Problem-Focused and Emotion Focused Coping

Three methods of coping include problem-focused, emotion-focused, and biology-focused coping, and each is effective in specific circumstances (Laureate Education, Inc., 2012). When choosing an effective coping strategy, one must take into account the changeability of the stressor and the individual's reaction to the stressor, and the adaptability of the human body through changeable physiological responses (Laureate Education, Inc., 2012). The purpose of this paper is to describe and provide examples for effective and ineffective problem-focused, emotion-focused, and biology-focused coping mechanisms and explain why each is effective or ineffective. In addition, its goal is to explain two approaches appropriate to address common ineffective coping mechanisms for parents of developmentally disabled children.

                                                 Examples of Coping Mechanisms

Problem-Focused Coping

Problem-focused coping focuses on the changing or modifying the fundamental cause of the stress. This can be an effective method of coping when it is practical, and the stressor is changeable or modifiable. The overarching goal for this type of coping is to reduce or remove the cause of the stressor. This type of coping focuses on individuals' taking control of the relationship between them and the stressor (Lazarus, 1991). In addition, problem-focused coping may include employing information seeking, or developing strategies to avoid the source of the stress.

Effective Problem-Focused Coping

For example, an individual plans to host Thanksgiving dinner for 27 people, but finds the thought of preparing such a feast extraordinarily stressful. Problem-focused coping has the potential to resolve her stress. By evaluating options, seeking information, and taking control of the situation, all of which are problem-focused methods of coping, the individual decided to have the event catered. The effectiveness of problem-focused coping depends on whether the stressor can be managed by changing it (Laureate Education, Inc., 2012). Carver (2011) found problem-focused coping had a biological effect on stress, lowering the cortisol levels and promoting recovery from the stress.

Ineffective Problem-Focused Coping

Problem-focused coping is ineffective when an individual cannot exert control over a circumstance or stressor, or cannot make an adjustment to the stressor (Carver, 2011). An example of ineffective problem-focused coping is utilizing problem-solving to manage the stress of the death of a family member. Although problem-solving may assist the individual in finding an effective coping strategy, problem solving is not the most effective coping strategy since the stressor (the death of a loved one) cannot be adjusted or modified.

                                           Emotion-Focused Coping Strategies

Emotion-focused coping strategies are effective in the management of unchangeable stressors (Baldacchino & Draper, 2001; DeGraff & Schaffer, 2008). These coping mechanisms involve a cognitive reappraisal process that includes self-reflection and taking control over one's emotions (Carver, 2011). Rather than changing the problem, as in problem-focused coping, emotion-focused coping examines the emotional response to the stressor. Folkman and Moskowitz (2004) found it relieved depression and anger in some circumstances. In addition, emotion-focused coping can facilitate expressing and processing emotions as a prelude to reappraising unchangeable stressors (Stanton, Kirk, Cameron, & Danoff-Burg, 2000).

Effective Emotion-Focused Coping Strategy

For example, when an individual's spouse is diagnosed with a terminal illness, the healthy partner cannot change the diagnosis. In this case, the most effective way to manage the stress is for the healthy partner to change his or her perspective or appraisal of the stressor (Laureate Education, Inc., 2012). It is more effective to effect change in the partner's emotional reaction to the diagnosis than it is to focus on changing or denying the diagnosis, although denial, too, is an emotion-focused means of coping (Laureate Education, Inc., 2012).

Ineffective Emotion-Focused Coping

Emotion-focused coping would not be effective when an individual is chronically late making their mortgage payment, although they have enough money to make the payment. In this case, changing one's emotional response to needing to make a payment in a timely manner will not help change the problem. Problem solving may be more appropriate since the stressor, (making late payments) is changeable.

                                         Biology-Focused Coping Strategies

Biology-focused coping involves utilizing techniques that modify behavior and affect the physiological stress response (Laureate Education, Inc., 2012). It is a coping strategy that focuses on the relationship between the mind and body and works toward affecting this relationship with relaxation techniques such as mindfulness, meditation, and deep breathing to effect physiological responses (Dusek et al., 2008). The psychophysiological change that takes place is the result of a relaxation response in the mind that results in a decrease of the body's stress response (Dusek et al., 2008). Physiological changes include lowered blood pressure and respiration rates as well as beneficial changes in the brain (Dusek et al., 2008; Lazar et al., 2000).

