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2 The Stress of Caregiving: Stressful Family Systems and the Differential Development of Coping

2 The Stress of Caregiving: Stressful Family Systems and the Differential Development of Coping

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12.1



Parent–Child Relationships and the Differential …



251



Other Resources and Vulnerabilities



Adaptive



STRESSES

Parent’s

APPRAISAL



Parent’s

COPING



SUPPORTS



Maladaptive



Adaptive



STRESSES



Child’s

COPING

Maladaptive



Child’s

APPRAISAL

SUPPORTS



Other Resources and Vulnerabilities



RECIPROCAL EFFECTS OF CHILDREN’S AND PARENTS’ COPING

Fig. 12.1 Parents’ and children’s coping as parts of a reciprocal interpersonal coping system, in

which parental coping (including coping with the normative demands of parenting) creates both

stressors and supports that shape children’s coping, and in which children’s adaptive and

maladaptive coping, in turn, generates stressors and supports for parent’s subsequent coping. Other

resources and vulnerabilities, as pictured in the boxes above and below parent–child coping,

enable and constrain the functioning of this interpersonal system



their impacts can be exerted indirectly and globally, through their effects on parents

and others available to children as social partners, including siblings, extended

family members, teachers, peers, neighbors, and so on. The most proximal of these

social contexts, for both caregivers and offspring, is the family system. And, of

most concern to the early development and continuity of maladaptive coping in

children and adolescents, are family contexts that are high in stress and low in

support. From this perspective, the systems conceptualization of child and adolescent coping (as depicted in Fig. 12.2) requires one more additional level, namely,

the societal level, including the demands that specific niches within society allow to

impinge on children and adolescents as they develop, and the supports that are

available to them, as well as the societal stressors and resources that influence their

social partners and contexts, such as neighborhoods, homes, and schools.

It is important to note that the connection between family stress and children’s

coping is a reciprocal one—in that family stress can be created by maladaptive coping

on the child’s part (e.g., oppositional reactions to parent demands, helplessness in the

face of difficult schoolwork, or ruminations about peer problems; Morris et al. 2007;

Taylor and Stanton 2007). Moreover, based on their biopsychosocial characteristics,

children seem to be differentially susceptible to the effects of their environments—



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Parenting, Family Stress, Developmental Cascades …



CAREGIVER

SCAFFOLD

5. Societal

Societal, Social & Personal Stressors and Resources



Adaptive



DEMANDS



CAREGIVER

COPING



Caregiver

APPRAISAL

SUPPORTS



Maladaptive



4. Inter-Personal



Adaptive

Adaptive

Adaptive

Adaptive



3. Action



COPING



DEMANDS



CHILD

APPRAISAL



Action

Action

Tendencies Regulation



SUPPORTS

Maladaptive

Maladaptive

Maladaptiv

MetaMal



Other Stressors and Resources



Attention

Emotion

2. Psychological

Motivation



1. Neurophysiological



SAM

PNS

HPA



Cognition



Cognition

Volition

PFC

Behavior

ACC

Amygdala



Temperament



CHILD COPING



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Parent–Child Relationships and the Differential …



253



b Fig. 12.2 Integrative multi-level conceptualization of coping as bio-psycho-social process that



operates at five levels: (1) the neurophysiological level, including psychobiological subsystems

used to detect and react to stress and to regulate stress reactivity, most centrally, the sympathetic–

adrenal–medullary (SAM) axis, the parasympathetic nervous system (PNS); the hypothalamic–

pituitary axis (HPA), the amygdala, and the prefrontal cortex (PFC), especially the anterior

cingulate cortex (ACC); (2) the psychological level, including the attentional, emotional, and

motivational subsystems involved in stress reactivity and regulation; (3) the level of action,

including the behavioral, cognitive, and meta-cognitive subsystems that jointly generate action

tendencies and that integrate and regulate them; (4) the interpersonal level, including participation

in coping by social partners as well as interpersonal relationships (such as with caregivers,

extended family, friends, peers, and teachers) that create the interpersonal matrix within which the

structure and functioning of coping’s many subsystems develop; and (5) the societal level,

including the demands that specific niches within society allow to impinge on children and

adolescents as they develop and the supports that are available to them, as well as the societal

stressors and resources that influence their social partners and contexts, such as neighborhoods,

