Coping Hypothesis

Historical Foundations

Kurt Goldstein initially put forward the coping hypothesis in the 1950s as he described the secondary behavioral difficulties experienced by those with brain damage as “protective mechanisms” manifesting as “neurotic symptoms” that are employed as reactions to cognitive deficits. He outlined how those with cognitive difficulties have problems adapting and adjusting behaviors appropriately. Hence, symptoms such as headache, dizziness, anxiety, fatigue, and irritability were assumed to be the result of this compensatory effort to overcome cognitive deficits.

Later, in the 1980s, Adriaan H. Van Zomeren elaborated on this idea by discussing these neurotic symptoms and used the term coping hypothesis to label this phenomenon. Struggles with attention, information processing, and memory skills interfere with the demands of daily life, and after brain injury, individuals must increase their efforts to meet the demands of daily living activities. The consequences of this increased effort and chronic stress are secondary symptoms that manifest as behavioral, social, and physiological difficulties.

Van Zomeren later referred to these “neurotic symptoms” as intolerances. He emphasized that such intolerances are present irrespective of head injury severity and may even be more significant in individuals with a hidden disability—those who have no physical, visible injuries but only cognitive difficulties. Subsequent studies indicated that since these difficulties are not evident on cognitive assessments, they are not directly related to the difficulties caused by the brain injury; rather, they result from the extra effort to compensate for the continued cognitive struggle experienced to meet both environmental and personal demands.

Literature on Coping

Richard Lazarus and Susan Folkman’s work played a pivotal role in laying the foundation for literature on coping in the field of psychology. They discuss coping strategies at length and describe two means of coping (i.e., reacting to aversive and stressful conditions): emotion focused and problem focused. Whereas emotion-focused coping involves the regulation of emotional reactions to the situation, problem-focused coping involves altering or changing the stressor.

There is strong evidence to indicate that it is important to match the coping strategy to the controllability of the situation; that is, a person should rely on problem-focused strategies in controllable situations and emotion focused-strategies in uncontrollable situations. For people with cognitive difficulties, the manipulation of such strategies and behaviors can be challenging. When individuals fail to demonstrate adequate coping strategies, regardless of the situation, the coping hypothesis predicts that they will present with cognitive, physiological, or behavioral secondary symptoms.

Empirical Research

There is research that examines the coping hypothesis in typically functioning animals (rats, bank voles, poultry, etc.). The coping hypothesis was supported by observations that animals demonstrating stereotypic behavior present with fewer physiological signs of stress than expected, that these behaviors appear to reduce pituitary–adrenocortical activity, and that opioid antagonists reduce the frequency of stereotypic behavior. Some researchers, however, have contested this viewpoint and stated that there is limited available support for the coping hypothesis in these animals. Hence, whereas some argued that a more enriched environment results in more stereotypic behaviors, lending support to the coping hypothesis, others demonstrated that support of the coping hypothesis, as measured by examining physiological signs of stress (cortisol levels, heart rate, etc.) was inconclusive.

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