Effective Biology-Focused Coping

If an individual is suffering from stress because he is worried about his blood pressure and his inability to relax, biology-focused coping that utilizes meditation and guided imagery to reduce stress will be beneficial psychologically and has the potential to lower his blood pressure. Biology-focused coping provokes a relaxation response, which lowers stress, and causes chemical changes in the body (Laureate Education, Inc., 2012; Dusek et al., 2008).

Ineffective Biology-Focused Coping

An example of ineffective biology-focused coping is when an individual decided to utilize meditation to cope with the fact that she must move out of her home in two weeks. This coping strategy will likely be unsuccessful for her and will not help her cope with the stressor of having to pack and move her belongings within two weeks. Problem-focused coping could help her weigh her options and plan how she is going to accomplish the move. Emotion-focused coping could help her accept that she must move and it has the potential to help her find at least one benefit in moving. A biology-focused approach will not be effective in this example because she has a changeable problem that is best mitigated by problem solving or problem-focused coping strategies that will help her take action to remove the stressor (Carver, 2011).

                    Effective Coping for Parents of Developmentally Disabled Children

Emotion-Focused Coping Mechanisms

One appropriate means of addressing ineffective coping in parents of developmentally disabled children is emotion-focused coping because of the negative and isolating thoughts associated with parenting these children. It is beneficial for this population to see the value in having a child with developmental disabilities. Emotion-focused coping strategies are appropriate because they have the potential to change the thoughts connected with the stressor, even though it is not possible to eliminate the stressor (which is the developmentally disabled child). Folkman and Moskowitz (2004) found emotional-focused coping was beneficial for relieving depression and anger, which is salient for his population because many of these parents become depressed and angry regarding their circumstances. In addition, emotion-focused coping has been found to be instrumental in the reappraisal process of unchangeable stressors (Stanton, Kirk, Cameron, & Danoff-Burg, 2000).

Biology-Focused Coping Mechanisms
Biology-focused coping mechanisms have the potential to provoke a relaxation response (Laureate Education, Inc., 2012; Lazar et al., 2000) that may provide psychological respite from the demands of parenting developmentally disabled children. Parenting these children has the potential to provoke unusual and chronic stress that can lead to a variety of psychological and physical health problems (Singer, Ethridge, & Aldana, 2007). Adopting behavioral changes that reduce the body's stress response has a variety of benefits (Laureate Education, Inc., 2012; Dusek et al., 2008). For this population, changes in behavior, such as focusing on a healthy diet and getting exercise and enough sleep may provide the needed respite from daily stress.

                                                                  Conclusion

The focus of coping must consider the changeability of the stressor, the perception or emotional reaction to the stressor, and the capacity of the human body to mitigate stress through behaviors that can induce psychophysiological changes. The focus of coping must consider the unique circumstances of the individuals, such as the unusual stress of parents raising children with developmental disabilities. Providing individuals with appropriate adaptive coping skills can reduce negative health outcomes and increase the ability to manage ongoing stress.

                                                                   References

Baldacchino, D., & Draper, P. (2001). Spiritual coping strategies: A review of the nursing research literature. Journal of Advanced Nursing, 34, 833-841.

Carver, C. S. (2011). Coping. In R. J. Contrada & A. Baum (Eds.), The handbook of stress science: Biology, psychology, and health (pp. 221–229). New York, NY: Springer Publishing Company.

DeGraff, A., & Schaffer, J. (2008). Emotion-focused coping: a primary defense against stress for people living with spinal cord injury. Journal Of Rehabilitation, 74(1), 19-24.

Dusek, J. A., Otu, H. H., Wohlhueter, A. L., Bhasin, M., Zerbini, L. F., Joseph, M. G., & ... Libermann, T. A. (2008). Genomic Counter-Stress Changes Induced by the Relaxation Response. Plos ONE, 3(7), 1-8. doi:10.1371/journal.pone.0002576

Folkman, S., & Moskowitz, J. T. (2004). Coping: Pitfalls and Promise. Annual Review of Psychology, 55(1), 745-774. doi: 10.1146/annurev.psych.55.090902.141456

Laureate Education, Inc. (2012). The Focus of Coping. [Handout]. Baltimore: Author.

