Assessment of cognitive coping styles

Clinical Psychology Review, Vol. 21, No. 1, pp. 85–104, 2001 Copyright © 2000 Elsevier Science Ltd. Printed in the USA. All rights reserved 0272-7358/01/$–see front matter

PII S0272-7358(99)00041-0

ASSESSMENT OF COGNITIVE COPING STYLES: A CLOSER LOOK AT SITUATION-RESPONSE INVENTORIES Patricia Bijttebier1, Hans Vertommen, and Gilbert Vander Steene University of Leuven

ABSTRACT. Cognitive coping style approaches establish two concepts central to the understanding of people’s responses to a stressful situation: “attention” and “avoidance”. Theoretical frameworks corresponding to these conceptions are Sensitization-Repression (Byrne, 1961), Monitoring-Blunting (Miller, 1980), and Vigilance-Cognitive Avoidance (Krohne, 1986). Such types of cognitive coping styles are usually measured by means of situation-response inventories. In the present article, we take a closer look at this kind of coping assessment by considering the scenarios, the coping options and response formats, the dimensionality of the constructs, and published data on the reliability and the validity of seven situation-response inventories. Three important points deserve to be highlighted: (a) it probably makes little sense to assess coping style using scenarios that diverge maximally with respect to controllability and predictability since coping is not assumed to show such complete cross-situational stability; (b) similarly named inventories rely on largely different operationalizations and can hardly be considered as measuring similar constructs; and (c) monitoring/vigilance and blunting/avoidance generally emerge as independent constructs, which argues against use of summary scores. © 2000 Elsevier Science Ltd. KEY WORDS. Assessment, Coping style, Situation-response inventory.

COGNITIVE COPING STYLE approaches establish two concepts central to the understanding of people’s responses to a stressful situation: “attention,” which is to be alert for and sensitized by the threat-related aspects of information, versus “avoidance”, which is to cognitively avoid or transform threat-relevant information or to seek distraction

Correspondence should be addressed to Dr. Patricia Bijttebier, Department of Psychology, University of Leuven, Tiensestraat 102, 3000 Leuven, Belgium. E-mail: Patricia.Bijttebier@ psy.kuleuven.ac.be 1Postdoctoral Fellow for the Fund of Scientific Research—Flanders(Belgium)(FWO).

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(Krohne, 1996). Theoretical frameworks corresponding to these conceptions are Sensitization-Repression (Byrne, 1961), Monitoring-Blunting (Miller, 1980), and Vigilance-Cognitive Avoidance (Krohne, 1986). For a long time, the most widely used self-report questionnaire for the assessment of cognitive coping styles has been Byrne’s (1961) Repression-Sensitization Scale. However, this scale has been criticized because of its lack of discriminant validity with respect to measures of trait anxiety (Abbott, 1972; Miller, 1987). Inspired by situationresponse inventories in anxiety research (e.g., Endler, Hunt, & Rosenstein, 1962), several new inventories, corresponding with the theoretical models of Miller and Krohne, have been developed. Using PsychLit, the search and retrieval system of the American Psychological Association, we identified seven inventories: the Mainz Coping Inventory (MCI(-R); Krohne, 1989), the Miller Behavioral Style Scale (MBSS; Miller, 1987), the Threatening Medical Situations Inventory (TMSI; Van Zuuren, 1992) and the Monitoring-Blunting Questionnaire (MBQ; Muris, Van Zuuren, De Jong, De Beurs, & Hanewald, 1994) for adults and the Child Behavioral Style Scale (CBSS; Miller, Roussi, Caputo, & Kruus, 1995), the Monitoring and Blunting Scale for Children (MBSC; Lepore & Kliewer, 1989) and an interview method of Hoffner (1993) for children. Situation-response inventories for assessment of cognitive informational styles tap people’s coping reactions in a number of hypothetical situations (e.g., the Broken Lamp scenario of CBSS: “Imagine that you’re playing in the living room with a friend and you accidentally break a lamp. Your mother will be home soon. What would you do, while you are waiting with your friend for your mother to come home?”) Answers to items of the same type (e.g., items referring to monitoring coping style) are summed up across situations to compute coping style scores. The rationale for this type of inventory is that coping disposition is reflected in the tendency to report the consistent use of a characteristic type of coping across situations. Behavior is aggregated over situations to investigate individual differences in the resulting aggregate units. By removing situational variance, this procedure accentuates stable individual differences at a situationless level (Mischel & Peake, 1983). Some authors argue that progress in coping assessment can only be achieved through enhancing the psychometric quality of coping measures (Endler & Parker, 1994; Parker & Endler, 1992). De Ridder (1997), however, points out that efforts to improve coping assessment should not be limited to psychometrics since many methodological shortcomings reflect more basic conceptual problems. Similarly, Barker, Pistrang, and Elliott (1994) argue that not just reliability and validity considerations need to be taken into account when appraising a measure. They stress the importance of looking closely at the fine detail of how it is put together. In this article, we discuss methodological issues relevant to assessment of cognitive coping styles, bringing in both conceptual aspects and psychometric properties of the measures identified in the PsychLit search. All of these inventories provide descriptions of hypothetical stress-evoking situations, followed by a list of coping options, referring to the two cognitive coping styles under investigation (vigilance and cognitive avoidance in MCI and MCI-R; monitoring and blunting in the other scales). In the first section, we discuss relevant characteristics of hypothetical scenarios. In the second section, coping options are analyzed, whereas in the third section, different methods to use subscale scores for the definition of coping style groups are discussed. In the fourth and final section, reliability and validity data are summarized.

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SCENARIOS According to Krohne and Egloff (in press), scenarios of situation-response inventories for assessment of coping styles have to meet at least three prerequisites. First, they have to be sufficiently imaginable for the respondents. This means that a vast majority of the people should have experienced similar stressors before. Imaginability is directly related to ecological validity. Scenarios that are too far removed from the everyday experience of the respondents do not guarantee valid answers. Second, scenarios have to induce a certain degree of threat in order to require coping efforts. But the experienced threat should not be too severe, in order to allow for variability in coping reactions. Third, scenarios should vary with regard to the configuration of appraised controllability and predictability. Below, we discuss each of these criteria, giving some critical comments and referring to the extent to which they are fulfilled in the inventories under review.

