Coping Intelligence
A Blueprint for Multimedia Patient Education
Elena Libin
Georgetown University, 4515 Willard Avenue, Chevy Chase, MD 20815, Washington, DC, U.S.A
Keywords: Life Difficulties, Multidimensional Positive Coping Model, Coping Intelligence, Self-management Skills,
Theory for Multimedia Education, Well-being Assessment, Effective Coping, Defensive Behaviours.
Abstract: This paper presents a new approach to the theory of multimedia well-being literacy education based on the
concept of Coping Intelligence. Multidimensional Positive Coping Model includes three cross-cutting
parameters differentiating each coping strategy as efficient or inefficient, emotional, cognitive or behavioral,
and active or passive. Results of the statistical analysis verified a basic two-factor structure of the Coping
Intelligence with the alternative solutions for efficient and inefficient coping strategies characterized via
three basic modalities. The unified methodology underlying the new concept of Coping Intelligence, as well
as Coping IQ assessment, is applicable for developing multimedia well-being literacy applications for both
clinical and general populations. CIQ parameters might serve as useful feedback while assessing changes in
individual coping repertoire, for it measures not stable traits, but strategies that can be modified as a result
of life experiences or educational training.
1 INTRODUCTION: COPING
INTELLIGENCE AS A SCIENCE
OF HUMAN STRENGTH
‘Creating a science of human strength’ is a
promising direction of modern psychology focuses
on ‘systematically building competence, not on
correcting weakness’ (Seligman, 2000). New course
of psychological research and practice is based on a
healthy, positive model of human behavior. The
basic principles of positive psychology strongly
correspond to the guidelines of differential
psychology, whose primary goal is to explore the
unique abilities and strength of human individuality
(Libin, A., 2008). The concept of human
competence is an ideal starting point for studying the
complexity of human individuality as well as
investigating the fundamental issues such as quality
of living, satisfaction with major life outcomes, self
and others.
2 TRADITIONAL APPROACH TO
EFFICIENT AND INEFFICIENT
COPING
There is a huge need among academic professionals
and practitioners, as well as among people with
various chronic health conditions and disability, for
knowledge on how to empower individual
competence by mastering of efficient coping skills.
However, existing studies on coping with life
difficulties are very contradictory. Literature
analysis of relevant concepts and related measures
revealed two major trends: coping with stress
(Lazarus and Folkman, 1984; Carver and Scheier,
1994) and applied problem solving (D’Zurilla and
Nezu, 1990; Heppner et al., 2004). The most known
in the first designated area of research is a cognitive
theory of stress, developed by Lazarus and Folkman
(1984), that interprets coping as either problem- or
emotion-oriented. Problem-focused coping is
directed toward managing a stressful situation and
takes place ‘if cognitive appraisal tells that
something can be undertaken’. Emotion-focused
coping is directed toward regulation of emotional
responses and occurs ‘when cognitive appraisal tells
that nothing can be done’ in order to resolve a
614
Libin E..
Coping Intelligence - A Blueprint for Multimedia Patient Education.
DOI: 10.5220/0004975706140621
In Proceedings of the 6th International Conference on Computer Supported Education (WeLL-2014), pages 614-621
ISBN: 978-989-758-020-8
Copyright
c
2014 SCITEPRESS (Science and Technology Publications, Lda.)
stressful situation (Folkman and Lazarus, 1985).
This approach frames the development of The Ways
of Coping (Lazarus and Folkman, 1984), which is a
widely used instrument in health and clinical studies.
Although this concept and the instrument proved to
be very reliable in studying stress-evoked coping
responses, a major limitation of this approach in the
context of coping with everyday life difficulties is
that emotional strategies are viewed as inefficient,
whereas cognitive and behavioral strategies are
always considered efficient.
A second trend in coping research emphasizes
the importance of studying social aspects of problem
solving competence through attitudes and underlying
belief systems. An example is the theory by
D’Zurilla & Nezu (1990) who developed a Social
Problem Solving Inventory (SPSI) consisting of the
problem solving skill scale (PSSS) and the problem
orientation scale (POS) that includes cognitive,
emotional and behavioral subscales. Although the
POS views cognitive and behavioral dimensions as
separate categories, an emotional problem solving
strategy still has the same negative connotation and
is measured as an inefficient strategy.