Lazar, S. W., Bush, G., Gollub, R. L., Fricchione, G. L., Khalsa, G., & Benson, H. (2000). Functional brain mapping of the relaxation response and meditation. NeuroReport, 11(7), 1581???1585. doi: 10.1097/00001756-200005150-00041

Lazarus, R. S. (1991). Progress on a cognitive-motivational-relational theory of emotion. American Psychologist, 46(8), 819.

Singer, G. H., Ethridge, B. L., & Aldana, S. I. (2007). Primary and secondary effects of parenting and stress management interventions for parents of children with developmental disabilities: A meta-analysis. Mental Retardation and Developmental Disabilities Research Reviews, 13(4), 357-369. doi: 10.1002/mrdd.20175

Stanton, A. L., Kirk, S. B., Cameron, C. L., & Danoff-Burg, S. (2000). Coping through emotional approach: Scale construction and validation. Journal of Personality and Social Psychology, 78(6), 1150-1169. doi: 10.1037//0022-3514.78.6.1150

Influences of Social Context on Coping Mechanism

Cultures influence an individual's coping style (Laureate Education, Inc., 2012). For example, when watching the evening news on television during times of social upheaval and civil fighting, it is not unusual to see Middle Eastern women mourning their dead in the streets. It is common for them to wail and scream over their losses in public places. In this country, however, we designate more private places for mourning, such as with family members in the home, or at funeral parlors during the wake and funeral.

Subcultures, such as immediate families, have a profound influence on coping as well (Laureate Education, Inc., 2012). Family relationships have been implicated in depressed mood (Gil-Rivas, Greenberger, Chen, Montero, & López-Lena, 2003). For example, parental warmth and acceptance mediate depression in adolescents (Gill-Rivas et al., 2003). From a slightly different perspective, and employing Bandura's theory of social learning, children learn from watching their parents (Laureate Education, Inc., 2012). This may include learning coping skills and the management of emotions. For example, if a parent closes himself off from the rest of the family when coping with stress, children may learn to similarly cope with their own stress, learning that this is the appropriate way to manage stress. In effect, the parent is modeling appropriate stress management behavior for the child. When the parent's coping style is maladaptive, the child will likely not understand the maladaptive nature of the parent's behavior, and will implement similar behaviors as a familiar model of stress management behavior.

Stress-Buffering Model

The Stress-Buffering Model suggests the benefits of social relationships derive from their ability to decrease the deleterious effects of stress on psychological and physical well-being (Ulchino & Birmingham, 2011). This buffering effect takes place early in the stress appraisal process. In effect, social support eases the initial psychological shock during appraisal and buffers the individual from making a harsher and more threatening appraisal of the circumstance (Ulchino & Birmingham, 2011).

I am always interested in evaluating behaviors from an evolutionary perspective. Humans seem to have an evolutionary history of being pack animals, or to have congregated in small family groups for survival. Isolation may be contrary to our innate ability to manage the effects of stress, ergo, isolation may increase the effects of stress. For example, a cave dweller would have found a pack of hungry wolves far more threatening when he was isolated from his clan or family. The same hungry pack would be perceived as far less threatening when in a group of twenty or so.

In addition, expanding on Bandura's (1999) concept of reciprocal determinism that postulates the social environment conditions people's behavior, and vice versa, it may be possible that without a social element with which to interact, isolation may inhibit an individual's ability to successfully adapt in crisis. This may take place as early as in the initial appraisal of the circumstance. For example, Bandura (1999) believed that individuals contribute to their own motivation and their overall development through reciprocity with other people.

The removal of resources, for example, lack of a support group or good friends on which to rely, creates a more challenging environment for coping (Rook, August, & Sorkin, 2011). Hogg, Hohman, and Rivera (2008) posited one of the reasons people are averse to isolation is that they have an inherent need to belong. If this is a basic human need, it may be that coping in isolation would produce less successful outcomes than coping with the resources and support of others.

All of this having been said, the Stress-Buffering Model depends on an individual's ability to respond to social support. This, of course, opens up a number of biological and neurological factors that have the potential to profoundly affect the individual's unique interpersonal and intrapersonal capabilities that will either augment or inhibit their interaction with their social environment.

