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SOCIAL SUPPORT, SOCIAL NETWORKS AND COPING OF PARENTS OF
CHILDREN WITH CANCER: COMPARING WHITE AND AFRICAN AMERICAN
HOLLY ANN WILLIAMS
A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL
OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT
OF THE REQUIREMENTS FOR THE DEGREE OF
DOCTOR OF PHILOSOPHY
UNIVERSITY OF FLORIDA
Holly Ann Williams
This dissertation is dedicated to the memory of Jodi
Michelle Lukacs, who was born on November 11, 1974, and died
on May 22, 1978, from aplastic anemia. Jodi was one of my
first patients that I cared for as a young staff nurse at Yale
University Hospital, New Haven, Conn. As only a young child
can, Jodi taught me that life is precious, and filled with
wonder and joy, even when one is faced with a life-threatening
illness. Jodi's influence on my personal and professional
life was profound, and she significantly altered my career
choices. My relationship with Jodi convinced me to work with
chronically and terminally ill children and their families.
I have never regretted that decision, and this dissertation is
a way of offering thanks to the memory of Jodi. This
dissertation is also dedicated with love to Jodi's family: her
mother Bonnie, her father Roy, and her baby sister Karie, who
all taught me that life can have meaning, in spite of
tremendous human tragedy.
There are many people to whom I owe gratitude for
assisting me with this dissertation. First and foremost, I
would like to thank the parents and children for allowing me
to enter some very private moments in their lives. They
tolerated seeing me in the examination and hospital rooms,
they talked to me during periods of extreme stress, and they
stayed late on clinic days so that I could finish an
interview. This is their story and I deeply appreciate their
kindness, their humor, and their patience.
I also could not have done the interviewing without the
assistance of all the health care professionals. They are too
numerous to mention, but they include nurses, physicians,
social workers, aides, child life therapists, pharmacists,
etc. In spite of very busy days and, often grueling
schedules, they helped me in whatever ways I needed. For the
out-of-town sites, I was always made to feel welcome and part
of the staff. The staff humored me and often helped me to
decompress after difficult interviews. This is also a story
about the work that they do on an everyday basis.
This research would not have been possible without the
financial support that I received from various sources, most
notably a five-year pre-doctoral fellowship from the National
Cancer Institute. I am deeply grateful to the following
sources of support: National Cancer Institute, Nurses'
Educational Funds, Inc., Transcultural Nursing Society,
Association of Pediatric Oncology Nurses, and the Alpha Theta
Tau chapter of Sigma Theta Tau, International Nursing Honorary
My research assistant, Ms. Karla Slocum, and my
transcriptionist, Ms. Monique Costantino, put in much time and
effort to assist me. Both were very interested in the
research and gave me much needed support during the times I
wondered if I would ever finish.
My committee members have been with me since the
beginning and have offered support, encouragement, and wisdom.
My outside committee members went far beyond the usual
commitments for committee members and gave willingly of their
time and efforts. Dr. Marjorie White was my nursing colleague
before she was a committee member. She gave me support and
empathetic understanding for the challenge of blending two
professional fields. Dr. Joe Feagin has been essential to my
beginning understanding of race relations. He not only
stimulated my thinking, but he made me challenge my own
preconceived notions about our society. He was always
generous with his time and was only a phone call away during
tough weekends of analysis and writing. Dr. Gary Lee has
nurtured my interest in family studies since the beginning of
my graduate career. He helped me to think like a sociologist,
as well as an anthropologist. He also spent much time just
being there for me.
The anthropologists on my committee helped to shape who
I am as an anthropologist. Dr. Otto von Mering taught me the
wonders and the perils of being a medical anthropologist. He
offered suggestions for making my daily life sane,
particularly during the last few months Dr. Tony Oliver-
Smith sharpened my thoughts concerning the place of human
tragedy in our lives. He stimulated me to understand personal
meanings that we use to contextualize events in our lives. My
chairperson, Dr. H. Russell Bernard, has been involved in my
career since the beginning of my doctoral program. He taught
me the importance of grantsmanship. He also worked hard over
the years to improve my writing skills. Whatever improvements
I have made, I owe to him. I deeply thank my committee
I owe a large debt of gratitude to Dr. John Dixon,
Coordinator for Computer Applications, at the Center for
Instructional and Research Computing Activities (CIRCA) at the
University of Florida. Although not a committee member, he
patiently and consistently worked with me on my statistical
analyses. His mentoring skills are excellent, and he believed
in my abilities. From him, I learned statistics, data
analysis, and that I was capable of doing complex analyses.
Family and friends all across the country offered
listening ears, words of comfort, and laughter when it was
most needed. They understood how the process affected our
friendships, and were patient. My pediatric oncology nursing
colleagues reminded me how important this research was to our
Perhaps the hardest people to thank are my family
members. I am sorry that my father, Plummer H. Williams, did
not live long enough to see me finish the research. He and my
mother, Jane Williams, were always by my side. Many times
they did not understand the process, but they were there for
me. My sister, Dr. Susan Williams, knew from first-hand
experience how grueling doctoral studies were. She was a
critical support for me. She will never know how grateful I
am for the long-distant calls, the encouragement, the cheers,
and the constant belief in me as a person, as well as a future
I offer much love and gratitude to my husband, Dr. Art
Hansen. He had to straddle two difficult positions, being a
faculty member in anthropology and being my husband. His
never ceasing love and words of support carried me through the
bleakest times. I could not have done this without his love.
My life was enriched during my doctoral studies by having two
children enter my life: my stepson, Akim Ben Hansen, and my
daughter, Kaitlin Williams Hansen. Akim challenged my
thinking on everything, but always made me laugh and look at
life from a less serious perspective. Kaitlin gave me the
gift of her precious little self and, with that gift, I
understood my priorities. While education and research are
important, family ties are what really matter in the end.
TABLE OF CONTENTS
ACKNOWLEDGMENTS . .
ABSTRACT . . .
1 INTRODUCTION . .
Like a Blanket of Love .
Aims of the Study . .
Research Questions . .
Theoretical Framework .
Outline and Descriptions of Chapters
2 SOCIAL SUPPORT AND SOCIAL NETWORKS
Social Support . .
*. .. .. 1
Attempting to Define Social Support .
Social Support and Psychological Adaptation
Social Exchange Theory .. .....
Negative Aspects of Social Support .
Reciprocity and Social Support .
Relationship Between Social Support and
Social Networks . .
Social Networks . .
Network Research Findings .
Personal Networks . .
Geographical Distances From Networks .
Density of Networks . .
Social Support, Social Networks and Cancer
The Role of Social Support in Parenting
an I11 Child . .
3 AFRICAN AMERICAN FAMILIES . .
Historical Review of the Social Forces Shaping
the African American Family .
The Period of Slavery . .
African Influence . .
Emancipation Through the Early Twentieth
Century . .
The Viability of the African American Family
Cultural Deviant or Pathological Model .
Cultural Relativity or Cultural Variant
School . . .
Adaptive Responses to Society .
Contemporary Family Organization .
Societal Trends Affecting Families .
Causative Factor for Family Structural
Changes . . .
Social Networks and the Provision of Support
Social Networks of African American Families
Extended Families . .
The Consequences of Support and the Need
for Reciprocity . .
Informal Ties .
Comparisons Between African American and
White Social Networks . .
Relationship Between Patterns of Support
and Family Structure . .
Helping Traditions in African American
Communities . .
Conclusions . . .
4 COPING . . .
Review of the Literature . .
