Quality of coping skills predicts depressive symptom reactivity over repeated stressors.

A substantial body of research has documented that the use of some coping strategies is associated with better psychological adjustment and superior physical health (Taylor & Stanton, 2007). In a recent meta-analysis, Aldao, Nolen-Hoeksema, and Schweizer (2010) reported that, across clinical and nonclinical samples, strategies involving problem solving and cognitive reappraisal were associated with fewer depressive symptoms. While researchers have recently focused on skill development among psychotherapy clients (Strunk, DeRubeis, Chiu, & Alvarez, 2007), relatively little is known about whether (or under what conditions) these skills are normally useful to people (who are not psychotherapy clients) coping with depressive symptoms that arise in response to everyday stressors. In this article, we examined whether variability in coping skills predicts depressive symptom reactivity (i.e., the extent of symptom worsening vs. improvement) in the wake of a series of commonplace stressors, namely, receipt of disappointing exam grades in a college class. We focused on depressive symptom reactivity over several days as we suspect the effects of coping skill use would likely occur over this relatively short interval. We further examined two potentially important contextual factors: depressive symptom severity and the degree to which stressors were associated with an affective reaction. We expected these skills would be more strongly predictive of depressive symptom reactivity among those with greater depressive symptom severity. In addition, as the use of coping skills has been proposed to be most beneficial on occasions when a notable affective shift has occurred (Beck, 1995), we expected coping skills to be more strongly related to depressive symptom reactivity on occasions involving these more marked affective reactions. Finally, we compared the predictive validity of skills assessed in the context of recurrent naturalistic stressors with a more commonly used one-time skill assessment method. Measuring Coping Skills Although various measures of coping skills exist, the Ways of Responding Inventory (WOR; Barber & DeRubeis, 1992) is well-suited to our purpose because it uses an open response format that is easily adapted to assess stressor-specific coping. The WOR presents participants with a series of challenging hypothetical situations (e.g., experiencing the sudden end of a relationship) and asks them to describe how they would cope with each situation. Using a manual, trained coders rate respondents’ descriptions according to the degree to which responses are consistent with adaptive coping strategies (e.g., considering evidence relevant to re-evaluation of an initial thought or generating a specific plan to cope). This rating procedure generates two summary scores: a total score and an overall quality score. The WOR Total score reflects the relative frequency of response segments deemed to be positive or negative (see Appendix for details), whereas the WOR Quality score reflects the overall quality of participants’ responses to each WOR scenario. Unlike the total score, quality scores are not constrained by the length of responses. With quality scores, raters can identify a single very positive response as reflecting more adaptive coping than two slightly positive responses. For this reason, we chose WOR quality scores as our primary coping measure. While the WOR was developed to measure skills taught in cognitive therapy (CT; Beck, Rush, Shaw, & Emery, 1979), there is evidence to suggest that meaningful variability in these skills exists among people who have learned coping skills naturalistically. In a college student sample, Barber and DeRubeis (1992) found a moderate relationship between better coping scores on the WOR and lower depressive symptoms. In a study of smokers, those with a history of depression reported poorer coping skills on the WOR than those without a history of depression (Haaga, Thorndike, Freedman-Wheeler, Pearlman, & Wernicke, 2004). Thus, meaningful variability in coping skills has been evident even among those who have not participated in CT. Although coping skills have been related to changes in depressive symptoms, it is unclear how well the WOR predicts coping with specific everyday stressors. Strunk and colleagues (2007) found that WOR scores were remarkably unrelated to a measure of the extent to which CT clients independently practiced using coping skills outside of therapy sessions. This finding has led us to wonder how well the WOR predicts respondents’ responses to real stressors. Compared with the WOR’s reliance on hypothetical situations, we suspected the assessment of coping following actual life events might provide a more precise estimate of coping skills as they are used. To the extent that the WOR does predict the use of coping skills in response to these stressors, the validity of the WOR would be supported. To the extent that use of coping skills in response to specific stressors is not well captured by the WOR, additional assessment strategies may be needed to capture individual differences in the use of coping skills. Coping Skills in Context: Depressive Symptoms and Affective Reactions Beyond examining whether coping skills are related to depressive symptom reactivity overall, we planned to examine two potentially important contextual factors: depressive symptom severity and the extent of affective reactions associated with a stressor. Aldao and colleagues (2010) found that the relation of coping strategy use and symptoms was stronger in clinical samples as compared with nonclinical samples-a finding that might be attributable to the higher symptom severity of clinical samples. With this in mind, we hypothesized that coping skills would be more consequential among those with greater depressive symptom severity. With regard to the strength of affective reactions as a possible contextual factor, we suspected that the extent to which one uses coping skills on occasions when stressors are accompanied by affective shifts is likely to be particularly important in determining the degree of depressive symptom reactivity on those occasions. Within the CT model, therapists emphasize the use of coping skills shortly after a mood shift occurs (Beck, 1995). As affective shifts are thought to identify periods in which emotionally salient thoughts have occurred, we expect the potential benefits of using coping skills to be of greater consequence on these occasions.