Social Contexts: Influence on Parents of Developmentally Disabled Children

The population I chose is parents of children with developmental disabilities. This population's role of parenting has the potential to provoke extraordinary stress (Singer, Ethridge, & Aldana, 2007). Typical symptoms of this stress includes ongoing sadness, isolation, and an increased risk of mental illness and a higher rate of divorce (Singer et al., 2007). Approximately 35% of mothers of children with developmental disabilities experience episodes of depression more severe than those experienced by mothers of typically developing children (Singer, 2006). The symptoms most commonly reported are depression (Singer, 2006) and feelings of intense isolation (Gupta, 2007).

Social context definitely has an influence the coping mechanisms of this population. They feel isolated from the majority population because they feel different and separate from others who cannot understand their circumstances (Gupta, 2007). Or they may not have strong support systems in place, and find it difficult to create them while simultaneously caring for their child. Isolation increases the risk for depression and other mental illnesses (Singer et al., 2007). For minority populations, the experience of isolation is more profound since they have a difficult time understanding the resources available to them (Gupta, 2007).

References

Bandura, A. (1999). Social cognitive theory of personality. In L. A. Pervin & O. P. John (Eds.),
Handbook of personality: Theory and research (2nd ed., pp. 154-196). New York: The Guilford Press.

Gil-Rivas, V., Greenberger, E., Chen, C., Montero, M., & López-Lena, M. (2003). Understanding depressed mood in the context of a family-oriented culture. Adolescence, 38(149), 93-109.

Gupta, V. (2007). Comparison of parenting stress in different developmental disabilities. Journal Of Developmental & Physical Disabilities, 19(4), 417-425. doi:10.1007/s10882-007-9060-x

Hogg, M.A., Hohman, Z.P., & Rivera, J.E. (2008). Why do people join groups? Three motivational accounts from social psychology. Social and Personality Psychology Compass, 2, 1269-1280.

Rook, K. S., August, K. J., & Sorkin, D. H. (2011). Social network functions and health. In R. J. Contrada & A. Baum (Eds.), The handbook of stress science: Biology, psychology, and health (pp. 123–136). New York, NY: Springer Publishing Company.

Singer, G. S. (2006). Meta-analysis of comparative studies of depression in mothers of children with and without developmental disabilities. American Journal on Mental Retardation, 111(3), 155. doi: 10.1352/0895-8017(2006)111[155:MOCSOD]2.0.CO;2

Singer, G. H., Ethridge, B. L., & Aldana, S. I. (2007). Primary and secondary effects of parenting and stress management interventions for parents of children with developmental disabilities: A meta-analysis. Mental Retardation and Developmental Disabilities Research Reviews, 13(4), 357-369. doi: 10.1002/mrdd.20175

Laureate Education, Inc. (2012). Coping in a social context. [Handout].

Ulchino, B. N., & Birmingham, W. (2011). Stress and Support Processes. In R. J. Contrada & A. Baum (Eds.), The handbook of stress science: Biology, psychology, and health (pp. 111-121). New York, NY: Springer Publishing Company.

The Post Trauma of Wartime

I have been thinking a lot about the post traumatic effects of wartime. One of the reasons I think it is so difficult to ameliorate this intense and ongoing stress is the inhumanity of the experience. At one time in human history, perhaps physical combat was a necessary evil - one clan or group needed to claim an area for their survival. Now, however, in some ways, we have evolved into complex thinkers with the ability to engage in verbal resolution and higher thought processes.

There seems to be a disparity between the capabilities of the human race and wartime activity. It must be inherently difficult to have the capacity for complex thought but have to take aim (literally) at an enemy. I wonder about the extent to which this conundrum plays a role in brain changes that are a result of experiencing intense stress. For example, the amygdala, which is involved in the memory of emotion, becomes overactive. The hippocampus, which functions as a memory consolidator, goes through an atrophy process that causes it to shrink (Laureate Education, Inc., 2012). Do these changes reflect a self-preserving mechanism within the brain? Or do these intense emotional and traumatic experiences somehow "short-circuit" proper functioning in the brain? The brain changes addressed in Laureate Education, Inc. (2012) cultivate nagging questions for me. For example, does the shrinking of the hippocampus reduce the impact of the emotional experience? I wonder about future research that will discover a way to induce or increase hippocampal growth (stimulate neurons) to restore (after treatment) the damage sustained by the trauma.