Coping: Definitions in the Literature .
Anthropological Use of Coping .
Historical Approaches to the Study of Coping
Models of Coping . .
Empirical Testing of the Coping Process .
Family Stress and Coping . .
Coping with Childhood Cancer .
Limitations to the Literature . .
Cross-Sectional Design . .
The Use of Retrospective Data .
Lack of Multi-Variate Models .
Situation-Specific Studies . .
Cultural Influences to Coping .. 116
Demographic Characteristics That Have Been
Ignored . . 117
Unsolicited and/or Negative Sources of
Support . ........... 118
Measurement of the Coping Process and
Desired Outcomes . .. 118
Outcomes . . 119
Efficacy of Coping . .. 120
5 STUDY DESIGN AND METHODS . .. 122
Human Subjects Protection . 122
Sample and Settings .............. 124
Data Collection Schedule and Procedures .... .127
Instruments . . 129
The Interview . .. 129
Instruments Used to Measure the Outcome
Variables . . 130
Social Network Inventory . .. 131
Historical Influence on Sampling ... .132
Analysis . . 135
Social Networks . ..... 136
The Ways of Coping Questionnaire (WCQ) 137
Brief Symptom Inventory ... .. 155
Center for Epidemiological Studies
Depression Scale (CES-D) ... 157
Coping Health Inventory for Parents (CHIP) 157
Testing the Conceptual Model .. 158
6 PARENTS OF CHILDREN WITH CANCER: DEMOGRAPHICS .162
Pediatric Oncology Services in Three Research
Sites . . ... 163
Atlanta, Georgia . .. 165
Gainesville, Florida . .. 166
Jacksonville, Florida . .. 167
Parent Demographics. . .168
Socioeconomic Demographics . .. 170
Employment Status . .. 173
Marital Status . .. 176
Characteristics of the Ill Children .
Age of the Ill Child .. .
Gender of the Ill Child ...
Variables Pertaining to the Children's
Illnesses . .
Financial Costs and Burdens Caused by the
Child's Illness . ...
Gross Estimates of Out-of-Pocket Costs
of Child's Illness . .
Additional Jobs and Loans as a Way to
Supplement Income . .
7 THE PROVISION OF SOCIAL SUPPORT: WHAT IT IS
AND WHO PROVIDES IT . .
A Heart Feeling . .
Emic Definition of Support . .
Coding of Responses for the Definition of
Support . .
Definition of Support as Compared by Race
Provision of Social Support . .
Situational Types of Support .
Offers of Spontaneous Assistance .
Support During Periods of Hospitalizations
Financial Assistance with Costs of Illness
Social Networks: Membership and Structural
Aspects . .
Network Membership Features .
Perception of Support from Alters .
Structural Characteristics of Social Networks
Relationships of Social Network Measures
to the Psychological Outcomes .
Concluding Discussion of Social Support .
8 THE PROCESS OF COPING AND ITS INFLUENCE ON
PSYCHOLOGICAL OUTCOMES . .
Types of Stressful Events Experienced by
by the Parents . .
Influence of Type of Stressful Event on
Coping Behaviors . .
Secondary Cognitive Appraisal of Stress .
Types of Coping Behaviors Used in Response
to Identified Stressful Events .
Significant Differences in Types of Coping
Behaviors Used by Race and Gender 255
Significant Differences in Functions of Coping
by Race and Gender . .. 258
Perceived Satisfaction with Outcome of
Stressful Situation . .. 259
Does the Process of Coping Affect Psychological
Outcomes? . . 263
Comparison of Mean Scores of Outcome Variables
by Coping Type, Gender, and Race 270
Do Coping Patterns Predict Psychological
Outcomes? ... . ... 273
Influence of Type of Coping and Perception of
Control on Psychological Outcomes 276
Correlations of Independent Variables and
Dependent Variables . .. 280
Multiple Regression Results with the Full
Conceptual Model.. . 282
Comparison of Parents' Psychological Outcomes
to Other Populations .. . 285
Limitations and Discussion of Findings in
Regard to the Theoretical Framework .. 293
9 PARENTS' PERCEPTIONS OF RACISM AS A FACTOR IN
OBTAINING MEDICAL CARE FOR THEIR CHILDREN 298
Racism, Discrimination and Health Care .. 299
Interview Questions Pertaining to Racism
and Discrimination . .. 303
Parents' Perceptions of Racism in the Pediatric
Oncology Setting . .. 304
Differences in Care Based on Race ... 307
African Americans' Perceptions Regarding
Differences in Care Based on Race 308
White's Perceptions of Differences in Care
Based on Race . ... 308
Illness and Medical Treatments as Buffers
from Everyday Racism . .. 310
"I Didn't Notice It or Didn't Care to Notice
It . . 313
Personal Observations of Racism. .315
10 CONCLUSIONS .................. .319
Personal Reflections about the Research .. 319
Random Acts of Kindness. . .324
Summary of Research Questions and Hypotheses 325
Major Research Questions and Aim of the
Study . . 325
Summary of Findings Pertaining to Social
Networks . . .. 327
Summary of Findings Pertaining to Support 331
Summary of Findings Related to Coping 334
Summary of Research Hypotheses .. 335
Review of the Theoretical Base of
the Research ... ........ .. 339
Modification of the Conceptual Model .. 341
Implications for Applied Practice . 344
Suggestions for Family, Friends, and Others
in How to Assist Parents of Ill Children 347
Areas for Future Research . .. 352
APPENDIX A INTERVIEW SCHEDULE . .. 355
APPENDIX B SOCIAL NETWORK INVENTORY . .. 361
REFERENCES . .. 362
BIOGRAPHICAL SKETCH. .. . .391
Abstract of Dissertation Presented to the Graduate School
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philosophy
SOCIAL SUPPORT, SOCIAL NETWORKS AND COPING OF PARENTS OF
CHILDREN WITH CANCER: COMPARING WHITE AND AFRICAN AMERICAN
Holly Ann Williams
Chairperson: Dr. H. Russell Bernard
Major Department: Anthropology
Having a child diagnosed with cancer is an overwhelming
experience for parents. The goal of this research was to
understand why some parents do better with this situation than
do others. Research questions included the following: Who
provides support to the parents? What is provided? What do
parents do to cope? In addition, this research compared white
parents to African American parents in an effort to explicate
racial and cultural differences in experiencing childhood
Two hundred two parents (150 white and 52 African
American) of children with cancer were interviewed in a
hospital or clinic setting in three southeastern US cities.
In addition, several standardized psychological instruments
were used to measure anxiety, depression, somatization, and
general level of psychological symptomatology. Qualitative
and quantitative analyses were performed on the data.
This was a story of courage and of incredible human
caring for others in distress. Overall, there were few
significant differences by race, gender, or site. These
parents had multiple sources of support. White parents had
larger social networks, but African Americans perceived
receiving more support from their network alters. Networks
were small, dense, kin-centered social networks of long
duration, with members living near to one another. Emic
definitions of support differed by race, with whites defining
support in emotional terms and African Americans defining it
more broadly, both in terms of emotional and instrumental
actions. Social network properties and characteristics did
not significantly correlate with or predict the psychological
Most parents used a combination of problem-focused and
emotion-focused coping behaviors to deal with stressful
situations. Only a small percentage of parents showed poor
psychological functioning. However, use of emotion-focused
coping behaviors, particularly escape-avoidance behaviors,
best predicted poorer psychological outcomes. Few of the
variables commonly thought to influence positive outcomes
(such as social support, income) predicted the psychological
variables. The experience of having a child with cancer was
so encompassing that nothing else mattered, not the amount of
support, or who provided it, or how much.
