury, and torture. This comprehensive reference features state-of-the-art psychosocial and biological treatments and community-based intervention strategies.

Several people have asked what motivated us to write a book about commut­ ing, something that we all do but over which we have very little control. As a matter of fact, the general reaction from professional colleagues and friends alike was first a sort of knowing smile followed by some story. Everyone has a story about a personal commuting experience. Whether it was a problem with a delayed bus, a late arrival, broken-down automobiles, hot trains or subways, during the past year we have heard it all. Many of these stories must be apocryphal because, if they were all true, it is amazing that anyone ever arrived at work on time, at home, or at some other destination. The interest for us likely stems from many factors that over the years have probably influenced our thinking. All of the authors studied and/or grew up in the New York City metropolitan area. For illustration, let's devote a few paragraphs to describing some of the senior author's (Koslowsky's) life experiences. As a young man in New York City, he was a constant user of the New York City subway system. The whole network was and still is quite impressive. For a relatively small sum, one can spend the whole day and night in an underground world (growing up in New York often makes one think that the whole world is contained in its five boroughs).

The editors of Beyond Trauma: Cultural and Societal Dynamics have created a volume that goes beyond the individual's psychological dynamics of trauma, exploring its social, cultural, politica!, and ethical dimensions from an international as well as a global perspective. In the opening address as International Chair of the First World Conference of the International Society for Traumatic Stress Studies on Trauma and Tragedy: The Origins, Management, and Prevention of Traumatic Stress in Today's World, June 22-26, 1992, Amsterdam, The Netherlands, the conference that formed the foundation for the col­ lected chapters in this volume, 1 commented: This meeting is a landmark in accomplishing the Society's universal mission. Our distinguished International Scientific Advisory Committee and Honor­ ary Committee, whose membership was drawn from over 60 countries, the cooperation of six United Nations bodies, and the participation anei endorse­ ment of numerous nongovernmental organizations and institutions attest to the Society's emerging presence as a major international forum for profes­ sionals of ali disciplines working with victims and trauma survivors.

While insights sometimes are slow in coming, they often seem obvious when they finally arrive. This handbook is an outcome of the insight that the topics of social support and the family are very closely linked. Obvious as this might seem, the fact remains that the literatures dealing with social support and the family have been deceptively separate and distinct. For example, work on social support began in the 1970s with the accumulation of evidence that social ties and social integration play important roles in health and personal adjustment. Even though family members are often the key social supporters of individuals, relatively little re­ search of social support was targeted on family interactions as a path to specifying supporter processes. It is now recognized that one of the most important features of the family is its role in providing the individual with a source of support and acceptance. Fortunately, in recen t years, the distinctness and separateness of the fields of social support and the family have blurred. This handbook provides the first collation and integration of social support and family research. This integration calls for specifying processes (such as the cognitions associated with poor support availability and unrewarding faIllily constellations) and factors (such as cultural differences in family life and support provision) that are pertinent to integration.

Much of what we know about the subject of coping is based on human behavior and cognition during times of crisis and transition. Yet the alarms and m~or upheavals of life comprise only a portion of those experiences that call for adaptive efforts. There remains a vast array of life situations and conditions that pose continuing hardship and threat and do not promise resolution. These chronic stressors issue in part from persistently difficult life circumstances, roles, and burdens, and in part from the conversion of traumatic events into persisting adjustment challenges. Indeed, there is growing recognition of the fact that many traumatic experiences leave a long-lasting emotional residue. Whether or not coping with chronic problems differs in form, emphasis, or func­ tion from the ways people handle acute life events and transitions is one of the central issues taken up in these pages. This volume explores the varied circumstances and experiences that give rise to chronic stress, as well as the ways in which individuals adapt to and accommodate them. It addresses a number of substantive and methodological questions that have been largely overlooked or sidelined in previous inquiries on the stress and coping process.

While most studies of the stresses experienced by minorities, migrants, and refugees focus on North America, this work assumes an unusually broad scope. African-Americans, Latin Americans, Hutterites, Southeast Asians, and Native Americans are all considered in the context of the U.S. and Canada. However, separate chapters also discuss North Africans in France, Turks in Belgium, native culture in New Zealand, Jews inside and outside Israel, Gypsies in Europe, and Germans migrating west in their newly united nation. This unique look at the stresses facing such groups is an important resource for researchers, practitioners, and graduate students in clinical psychology, counseling, and psychiatric social work.

In this extraordinary new text, an international array of scholars explore the enduring legacy of such social shocks as war, genocide, slavery, tyranny, crime, and disease. Among the cases addressed are - instances of genocide in Turkey, Cambodia, and Russia - the plight of the families of Holocaust survivors, atomic bomb survivors in Japan, and even the children of Nazis - the long-term effects associated with the Vietnam War and the war in Yugoslavia - and the psychology arising from the legacy of slavery in America.