The merge of the traditional applied problem
solving concept and the stress-related coping theory
resulted in Problem-Focused Style of Coping Scale
(PF-SOC) developed by Heppner with colleagues
(2004). The perceived effectiveness of a problem
solving activity is viewed as the degree to which
one’s actions facilitate or inhibit progress toward a
resolution of the problem. The PF-SOC measures 18
strategies organized into three factors – reflective,
reactive and suppressive styles. Reflective style
measures cognitive activities that promote problem
solving, whereas reactive style emphasizes distorted
cognitive and emotional activities. Denial and
avoidance form suppressive style. A cognitive
strategy is analyzed as efficient or inefficient
depending on the organization of the cognitive
efforts, whereas emotional strategies along with
behavioral ones, are defined as strictly inefficient.
2.1 New Positive Coping Model:
Efficient and Inefficient
Management of Everyday Life
Difficulties
The above described traditional approaches, while
identifying cognitive, emotional, and behavioral
aspects of coping, often confuse the modality of the
strategy with its functionality and outcome. This
conceptual drawback presents quite a few challenges
to the measurement of efficient and inefficient
strategies in coping research and psychological
practice.
First of all, our review illustrates that the study
of efficient and inefficient strategies has been
limited in scope and in the choice of basic
parameters. For instance, the inadequate conclusion
that cognitive efforts are always efficient while
emotional activities are always inefficient is based
on a false assumption that basic parameters
differentiating between efficient and inefficient
strategies are associated with only one predominant
modality. Secondly, existing models offer a very
unclear depiction of the role of behavioral efforts.
Behavioral strategies either form a separate category
of inefficient coping (D’Zurilla and Nezu, 1990), or
are combined with cognitive efficient strategies in
one single class (Lazarus and Folkman, 1984;
Carver and Scheier, 1994). Most importantly,
according to the existing traditional approaches
emotional strategies are viewed contradictory to
cognitive and behavioral ones. In the last two
decades, numerous studies proved the beneficial role
emotions play in resolving life difficulties. Data
suggest that particular characteristics of emotional
experience such as optimism, hope, and emotional
intelligence positively influence the coping process
(Seligman, 1991; Snyder, 1998; Averill, 2000;
Fredrickson, 2002). Salovey and Mayer, defining the
concept of Emotional Intelligence (1990), stated that
‘emotion and intelligence are not mutually
contradictory’. Emotional strategies may be
inefficient if they are used inadequately and efficient
if they employed adequately for the process of
resolving life difficulties. Used correctly and
adaptively, emotions help in reasoning, information
processing and problem solving by prioritizing
thinking, shaping memory and facilitating creativity.
This findings support a new paradigm of
understanding human intelligence that overcomes
the limitations of ‘pure intelligence’ (Gardner, 1999)
and its role in individual well-being. The
contemporary view on individual competence
considers emotional, cognitive, behavioral, and
social abilities as integral parts of generalized
intelligence (Goody, 1995; 2000; Libin, E., 2004;
Sternberg et al., 2003). In sum, traditional perception
of the incongruency between modalities (cognitive,
emotional, or behavioral) of a particular strategy and
its functionality or organizational efforts (efficient
vs. inefficient) hinders the development of an
integrated methodology for a generalized coping
process and the design of an adequate assessment
instrument.
A proposed concept of Coping Intelligence based
CopingIntelligence-ABlueprintforMultimediaPatientEducation
615
on Multidimensional Positive Coping Model (Libin,
2003a) lays at the foundation of a new blueprint for
multimedia patient0centered education. This model
strives to overcome limitations in studying coping
by suggesting cross-cutting parameters for the
unified classification of efficient and inefficient
strategies. Coping Intelligence is defined by the
quality, functionality, repertoire, and efficiency of
cognitive, emotional, and behavioural strategies of
varying intensity.
Figure 1: Multi-dimensional Model of Coping Intelligence
as a Conceptual Framework for Patient-Centred
Multimedia Education.