Like a Blanket of Love
This is a story about everyday people who are
experiencing one of the biggest, most demanding, and
frightening challenges of their lives. They all are parents
of children with cancer. The children are of different ages,
have different diseases, and have different prognoses.
However different these families may seem initially, the
experience of being told that your child has a potentially
fatal illness unites them in a myriad of ways. From hearing
the chilling words at diagnosis, "your child has cancer," to
traveling over and over again to the cancer clinics and
hospitals, to the days of waiting for lab test results, the
lives of these families are irreversibly changed. For some
families, this challenge heightens their spirit of life and is
turned into a positive challenge to be met together. For
others, the days become a vast wasteland from which nothing
good could ever spring, filled with pain and isolation.
Family becomes a metaphor for broken spirits and failed
While the specific details may vary as to the physical
environment or the people involved in the actions, the daily
drama of childhood cancer is repeated hundreds of times in
clinics and hospitals across the country. In some settings,
there is an attempt to make the surroundings as pleasant and
conducive to normal childhood activities as possible. One
sees volunteers assisting children with fun things to do;
furniture is bright and child-sized; examination rooms are
painted with murals and motifs and come with hanging mobiles
so that the children may concentrate on fantasies, and not on
Other clinics look like any standard hospital area. The
walls are a drab green or gray, there is never enough room for
everyone to sit down, equipment is scattered around the
hallway, and there is a sense of chaos that permeates
throughout. Children and families appear to get lost in the
vast machinery that is called the "medical system."
Yet appearances can be misleading. It only takes a few
moments of sitting with the children and families to realize
that something intangible occurs in these spaces. An
overwhelming sense of caring for these children and a profound
respect for the resilience within each child are seen over and
over again in many different ways. Although cluttered, the
hallways and the examination rooms are filled with photos of
the children and the children's hand-drawn pictures. People
stop whatever they are doing to give or get a hug from the
children, and to take time to listen about the latest school
adventure or a new pet in the family.
Families learn about each other and become "friends" in
a very special way that is circumscribed by events and the
clinic or hospital surroundings. They share in the joy of
good news, in the fear when their children come off treatment,
and in the grief of a relapse or death. Their silent language
of shared understanding is so well communicated that words are
The research presented here focused primarily on the
parents of the children. The story would not be complete,
however, without recognizing the efforts of others. For many
of the families, help comes from the health care staff, family
members, co-workers, and neighbors. Perhaps most striking was
the kind assistance I saw being given by strangers who reached
out to touch the lives of children and parents with whom they
had never met. As one mother described the support, it was
"like a blanket of love that surrounds you and protects you
from what you are going through at the time."
I have been a pediatric nurse specializing in pediatric
thanatology for 18 years. These months of research have, once
again, filled me with awe and wonder of the human spirit. I
watched these families cope with incredible circumstances that
made me shudder at times. Yet, they maintained a sense of
humor and an awareness of others, and they survived in the
truest sense of the word.
Aims of the Study
My research was motivated by these questions: Who
provides support to the parents? What is provided? What do
parents do to cope? The goal was to understand why some
parents do better with this situation than do others.
Historically, studies on coping and social support of parents
of children with cancer used white parents for subjects. Yet
the pediatric oncology population is racially and culturally
diverse. This research compared white parents to African
American parents in a effort to explicate racial and cultural
differences in families experiencing childhood cancer.
The specific aims of the study were a) to describe and
understand the differences for African American and white
parents in the experience of parenting a child with cancer,
2) to understand why some families experiencing childhood
cancer seem to have more social support than others, and 3) to
ask whether African American parents experience problems,
based on race, in receiving care for their children.
The research questions were as follows:
1) Are there racial or gender differences in the
characteristics of the social networks of parents of children
2) During the period of the child's illness, how do
social network members function to exacerbate or alleviate the
stress of having a child with cancer?
3) Are certain network properties associated with the
perception of being supported?
4) Are certain network properties associated with better
or worse levels of psychological symptoms?
5) How much support is given to parents of children with
cancer? Does this vary by race or gender?
6) What types of support are given to parents of children
7) Do different ways of coping predict better
psychological outcomes for these parents?
Lazarus and Folkman's (1984) transactional model of
stress, appraisal, and coping is the theoretical base of the
research. Coping is examined in detail and is tested in a
theoretical model to see if it predicts psychological outcomes
in the parents. Coping is defined as "constantly changing
cognitive and behavioral efforts to manage specific external
and/or internal demands that are appraised as taxing or
exceeding the resources of the person (Lazarus & Folkman 1984:
141). Coping is further differentiated into problem-focused
coping and emotion-focused coping. Problem-focused coping is
defined as "coping that is directed at managing or altering
the problem causing the distress," while emotion-focused
coping is "coping that is directed at regulating emotional
response to the problem" (Lazarus & Folkman 1984: 150).
A conceptual framework built on the stress, appraisal,
coping model of Lazarus and Folkman (1984) guided my research
questions (see Figure 1.1). Personal factors, such as race,
gender, education, marital status, and social network
characteristics combined with situational/environmental
factors (income, total amount of government assistance
received, length of child's illness, and social support) to
influence the primary appraisal of a stressful situation.
Secondary appraisal was thought to be influenced by social
support, degree of perceived control over the stressful
situation, as well as the personal and situational factors
that influenced primary appraisal. Coping behaviors included
emotion-focused coping and problem-focused coping. An
immediate outcome from the coping process was the perception
of satisfaction with the outcome of the stressful event.
Longer-term psychological outcomes included anxiety,
depression, somatization, and global level of psychological
symptomatology. At any point in this process, feedback
mechanisms could influence prior variables in the model.
This study also tests the applicability of previous
social support findings for African American families in
crisis. It compares coping across racial and gender
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categories. In addition, it examines whether racism is an
additional burden to African American families.
Based on a literature review and two pilot studies
conducted prior to the dissertation (Williams 1992, 1993) the
following hypotheses guided my work:
1) In situations characterized by a perceived minimum of
control, parents who use emotion-focused coping strategies
will demonstrate positive adaptational outcomes (e.g. lower
levels of psychological symptoms, less depression and
2) in situations characterized by a perceived sense of
control or changeability, parents who use problem-focused
coping will demonstrate positive adaptational outcomes;
3) social network characteristics (e.g. size, density,
length of time members have known one another) will not
predict perception of support;
4) white parents will define support primarily as
5) African American parents will define support primarily
as instrumental actions;
6) married parents will perceive and receive greater
levels of support than single parents, irrespective of race;
7) parents with higher incomes and education will
demonstrate a higher level of perceived support and will
receive greater levels of enacted support;
8) higher incomes will be associated with larger social
9) parents with lower incomes will demonstrate greater
psychological symptomatology, with single poor parents having
the worst adaptational outcomes; and
10) the shared experience of parenting a child with
cancer will diminish racial and cultural differences between
the African American and the white parents.
Outline and Descriptions of Chapters
The dissertation will present selected aspects of the
entire research process. Research findings that are not
presented in the dissertation will be completed at a later
date in the form of manuscripts submitted for publication. As
usual, I have far too much data to ever include in one
dissertation. Although much of the dissertation focuses on
the quantitative analyses that I completed, qualitative
analyses were also performed. Whenever appropriate, the
qualitative material will be combined with the quantitative
findings for better illustration of a point or concept.