Imaginability Arguments for use of hypothetical situations rather than people’s own real-life experiences center around validity aspects (Van Zuuren, De Groot, Mulder, & Muris, 1996). Asking all respondents to imagine the same fictitious situations has the obvious advantage that they have more or less the same situation in mind while endorsing items. In contrast, people who recall a prior real-life situation experience something that has a unique personal significance for them but maybe not for others, which complicates comparability between situations (Schwarzer & Schwarzer, 1996). However, use of hypothetical situations can also impair the validity of the responses. It is important to choose scenarios people are sufficiently familiar with to ensure that they can imagine themselves being confronted with it (Muris, Van Zuuren, De Jong, et al., 1994) and that they have knowledge of the range of coping options available in it (Hoffner, 1993). The hypothetical scenarios used in the inventories differ with respect to frequency of occurrence in people’s lives. The Hostage situation (MBSS; “being held hostage by a group of armed terrorists”) in particular has been found to be too far removed from the everyday experience of many people (Steptoe, 1989), leading to low imaginability of the scenario (Muris, Van Zuuren, De Jong, et al., 1994). Difficulties have also arisen with the Dubious People scenario (MCI-R, MBQ; “In the late evening, a group of dubious people approaches you from out of a side street”) and, in some samples, with the Airplane scenario (MBSS, MCI-R, MBQ; “turbulent flight”) since many persons have never flown nor have any intention of ever doing so (Steptoe, 1989). These difficulties demonstrate the situational and cultural relativity of the scenarios, which may impair the ecological validity of the responses. To overcome problems of ecological validity three solutions have been put forward: (a) omission of scenarios that are too far removed from everyday experience; (b) addition of specific concern-related scenarios attuned to the sample to be studied; and (c) construction of specific questionnaires pertaining to a more circumscribed domain (e.g., medical threat). (a) To overcome the problem of low imaginability of the MBSS Hostage and Airplane scenarios, Steptoe (1989) has proposed to use an abbreviated MBSS with only the two scenarios that are close enough to everyday experience, namely Dentist (“you have to get some dental work done”) and Dismissal (“you might

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be laid off”). This abbreviated questionnaire was found to provide an adequate estimate of responses to the complete questionnaire. However, the author does not report the internal consistency of the abbreviated subscales. Knowing that homogeneity of the complete MBSS subscales (based on four scenarios) generally falls at the low end of the traditionally acceptable range (see below), the abbreviated subscales stand a chance of failing to meet reliability standards. Insufficient reliability of such a shortened form was reported recently by Van Zuuren, De Jongh, Beekers, and Swinkels (1999), who administered only the Dentist scenario from the MBSS and found the internal consistency of the corresponding subscales to be insufficient. (b) A second solution was suggested by Krohne (1989), who advises researchers to add a specific stress scenario attuned to the sample to be studied. Van Zuuren et al. (1996) investigated usefulness of this situation-specific kind of assessment by extending the TMSI with specific stress scenarios for HIV patients and surgery patients. They found that the mean subscale scores on the sample scenarios lie somewhat higher than these of the more remote, standard scenarios, which suggests that people find coping alternatives pertaining to their actual threatening situation rather easily applicable. Nevertheless, it remains important to emphasize that such scenarios must also be used with care. The factor structure of the ad hoc developed item sets cannot be taken for granted and their internal consistency is usually too low to allow for separate use. (c) The last solution was put forward by Van Zuuren and Hanewald (1993). Since the monitoring-blunting concept is studied most frequently within the domain of threatening medical situations, the samples often consist of medical patients. These people sometimes get irritated over the irrelevant, hypothetical character of some MBSS and MCI scenarios. For this reason, Van Zuuren and Hanewald (1993) have devised the TMSI, focusing specifically on the domain of medical threat. The idea behind the TMSI is that medical situations are less hypothetical in nature for patient samples, which might enhance the validity of those patients’ answers. Moreover, it appears to be much more motivating for people to fill in a questionnaire when the situations described are relevant to the context that they find themselves in (Van Zuuren & Muris, 1993).

Threatfulness Krohne and Egloff (in press) state that the situations used in situation-response inventories for the assessment of cognitive informational styles should, to some extent, be threatening. Not all authors share this conviction. According to Schwarzer and Schwarzer (1996), scenarios should not be restricted to situations that are appraised as threatening; all scenarios that are appraised as stressful tend to elicit coping responses and are thus suitable for use in situation-response inventories to assess coping. Folkman (1984) distinguishes three types of stressful appraisals: harm/loss, threat, and challenge. Harm/loss refers to injury or damage already done, threat to a potential for harm or loss, and challenge to an opportunity for growth, mastery, or gain. In other words, Schwarzer and Schwarzer (1996) recommend the addition of scenarios that lead to a primary appraisal of harm/loss or challenge. McCrae (1984) investigated the influence of threat, loss, and challenge appraisals on the choice of coping mechanisms. He found significant differences in the coping options chosen depending on the type of appraisal. In response to threat, for exam-

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ple, people are more inclined to use avoidant coping mechanisms (such as active forgetting), whereas positive reappraisal is used more often in response to challenge. For scenarios appraised as threatening, threatfulness should not be too high either, in order to allow for coping variability. Krohne and Egloff (in press) hypothesize that highly threatening scenarios will promote monitoring or vigilant responses, since people generally find it difficult or even impossible to distract themselves from very intense threat. The data of Hoffner (1993), however, seem to suggest that this is certainly not always the case. She found reappraisal to become the favored blunting method when the threatfulness of the situation is judged likely to interfere with cognitive distraction. The results of both McCrae (1984) and Hoffner (1993) show that situational appraisals have an impact on coping choices but do not necessarily outreach the impact of dispositional factors. In the studies reported here, they only lead to the choice of another subtype of monitoring or blunting strategies (e.g., blunting by reappraisal instead of by avoidance), not to a switch from monitoring to blunting or vice versa. Muris and De Jong (1993) assessed the perceived threatfulness of hypothetical situations used in MBSS, TMSI, and MCI. They found considerable variation in the degree of perceived threat across situations. Relatively low levels of threatfulness were ascribed to the Dentist scenario (MBSS, MCI) and the Appendicitis scenario (TMSI; “the doctor diagnoses an acute appendicitis and tells you have to be operated as soon as possible”), whereas the Headache scenario (TMSI; “you suffer from headaches and dizziness, the doctor tells you things don’t look too well and refers you for a rather trying medical examination”), the Passenger scenario (MCI; “you are riding in a car as a front-seat passenger next to an obviously inexperienced driver”) and the Hostage scenario (MBSS) were perceived as fairly threatening. With respect to the child inventories, Hoffner (1993) investigated the appraised threatfulness of the four situations used in her method, namely Airplane, Dentist, Vaccination (“you have to get a vaccination”), and Test (“waiting for the results of an important test”). She found the Dentist scenario to be appraised as significantly less threatening than the other scenarios, which is in line with the results of Muris and De Jong (1993). Situational appraisals have not only been studied across situations. Studies exploring variation in situational appraisals across respondents suggest that the perceived threatfulness of scenarios is related to monitoring coping styles: individuals with a high monitoring coping style tend to perceive situations as more threatening than individuals with a low monitoring coping style (Muris & De Jong, 1993; Russell & Davey, 1993; Van Zuuren & Wolfs, 1991). This suggests that monitoring coping style not only affects coping behavior (reflected in the coping options endorsed) but already has an influence on the appraisal process (the perceived situational characteristics of the scenarios).