Taking into account the new findings on generalized
properties of human intelligence described in the
previous section, the proposed model categorizes
efficient and inefficient strategies based not on their
modality, but on their functionality or the
organization of coping efforts. According to the
Multidimensional Positive Coping Model each
strategy is characterized by:
The primary cross-cutting parameter:
organization of the efforts (efficient or
inefficient)
The secondary cross-cutting parameter:
modality of manifestation (emotional, cognitive
or behavioral), and
The tertiary cross-cutting parameter: intensity
of efforts (active or passive)
Thus, the organizational efforts define a coping
activity as efficient or inefficient, whereas the
modality characterizes any given efficient or
inefficient strategy as emotional, cognitive or
behavioral. In addition, each emotional, cognitive or
behavioral strategy can be evaluated as active or
passive depending on the intensity of provided
efforts. Hereby, a strategy is defined as a vector of
emotional, cognitive, or behavioral efforts of
varying intensity resulting either in an effective or
ineffective outcome for dealing with life difficulties.
Efficient coping strategies focus on the resolution of
the difficult situation. Accordingly, inefficient
coping strategies diverge from the resolution of life
difficulties.
2.2 Coping IntelligenceModel:
Experimental Analysis
Based on a newly developed model, a Coping
Intelligence Questionnaire (CIQ; Libin, 2002, 2003,
2008) differentiates between efficient or inefficient
strategies as they relates to three modalities –
cognitive, emotional, and behavioral, while
including three measures of the primary orientation
such as self-, subject- or others-oriented, and two
measures of the intensity of individual involvement
with difficult situation, such as passive or active (see
Figure 2). A central element of the Coping
Intelligence™ framework is a conceptual
classification scheme that allows describing each
efficient or inefficient strategy according to four
criteria: organization of the efforts that a person
exhibits in a difficult situation; leading modality of
the efforts; an orientation vector of employed
efforts; and intensity of the efforts.
Figure 2: Experimental Coping Intelligence™ Framework.
The present article focuses on the first experimental
phase of the new assessment tool development,
whereas a theoretical framework for the positive
coping approach is described in details elsewhere
(Libin, 2003 a,b).
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2.2.1 Research Methodology
Four consequential steps were performed in
developing the Coping IQ (CIQ) assessment
including (1) literature analysis and the development
of a pool of items, (2) studying content validity of
the new measure through the expert review panel,
(3) exploring psychometric properties of the CIQ via
Cronbach alphas, (4) and validation of the proposed
measure via the analysis of individual differences in
efficient and inefficient coping strategies with
relation to age, gender, temperament, and subjective
evaluation of meaningful life outcomes.
The sample consisted of 114 participants with
the mean age of 25.7 years including 28 (25%)
males and 86 (75%) females. Participants were
adolescents, recruited from public high school and
college, and adults attending secondary education
classes. The presented data is part of a larger cross-
cultural study on coping with life difficulties
currently being conducted in the U.S. Russia, and
Ukraine.
Participants who were enrolled in academic
programs were approached for informed consent
through the Office of Academic Programs. All
participants were assigned a number for the study,
thereby maintaining their anonymity. Researchers
involved with the project were trained and sensitized
to the importance of confidentiality of the data.
The Coping IQ instrument (CIQ) is designed to
measure cognitive, emotional, and behavioral
responses to a difficult situation viewed as a meta-
concept of problematic events that trigger coping
efforts. CIQ is a self-report measure consisting of 72
items, which assesses 3 efficient and 3 inefficient
scales differentiated by the cognitive, emotional, and
behavioral modality of coping responses. The
instruction asks a participant to indicate whether he
or she employs a particular strategy while facing a
difficult situation, using a 5-point Likert-type scale
of frequency with ‘1= never’ and ‘5=always’.
Outcome variables included 3 measures of efficient
and 3 measures of inefficient coping scales, two
general indexes for efficient and inefficient
strategies and four indexes for active and passive
efficient and inefficient measures, as well as a
combined quantitative measure named coping
intelligence quotation calculated as a ratio of
efficient strategies index divided by the inefficient
strategies index. All indexes and scales were
calculated as a mean of appropriate strategies. Each
of six CIQ basic scales can be briefly described as
follows:
Efficient cognitive coping is characterized by
cognitive activity focused on the resolution of the
difficult situation, whereas inefficient coping
characterizes cognitive activity deviating from the
task at hand.