Verbatim quotes will be used throughout the text to portray
the sentiments of the informants in their own words. Names,
institutions and locations will be disguised as needed to
preserve the confidentiality of the informants.
Chapters 2 through 4 review pertinent bodies of litera-
ture. Chapter 2 reviews social support, Chapter 3 discusses
the African American family, and Chapter 4 details coping.
Chapter 5 outlines the study design and the methods that I
used. Chapter 6 provides demographic information on the
informants, the ill children, and the research sites. In
addition, information pertaining to the financial status of
the parents is presented, as finances were a major worry for
these parents. Chapter 7 presents the findings related to
social support and social networks. Support is defined
emically by the parents. The types of support offered to the
parents are discussed, as well as identifying the support
providers. Structural aspects of the social networks are
detailed. The chapter concludes with a discussion of whether
social network attributes contributed to the psychological
outcomes of the parents. Chapter 8 focuses on coping. It
looks at which coping behaviors are used to manage a
particular stressful event using data from the Ways of Coping
Questionnaire (Folkman & Lazarus 1988a). For the sake of
brevity, the second coping instrument used, the Coping Health
Inventory for Parents (McCubbin & Thompson 1983), will not be
discussed in the dissertation. Data regarding whether coping
predicts psychological outcomes will be presented as well as
the results of multiple regression analyses based on the
conceptual model. Selected social network variables, demo-
graphic variables, social support variables, and coping
variables were all entered into the conceptual model. Chap-
ter 9 presents the results of whether African American parents
perceived racism and discrimination as problems in obtaining
care for their children. Chapter 10 summarizes the major
results of the research. Personal insights gleaned from the
research are shared. Each research question and study
hypothesis is reviewed. The theoretical base of the research
is highlighted, and modifications to the conceptual model,
based on the findings, are discussed. Lastly, clinical
interventions and lay suggestions for offering assistance in
this type of situation are outlined. Areas for future
research are presented.
SOCIAL SUPPORT AND SOCIAL NETWORKS
The experience of parenting a sick child can be likened
to riding a roller-coaster. Throughout the time of the
illness, there are many emotional ups and downs and sharp
corners to be turned without knowing what lies ahead. How-
ever, what is missing in this simile is the thrill and fun-
seeking aspects that one normally associates with riding a
roller-coaster. The events and experiences that cause the ups
and downs differ as the illness progresses, and parents'
abilities to withstand the tensions alter as time goes by.
But unlike riding a carnival ride, parents can not simply get
up and leave when the ride is finished. The course of the
illness varies and may last for years, requiring combined
modalities of treatments.
Diagnosis is an especially frightening time. For some
families, it represents the first time their child has been
seriously ill. Some parents and children may have to travel
to obtain care at a distant, specialized pediatric oncology
center. In an amazingly short period of time, parents are
asked to make decisions regarding the care of their child, and
to consent to treatment protocols that appear to be written in
foreign languages. Hospital routines and a new vocabulary of
medical terms and abbreviations must be learned.
Hospital and clinic bureaucracies present mazes that, at
times, entangle parents in their webs. Parents are confronted
with answering never-ending lists of questions, giving medical
histories over and over to new members of the health care
team, and filling out piles of insurance forms and/or
applications for much needed social services. Particularly
during the first year of treatment, the out-of-pocket
financial costs may exceed the family's expected budget. Few
health care professionals remember that parents are expected
to perform all these tasks at the same time that they are
exhausted from caring for their child and worried about the
short and long-term consequences of their child's illness.
For many children, their cancer goes into remission and
the stresses alter for the parents and children. Although the
child appears to be much healthier, the family is still
confronted with unexpected emergencies and must plan their
daily lives around a series of in-patient hospitalizations and
clinic visits. Whatever was deemed as "normal daily life" is
now altered due to the child's illness and treatment
requirements. New ways of interacting with friends and family
are incorporated so that the immune suppressed child is
protected. Sibling needs become more apparent and demand
parental attention. Parents must deal also with work
responsibilities that often were ignored during the initial
phases of the illness. Throughout the time of remission, the
fear remains that the child has relapsed, and the disease has
As the illness trajectory continues, some children are
cured, some remain chronically ill for years, and some
children die. Each scenario has its own stresses and demands,
even for the "cured" child. Years go by and parents worry
whether the cancer will eventually return.
Social support from a network of family, friends,
neighbors, acquaintances, and sometimes even strangers is
thought to lessen some of the intensity of the stress in this
situation. This chapter reviews the literature on social
support and social networks. The term "social support"
encompasses both perceived support and received or enacted
support. Perception of support refers to the belief that
support is available if needed, as compared to support that is
actually received. Social networks, the set of relationships
from which the support is provided, are also discussed. In
addition, the literature pertinent to support for parents of
ill children, especially children with cancer, is highlighted.
The literature on social support is vast and, at times,
unwieldy. This literature review concentrates only on the
aspects of support that are most relevant to my research.
Recent literature regarding social support and social networks
will also be incorporated into the discussion sections of the
Attempting to Define Social Support
Social support is a complex and multi-dimensional con-
struct. It has been studied in a myriad of ways to determine
types of support provided, categories of support providers,
mechanisms by which support protects people against the
negative effects of stress, and even what the best definition
is for support. Bruhn and Philips (1984: 152-53) suggest that
environmental, physical, social, interpersonal and cultural
facets of social support should be considered in any
definition of the concept. Classical definitions, such as
Caplan (1974) and Cobb (1976), stress the affective component
of support. An often used definition of social support notes
that it consists of interpersonal transactions that have at
least one of three characteristics: affect, affirmation, and
aid (Kahn & Antonucci 1980). Gottleib and Wagner (1991: 166)
stress the processual nature of support defining it as "a
social process that is shaped by the commerce occurring
between people in particular relationships who are attempting
to maintain their equilibrium in the face of conditions that
are personally and socially destabilizing."
Social support can also be conceptualized into the
dimensions of perception of support, enacted support, and
social embeddedness (Barrera 1986). Barrera notes that these
concepts were only mildly related and should be treated as
separate components of the construct social support. He
defines social embeddedness as ". the connections that
individuals have to significant others in their social
environments" (p. 415); perceived support as the ". the
cognitive appraisal of being reliably connected to others"
(p. 416); and enacted support as ". actions that others
perform when they render assistance to a focal person"
(p. 417) (Barrera 1986). I am modifying Barrera's concept of
social embeddedness for this research. Consistent with the
extant literature, I refer to social embeddedness as simply
the parents' social support networks. Social networks are
viewed as the source from which social support arises.
A consistent and major criticism of social support
research is the absence or inadequate conceptualization and
operationalization of the construct (Antonucci & Depner 1982;
Brownell & Shumaker 1984; Heller & Swindle 1983; LaRocco,
House & French 1980; Ryan & Austin 1989; Thoits 1982; Wortman
& Dunkel-Schetter 1987). Different aspects of support (i.e.,
enacted support and perceived support) have been discussed as
if they were equivalent (Heller & Swindle 1983). However,
research results from the past fifteen years demonstrate that
social support can not be conceptualized adequately as a soli-
tary dimension. Critics of the early work on support urged
for disaggregating the construct into separate components,
each of which could then be defined clearly and operation-
alized (Rook 1984; Lieberman 1986).