homes, and schools



including both negative (risk-promoting) and positive (development-enhancing)

family conditions. For example, as Ellis et al. (2011) posit in their evolutionary–

neurodevelopmental theory of biological susceptibility, “[v]ariation in neurobiological susceptibility to the environment … constitutes a central mechanism in the

regulation of alternative patterns of human development, specifically, differential

susceptibility moderates the effects of environmental exposures on developmental

and life outcomes. Ultimately, this means that the development of some individuals,

more than others, will be influenced by their experiences and environments (even if

these were exactly the same)” (p. 8). In this section, we focus on the feed forward

effects of family stress on children’s coping, while keeping in mind the feedback

effects of children on their families (Crouter and Booth 2003), and the differential

effects of family stress on children with different neurophysiological, temperamental,

and psychological characteristics (Eisenberg and Valiente 2004).



12.2.1 Stressful Family Systems

Because the family is a primary source of comfort and support for all members, it

should serve as a basis for protection during times of stress. Thus, it is not surprising that stressful events occurring within the family, especially those which

threaten its connectedness, can have detrimental effects on the health of all members

and add vulnerabilities at all levels of the family system (Cicchetti 2016; Lynch and

Cicchetti 1998; Repetti et al. 2002). A wide range of such “developmentally

challenging circumstances” (Bradley 2007) have been studied, including marital

conflict or violence, divorce, family turmoil, death of a parent or sibling, parental

problems (substance abuse, physical or mental illness, incarceration), high rates of

mobility, crowding and noise, and generally living in conditions of poverty and

oppression, in dangerous neighborhoods, or in communities exposed to



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Parenting, Family Stress, Developmental Cascades …



environmental pollution, war, or natural disasters. All of these toxic events can be

considered developmentally challenging stressors because they “pose direct harm,

have the potential to seriously undermine emotional security, dislodge productive

coping strategies, and impede the use of existing assets or the formation of new

ones” (Bradley 2007, p. 102).

Stressors stemming from family life can be doubly dangerous to children,

because they stress children directly (creating neurophysiological, psychological,

and social problems) at the same time that they stress parents. In fact, such family

stressors may also be doubly stressful for parents. Toxic family events place heavy

demands on parents. They have to deal not only with the events themselves and

their own distress, but also with (all their) children’s emotional and behavioral

reactions to the events. As a result, just when children require more from their

parents to offset the potential harm posed by these circumstances, the family system

is disrupted, leaving parents with fewer resources to provide an adequate level of

support for their offspring (Sandler et al. 2000).

Cumulative risk. Researchers also point out that these stressful events and

developmentally challenging circumstances are not randomly distributed throughout the population (Luther 2006). Instead, particular niches within society may have

profiles of cumulative risk (Sameroff 2010). These can be linked with poverty,

discrimination, and oppression, which disproportionately contain environmental

risk and dangers, and lack supportive resources (Evans 2004; Evans and Kim

2012). Researchers use terms such as “cumulative risk” and “high allostatic load” to

describe the conditions created by these societal niches. As described previously,

these concepts refer to one’s aggregate stress exposure, and can be extended to

apply to the total levels of stress to which a dyad or family unit is exposed

(Shonkoff et al. 2009). Researchers have identified many such high stress niches for

families and have documented the high levels of suffering, distress, and dysfunction

found at these social addresses. In general, such niches include individuals who are

forced to parent in demanding conditions (e.g., parents who have multiple young

children with high needs), at the same time that they are experiencing many

additional stressors (e.g., suffering from mental health problems, an abusive history,

or violent partner), with limited caregiving resources (e.g., neglectful extended

family, dangerous neighborhood), and few other sources of support (e.g., low

income with few employment options, limited social services, few high quality

childcare facilities). Such research draws attention to the larger context of stressors

and supports within which children and their families function, and helps to explain

the vulnerabilities in family systems created by living in niches characterized by a

high allostatic load (Blair and Raver 2012; Seeman et al. 2010).