Controllability and Predictability One of the most important situational characteristics affecting coping responses is controllability. In contrast to the situational dimensions described above, controllability is clearly believed to affect the choice between monitoring and blunting. In one of her first papers on monitoring and blunting, Miller (1981) writes: When an aversive event is controllable, monitoring is the main coping mode. Although it heightens arousal, this tactic enables the individual to execute controlling actions. When an aversive event is uncontrollable, however, monitoring (which heightens arousal) has no instrumental value. Therefore, blunting becomes the main coping mode on these oc-

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Besides controllability, predictability also has been assumed to influence coping. Miller and Green (1985) point out that even in uncontrollable aversive situations, high levels of predictability may interfere with the person’s ability to distract psychologically. In fact, the effects of controllability and predictability can be expected to strengthen each other, with the combination of high predictability and high controllability promoting monitoring and the combination of low predictability and low controllability promoting blunting (Van Zuuren et al., 1996). The scenarios of some situation-response inventories for the assessment of cognitive informational coping styles (e.g., MCI(-R), TMSI) have explicitly been chosen to contain varying degrees of controllability and predictability in order to rule out as many situational effects as possible. A point of critique often given on scales with scenarios that do not diverge in this respect (MBSS, CBSS, and MBSC, which contain mainly uncontrollable scenarios) is that these instruments do not enable the researcher to assess coping style since manifestation of only one type of behavior (the less adaptive in those situations) can be related to habitual tendencies. For example, blunting is the main coping mode in uncontrollable situations. In inventories with mainly uncontrollable scenarios, the influence of situational factors may outreach that of dispositional factors, leaving it unclear whether the blunting score is determined by situative or by habitual factors (Krohne, 1996). It is important to emphasize that this is only one point of view, reflecting a very stringent conceptualization of coping style, assuming cross-situational stability of coping even across situations that are divergent on such critical characteristics. The aggregation of coping responses over scenarios rules out situational effects, considering them as “error.” By choosing scenarios that diverge as much as possible, the situation effects on the coping responses are maximized. Mischel and Peake (1983) argue that, in such approaches, one can question the usefulness of summing up items across situations and treating the resulting sum scores as a reflection of one’s “true” position on the coping dimension. According to us, a somewhat less stringent conceptualization of coping style, such as the one mentioned by Benjamins, Schuurs, Kooreman, and Hoogstraten (1996) might solve this problem. Coping is assumed only to be relatively stable in comparable situations, while it may show considerable variation is dissimilar situations, depending on situational controllability and predictability. In this line of reasoning, it makes little sense to assess coping style by means of situation-response inventories with maximally divergent scenarios, since coping is not assumed to show such complete cross-situational stability. The assessment of coping style within one type of situation, namely situations that are similar with respect to such critical characteristics as controllability, may be a less ambitious project than assessing an overall coping disposition, but it probably is a better reflection of reality and it almost certainly will have a greater predictive value towards actual coping in that type of situation.

COPING OPTIONS AND RESPONSE FORMAT The “situation” component of situation-response inventories is reflected in the scenarios, the “response” component in the items: i.e., coping options. Based on a macroanalytic approach to coping, questionnaires of this type do not assess a large number of

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specific coping strategies but operate at a higher level of aggregation, thus concentrating on more fundamental constructs in coping research (Krohne, 1996). In most of the inventories under review, scenarios are followed by a list of coping options, referring to one of both cognitive coping styles (monitoring/vigilance, blunting/avoidance). People are asked to indicate for each coping option the extent to which they would rely on it by choosing one of the response categories. In the first section, we analyze the coping options used as operationalizations of monitoring and blunting. In the second section, we discuss response formats.

Operationalizations of Monitoring and Blunting A closer inspection of the items used as operationalizations of monitoring/vigilance and blunting/avoidance reveals a wide and diverse range of coping options. To obtain some grip on these operationalizations, we have classified the items of five cognitive informational style scales into subcategories of monitoring and blunting according to their content. Operationalizations of monitoring. Monitoring is generally assumed to refer to the basic coping dimension of approach: more specifically, approach through threat-related attention. Two broad groups of monitoring items can be distinguished, corresponding with the two forms of threat-related attention described by Miller et al. (1995), namely sensory vigilance and active information seeking. Sensory Vigilance reflects a perseverative attentional and cognitive focus on threat in an attempt to emotionally process the event as it is unfolding (Miller et al., 1995). It involves attention to sensory information in the situation (sights, sounds, or feelings, e.g., “watch every movement of the captors and keep an eye on their weapons,” MBSS Hostage), recall of previous negative events (e.g., “remember previous dental treatments,” MCI-R Dentist), anticipation of negative events (e.g., “think about what I don’t want the dentist to do,” CBSS Dentist) and cognitive problem-solving, that is, thinking about how to behave in the situation, coming up with action strategies (Carver, Scheier, & Weintraub, 1989) (e.g., “think about what I can do if I lose track of what I wanted to say,” MCI-R Speech). The second group of monitoring strategies is labeled active information seeking, manifesting itself in question asking (e.g., “ask the doctor exactly what he is going to do,” MBSC Vaccination), talking about the stressor with other people or consulting other sources (“carefully read the information leaflets about tooth diseases and treatments in the waiting room,” MCI-R Dentist), in some cases with the intention to take precautions (“read the security instruction for emergencies and look for the nearest emergency exit,” MCI-R Airplane). This group of strategies involves a more proactive problem-solving search than sensory vigilance, which generally refers to a rather ruminative focus on threat (Miller et al., 1995). The distribution of the monitoring items over the monitoring categories is given in Table 1. An inspection of the table reveals that the inventories differ considerably in the content of their monitoring items. The content analysis reveals the largest similarities between the adult MCI-R and the child CBSS (stressing sensory vigilance) and between the adult TMSI and the child MBSC (emphasizing active information search) with respect to the monitoring items. Operationalizations of blunting. Blunting refers to the basic coping dimension of avoidance, which serves as a form of escape from the unpleasant stressful situation (Parker &