Reviewing the literature on social support, Wortman and
Dunkle-Schetter (1987: 70-71) suggest that support can be
distinguished into the following types: a) expressing agree-
ment of a person's beliefs, b) encouraging open expression of
feelings and beliefs, c) expressing of positive affect,
d) offering material aid, e) offering information or advice,
f) instrumental assistance with tasks, and g) acknowledging
that the person is part of a system of mutual obligation or
reciprocal help. Dunkel-Schetter and Bennett (1990) urge the
differentiation of support into cognitive and behavioral
aspects. They conceptualize support as either available or
activated. Once activated, there are differences in the
extent to which people seek support, the need or desire for
support in certain circumstances, and the actual receipt of
specific types of support from particular persons (Dunkel-
Schetter & Bennett 1990: 268).
Support has been measured generally in two ways:
perceptual appraisal and structural network measures (Ryan &
Austin 1989). Both measurement approaches need to be included
in research. It should be noted that support changes circum-
stantially and temporally and these changes can cause discre-
pancies in individual answers versus objective counts of
support (Singer & Lord 1984). The relationship between the
support provider and the support recipient and how this
affects the outcome of the stressful situation is a component
of social support research that is sorely lacking (Coyne &
Social Support and Psychological Adaptation
Since Cassel's (1974) classic paper on the relationship
between stress and social support, researchers have been
studying if and how social support protects people from the
effects of stress. Numerous papers have summarized the
beneficial effects of support in a variety of situations
(Bloom 1982; Broadhead & Kaplan 1991; Brownell & Shumaker
1984; Dean and Lin 1977; Lin, Woelfel & Light 1985; Wortman &
Dunkel-Schetter 1987). Assuming this to be so, the center-
piece of prevention and intervention programs has been to
strengthen systems of social support to enhance human
adaptation in a variety of circumstances. Whether or not
social support is consequential for mental health in any
causal sense is now being questioned (Coyne & DeLongis 1986:
454). While well-being may be tied to supportive relation-
ships, the linkages are thought to be complex, reciprocal, and
contingent. The contextual situations that govern the
relationship between perception of support and its supposed
adaptational consequences need attention (Coyne & DeLongis
Social Exchange Theory
Aspects of social support can be conceptualized using
social exchange theory. This theory stresses the mutual
interdependency of people and proposes that one strives to
maintain equity of exchanges in relationships (Blau 1964;
Chadwick-Jones 1976; Gouldner 1960). Although equity is
desired, there is a tendency toward imbalance (Chadwick-Jones
1976). Inequitable relationships over time will cause
distress, and individuals will seek to restore equity in
unbalanced relationships. Both the overbenefitted and the
underbenefitted will feel stress (Stewart 1989; Tilden &
While this theory may have some applicability in studying
social support exchanges, there are additional considerations
that need to be examined. The costs of receiving assistance
need to be studied in closer detail. As well, the desire for
equitable exchange may be differentiated on the basis of the
type of social relationship, the timing of the assistance,
and/or the specific type of assistance given (Rook 1987).
Much of this work has been done in experimental laboratory
settings and needs to be tested in field settings (Antonucci
& Jackson 1990). How reciprocity operates within the context
of specific situation needs to be further studied.
Negative Aspects of Social Support
Confounding the problem of inadequate conceptualization
has been the implicit understanding that social support is, by
its very nature, "good" or positive (Coyne & DeLongis 1986;
Coyne, Wortman & Lehman 1988; Rook 1984; Wellman 1981; Wortman
& Dunkel-Schetter 1987). Quantity of contact with others has
been equated with high levels of social support, yet few
studies look at the problems found in such contacts (Rook
1984). By focusing solely on the positive aspects of
relationships, the negative elements of support and the
uncertain and/or unsuccessful attempts to obtain support have
In order for social support to be effective, it must meet
the needs of the support recipient by decreasing the demands
placed on the recipient, increasing resources or altering the
consequences of failing to manage such demands (Woods, Yates,
& Primomo 1989). Recent findings indicate that "supportive"
interactions can result in significant stress and problems
concurrently with providing much needed assistance (Cramer,
Riley & Kiger 1991; Fisher et al. 1988; Tilden & Galyen 1987;
Wellman 1981; Wortman & Dunkel-Schetter 1987). Problematic
areas include a) differing perceptions of efficacy between the
provider and the recipient, b) availability of social network
members during a crisis, c) level of satisfaction (adequacy)
with received support, and d) activation of support, the
extent to which support is desired, needed, sought, or
received (Bloom 1982; Wortman & Dunkel-Schetter 1987). Social
support can be seen as unhelpful when it serves to undermine
self-esteem (Stewart 1989). In addition, the process of
support is affected by contingencies that arise during the
stressful event that precipitated the need for support. These
contingencies include a) the amount of distress communicated;
b) the nature of the topic and the help expected; c) both
parties' responses to the stressor; d) and the restraints that
each person's coping strategies place on the other's receipt
of support (Gottleib & Wagner 1991:171).
Reciprocity and Social Support
Reciprocity involves the processes of giving, receiving,
and repaying. Giving and receiving are essential elements of
social support. In everyday social relationships reciprocity
plays an important role by balancing obligations among members
of social groups. Relationships characterized by either
excessive giving or receiving (i.e., the situation of the
parents of ill children) can be detrimental to the support
process (Ingersoll-Dayton & Antonucci 1988).
Wentowski (1981) studied exchanges among older people and
found that the nature of the relationship was more important
than age. Both equivalency of exchange and time of exchange
were important factors. She also delineated types of recipro-
city: immediate, deferred, and generalized. Superficial
relationships used stricter rules of exchange and expected the
return of equivalent gifts in a shorter period of time.
Intimate and longer term relationships allowed for non-
equivalent exchanges over a longer span of time. Wentowski's
work did not ask what happened if the recipient was unable to
return the assistance.
Similarly, Clark (1984) distinguished social relation-
ships as either communal or exchange relationships. Communal
relationships are closer relationships that have an implicit
assumption that the parties in the relationship will be
responsive to each other's needs in a general way. Exchange
relationships are based on a pragmatic relationship in which
assistance is offered in response to specific benefits
Bruhn and Philips (1984: 155) hypothesize that the
relationship between a person's level of functioning and the
social support received is related to the degree to which the
individual reciprocates social support. If support recipients
feel that they are unable to return the benefit then social
relationships can become strained. Perhaps more importantly,
those in need of help may then be unwilling to seek help or
accept offered support (Antonucci & Israel 1986; Stewart 1989;
Woods, Yates, & Primomo 1989).
There are some gaps in the conceptualization of
reciprocal relationships when one considers a crisis
situation, such as parenting a child with cancer. First, it
is not solely a dyadic exchange. As noted before, it may
involve both kin and non-kin, as well as others outside the
social network. Patterns of exchange occur that reflect both
communal and exchange relationships. Therefore, long held
expectations about the balance of support over a life-time in
intimate relationships are pertinent to only some of the
Support is an interactional process and recipients simply
do not passively accept such assistance. But as Silver,
Wortman, and Crofton (1990: 398) note, little attention has
been paid to the recipient variable that may influence the
provision of support. Rarely has the recipient been asked if
they feel a need to reciprocate, and, if so, how would they do
Reciprocity is difficult, if not impossible, to practice
in the situation of parenting a seriously ill child. The time
demands created by the illness and treatments are immense.
Most parents have conflicting pressures between managing the
illness and managing work responsibilities. Emotionally, many
parents talk about being depleted of any extra energy with
which they could do other things. In addition, siblings
frequently require special assistance during this time.