Stress, as we have learned, affects the serotonergic system (Dabhar, 2011; Wilson & Warise, 2008). In Parkinson's patients, within whom there is a loss or degeneration of dopaminergic neurons, some research has discovered the possibility of replacing this degeneration with new cells (Arias-Carrion, Freundlieb, Oertel, & Hoglinger, 2007). I look forward to reading about stimulating neurogenesis in PTSD patients to restore the system that manage emotional memories.

After searching for answers to some of my questions, I found DeCarolis & Eisch (2010) who may have asked some of the same questions. They believed a hippocampal-based treatment might be the answer to many mental illnesses such as PTSD. Hippocampal neurogenesis may have the potential to reduce or relieve the stronghold of trauma on this brain part, which may lead to the individual making a full recovery that would include the psychological as well as the biological factors of the effects of post-traumatic stress.

References

Arias-Carrion, O., Freundlieb, N., Oertel, W. H., & Hoglinger, G. U. (2007). Adult Neurogenesis and Parkinson's Disease. CNS & Neurological Disorders - Drug Targets (Formerly Current Drug Targets - CNS & Neurological Disorders), 6(5), 326-335. doi: 10.2174/187152707783220875

Dhabhar, F. S. (2011). Effects of stress on immune function: Implications for immunoprotection and immunopathology. In R. J. Contrada & A. Baum (Eds.), The handbook of stress science: Biology, psychology, and health (pp. 47–63). New York, NY: Springer Publishing Company.

DeCarolis, N. A., & Eisch, A. J. (2010). Hippocampal neurogenesis as a target for the treatment of mental illness: A critical evaluation. Neuropharmacology, 58(6), 884-893. doi: 10.1016/j.neuropharm.2009.12.013

Laureate Education, Inc. (2012). Acute stress disorder and posttraumatic stress disorder. [Handout].

Wilson, D. R., & Warise, L. (2008). Cytokines and their role in depression. Perspectives in Psychiatric Care, 44(4), 285–289.

Stress Management for Parents of Children with Developmental Disabilities

Parenting children with developmental disabilities has the potential to provoke unusual stress management needs (Singer, Ethridge, & Aldana, 2007). For strategies to be effective, they must be based on the specific needs of a population, and must meet the demands consistent and continuous for this parent population (Singer et al., 2007). The goal of this paper is to define and describe the population of parents providing care for their developmentally disabled children and the stressors and health issues common for this population. Further, it will characterize effective stress management strategies as well as explicate why these strategies are effective.

                                                  Common Stressors and Health Issues

There is no paucity of contemporary scholarship on the stress experienced by parents of children with developmental disabilities (Singer et al., 2007). This population has traditionally been thought to experience chronic deleterious effects from the stress of parenting their children. These effects include ongoing sadness, isolation, an increased risk of psychological and physiological illness, and a higher likelihood of divorce (Singer et al., 2007). Further, these parents must contend with psychosocial problems in siblings of the child with developmental disabilities.

The ability of parents to adapt to their child's disability can be identified on a spectrum with some parents experiencing long-term, severe chronic stress to reasonable and normal levels of adaptation and the ability to manage the stress of caring for their child (Singer, et al., 2007). Singer (2006) found up to 70% of parents with children with developmental and intellectual disabilities did not experience an increase in stress compared to parents without developmentally delayed or disabled children. However, approximately 35% of mothers of children with developmental and intellectual disabilities had more episodes of depression and the episodes were more severe than parents of typically developing children (Singer, 2006).

In any event, the potential exists for severe stress specific to the population of parents of children with developmental disabilities. The most commonly reported symptom for this population is depression (Singer, 2006) and feelings of intense isolation (Gupta, 2007). Additionally, it is not unusual for these parents to experience economic strain and emotional and social stressors associated with their child's disability (Woolfson & Grant, 2005). Although this parent population may not experience recognizable levels of stress and depression, they may experience an accumulation of stress because of an unrecognized chronic low level of stress associated with parenting their children (Hastings & Beck, 2004).