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Table 1. Distribution of Monitoring Items over Monitoring Categories

Sensory vigilance Perceptual focus Recall similar situations Cognitive focus Negative anticipation Cognitive problem-solving Active information search Question-asking expert Talking with others Information other sources Precautions Rest category Social comparison Self-blame

MBSS

TMSI

MCI-R

CBSS

MBSC

31% – 19% – –

8% – – 17% –

10% 18% 2% 25% 15%

13% 19% 31% 31% –

29% – 7% – –

19% 13% 6% 13%

33% 17% 25% –

3% 5% 8% 5%

6% – – –

29% 11% 4% 21%

– –

– –

3% 8%

– –

– –

Note. MBSS ⫽ Miller Behavioral Style Scale; TMSI ⫽ Threatening Medical Situations Inventory; MCI-R ⫽ Mainz Coping Inventory; CBSS ⫽ Child Behavioral Style Scale; MBSC ⫽ Monitoring and Blunting Scale for Children.

Endler, 1992). Blunting strategies allow the person to absent him/herself psychologically from the danger signal (Miller, 1981). Compared with the various strategies that reflect the tendency to monitor, blunting strategies appear less homogeneous and are often subject to conceptual confusion (Fuller & Connor, 1990). An example of this confusion is the fact that some strategies described as forms of blunting clearly imply effortful and purposeful reactions and can be considered as real coping (e.g., behavioral distraction), whereas others can rather be viewed as unconscious processes, closely related to defenses (e.g., denial) (Phipps, Fairclough, & Mulhern, 1995). Altshuler and Ruble (1989) made a significant contribution to the conceptualization of avoidance-based coping by dividing avoidance tactics according to two characteristics. First, they make a distinction between strategies serving to completely shut out stressful information from consciousness (complete avoidance) and strategies that accomplish some degree of arousal reduction but do not impede completely the processing of threat-relevant information (partial avoidance or distraction). Second, they distinguish behavioral strategies from cognitive strategies. This classification yields four distinct groups of avoidance-based coping tactics, namely Behavioral Distraction and Cognitive Distraction as forms of partial avoidance, and Behavioral Avoidance (escape) and Cognitive Avoidance (denial) as forms of complete avoidance. Distraction (or partial avoidance) can be defined as turning away from a salient unpleasant stimulus and focusing on incompatible thoughts or activities. This means that the person diverts his attention away from the stressor but remains aware of it to some degree (Altshuler & Ruble, 1989). Cognitive Distraction refers to cognitive attempts to keep thoughts away from a stressor (Ryan-Wenger, 1992) (e.g., “do mental puzzles in my mind,” MBSS Dentist), whereas behavioral distraction means that the person uses an alternative behavioral activity to avoid thinking about the event (Altshuler & Ruble, 1989) or to delay the need to deal with it (Ryan-Wenger, 1992) (e.g.,

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Table 2. Distribution of Blunting Items over Blunting Categories

Distraction Behavioral distraction Social diversion Cognitive distraction Avoidance Behavioral avoidance Cognitive avoidance Emotion-focused blunting Reappraisal Comforting self-talk Tension reduction

MBSS

TMSI

MCI-R

CBSS

MBSC

19% 13% 25%

8% – –

15% 3% –

38% 6% 38%

18% 21% 39%

19% 13%

– 17%

– 10%

– 13%

18% 4%

– – 13%

– 50% 25%

15% 38% 20%

6% – –

– – –

Note. MBSS ⫽ Miller Behavioral Style Scale; TMSI ⫽ Threatening Medical Situations Inventory; MCI-R ⫽ Mainz Coping Inventory; CBSS ⫽ Child Behavioral Style Scale; MBSC ⫽ Monitoring and Blunting Scale for Children.

“put on the earphone and listen to music,” MCI-R Airplane). One particular subtype of behavioral distraction, by some authors (Endler & Parker, 1990) considered as a distinct category, is social diversion, that is, seeking out other people to avoid thinking about the event (e.g., “exchange life stories with the other hostages,” MBSS Hostage). Complete avoidance comprises strategies serving to completely shut out stressful information from consciousness. Cognitive avoidance consists of cognitive attempts to avoid acknowledging the existence of a stressor (Ryan-Wenger, 1992) or to act as though the stressor is not real (Carver et al., 1989) (e.g., “close your eyes and pretend you are someplace else,” CBSS Dentist). Behavioral avoidance refers to behavioral attempts to keep oneself away from a stressor (e.g., “hide with a friend when it’s time to go,” MBSC Vaccination). Since not all items in the blunting subscales can be considered as forms of (behavioral or cognitive) distraction or (behavioral or cognitive) avoidance, three other categories emerge: reappraisal, comforting self-talk, and direct tension reduction. The strategies tapped by these blunting items are less clearly avoidance-based but more closely related to emotion-focused coping. Therefore we use the term emotion-focused blunting to refer to them. Reappraisal means redefining the stressor as benign and construing a stressful encounter in positive terms (e.g., “tell myself: these are completely normal turbulences that occur during every flight,” MCI-R Airplane). Comforting self-talk involves the use of self-statements or thoughts reflecting attempts to alleviate fears and discomfort (Curry & Russ, 1985). By means of such emotion-regulating cognitions, the individual tries to convince him/herself that he or she will be able to manage the situation (e.g., “think things will turn out to be allright,” TMSI Headache Examination). Finally, direct tension reduction (Altshuler & Ruble, 1989) includes symptom-directed strategies, devoted to moderate distress (Lazarus, 1976) (e.g., “order a drink or a tranquillizer,” MBSS Airplane). The distribution of the blunting items over the blunting categories is given in Table 2.