Relationship Between Social Support and Social Networks
The source from which support is provided, i.e., the
social network, is important in understanding how social
support operates. Analysis of social network ties may be used
to describe characteristics and variables that constitute the
opportunity for social support (Bloom 1982; Israel 1982;
Social support does not occur as an isolated entity but
rather it is derived from relations with members of one's
social network. Social networks are a series of ties or
social connections between individuals that vary in terms of
structure and function (Heller & Swindle 1983; Mitchell 1986).
Theoretically, social networks are representative of social
structure and the web of ties of different sorts can link
people throughout society, however remotely (Mitchell 1986).
It is important to remember that social network boundaries are
not fixed and static but, rather, fluid in response to situ-
ational contexts, perceptions of one's social relationships,
and even geographical distances and time (Jacobsen 1986). How
the alteration of such boundaries affect the provision and
receipt of support needs to be examined.
For the purpose of this research I concentrated on a
subset of the parent's total social network. The network has
been defined narrowly as a personal (ego-centered) social
support network. The network represents the ties between the
parents of children with cancer and the individuals whom the
parents identified as being helpful or important to them
during the course of their child's illness.
Social network analysis has emerged from the study of
sociometric analysis, British "Structural-Functionalism," and
crisis theory (Moos & Mitchell 1982). Network analysts study
social structure by analyzing patterns of ties linking its
members and describing how these patterns influence or
constrain social behavior (Mitchell 1969a; Wellman 1985). The
emphasis of study is on examining the concept of ties linking
nodes (i.e., persons, groups, organizations), the properties
of such ties (density, dispersion, content, duration, etc.),
and how resources flow across ties. Individual charac-
teristics of persons (such as the ability to ask for help,
degree of empathy, feelings of fear) may affect the flow of
resources. Culturally specific beliefs and values also shape
how resources are given and received within a network. How a
network is defined (i.e., who is included in the network) may
also be shaped by cultural beliefs (Jacobsen 1986).
Differences in the features of social networks have been
described as having structural, functional and interactional
characteristics (Rounds & Israel 1985). Functional charac-
teristics may include access to social contacts, maintenance
of social identity, and the provision of affective, affirma-
tional, and material aid (Rounds & Israel 1985). Structural
components are size or range, network density, and degree of
connection. Intensity, durability, multi-dimensionality,
directedness and reciprocity, relationship diversity,
dispersion, frequency and homogenicity describe the interac
tional elements (Mitchell & Trickett 1980).
Network Research Findings
The studies of social support and social networks are
closely interwoven in the research literature. For a person
experiencing stress, the existence and use of a social network
hedges against the collapse of a single relationship. In
addition, network members can offer consensual information and
validation (Gottleib 1988). Networks that are diverse in
nature and capable of providing multi-faceted support appear
to enhance perception of support and social adaptation in
Wellman (1985) studied a large community sample of
working-class adults to discern the kinds of supportive
resources flowing through a naturally occurring sample of ties
and networks. His data showed a complex, multi-dimensional
array of specific resource transfers with the most common
categories of support being companionship, emotional aid and
small services. The complex ties and resource transfers
suggested variation in the type, extent, and breadth of social
Fisher et al. (1988) reviewed the literature and found
that studies indicate that family members are chosen for
longer-term serious problems, while friends are chosen for
short-term everyday problems. Friends may be seen as
supplemental to the family, but not as a substitute. Other
data suggest that one source of support does not compensate
for another that is lacking (Coyne & DeLongis 1986).
In an intensive ethnographic analysis of unmarried
teen mothers, the better adapted teens displayed a more
differentiated view of their social networks' taxonomic
structure and perceived network members as more diverse in
their capacity to offer various types of support. The results
also suggested that support was best received from network
members who are perceived to be permanent and enduring
components of their social world (Boyce, Kay, & Uitti 88).
Geographical Distances From Networks
Sociological studies focused on the question of urban
isolation have demonstrated that due to communication and
transportation advances, urbanites are embedded in networks of
supportive others that fall disproportionately outside
boundaries of the immediate neighborhoods (Fischer 1982;
Wellman 1979). Significant others may be a component of
personal networks and yet live away from the contact person.
While this paper is not a study of urbanites, an understanding
of environmental determinants of networks can assist in
interpreting whether geographical isolation from a network
(such as being away from home in the hospital) affects network
Density of Networks
Findings regarding density appear to be situation-
specific, and somewhat contradictory. Some argue that dense
networks are able to offer emotional support to a person in
distress (Simmons 1994). For example, in family crises
involving death of a parent, children cope better in high-
density, close networks (Hammer 1981). Contrasting this,
Granovetter (1973) notes that weak ties may be more useful in
situations where linkages are needed outside the primary
group, such as moving or job-seeking. Hirsch (1980) studied
the adjustment of women in college and has found that dense
networks were significantly related to greater symptomatology,
poorer mood, and lower self-esteem.
A series of studies was recently completed that compared
parents of handicapped or chronically ill children to parents
of healthy children (Kazak 1987a; Kazak & Marvin 1984; Kazak,
Reber, & Carter 1988). Personal stress, marital satisfaction,
and network size and density were compared across sets of
parents. Stress was consistently found to be higher in the
parents of handicapped children, especially for the mothers.
Mothers of handicapped children were found to have higher
density measures of their social networks, but when compared
statistically, there were few significant differences between
groups with regard to the size and density of the parent
networks. However, for both sets of parents, larger, less
dense networks were associated with decreased experiences of
psychological distress, particularly for the mothers. How-
ever, the causal direction of this relationship is not known.
While these studies did not focus on the experience of child-
hood cancer, hypothetically these findings are applicable to
the issue of dealing with chronic illness, such as cancer.
The last section of this chapter focuses on the role of
social support and social networks for parents of children
with cancer. Although there is a vast array of literature
pertaining to social support and adult cancer patients it will
not be reviewed here. The support issues pertinent to adults
experiencing cancer are vastly different from the issues
confronting parents of children with cancer.
Social Support, Social Networks and Cancer
There is ample documentation of the turmoil and suffering
experienced by a family when a child has been diagnosed with
cancer (Bakke & Pomietto 1986; Binger et al. 1969; Chesler &
Barbarin 1984, 1987; Fife, Norton, & Groom 1987; Futterman &
Hoffman 1973; Moore, Kramer, & Perin 1986). Social support is
just one component of people's lives (Jacobsen 1986) but there
is broad agreement that social support is important in coping
with this turmoil and suffering.
There has been limited attention to the role of support
for pediatric oncology patients and their families, as
compared with studies of adult patients with cancer.
Perception of adequacy of support and satisfaction with
support has not been discussed (Hamlett, Pellegrini, & Katz
1992: 36). Findings indicate that support plays a role in
mitigating the stress of childhood cancer, although the
studies suffer from a lack of attention to the social networks
or other factors that might influence how support works (Fife,
Norton, & Groom 1987; Lynam 1987; Magni et al. 1986; McCubbin
et al. 1983).
The Role of Social Support in Parenting an Ill Child
As described previously, serious childhood illnesses,
such as cancer, pose multiple cognitive, emotional, and
physical demands on the entire family. Families cope not only
with the stress of caring for their ill child, but also with
life events such as illnesses/hospitalizations of other family
members, occupational changes, financial concerns, moving,
planning vacations, and deaths of other ill children or family
members (Kalnins, Churchill, & Terry 1980).