Notions of parent coping can meet up with research on the antecedents of

parenting (Bornstein 2012, vols. 2 and 4) to suggest a set of mechanisms through

which systemic stress can exert downward pressures on the family, parenting, and

the development of children’s coping, mechanisms such as: by blocking parents’

efforts to prevent overwhelming stressors from reaching children and adolescents;

by interfering with parents’ detection of the problems and difficulties facing their

children; by distorting appraisals so that parents view the demands of their children



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Parent–Child Relationships and the Differential …



255



as threatening or bothersome; by triggering impulsive and destructive parental

action tendencies, such as aggression or flight, in response to children’s problems or

their need for support; by undermining parents’ healthy regulation of emotion and

action tendencies; by creating contexts in which parents and siblings do not respond

positively to adaptive coping strategies (e.g., problem-solving, negotiation,

comfort-seeking) leading children to conclude that they do not work; and by

diverting parental resources that could otherwise be directed to offspring. Perhaps

most important, these stressful contexts contribute to the kinds of maladaptive

parent–child coping episodes that, over time, reduce both personal and social

regulatory resources, result in the development of self-system processes that consolidate negative views of each other, and prevent both parties from learning how to

deal constructively and cooperatively with stress. In that sense, family stress can

cumulatively contribute to the development of maladaptive coping in both children

and their parents.



12.3



Cascades in the Differential Development of Coping



All of the factors discussed in this section can be considered parts of “developmental cascades” (Masten and Cicchetti 2010; Wadsworth 2015). Cascades occur

when early conditions (neurophysiological, psychological, behavioral, or social) set

up initial difficulties that over time contribute to larger and larger problems. These

early signs of trouble, which may initially represent relatively minor deviations

from normative patterns, provide the ice crystals around which larger and larger

snowballs are built as time goes by, through the accumulation of risk factors, to

eventually potentiate behavioral problems and psychological disorders.

In larger discussions of risk and resilience, researchers consistently argue that the

long-term effects of any given risk factor depends on the other risk and protective

factors present in the lives of children and adolescents. In fact, it is the links and

interactions among a sequence of risk factors that create a developmental cascade.

The factors discussed in Part IV, namely, early chronic adversity, temperament,

attachment, parenting, and family stress, are the usual suspects implicated in creating developmental cascades that lead to almost any kind of problem behavior or

form of psychopathology (e.g., Dodge et al. 2008). According to this way of

thinking, each of these factors can be seen as comprising a series of steps along

pathways that become more difficult to reverse the longer they are followed.

The developmental cascades that involve coping are depicted in more detail in

Fig. 12.3. In the left portion of the figure is a broad arrow, within which are

depicted the kinds of factors that contribute to cascades leading toward the development of externalizing problems and disorders. These include high family stress

and early adversity; the temperamental characteristics of high approach, low inhibition, and low effortful control; insecure avoidant or disorganized attachment

relationships; and parenting typified by rejection, chaos, or coercion. These processes eventuate in maladaptive coping dominated by oppositional reactions to



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Parenting, Family Stress, Developmental Cascades …



12



FAMILY STRESS

TEMPERAMENT



FAMILY STRESS



Moderate APPROACH

Moderate INHIBITORY

HIGH EFFORTFUL CONTROL



HIGH APPROACH

Low Inhibitory

Low Effortful Control



HIGH INHIBITORY

Low Approach

Low Effortful Control



ATTACHMENT

Insecure

DISORGANIZED



PARENTING



SECURE



Insecure

AVOIDANT



Insecure

RESISTANT



Involvement

Structure

Autonomy Support



Rejection

Chaos

Coercion



Insecure

DISORGANIZED



Rejection

Chaos

Coercion



ADAPTIVE



COPING



Problem

Solve



MALADAPTIVE



COPING

Escape



Seek

Info



COPING

Seek

Support



Regulate

Distress



Isolate



Negotiate

Accommodate



MALADAPTIVE



COPING



Helpless



OPPOSE



Delegate



SUBMIT



RESILIENCE

EXTERNALIZING



INTERNALIZING



Fig. 12.3 Underlying neurophysiological factors and overarching socialization factors that

contribute to the differential development of maladaptive coping and increase the risk of behavior

problems and psychopathology. The broad arrow on the left depicts the kinds of factors that

contribute to cascades toward the development of externalizing problems and disorders. The broad

arrow on the right depicts the kinds of factors that contribute to cascades toward the development

of internalizing problems and disorders. The broad arrow in the middle depicts the accumulation of

factors that predispose the development of healthy coping and resilience. Dotted lines that start

from constructs in the cascades toward psychopathology and lead back toward the middle

resilience arrow indicate that individuals on risky pathways can always be redirected back toward

healthier development



stress, but also include tendencies toward escape and social isolation. In contrast,

the broad arrow in the right portion of the figure contains the kinds of factors that

contribute to cascades leading toward the development of internalizing problems

and disorders. These include high family stress and early adversity; the temperamental characteristics of high inhibition, low approach, and low effortful control;

insecure resistant or disorganized attachment relationships; and parenting typified

by rejection, chaos, or coercion. These processes eventuate in maladaptive coping

dominated by submission reactions to stress, but also include tendencies toward

delegation and helplessness.