Efficient emotional coping is comprised of
emotional efforts concentrated on the problem’s
solution, while inefficient coping is associated with
the emotional efforts divergent from resolving
difficulties.
Efficient behavioral coping consists of behavioral
efforts applied toward resolving the difficulties. At
the same time, inefficient coping characterizes
behavioral activity deviating from problem-solving.
Subjective Life Satisfaction Scale (SLS) was
developed and validated by the author in previous
studies (Libin, 2003b). SLS measures subjective
satisfaction with life goals, self and relationships
with others on the 12 item Likert-type self-
evaluation scale from ‘1=completely dissatisfied’ to
‘5=completely satisfied’. Items refer to 5 separate,
but interrelated aspects of one’s life – indexes of
satisfaction with meaningful life outcomes (‘things
that happened in my life’, ‘projected goals’, and ‘the
way the life goes’), and indexes of satisfaction with
socially-oriented life areas including distant
relationships (with superiors, colleagues, and peers)
and close relationships (with friends, parents, and
other family members). SLS also includes three
single items evaluating satisfaction with self,
professional relationships, and relations with the
opposite sex in general. SLS was tested on 60 people
of both genders with the age mean of 27.4 years.
Psychometric analysis showed a sufficient level of
internal validity of scales with the range of
Cronbach alphas from 0.84 to 0.93.
The Object-related and Communicative
Temperament Inventory (STQ; Rusalov, 1989) is
based on the four-phase algorithm underlying
Anokhin’s functional systems model (Anokhin,
1975). The STQ comprises 105 "agree-disagree"
items organized in eight scales, measuring 4 basic
temperamental parameters including ergonicity,
plasticity, tempo and emotionality as they relate to
social-oriented (communicative) and object-oriented
areas of human activities. Four object-oriented
scales measure ergonicity (Er), plasticity (P), tempo
(T) and emotionality (Em) reflecting different
aspects of mastering the object world. Social-
oriented scales such as ergonicity (SEr), plasticity
(SP), tempo (ST), and emotionality (SEm) measure
respectively the level of social activity, the ease of
switching from one social contact to another, the
speed of social performance, and sensitivity in the
communicative sphere. The STQ is shown to be a
CopingIntelligence-ABlueprintforMultimediaPatientEducation
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valid and reliable measure of temperament with
Cronbach alphas ranging from 0.72 to 0.84
(Rusalov, 1989; Bishop and Hertenstein, 2004).
During the study, 128 participants were
administered a set of three questionnaires over a
one-month period. A qualified researcher supervised
the assessment performance. Each participant
conducted self-evaluation individually. 14
participants were unable to compete the whole set
due to the different reasons, therefore a total of 114
participants were included in the final analysis. Data
were analyzed using SPSS 12.0.
2.2.2 Experimental Findings: Relationships
between Effective and Ineffective
Coping and Individual Characteristics
The study of content validity of the CIQ was
conducted through the expert review panel, which
included four experts familiar with the literature on
coping. All experts were psychologists and academic
professionals experienced at teaching high school,
undergraduate and adult students. The panel
reviewed all CIQ items prior to the testing.
Necessary word changes were made so that the
proposed items would be better understood by the
participants. Then experts reviewed the list of items,
rating relevance of the items to efficient or
inefficient coping. The initial pool for the
questionnaire included 180 items, which after initial
reviewing with the group of four researchers was
narrowed down to 108 items. During the next step
an internal consistency of the CIQ was studied via
data collected from 114 participants. As a result 36
more items were excluded, leaving 72 items with
most significant loading organized in six scales with
Cronbach alphas ranging from 0.72 to 0.81.
The next step was to study a structure of the CIQ
via factor analysis. We assumed that two basic
dimensions, inefficient and efficient coping, would
be associated with two different factors. This
structure of the CIQ was confirmed by the principal
component factor analysis with Varimax rotation of
72 items. The result revealed a basic two-factor
structure with the alternative factor solutions for
efficient and inefficient strategies. Each efficient or
inefficient factor included strategies of all three
(cognitive, emotional and behavioral) modalities.