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Response Format Most inventories under review use fixed responses and provide their respondents with discrete response scales to answer the items. MCI, MCI-R, the original MBSS, CBSS, and MBSC have a dichotomous response scale with a yes/no format, whereas the adapted Dutch-language MBSS and the TMSI use a 5-point rating scale, ranging from 1 ⫽ “not at all applicable to me” to 5 ⫽ “strongly applicable to me”. The advantage of a 5-point scale over a dichotomous scale is that it leads to more variability in the data, which generally increases the reliability. Muris, Van Zuuren, De Jong, et al. (1994) compare the dichotomous and the 5-point versions of MBSS and find that both versions correlate significantly with each other but that only the 5-point version meets the criterion of sufficient internal consistency (see below). A slightly different response format is used in MBQ, which requires the respondents to give two 10-point ratings (one for monitoring and one for blunting) per scenario. The internal consistency of the MBQ subscales is found to be considerably higher than that of MBSS and TMSI, but given the fact that there is only one monitoring and blunting rating per scenario (formulated in an identical way for all scenarios), the coefficients reported reflect cross-situational coping stability rather than internal consistency. In the method of Hoffner (1993), open-ended responses are used rather than a fixed response scale. Children hear stories depicting stressful situations (cf. scenarios) and are asked to describe what they would do or think about while in each of these situations. An advantage of this method is that it has the potential of eliciting a much broader range of coping responses (whatever response the child provides). However, in Hoffner’s method, children’s responses are assigned to a priori coding categories derived from Miller’s theoretical formulations rather than to empirically derived categories. Doing this, the chance of discovering “new” aspects of monitoring and blunting is minimized rather than maximized.

DIMENSIONALITY OF THE CONSTRUCTS In situation-response inventories, answers to items of the same type are summed up across situations to compute coping style scores, by means of which respondents can be classified into coping style groups. Depending on the assumptions concerning the dimensionality of the contructs, several methods have been used to accomplish this and below we will make clear that the three cognitive informational coping style theories mentioned above differ from each other in this respect. Byrne (1964) explicitly conceptualizes repression-sensitization as a unidimensional bipolar construct and measures it by the Repression-Sensitization Scale. Persons located at one pole of the dimension are called “repressors,” whereas persons at the opposite pole are named “sensitizers.” This conception has largely been criticized (Chabot, 1973; Miller, 1987) because of the implicit assumption that all people preferentially rely on either repression or sensitization, which makes it impossible to identify people scoring high on both coping styles and people scoring low on both coping styles. These two groups probably score in the middle range of the S–R scale and cannot be distinguished from each other on the basis of their score. Krohne (1989) postulates an independent functioning of the vigilance and cognitive avoidance dimensions. In line with his theoretical model, MCI-R vigilance and cognitive avoidance scores are considered as orthogonal dimensions, with the combination of both leading to four coping style configurations: consistent vigilance, consis-

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tent avoidance, situation-related coping, and fluctuating coping (Kohlmann, 1993). Persons with high vigilance scores and low avoidance scores are called “sensitizers,” whereas persons with high avoidance scores and low vigilance scores are named “repressors.” “Nondefensives” score low on both vigilance and cognitive avoidance, which enables them to adopt a flexible, situation-related use of coping strategies. Finally, persons with high scores on both vigilance and cognitive avoidance show a pattern of “fluctuating coping”. The approach of Miller is rather inconsistent. In some early papers (e.g., Miller, 1980), she considers monitoring and blunting as the opposite poles of one dimension, namely “seeking out versus distracting from threat-relevant information.” In more recent articles (Miller, 1987), however, monitoring and blunting are considered as dimensions on their own, referring to “seeking versus not seeking threat-relevant information” and “seeking versus not seeking distraction under threat.” There is a dissimilarity across studies in the approach of dimensionality and consequently also in the method of manipulating monitoring and blunting scores to define coping style groups. In all child studies published thus far, monitoring and blunting are treated as independent dimensions. Using the MBSC, Kliewer (1991) computes both a monitoring and a blunting score, distinguishes high and low monitors and high and low blunters using median split procedures, and conducts separate analyses for monitoring and blunting. Miller et al. (1995) focus on monitoring and only use the CBSS monitoring score to divide their participants into high and low monitors, while Phipps et al. (1995) perform median split procedures on both the monitoring and the blunting score and distinguish four configurations: Monitors (high monitoring, low blunting), Blunters (low monitoring, high blunting), Active Copers (high on both scales), and Passive Copers (low on both scales). Some investigations using the adult MBSS (e.g., Miller & Mangan, 1983) consider monitoring and blunting as opposite poles of one dimension. In these studies, MBSS scores are combined and a median split procedure is performed on the resulting score to divide participants into “monitors” and “blunters.” In other studies however, monitoring and blunting are treated as independent dimensions and generally only monitoring scores are used in the analyses, leading to “high monitors” versus “low monitors.” Muris, Van Zuuren, De Jong, et al. (1994) investigated the relationship between MBSS summary scores and separate monitoring and blunting scores and found high Pearson correlations (r ⫽ .74, p ⬍ .01, for summary score and monitoring; r ⫽ ⫺.76, p ⬍ .01, for summary score and blunting). However, this does not mean that it makes no difference whether a researcher uses separate scores or a summary score. The choice between the two methods should also be made on a conceptual basis. Given the recent formulations of monitoring and blunting as independent constructs and the large deal of empirical evidence (Miller, Brody, & Summerton, 1988; Muris, Van Zuuren, De Jong, et al., 1994) suggesting that monitoring and blunting subscale scores are unrelated, it appears rather inappropriate to calculate a summary score.