Finally, in the middle of the figure is a broad arrow depicting the accumulation

of factors that predispose the development of healthy coping and resilience. As

described in previous sections, these include low levels of early adversity and

family stress, temperaments that entail moderate approach and inhibition or balance

out high levels with commensurate levels of effortful control, secure attachment

relationships with caregivers, and parenting that involves high levels of warmth and



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Parent–Child Relationships and the Differential …



257



involvement, appropriate structure, and autonomy support. These conditions promote the development of coping that relies on a repertoire of adaptive strategies for

relieving distress and resolving problems. Especially important in this figure are the

dotted lines that start from constructs in the cascades toward psychopathology and

lead back toward the middle pathway eventuating in resilience. These are meant to

indicate that individuals on risky pathways (due, for example, to early stress

exposure or difficult temperaments) can always be redirected back toward healthier

development by, for example, participating in secure attachment relationships or

high quality parenting.

In this section, we attempt to add to theories and evidence in this area, by

proposing the notion that infant, toddler, child, and adolescent patterns of maladaptive stress reactivity and coping are integral parts of all of these cascades,

participating in important developmental processes as individuals are drawn away

from normative trajectories and impelled toward differential pathways that eventuate in the emergence of problems and psychopathology (for more detailed discussion, see Zimmer-Gembeck and Skinner 2016). We highlight three ways in

which maladaptive stress reactivity and coping are involved in these developmental

cascades. First, they can be considered important markers that comprise early

warning signs of emerging vulnerabilities and the potential for adjustment problems

and disorder. Second, processes of maladaptive appraisals, stress reactivity, and

coping are likely to show their own recursive internal dynamics that sustain or

exacerbate risk. Third, poor coping is also likely to represent a significant player, or

“active ingredient” in propelling downward movement, by directly influencing

subsequent next steps in developmental cascades. In this sense, it may be an

important mediator of the effects of the “usual suspects” on differential development as well as an influential factor in its own right.



12.3.1 Maladaptive Coping as a Marker of Developmental

Difficulties

The notion that poor coping can be considered as a symptom or early warning sign

of developmental problems is consistent with research on the effects of chronic

adversity, temperament, attachment, parenting, and family stress. Although not

always called out explicitly under the rubric of “coping,” theories and studies in all

these areas devote considerable attention to characterizing connections between

their target phenomena and the ways that infants, children, and adolescents detect,

appraise, and deal with threats and challenges.

Early adversity and family stress. Such connections are highlighted most

clearly in research on the long-term effects of early life adversity, where researchers

frequently point out the significant problems that enduring modifications to stress

reactivity systems can create for developing coping systems, and the likelihood that



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maladaptive stress reactions and poor coping will result (e.g., Doom and Gunnar

2013; Lupien et al. 2009; McEwen 2012). In the same vein, research on some

classes of family stressors (such as divorce, parental bereavement, parental cancer,

or poverty) often singles out the effect of these stressors on children’s coping, both

as symptoms of the stressfulness of these events and as possible entry points for

intervention (Compas et al. 1996; Tolan and Grant 2009; Wolchik and Sandler

1997). Thus, poor coping is more likely to typify children and adolescents living in

family systems dealing with these kinds of stressful life events. It would not be

surprising if most family systems characterized generally as “stressed out” were

also found to contain adult and child members who rely on multiple kinds of

maladaptive coping.