In 1996, representatives from 27 different countries met in Jerusalem to share ideas about traumatic stress and its impact. For many, this represented the first dialogue that they had ever had with a mental health professional from another country. Many of the attendees had themselves been exposed to either personal trauma or traumatizing stories involving their patients, and represented countries that were embroiled in conflicts with each other. Listening to one another became possible because of the humbling humanity of each participant, and the accuracy and objectivity of the data presented. Understanding human traumatization had thus become a common denomi­ nator, binding together all attendees. This book tries to capture the spirit of the Jerusalem World Conference on Traumatic Stress, bringing forward the diversities and commonalties of its constructive discourse. In trying to structure the various themes that arose, it was all too obvious that paradigms of different ways of conceiving of traumatic stress should be addressed first. In fact, the very idea that psychological trauma can result in mental health symptoms that should be treated has not yet gained universal acceptability. Even within medicine and mental health, competing approaches about the impact of trauma and the origins of symptoms abound. Part I discusses how the current paradigm of traumatic stress disorder developed within the historical, social, and process contexts. It also grapples with some of the difficulties that are presented by this paradigm from anthropologic, ethical, and scientific perspectives.

The goal of a trauma centre (CTC) is to help survivors and/or victims re-empower themselves, restore wholeness and meaning, and integrate the trauma(s) they have experienced into their lives so that they are no longer at the mercy of those external events. The CTCs described in this book vary in type and form but seek to provide a variety of services to victims and/or survivors by complementing and co-ordinating services with existing programmes.

In 1997 the National Institute of Mental Health assembled a working group of international experts to address the mental health consequences of torture and related violence and trauma; report on the status of scientific knowledge; and include research recommendations with implications for treatment, services, and policy development. This book, dedicated to those who experience the horrors of torture and those who work to end it, is based on that report.

Over the past two decades the world has witnessed an increasing number of disasters involving massive exposure of the population to radiation, chemical toxins, or other hazardous agents. The recent bombings of the World Trade Center in New York -- setting aside all other personal, economic, or geopolitical aspects encompassed by this tragic event -- is yet another unfortunate example. Besides the massive loss of life, a large segment of the population of Manhattan was willfully exposed to large clouds of dust and smoke, asbestos, and other harmful materials. As a consequence of this terrorist act, apprehension about possible further attacks, perhaps with biological or chemical weapons, will continue to hold the country in its grip for quite some time. The term `ecological disaster' is used to indicate these incidents, some minor, some catastrophic or apocalyptic. Often these accidents are followed by widespread fear of future adverse health effects. In many cases these fears are justified or partly justified for those who became exposed. However sometimes illness may occur in the absence of significant exposure to toxic substances.Concerns and worries about health tend to facilitate the appearance of medically unexplained symptoms or syndromes. This mental health component has received relatively little attention in the disaster literature. It can occur simultaneously with direct physical consequences and is not always clearly distinguishable from it. This situation appears to be particularly likely to occur in the wake of chemical and nuclear events, which are usually followed by years of disputes about facts and opinions about health effects and their relation to the disaster. This book presents an overview of research on the psychological and societal consequences of ecological disasters. It gives in-depth case studies on most of the major incidents that have occurred in the 1980s and 1990s. It summarizes the accumulated knowledge in this area and identifies areas of future research. It can serve as a resource for practitioners and policymakers dealing with current and future ecological calamities and may help them to define an adequate response to the complex public health challenges these incidents represent.

While most studies of the stresses experienced by minorities, migrants, and refugees focus on North America, this work assumes an unusually broad scope. African-Americans, Latin Americans, Hutterites, Southeast Asians, and Native Americans are all considered in the context of the U.S. and Canada. However, separate chapters also discuss North Africans in France, Turks in Belgium, native culture in New Zealand, Jews inside and outside Israel, Gypsies in Europe, and Germans migrating west in their newly united nation. This unique look at the stresses facing such groups is an important resource for researchers, practitioners, and graduate students in clinical psychology, counseling, and psychiatric social work.

Based on a unique research study, this volume examines the later life development of Holocaust survivors from Israel and the US. Through systematic interviews, the authors – noted researchers and clinicians – collected data about the lives of these survivors and how they compared to peers who did not share this experience. The orientation of the book synthesizes several conceptual approaches – gerontological and life span development, stress research, and traumatology, and also reflects the varied disciplines of the authors, spanning psychology, social work, and sociology. The result is a multi-faceted view of their subject with an understanding of the individual, society, and the interaction of the two, tempered by the authors’ own Holocaust experiences. Chapters cover a range of areas including stress and coping of these survivors, reviews of their heath and mental health, an examination of their social integration, as well as a review of the multiple predictors of psychological well-being and adaptation to aging. This book will be of interest to psychologists, social workers, sociologists, psychiatrists, and all those who study both trauma and aging.

In this highly readable text, the author details the findings of an exhaustive series of studies of Isreali combat veterans, documenting the effects of combat stress reaction on mental and physical health, social interaction, and military effectiveness. In addition to providing mental health professionals, trauma victims, and military personnel with an unparalleled source of information, the work's exploration of the cultural, social, and political processes affecting recovery from combat stress reaction offers a unique perspective of contemporary Isreali culture.