RELIABILITY AND VALIDITY Reliability and validity are commonly used psychometric criteria to evaluate the quality of self-report questionnaires. In this section, we discuss some commonly investigated forms of reliability and validity in the context of cognitive informational coping style measurement. Empirical data from psychometric studies of the questionnaires

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Table 3. Description of the Samples in Reliability and Validity Studies Instrument(s) MCI MCI MCI MCI-R MCI-R MBSS MBSS MBSS MBSS MBSS MBSS MBSS MBQ MBSS, TMSI, MCI TMSI

TMSI TMSI CBSS MBSC

Study

Sample

Krohne (1989) Krohne (1993) Hock, Krohne, & Kaiser (1996) Egloff & Hock (1997) Krohne & Egloff (in press) Miller, Roussi, Altman, Helm & Steinberg (1994) Miller & Mangan (1983) Steketee, Bransfield, Miller, & Foa (1989) Steptoe & O’Sullivan (1986) Davey (1993) Muris & Schouten (1994) Muris, Van Zuuren, DeJong, De Beurs, & Hanewald (1994) Muris, Van Zuuren, DeJong, DeBeurs, & Hanewald (1994) Muris, Van Zuuren, & De Vries (1994)

review, samples not described review, samples not described 58 students 119 ⫹ 162 students 227 ⫹ 169 ⫹ 325 students 36 gynecologic patients

Van Zuuren, De Groot, Mulder, & Muris (1996)

123 students, 80 dental patients, 42 HIV patients, 123 surgery patients 60 people (community) 68 dental patients

Van Zuuren & Dooper (1999) Van Zuuren, De Jongh, Beekers, & Swinkels (1999) Miller, Roussi, Caputo, & Kruus (1995) Kliewer (1991)

40 gynecologic patients 33 phobic patients 71 gynecologic patients 136 people (community) 583 students 70 students 42 students 70 students

82 dental child patients 100 school children

Note. MCI, MCI-R ⫽ Mainz Coping Inventory; MBSS ⫽ Miller Behavioral Style Scale; MBQ ⫽ Monitoring-Blunting Questionnaire; TMSI ⫽ Threatening Medical Situations Inventory; CBSS ⫽ Child Behavioral Style Scale; MBSC ⫽ Monitoring and Blunting Scale for Children.

under review are summarized in tables2. A brief description of the samples used in the studies on which the review is based is given in Table 3.

Reliability Two types of reliability are commonly investigated with respect to cognitive informational style questionnaires, namely internal consistency and test-retest reliability. Barker et al. (1994) give some standards for evaluating the reliability of measurements. Generally speaking, coefficients below .60 are considered as insufficient (“⫺”). Coefficients exceeding .60 can be considered as marginal (“⫾”), exceeding .70 as ac2We omit Hoffner’s method from the tables, since it is an interview method using open-ended questions rather than a quantitative self-report questionnaire. Moreover, we found no data on any of the reliability or validity aspects tabulated. Hoffner (1993) only provides some data on interrater agreement, namely 85.0% interscorer agreement for individual coping strategies and 89.5% for coping style categories.

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Table 4. Summary of Reliability Data MCI

MCI-R

n items 72 80 Response format 0–1 0–1 Internal consistency Monitoring/ vigilance ⫹⫹ ⫹⫹ Blunting/ avoidance ⫹⫹ ⫹⫹ Test-retest (1 week) (2 weeks) Monitoring/ vigilance ⫾ ⫹ Blunting/ avoidance ⫾ ⫹⫹

MBSS MBSS (dichotomous) (5-point) 32 0–1

⫹ ⫺Ⲑ⫾ (4 months)

32

TMSI 24

MBQ 20

CBSS 32

1–5

1–5

VAS

0–1

⫹

⫹Ⲑ⫹⫹

n.a.

⫾

⫹

⫹ n.a. (2 weeks) (1 month)

⫺

⫹

?

⫹⫹

⫾

?

⫹

?

⫹⫹

⫹⫹

?

Note. Relying on the reliability criteria of Barker, Pistrang, and Elliott (1994), the following signs are used to indicate internal consistency and test-retest coefficients: ⫹⫹ ⫽ good (r ⬎ .80); ⫹ ⫽ acceptable (r ⬎ .70); ⫾ ⫽ marginal (r ⬎ .60); ⫺ ⫽ insufficient (r ⬍ .60); ? ⫽ no data available; n.a. ⫽ not applicable. MCI, MCI-R ⫽ Mainz Coping Inventory; MBSS ⫽ Miller Behavioral Style Scale; TMSI ⫽ Threatening Medical Situations Inventory; MBQ ⫽ Monitoring-Blunting Questionnaire; CBSS ⫽ Child Behavioral Style Scale, VAS ⫽ Visual Analogue Scale.

ceptable (“⫹”) and exceeding .80 as good (“⫹⫹”). Table 4 summarizes the reliabilities of the scales, based on Krohne (1989, 1993) and Hock, Krohne, and Kaiser (1996) for MCI; Egloff and Hock (1997) and Krohne and Egloff (in press) for MCI-R; Miller, Roussi, Altman, Helm, and Steinberg (1994) for the dichotomous MBSS, and Muris, Van Zuuren, De Jong, et al. (1994) for the 5-point MBSS; Van Zuuren et al. (1996), Van Zuuren and Dooper (1999) and Van Zuuren et al. (1999) for TMSI; Muris, Van Zuuren, De Jong, et al. (1994) for MBQ; Miller et al. (1995) for CBSS; Kliewer (1991) for MBSC. An inspection of the table reveals that most subscales show a sufficient level of internal consistency and that monitoring/vigilance subscales are generally somewhat more homogeneous than blunting/avoidance subscales. Only the internal consistency coefficients of the blunting subscales from the original, dichotomous MBSS and the CBSS are problematically low. With respect to test-retest reliability, it makes little sense to compare the reliabilities of the instruments since there are substantial differences between studies in the length of the time period between the first and the second administration. Generally, responses on the blunting/avoidance subscales are found to be somewhat more stable than responses on the monitoring/vigilance subscales.