Temperament and attachment. Although not typically identified explicitly as

“coping,” research on temperament and attachment also make reference to

coping-esque processes in discussions of their constituents or immediate effects. In

work on temperament, certain styles are considered to create vulnerabilities precisely

because they trigger maladaptive reactions to external “stressors,” such as novelty,

changes, or other demands. Children with “difficult” temperaments are so difficult

partly because of their overreactions to stimulation as well as their inability to

flexibly accommodate to demands and recover from stress. However they are

labeled, these difficulties depict maladaptive coping. By the same token, constructs

of coping are also visible in descriptions of children’s behavior in attachment

relationships. It could even be argued that maladaptive stress reactivity and coping

are defining features of insecure caregiver–child attachments. Heightened reactivity

and poor coping behaviors are most clearly on display as infants and young children

try to deal with the stress of separation, and again when they attempt (or fail) to take

advantage of the caregiver in order to recover from the distress triggered by separation. In fact, reactivity and coping are some of the very behaviors used to distinguish insecure from secure attachments: High distress reactivity and poor

interpersonal coping and emotion regulation distinguish insecure-resistant from

secure attachments, and low distress reactivity and avoidant interpersonal coping

distinguish insecure-avoidant from secure attachments. In short, coping is directly

relevant to understanding developmental cascades toward psychopathology because

many of the risk factors for these cascades, including early adversity, family stress,

difficult temperaments, and insecure attachments, explicitly or implicitly incorporate

stress reactivity and coping as early markers that signal the advent of potential

problems.



12.3.2 Internal Dynamics Can Amplify Maladaptive

Patterns of Coping

A second reason why maladaptive coping is so closely intertwined with developmental cascades towards long-term problems is that processes all along the arc of



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coping can contribute to “vicious circles” that magnify their negative effects over

time. As discussed in many previous chapters, recursive components of maladaptive coping systems include high stress reactivity, threat appraisals colored by fear,

anger, excessive worry or resentment, experiences of ineffectiveness in dealing with

problems, shame and other difficult emotions, impulsive behaviors, and the harsh

social reactions they elicit. Together this coping system creates an integrated

biopsychosocial experience that will tend to intensify actual and subjective stress.

This kind of coping system will also serve to heighten reactivity and regulatory

vulnerabilities—channeling development toward maladaptation.

Undermining adaptive stress appraisals, regulation, and coping. Coping

systems characterized by such maladaptive patterns not only amplify poor coping

over time, they can also actively undermine the development of more adaptive

coping and regulatory capacities. Maladaptive coping systems manifest these

destructive internal dynamics in several ways. High and persistent stress reactivity,

by preoccupying attention and siphoning off energetic reserves, hinders children’s

access to their own more adaptive competencies, such as their emerging executive

functions or regulatory resources. This drain on resources can prevent children and

adolescents from utilizing the most adaptive strategies of which they are capable,

and, over time, such lack of exercise weakens existing regulatory and coping

“muscles” and undercuts the development of new capabilities. As explicit appraisal

systems emerge, children may feel more and more powerless in the face of their

own reactions and urges, and these discouraging appraisals further destabilize

problem- and emotion-focused coping efforts. Moreover, the emotional and action

impulses characteristic of maladaptive coping systems can become so overwhelming and so habitual that they make children and adolescents feel that such

negative behaviors are fully justified to defend against imminent threat (Lansford,

Malone, Dodge, Pettit, and Bates, 2010).

Stress generation. An important mechanism through which maladaptive coping

can help create vicious cycles, as mentioned in previous chapters, is by generating

more stress (Liu 2015), especially by provoking negative reactions from other

people. Maladaptive ways of coping (such as helplessness, opposition, submission,

or delegation) are characterized by emotional reactions (e.g., anger, frustration, fear)

and action tendencies (e.g., passivity, blaming others, resistance) that are likely to

get children and adolescents in trouble—at home, in the classroom, on sports teams,

when in play with peers, and in many other circumstances where more adaptive

coping responses are expected. In these ways, maladaptive coping can have direct

effects on repelling positive supports that might otherwise have been offered.

Moreover, it may even incite reactions from others that are intrusive, retaliatory, or

rejecting (Skinner et al. 2013). Poor coping responses can directly elicit negative

reactions from adults and peer interaction partners, and these harsh reactions

combined with the absence of important positive socializing experience can contribute to long-term negative effects on children’s emotional, social, cognitive, and

behavioral development, including persistence in maladaptive patterns of stress

reactivity and coping.



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12.3.3 Maladaptive Coping as an Active “Trouble Maker”

in Developmental Cascades

A third way in which maladaptive coping participates in the creation and perpetuation of developmental cascades is by directly eliciting harmful next steps.