The relationship between efficient and inefficient
coping, measured by CIQ, and gender, age, and
individual characteristics such as temperament and
life satisfaction were studied on groups of 61 and 70
people respectively. Additionally, gender differences
were studied on the balanced by age group of 48
people including 24 male and 24 female.
2.2.3 Gender and Age Differences in
Efficient and Inefficient Coping
Analysis via independent sample using Levene`s test
for equity of variances as a statistical measure (F) of
the differences between the groups (N=48) showed
no significant gender-related differences regarding
the preference of efficient vs. inefficient strategies.
Comparison by Levene`s test between two balanced
by gender age groups – 15 – 16 year old (N=31) and
17 – 21 year old (N=36) – revealed significant
differences in inefficient emotional and efficient
cognitive coping scales. Additionally, comparisons
revealed differences in the integrative coping
intelligence quotation, as well as in the intensity of
coping efforts measured through indexes of active
and passive strategies. Only outcomes with an alpha
level of less than .05 were considered for
interpretation. Distribution of the analysed variables
was fairly symmetric and had no outliers.
Correlation analysis of the coping, subjective life
satisfaction and temperamental parameters,
measured respectively via CIQ, STQ and SLS,
confirmed our initial hypothesis about the links
between inefficient strategies, life dissatisfaction,
and temperamental impulsivity and neuroticism.
Results of the correlation analysis showed that a
higher index of inefficient coping via CIQ was
associated with the lower levels of meaningful life
outcomes, including goals, major life events and
future prospects, personal well-being, and social
relationships. The largest number of significant
correlations between ineffective coping and low
scores on STQ was found for the parameters of
temperamental emotionality (neuroticism) and
tempo (impulsivity). Cognitive, emotional and
behavioral ineffective coping strategies were also
associated with subjective dissatisfaction in various
domains of life. The general index of inefficient
coping, measured as a mean of all three scales,
correlated negatively with major life satisfaction
parameters. Statistically significant links were found
between coping strategies and all temperamental
parameters, with the exception of object-oriented
ergonicity and plasticity. In sum, inefficient coping
correlated positively with neuroticism and
negatively with social impulsivity and activity.
Efficient coping was positively associated with both
socio-oriented plasticity and temperamental activity,
while negatively with neuroticism products, such as
A T-test was performed to clarify the structure of the
relationships between different levels of coping
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intelligence quotation, temperament and life
satisfaction. The comparative analysis of groups
(mean age 23 years) with high and low levels of
coping intelligence quotation by temperament and
subjective life satisfaction revealed that individuals
with efficient coping are characterized by a higher
level of social-oriented plasticity (t
(39)
= -3.05,
p<0.04) and index of social-oriented activity (t
(39)
=-
3.36, p<0.02). Individuals with inefficient coping are
distinguished by the higher level of object-oriented
tempo (t
(39)
= 2.14, p<0.04).
Also, participants with high levels of inefficient
coping are characterized by an increased level of
dissatisfaction with meaningful life outcomes (t
(34)
=-2.47, p<0.02), social relationships in general (t
(34)
=-2.56, p<0.02), and distant social relationships
in particular (t
(34)
=-2.53, p<0.02). Individuals with
low coping IQ are more dissatisfied with major
aspects of life, including ‘things that happened in
life’ (t
(34)
=-1.08, p<0.05), ‘projected goals’ (t
(34)
=-
2.22, p<0.03), and ‘the way life goes’ (t
(34)
=-1.99,
p<0.05). In socially-oriented areas they are
especially unhappy with their distant relationships,
including those with superiors (t
(34)
=-2.62, p<0.01),
colleagues and peers (t
(34)
=-2.00, p<0.02), with their
parents (t
(34)
=-2.48, p<0.05), and with their
relationships with the opposite gender (t
(34)
=-2.06,
p<0.05).
The general conclusion is that a low coping
intelligence quotation, associated with a
predominance in individual repertoire of ineffective
strategies, is linked with high scores on such
individual variables as temperamental impulsivity
(tempo) and subjective dissatisfaction with personal
achievements and relationships with others. On the
contrary, a high coping IQ, associated with a
predominance of effective strategies, is linked to
socio-oriented temperamental flexibility (plasticity)
and subjective satisfaction with both personal
achievements and social aspects of life.