Validity An important form of validity is construct validity, indicating the extent to which the test may be said to measure a theoretical construct (Anastasi, 1976). Two subtypes of construct validity have been distinguished. Internal construct validity refers to the extent to which the internal structure of the instrument represents the underlying theo-

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Table 5. Summary of Intercorrelations Between the Corresponding Scales

MCI-MBSS MCI-TMSI MBSS-TMSI

Monitoring/vigilance

Blunting/avoidance

⫹ ⫹⫹ ⫹⫹

⫹⫹ ⫹⫹ ⫹

Note. Relying on the validity criteria of Barker, Pistrang, and Elliott (1994), the following signs are used to indicate convergent validity evidence: ⫹⫹ ⫽ good (r ⬎ .50); ⫹ ⫽ acceptable (r ⬎ .40). MCI ⫽ Mainz Coping Inventory; MBSS ⫽ Miller Behavioral Style Scale; TMSI ⫽ Threatening Medical Situations Inventory.

retical construct and is usually investigated by means of factor analysis. External construct validity asks whether the pattern of relationships between the instrument and other instruments is consistent with theoretical expectations. A distinction can be made between convergent validity (correlation with other measures of the same construct) and discriminant validity (absence of correlations with measures of other constructs). Factorial validity. Factorial validity has not been investigated for all cognitive informational style scales reviewed in this article. Thus far, we only found published data on adult inventories, namely MCI (Krohne, 1989), MCI-R (Krohne & Egloff, in press), the Dutch-language version of MBSS2 (Muris & Schouten, 1994) and TMSI (Van Zuuren et al., 1996). Despite the fact that all these studies rely on principal components analysis with varimax rotation, there is divergence between studies with respect to which scores are entered into the analysis. Some authors (Muris & Schouten, 1994; Van Zuuren et al., 1996) enter all individual responses to the monitoring and coping items into the analysis, while others (Krohne, 1989; Krohne and Egloff, in press) sum up several items and enter these sums into the analysis3. In all four studies two factors are extracted. These factors explain together 24% of the total variance in the MBSS study of Muris and Schouten (1994), about 34% in the TMSI study of Van Zuuren et al. (1996), 44% in the MCI study of Krohne (1989) and 39% in the MCI-R study of Krohne and Egloff (in press). Despite the fact that the authors of the four studies mentioned clearly had the intention to check how well the data fit the theoretical two-factor model (calling for a confirmatory approach), they all relied on exploratory principal components analysis.

2Despite

the large body of empirical research using the original English-language MBSS, there are no published data on its factor structure. 3Krohne

(1989) summed up the answers to the nine vigilance and the nine avoidance options across the four physical threat situations of MCI and performed a principal component analysis on the resulting 18 variables. Krohne and Egloff (in press) used a different procedure: they summed up the answers to the five vigilance and the five avoidance options for each situation of MCI-r, thus creating eight vigilance and eight avoidance variables (corresponding with eight situations). In our opinion, these two methods provide an answer to different questions. The first method aggregates over situations and explores the extent to which the coping categories distinguished by the authors indeed represent the two higher-order categories. The second method aggregates over coping options and appears to measure cross-situational consistency rather than construct validity.

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Table 6. Summary of Discriminant Validity Evidence

Trait anxiety Monitoring/vigilance Blunting/avoidance Neuroticism Monitoring/vigilance Blunting/avoidance Depression Monitoring/vigilance Blunting/avoidance Psychiatric symptoms Monitoring/vigilance Blunting/avoidance

MCI(-R)

MBSS

TMSI

MBQ

⫺ ⫺

⫾ ⫹

⫹ ⫹

⫹ ⫹

⫺ ⫺

⫺ ⫹

⫹ ⫹

? ?

⫾ ⫾

⫺ ⫹

⫹ ⫹

? ?

⫺ ⫾

⫺ ⫹

⫹ ⫹

? ?

Note. The following signs are used to indicate discriminant validity evidence: ⫹ ⫽ convincing evidence (nonsignificant correlations); ⫾ ⫽ mixed evidence (conflicting results); ⫺ ⫽ lack of discriminant validity (significant correlations); ? ⫽ no data available. MCI-R ⫽ Mainz Coping Inventory; MBSS ⫽ Miller Behavioral Style Scale; TMSI ⫽ Threatening Medical Situations Inventory; MBQ ⫽ Monitoring-Blunting Questionnaire.

Convergent validity. To examine the convergent validity of their instrument, most cognitive informational style researchers have computed correlations between the subscales of their instrument and related measures and relied on a visual inspection of the correlation matrix looking for significant intercorrelations. Values of coefficients in validity research are typically substantially lower than in reliability research. Inspired by the standards proposed by Barker et al. (1994), validity values exceeding .30 are considered marginal (“⫾”), exceeding .40 acceptable (“⫹”) and exceeding .50 good4 (“⫹⫹”). Values below .30 are insufficient (“⫺”). Table 5 summarizes empirical data on the intercorrelations of three inventories for use in adult samples, based on a Dutch study by Muris, Van Zuuren, and De Vries (1994). Thus far, we have not found any published data on the intercorrelations between child measures nor any data on the convergent validity of the MBQ with other adult scales. Discriminant validity. To examine discriminant validity of cognitive informational style scales, correlations have been computed with measures of dispositional anxiety and psychopathology. Table 6 provides a summary of discriminant validity evidence, based on Hock et al. (1996) for MCI; Krohne and Egloff (in press) for MCI-R; Miller and Mangan (1983), Steketee, Bransfield, Miller, and Foa (1989), Davey (1993), Muris, Van Zuuren, De Jong, et al. (1994), and Steptoe and O’Sullivan (1986) for MBSS; Van Zuuren et al. (1996) and Van Zuuren et al. (1999) for TMSI; Muris, Van Zuuren, De Jong, et al. (1994) for MBQ. We have only mentioned correlations with variables that have been used for the study of discriminant validity of at least two different inventories. Moreover, the data are limited to adult inventories. Thus far, we have not found any published data on 4This

is not a very stringent criterion. A correlation of .50 between two scales shows that there is a considerable degree of convergence but it certainly does not establish that they tap same construct.

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the discriminant validity of child measures. Three evaluation categories are used: convincing evidence (“⫹”), referring to nonsignificant correlations; mixed evidence (“⫾”), referring to conflicting results; and lack of discrimant validity (“⫺”), referring to significant intercorrelations with measures of anxiety and/or psychopathology5. In the three monitoring-blunting inventories, blunting is found to be unrelated to trait anxiety, neuroticism, and psychiatric symptoms. The discriminant validity of cognitive avoidance subscale of MCI(-R), however, is far from evident: It shows significantly negative correlations with trait anxiety and neuroticism, and inconsistent data emerge concerning its relationship to depression and psychiatric symptoms. With respect to monitoring, both TMSI and MBQ monitoring appear to be unrelated to trait anxiety. MCI(-R) monitoring and—to a lesser extent—MBSS monitoring, in contrast, are found to be related to dispositional anxiety, neuroticism, depression, and psychiatric symptoms.