Interventions and stress management strategies for this population should take place at the time of initial diagnosis, which is ordinarily perceived as a crisis and an experience that provokes a range of emotional responses (Trute & Hiebert-Murphy, 2002). Some disabilities cause more stress than others, and the disability causing the parental stress should be considered (Gupta, 2007). Interventions and stress management strategies must take into account proficiency in English as well. Further, the educational level of the parents has been proven to be determinants of parental stress and should be considered in the development of stress management strategies (Gupta, 2007). Although several factors must be identified and addressed, parental stress can be mitigated through comprehensive care, even when parents face chronically stressful conditions (Hastings & Beck, 2004).

                                                 Stress Management Strategies

Cognitive Behavioral Strategies and Self-Care
For parents of children with developmental disabilities, the element that determines the overall stress load of the parent is the subjective interpretation of the circumstances (Trute & Hiebert-Murphy, 2002). Whether parents appraise the situation as a threat or crisis will ultimately determine their coping strategies and ability to cope. The cognitive appraisal, according to Lazarus (1991) is the interplay of mediating and moderating variables including personality style and the nature of the situation. Singer et al. (2007) found that the most salient aspect of the families coping with the distress of a developmentally disabled child was their ability to be resilient. However, even parents and families who were characteristically resilient faced unmanageable stress at times. Mothers of developmentally disabled children are especially vulnerable to psychological distress and depression (Singer et al., 2007).

Since cognitive appraisals are pivotal in the ability to manage stress, changing parents' subjective interpretation of their family situation may be effective in the development of adaptive coping strategies (Singer et al., 2007). Cognitive behavioral training (CBT) directly targeted parental stress and provided the parents with tools to effectively manage stress. In addition, self-management skills (self-care), which has shown consistent benefits in this population, should be taught and used proactively to reduce and prevent psychological distress (Nixon & Singer, 1993; Singer et al., 2007). By managing their own well-being and their cognitive appraisals, parents were less threatened by their circumstances, and their stress was reduced (Singer et al., 2007). In effect, the parents were given resources that strengthened their ability to cope, which indirectly caused them to reassess the threat of their environment.

Family Systems Therapy

Because family quality of life is affected by a family member having a developmental disability, families, especially those with additional children must find ways to adapt to the challenge of having a developmentally disabled child or sibling (Singer et al., 2007). Family therapy can help each of the family members adapt in a positive and personalized way to the radical change in their family (Pelchat, Bisson, Ricard, Perreault, & Bouchard, 1999). In addition, family therapy seeks to find the benefit and the positive contribution made by each family member, including the child with developmental disability (Pelchat et al., 1999). Strategies for the effective family management of stress should include changing negative and detrimental perceptions developed from the initial psychological shock of learning they have a family member with a developmental disability (Dukmak & Aburezeq, 2012). This therapy should foster healthy family adaptation and encourage spouses to support each other. In addition, families should be taught and encouraged to acknowledge and respect the contribution of each family member in their joined effort to adapt (Pelchat et al., 1999). Fostering relationships with others can help the family develop and maintain resources to help them cope longitudinally (Pelchat et al., 1999).

                                      Explanation of Efficacy of Chosen Strategies

Psychosocial stress has been explained as an incongruence between an individual's needs and the individual's environment (Storch, Gaab, Küttel, Stüssi, & Fend, 2007). Lazarus (2005) further defined stress as a result of the cognitive appraisal of a situation, what is being threatened by the circumstance, and whether and to what extent the individual believes he or she can affect the situation. Trute and Hiebert-Murphy (2002) found similar results that cognitive appraisal is the pivotal point upon which an individual creates the relationship between the stressor and the ability to adjust. This is true with the parental cognitive appraisal of the impact or threat of a child's developmental disability (Trute & Hiebert-Murphy, 2002). CBT and cognitive stress reappraisal has been shown to have powerful and longitudinal effects on stress (Storch et al., 2007).