2.2.4 Discussion: Coping Intelligence in the
Context of Learner’s Characteristics
The absence of general principles for classification
of efficient and inefficient coping poses
methodological and practical difficulties in their
diagnostics and differentiation, thereby causing
additional obstacles in the systematic study of this
important phenomenon. The newly developed
concept of Coping Intelligence suggests the use of
cross-cutting parameters to facilitate the unified
classification of efficient and inefficient coping
strategies. Results of the factor analysis verified a
basic two-factor structure of Coping Intelligence
with alternative solutions for efficient and inefficient
strategies characterized via three basic modalities.
A theorized relationship between efficient and
inefficient coping, positioned in the continuum
formed by three basic modalities – cognitive,
emotional, and behavioral, guided the development
of the Coping IQ (CIQ) instrument designed to
measure a variety of strategies in all three domains.
While organization of the efforts, being the primary
cross-cutting parameter, differentiates between
effective and ineffective coping, the secondary
parameter describes each efficient and inefficient
strategy as cognitive, emotional or behavioral
according to the manifest modality of the efforts,
whereas the tertiary parameter characterizes each
strategy as passive or active.
The final version of the CIQ instrument consists
of 72 items to ensure high reliability for each of 3
effective and 3 ineffective scales. Outcome variables
included six CIQ basic scales, two general indexes
for efficient and inefficient strategies, and coping
intelligence quotation calculated as a ratio of
efficient coping index divided by the inefficient
coping index. As a quantity indicator, coping IQ
shows whether efficient or inefficient coping
strategies prevail in the individual’s repertoire.
Results showed that adults employ efficient
strategies more often than teenagers. Changes in
coping related to age dynamics suggest that
individual efficient coping repertoire arises initially
as a result of the development of emotional and
cognitive mental processes. Our findings also
confirmed that not only emotional, but also
cognitive and behavioral inefficient strategies are
associated with low life satisfaction.
The greater number of statistically significant
correlations between temperamental characteristics
and inefficient strategies demonstrates close ties
between formal-dynamic, biologically determined,
variables and inadequate ways of dealing with
difficult situations. In comparison to efficient
coping, inefficient strategies also revealed a much
greater extent of negative association with subjective
life satisfaction parameters, thus illustrating strong
association between inefficient coping and personal
dissatisfaction with various aspects of life. In sum,
efficient and inefficient coping strategies
demonstrate reverse relations with both
temperamental (formal-dynamic) and subjective life
satisfaction (socio-psychological) characteristics.
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3 CONCLUSIONS
The association between inefficient coping strategies
and object-oriented temperamental impulsivity (high
tempo) corresponds with the data on increased
problematic behaviors in persons with high levels of
impulsivity (Horton and Oakland, 1997; Mcevoy
and Welker, 2000). This allows us to make an
assumption that abundant psychomotor activity is
negatively associated with coping outcomes. Our
findings also suggest, that it is not the speed of
object-oriented mental operations and motor acts
performance, but rather the accuracy with which
mental and motor activity are performed (adequate
and timely channeled tempo) along with the
plasticity of social-oriented activity, contribute to the
successful resolution of difficult situations. In the
realm of social relationships, a broader repertoire of
communicative programs, and flexibility in social
relationships and in establishing social contacts
(indicators of high social plasticity) are most likely
to result in more efficient ways of handling life
challenges. These individual trends should be
considered in tailoring multimedia education to the
need of the end users as part of the overall program
on well-being literacy.
ACKNOWLEDGEMENTS
This article was supported in part by the Coping
Institute (USA), the Department of Psychology at
the Georgetown University (USA), and the
Laboratory of Differential Psychology and
Psychophysiology at the Institute of Psychology,
Russian Academy of Education. The author would
like to express sincere gratitude to Dr. Alexander
Libin, Dr. James T. Lamiell, Dr. Nickolay Aminov,
and Dr. Michael Kabardov for their contributions to
the article and continuing support of the coping
intelligence project. The author is thankful to Ms.
Erica Molly Lessem and Ms. Jennifer Bresnahan for
their dedication to this study.
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