SUMMARY AND RECOMMENDATIONS This article has discussed a number of issues relevant to the assessment of cognitive informational coping styles by means of situation-response inventories, more specifically scenarios, coping options, dimensionality of the constructs, reliability, and validity. Seven of these inventories have been extensively reviewed. Below, we summarize the main points and give a few suggestions of how to handle some problems.

Scenarios Situation-response inventories ask their respondents to imagine themselves being confronted with a hypothetical situation and to indicate how they would react to it. According to Krohne and Egloff (in press), such scenarios must be sufficiently imaginable, moderately threatening, and of varying controllability and predictability. We agree that imaginability is important to obtain valid answers, and pointed to the situational and cultural relativity of the scenarios. Researchers who use an existing instrument in a new sample and particularly those who translate an existing scale to another language (usually to administer it in a culturally different sample) should be well aware of this and not take for granted the comparability of the scenarios. The low reliability of some of the measures might, for example, be related to cultural discrepancies in the familiarity of the scenarios. Before using a measure in a new sample (e.g., a different culture), it might be useful to investigate the situational appraisal of the scenarios in that sample. With respect to the criterion of threatfulness, we questioned the necessity of choosing only scenarios that lead to an appraisal of threat, arguing that scenarios appraised as loss/harm and scenarios appraised as challenge also elicit coping responses and thus can be used in situation-response inventories to measure coping styles. Researchers using different types of appraisal in one inventory should take into account the re5This is a stronger criterion than the criterion Krohne and Egloff (in press) appear to rely on. These authors report significant intercorrelations between MCI-R subscales and measures of anxiety and psychopathology (ranging in magnitude from .20 to .55) and nevertheless conclude that discriminant validity is evidenced, since “none of the coefficients reached a level that could indicate lacking discriminant validity...” (p. 17).

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sults of McCrae (1984), who found different blunting strategies associated with different types of appraisal. Situation-response inventories with scenarios of different appraisal types should thus contain different types of strategies representing each coping style (e.g., both distraction and reappraisal items in the blunting scale). If not, they stand a chance that situational appraisals will outreach the influence of dispositional factors. A similar remark can be made with respect to the intensity of threat in scenarios appraised as threatful. Given the fact that highly threatening situations have also been found to lead to the endorsement of different strategies within the same coping style rather than strategies of the opposite style, a sufficient degree of diversity in the coping options representing both styles is to be recommended. Another rationale has been developed with respect to the prerequisite of varying controllability and predictability. Given the established effects of these situational appraisals on the choice between monitoring and blunting options, we have questioned usefulness of assessing coping style using inventories with scenarios that diverge maximally with respect to these characterisitics. Maximizing the situational effects on coping responses and then ignoring these effects by summing up all items across situations probably makes little sense. Nevertheless, we agree that situation-response inventories with maximally divergent scenarios can be valuable, namely for research guided by different types of questions. First, studies conducted within an interactionist framework generally use such inventories to determine the amount of variance explained by persons, situations, and the interaction between both (Furnham & Jaspars, 1983). Second, such inventories may also be useful in studies focusing on coping consistency as an interindividual difference variable. Results of the widely cited personality study of Bem and Allen (1974) suggest that consistency itself may constitute an important dimension of personality, reflecting individual differences in the extent to which the person behaves in a consistent manner. Situation-response inventories with divergent scenarios can enable the researcher to assess the degree of consistency of people across different types of situations.

Coping Options In order to get some grip on the monitoring and blunting operationalizations in situation-response inventories, we have performed a content analysis. Two broad groups of monitoring items emerged, referring to the two aspects of threat-related attention distinguished by Miller et al. (1995), namely sensory vigilance and active information search. Blunting items were divided into three broad groups, namely distraction, avoidance, and emotion-focused blunting. A comparison of the distribution of the items of the different scales over the monitoring and blunting categories revealed significant differences. It is striking how similarly named measures rely on considerably different operationalizations of the central constructs. This may in part explain the rather modest correlations found between these measures. The content analysis of monitoring and blunting items presented in this paper should be considered as only a first step towards more conceptual clarity. Some of the distinctions made are quite subtle and empirical confirmation is needed. In ongoing research, we are gathering empirical evidence for the content analysis applying confirmatory factor analyses to data from both child and adult scales. Finally, we point to the fact that most checklist measures of cognitive informational styles contain an equal number of strategies referring to each style. It is important to note, however, that in a specific threatening situation, the possibilities for monitoring

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or vigilance are restricted to a few options, whereas there are many ways in which a person can be engaged in cognitive avoidance or blunting (Muris & Schouten, 1994). Given the greater variability in the types of blunting strategies people use spontaneously, individual blunting preferences may make people less likely to endorse particular blunting items on a checklist (e.g., “go to the movies” versus “read a book”). This can lead to an underestimate of blunting. To overcome this problem, Hoffner (1993) uses open-ended questions (“describe what you would do or think about...”). An alternative solution is put forward by Muris and Schouten (1994), who argue that blunting items should be put in more general terms (e.g., “distract myself by engaging in some other activity, like going to the movies”) in order to apply to people who do blunt but not by engaging in the specific activity described.

Dimensionality of the Constructs Depending on the assumption concerning the dimensionality of the constructs, several methods have been used to divide respondents into coping style groups: median split on summary scores (assumption of undimensionality), or median split on both coping style scores (assumption of bidimensionality). We have argued that the choice between the two methods should be made on a conceptual basis and should not only be a consequence of the empirically assessed relationship between the subscale scores. Given the recent formulations of cognitive informational styles as independent constructs (Krohne, 1989; Miller, 1987) and the large amount of empirical evidence (Miller, et al., 1988; Muris, Van Zuuren, De Jong, et al., 1994) suggesting that subscale scores are unrelated, it appears rather inappropriate to calculate a summary score.

Reliability and Validity The summary of published data on the reliability and validity of the instruments under review may have risen the expectation of a conclusion about which scale should be considered as the best one. Unfortunately, data are far too scare to choose between them. Moreover, given the fact that similarly named measures show only modest correlations with each other, considerable conceptual and empirical efforts are needed to bring clarity in this area.

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