In response to this situation, members of the parent's
social networks offer assistance. Networks expand to include
strangers and communities who become involved in making the
life of the family easier in a myriad of ways. In fact,
family growth and survival during the period of treatment may
be determined by the family's abilities to mobilize and
maintain their resources (Thoma, Hockenberry-Eaton, & Kemp
Social support, both perceived and actual, is thus seen
as an important coping resource for the parents (Huang 1991-
1992; Tunali & Power 1993). Parents seek support from a
variety of sources and employ a broad range of coping stra-
tegies to deal with childhood cancer (Chesler, Barbarin, &
Lebo-Stein, 1984). Psychosocial adjustment in parents has
been positively correlated with the amount of support received
(Morrow, Hoagland, & Morse 1982). Kazak and Marvin (1984)
suggest that informal sources of support are more critical to
family well-being than are formal sources of support. Find-
ings from other studies indicate that spouses, the medical
community, and other parents from self-help groups are
valuable sources of support (Barbarin, Hughes, & Chesler 1985;
Lynam 1987; Morrow, Hoagland, & Morse 1982).
Chesler and Barbarin (1984) note that parents' abilities
to identify their need for help correlates positively with
success in receiving help. Families with higher socioeconomic
status (SES) used friends for support, while families with
lower SES used health professionals. Other factors
influencing family adjustment to childhood illness include
economic resources, family communication patterns, marital
adjustment, access to medical care, and parental perceptions
of the child's illness (Clements, Copeland, & Loftus 1990).
Perceived social support continues to have a positive
effect for parents of childhood cancer survivors. Parents
experiencing low levels of perceived social support were
significantly more depressed and anxious than parents of
healthy children in one study. For mothers, the generalized
perception of support is most important to psychological well-
being. For fathers, a combination of the specific support
offered by marriage and the generalized perception of social
support is most conducive to well-being (Speechley & Noh 1992:
This chapter examines the role that social support plays
in helping families deal with the experience of childhood
cancer. It questions whether social support and assistance
are always helpful processes. It delineates the differences
between social support and social networks, and concludes with
a review of social support specific to parents of ill
children. The next chapter reviews the African American
family, paying particular attention to the role of support in
AFRICAN AMERICAN FAMILIES
The subject of the African American family has
received tremendous attention during the past six decades.
Various theoretical paradigms have argued the origins and
variability of the African American family. Some writers said
that the African American family evolved into a unique
cultural form as a response to racism, while others argued
whether the African American family was a pathological
institution. Still others argued whether the African American
family was a variant on the white family.
The literature remains weak in some areas regarding the
study of African American families. In-depth ethnographies of
African American families have not been written since the
1970s (e.g., Aschenbrenner 1975; Stack 1974). Recently, a few
large, randomized studies have been completed which examine
diverse phenomena affecting African American family life
(Taylor, Chatters, & May 1988; Taylor 1990). It is not known
whether contemporary societal conditions have overwhelmed the
African American family to the point that years of tradition
of extended assistance npw fall short. Are problems so severe
now that available help has been depleted? If so, what
happens when a catastrophic event, such as childhood cancer,
faces a family? To whom do they turn? Is there a difference
between African American and white families facing this issue?
I argue in this chapter that the African American family
survives as a viable institution with its own norms and expec-
tations. Family structure and the family's ability to provide
assistance have altered in the face of years of racism, denied
social and economic opportunities, and a deteriorating social
environment affecting both the dominant white culture and the
African American culture.
This chapter examines the African American family from a
variety of perspectives. The literature on the African Amer-
ican family is voluminous. The chapter concentrates on those
topics most relevant to the dissertation research. First, it
is necessary to determine historically the social forces that
shaped the family organization before one can question the
viability of the family. Therefore, the history of the
African American family as an institution from slavery to
modern times is briefly described. Major theoretical para-
digms are discussed regarding the structure and viability of
African American family life. The final section of the paper
focuses on African American family social network research.
Extended family support is seen as a strength of the African
American family. Extant literature is reviewed regarding how
and if social support is received from members of the extended
African American family and others. Intra-cultural variation
regarding social support and characteristics of social
networks for both African American and for white families is
a crucial component of the dissertation.
Historical Review of the Social Forces Shaping
the African American Family
The Period Of Slavery
Slavery challenged the resilience of both individuals and
families. Individuals suffered multiple losses loss of
a homeland, customs, and emotional attachments to the land and
to people left behind; loss of freedom and dignity; and, for
some, loss of life.
Scholastic arguments developed regarding how African
American men, women, and families responded to the conditions
of slavery. A prominent argument stated that the demise and
disorganization of the African American family began in the
wretched conditions of slavery. Families disbanded; sexual
mores did not exist; and women ruled the slave family with
little need for or regard to the slave man. Proponents of
this argument held that slavery was the first step in a long
process of family disintegration (Frazier 1939; Harris 1979).
Not only did slavery destroy the family, according to
this argument, slavery also served to strip African American
families of all their cultural heritage and customs. Frazier
(1939) argued that enslavement erased any perpetuation of
African kinship and family relations. Conditions of life in
America destroyed the significance of an African heritage, and
new habits and attitudes formed to meet the new situations
(Frazier 1957). Family life during slavery was portrayed as
non-existent due to the selling of children, the separation of
kin as slaves arrived in America, and the emasculation of the
African American male. The African American woman was seen as
the most dependable and most important member of the family.
Frazier's description of slave life was harsh and focused
attention and blame on the slaves. He described a loss of
morals and wanton sexual behavior of the slaves, particularly
Contrasting the belief that slavery eroded the family,
others argued that the family as an institution survived.
Family life was important; attachment between slaves was real;
and thousands of slaves fled in search of missing family
members (Franklin 1988a). Gutman (1976) destroyed the myth of
the dissolution of the African American family during slavery.
He studied records from enslaved African Americans, their
children and grandchildren, and showed how they adapted to
enslavement by developing distinctive domestic arrangements
and kin networks. Those networks fostered a new Afro-American
Using census data from various cities (1880-1925), Gutman
demonstrated most African Americans lived in nuclear families,
regardless of social class, and that the two-parent family was
the dominant form. He further argued that current family and
kinship patterns originated during slavery, and that these
practices reflected an African heritage. Slave conceptions
regarding marital, familial, and kin obligations were passed
from generation to generation by slaves in marriages of long
duration. Extended kin networks revealed one aspect of the
adaptive capacities of the slaves and their offspring. This
study was critically important in addressing the question of
whether the institution of the African American family had
According to many authors, African heritage played a
prominent role in the survival and adaptation of the African
American family during slavery and afterward as well (Foster
1983; Herskovits 1958; Martin & Martin 1985; Sudarkasa 1988).
However, this view is not universally accepted. In the 1957
revision of Frazier's book (1939), he continued to espouse
that it was difficult to establish any factual linkage between
the African family system and the African American family.
More recently, Martin & Martin (1985) said that the brutality
of slavery was, in itself, a force against the perpetuation of
former cultural traits. African slaves came from diverse
tribal backgrounds and did not share a common language. Slave
masters fought against the retention of cultural traits, and
mere survival, at times, forced slaves to forego their efforts
to maintain their culture.
Yet, in spite of the forces that militated against
retaining African traditions, aspects of slavery worked to
foster humanistic values and patterns of assistance (Martin &
Martin 1985). Helping traditions were deeply rooted in
African culture, and non-institutionalized aspects of culture
were maintained more easily than other cultural ways. The
slave system demanded cooperation to ensure survival. Slaves
established their own community structures in the slave
quarters during the few hours when they were not working for
the masters. Leaders arose and attempted to maintain the
spirit of life as previously known in Africa. In short,
oppression led to patterns of assistance necessary for day-to-
day existence (McCray 1980).