Multi-faceted interventions implemented over longer time frames are more effective than single component interventions (Singer et al., 2007). The use of CBT, self-management tools, and family therapy was more effective than the use of either intervention alone. Lazarus (1991) believed stress is a complex interplay of a variety of components that include cognitive appraisal, the perception of available resources, and mediating and moderating variables. Utilizing a more complex combination of stress management strategies may be consistent with Lazarus' findings. The addition of family therapy fosters the growth of the family as an entity, and it places value on the psychological experience of each family member (Pelchat et al., 2012). Families have an increased vulnerability to stress because of their primary stress of raising a child with developmental disabilities. This stress affects each family member and influences how the parents raise their other children (Dukmak & Aburezeq, 2012).

                                                                      Conclusion

Parenting children with developmental disabilities has the potential to cause unusual, extensive, and chronic stress (Wolfson & Grant, 2006). Three effective interventions for the management of stress in this population may include CBT, self-management, and family therapy (Singer et al., 2007). Having a child with developmental disabilities has the potential for long-term stress for parents and the family. Complex stress management strategies should be presented to parents and families over the longest possible amount of time, and strategies should be reviewed as necessary (Pelchat et al., 2012). Strategies for this population should address quality of life for the family of the developmentally disabled child and foster the perception that children with developmental disabilities have a positive contribution to make to their families.

References

Dukmak, S. J., & Aburezeq, I. M. (2012). Family functioning, social opportunities and health as predictors of stress in families of children with developmental disability in the United Arab Emirates. Journal Of International Special Needs Education, 15(2), 120-134.

Gupta, V. (2007). Comparison of parenting stress in different developmental disabilities. Journal Of Developmental & Physical Disabilities, 19(4), 417-425. doi:10.1007/s10882- 007-9060-x

Hastings, R. P., & Beck, A. (2004). Practitioner review: Stress intervention for parents of children with intellectual disabilities. Journal of Child Psychology and Psychiatry, 45(8), 1338-1349. doi: 10.1111/j.1469-7610.2004.00841.x

Lazarus, R. S. (1991). Progress on a cognitive-motivational-relational theory of emotion. American Psychologist, 46(8), 819-834. doi:10.1037/0003-066X.46.8.819

Lazarus, R. S. (2006). Emotions and interpersonal relationships: Toward a person-centered conceptualization of emotions and coping. Journal of Personality, 74(1), 9-46. doi: 10.1111/j.1467-6494.2005.00368.x

Mailick Seltzer, M., Greenberg, J. S., Floyd, F. J., Pettee, Y., & Hong, J. (2001). Life course impacts of parenting a child with a disability. American Journal on Mental Retardation, 106(3), 265. doi: 10.1352/0895-8017(2001)1062.0.CO;2

Nixon C. D., & Singer G. S. (1993). A group cognitive behavioral treatment for excessive parental self-blame and guilt. American Journal of Mental Retardation 97, 665–672.

Pelchat, D., Bisson, J., Ricard, N., Perreault, M., & Bouchard, J. (1999). Longitudinal effects of an early family intervention programme on the adaptation of parents of children with a disability. International Journal Of Nursing Studies, 36(6), 465-477. doi: 10.1016/S0020- 7489(99)00047-4

Singer, G. S. (2006). Meta-analysis of comparative studies of depression in mothers of children with and without developmental disabilities. American Journal on Mental Retardation, 111(3), 155. doi: 10.1352/0895-8017(2006)111[155:MOCSOD]2.0.CO;2

Singer, G. H., Ethridge, B. L., & Aldana, S. I. (2007). Primary and secondary effects of parenting and stress management interventions for parents of children with developmental disabilities: A meta-analysis. Mental Retardation and Developmental Disabilities Research Reviews, 13(4), 357-369. doi: 10.1002/mrdd.20175

Storch, M., Gaab, J., Küttel, Y., Stüssi, A., & Fend, H. (2007). Psychoneuroendocrine effects of resource-activating stress management training. Health Psychology, 26(4), 456-463. doi:10.1037/0278-6133.26.4.456

Trute, B., & Hiebert-Murphy, D. (2002). Family adjustment to childhood developmental disability: A measure of parent appraisal of family impacts. Journal Of Pediatric Psychology, 27(3), 271-280.

Woolfson, L., & Grant, E. (2006). Authoritative parenting and parental stress in parents of pre- school and older children with developmental disabilities. Child: Care, Health & Development, 32(2), 177-184.