Maladaptive coping plays this unhappy role in multiple ways. For example, when

infants have temperaments that lead to patterns of poor coping, including high

stress reactivity, difficulty adjusting to novelty or changes and accommodating to

parental demands, and slow recovery from distress or frustration, these responses

make it much more difficult for caregivers to be sensitive and responsive to them.

As a result, parents and children are more likely to form insecure or disorganized

attachments. The parent–infant interactions characteristic of these kinds of attachments circle back over time to shape the neurophysiological processes underlying

reactivity, sensitizing infants and young children to the effects of stress, perhaps

even at the epigenetic level (Blair and Raver 2012). Moreover, these kinds of

attachments, characterized by stress reactivity and poor coping, also make it more

difficult for parents to remain warm, involved, structured, and autonomy supportive,

and so contribute to (or are the beginnings of) more general styles of problematic

parenting. The discordant parent–child interactions characteristic of these styles of

parenting contribute to an atmosphere of tension and turmoil in the larger family

system. This higher-order family stress permeates caregiving and may exert its

biggest effects on children who are biologically more susceptible to environmental

effects (Ellis et al. 2011).

The effects of maladaptive coping continue to be felt with the new social partners

in the successive contexts through which these developmental cascades will travel

as children get older. All developmental cascades depicted thus far in the literature

take children and adolescents into the worlds of school and peers, where their

maladaptive coping can create problems for them in forming supportive relationships with other adults (e.g., teachers) and peers, and could also put them at risk for

academic disaffection and underperformance, peer rejection and membership in

deviant peer groups, evasion of supervision by competent adults, and eventual

participation in a host of risky activities during adolescence, such as truancy,

delinquency, substance abuse, and unprotected sexual activity—activities that

themselves generate more stress (Liu 2013) and further constrict life paths during

emerging adulthood.



12.3.4 Self-righting Tendencies in Developmental Cascades

In this section, we have emphasized the amplifying dynamics that often characterize

developmental cascades, in which the same kinds of overwhelming stressors that

trigger intense reactions and poor coping are also likely to wreak havoc on many

other parts of the larger system needed to support the development of adaptive



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Parent–Child Relationships and the Differential …



261



coping, and in which risk factors exacerbate and potentiate each other over successive developmental periods. Nevertheless, it seems likely that the trajectories of

most children, even if they are sometimes bumpy or fall off the normative track at

various points, generally find their way back to adaptive and resilient functioning.

Although the most important factors that support children’s resilience are likely to

be social, contextual, and societal, it is clear that interpersonal and individual

coping will play a role as well. As mentioned previously, maladaptive coping can

signal problems—thus it can serve an important early warning function, by notifying concerned adults and peers that something is wrong. If, instead of reacting

negatively, social partners respond with warmth and greater support, these episodes

of poor coping can initiate compensatory processes that reinstate positive coping

and replenish social resources.

Adaptive coping, when supported across many contexts, can help children

temporarily withstand toxic situations, and can hand them successively more

powerful tools for understanding the causes and cures of distressing experiences,

allowing them to contribute more actively and intentionally to their own

“self-righting tendencies.” In fact, a repertoire of constructive coping strategies,

through all the mechanisms just described for maladaptive coping, may initiate and

sustain amplifying dynamics of its own, but in this case, these cascades should lead

toward healthy development, well-being, and resilience. Adaptive coping can move

children towards more successful school performance, positive friendships, mentoring from adults, less risky (and more typical) adolescent behaviors, and the

capacity to be autonomous and proactive builders of their own experiences. And, if

they accumulate over time, constructive coping episodes, as mentioned previously,

may even eventually contribute to improved stress resistance and resilience, culminating with the re-establishment of sound neurobiological systems for reacting to

and dealing with stress.

When researchers study temperament, attachment, academic progress, peer

relationships, teaching, and parenting under stress, they rarely assign a prominent

role to coping (either adaptive or maladaptive), or consider the problems they depict

as partly the result of poor coping (c.f., Spencer 2006). Nevertheless, work on these

topics can all contribute to research on coping. We would also argue that a focus on

coping and regulation under stress can provide a common ground where researchers

from these areas can come together to consider and build new conceptualizations

about how all these components work together, for children living in risky and in

privileged niches, to shape their short-term coping and their long-term development

for better or for worse.



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