DuBois (1908) was the first scholar to urge the study of
the African American American family against the background of
its African origins (Sudarkasa 1988). African cultural
traditions that were carried to America and transformed by
subsequent years of slavery and oppression included fictive
kin, extended family networks, marriage rules and rituals,
consanguineal kin groupings, husband-wife relations with
complementary and egalitarian roles, patterns of respect and
deference, socialization practices, and corporate identity
(Foster 1983; Martin & Martin 1985; Rodgers-Rose 1980;
Although enslaved Africans came from different West
African tribal groups, some features of kinship organization
and social institutions were commonly held (Sudarkasa 1988).
Patriarchy and polygyny figured prominently in African life,
and an individual could not place his or her personal
interests above those of the group. In many groups, lineage
membership was passed through women and women held important
instrumental and economic roles, particularly in regards to
bearing and raising children.' The universality of African
practices, values, and institutional arrangements aided
American slaves in establishing family organization during
slavery (Foster 1983; Sudarkasa 1988). The African principles
of respect, restraint, responsibility, reciprocity, and a
commitment to the collectivity provided a basis from which
African Americans would establish extended family networks
during slavery. The specific forms the networks took
reflected the political and economic circumstances of the
enslaved populations, as well as the influence of European-
derived institutions (Sudarkasa 1988).
Emancipation Through the Early Twentieth Century
The Civil War and Reconstruction presented new problems
and challenges for the African American family.2 Free African
Americans assisted in the freedom fight for others by their
'For more in-depth discussions of African practices and
their integration into African American life, see Foster
(1983) and Sudarkasa (1986).
2For a historical review of African American life in
American society, see Franklin and Moss (1988).
efforts in the Underground Railroad. Kin consciousness
extended to racial consciousness with the awareness of the
plight of all African Americans. Free African Americans
normalized the natural helping traditions of the slaves
(extended family and fictive kin) establishing churches,
benevolent societies, fraternal orders, and schools (Franklin
& Moss 1988; Martin & Martin 1985).
The resiliency of African American families was shown
through their efforts during Reconstruction to unite with lost
family members, to establish legitimate marriages with legal
marriage contracts, and to foster and adopt orphaned African
American children (Franklin & Moss 1988; Gutman 1976).
Sharecropping perpetuated poverty. Though mired in debt,
subsequent generations were tied to family land, and forced to
depend on relatives for survival (Martin & Martin 1985;
Sweeping social changes occurred at the turn of the
century with the transition from agriculture to urban indus-
trialism. European peasant immigrants competed for jobs; the
Great Depression hit; and, hoping to find better oppor-
tunities, southern African Americans migrated by the thousands
to the northern urban centers.
The agrarian system of the rural South was exploitative
and limited the opportunities for advancement of African
American families. Large extended families were an economic
necessity. As the migration took hold, families continued to
extend as they adjusted to social and economic conditions in
the cities. Although social welfare programs were introduced
in the New Deal, African Americans continued to face
overwhelming social injustice and lack of opportunity (Harris
1979; Foster 1983; Franklin & Moss 1988; Martin & Martin
The brief historical review is important for several
reasons. First, the family as a social institution cannot be
understood in isolation. From slavery to contemporary times
the political, economic, and social climate of the country has
alienated African Americans and hindered opportunities.
Racist ideologies and discriminatory practices, such as
segregation, are simple examples of the many forces affecting
the African American family. Second, the historical sequence
provides insight on the establishment and importance of
African American family organization, in spite of tremendous
outside pressures against its formation. From the beginning
of African American family life in America it is clear that
mutual support from established extended networks has been a
core tradition and value. Environmental conditions mitigated
against individualism and fostered cooperative patterns to
insure group survival. The collective, extended nature of
family life would later haunt the African American family as
critics argued that such a form was counter to the norm and,
thus, pathological. Third, understanding the impoverishment
of the African American community, the effects of rural-urban
migration, and the limited economic opportunities for African
American families sets the stage for reviewing the conflicting
models of the contemporary African American family.
Families everywhere--African American or white, national
or international--must adapt continuously to changes in the
larger society and its institutions by modifying their
structures and functions (Berardo 1990). A key issue that has
been fought, and continues to be fought, is whether African
American families are adaptable and resilient, or whether
external forces have weakened the family to the point of
collapse. I believe that history shows the adaptability of
the African American family. The next section presents the
contemporary arguments between the paradigms of the cultural-
deviance model versus the resilient-adaptive model. The
resilient-adaptive model is the stronger. The last section of
the chapter on African American networks and social support
exemplifies the adaptability of the African American family.
The Viability of the African American Family
Many writers have questioned the very existence of the
African American family as an institution over the past 50-60
years. The issue raised was ". is family and household
structure in the African American community indicative of
'social disorganization,' or are distinctive features of Afro-
American domestic groups adaptations to economic marginality
and oppression?" (Dressler, Hoeppner, & Pitts 1985: 853).
As the debate raged, more subtle questions emerged regarding
the extent to which the African American family and community
life reflected traditional African values and practices;
whether the issue of African American family structure
pertained more to class differences than racial differences;
and what the causes were for apparent racial differences
regarding family functioning.
The two major paradigms that emerged were the following:
a) African American family life is disorganized and patho-
logical (the mainstream view); and b) African American family
life is an organized, logical approach to oppression (the
dissenting view). The models will be discussed separately.
Cultural Deviant or Pathological Model
The pathological model (also referred to as the "cultural
ethnocentric school," Dodson 1988) saw the family as unable to
provide the social and psychological support necessary for
full assimilation into the dominant society. White middle-
class family values were considered the societal norm.
African American marriages were seen as the most fragile of
conjugal units, and the African American woman/mother was
depicted as the core of a matrifocal society.
E. Franklin Frazier (1939) studied race relations and the
process of how African American families were culturally
assimilated into white society. He attributed variations in
sexual and marital practices to a) matriarchal characteristics
of the family, whereby males were marginal; b) the lack of
legal marriages in slavery and casual sex as a norm causing
later marital instability patterns; and c) urbanization as a
force in the dissolution of family life (Staples 1986; Stewart
1990). He believed that contemporary family organization
traced back to slavery and to the influence of American
culture, not to African cultural transfers (Dodson 1988).
Contemporary with Frazier, African American
intellectuals, such as W.E. DuBois, urged assimilation and
stressed the need for the African American family to adopt
norms held by white, middle-class families. The model applied
to writers of this persuasion was called the "Cultural
Equivalent" model. This model depicted African Americans as
legitimate when they adopted the lifestyle and norms of
middle-class whites (Johnson 1988). (This was also the time
that the Structural/Functionalism ideology was popular.
Conservatism was accepted social patterns were
identified and reasons were created to justify those patterns.
Process, change and individual responses that were outside of
the mainstream were not valued in this paradigm.) However,
writers during the 1940s-50s challenged the idea that the
African American middle-class was economically secure and
better assimilated (Harris 1979). This period led to the more
scathing studies of the 1960s .the period of the African
American family seen in negative, pathological terms.
Best known of this genre is Moynihan's report (March
1965), The Negro Family--The Case for National Action. The
same themes as discussed earlier were repeated; the African
American community was characterized by matriarchy, broken
families, economic dependency, and delinquency and crime.
Moynihan described the African American community as a "tangle
of pathology" and identified the fundamental problem as the
crumbling family structure. The matriarchal structure was
inconsistent with American society, and African Americans were
disadvantaged as their values were not in line with the
dominant societal values. Moynihan's report was linked to the
"Culture of Poverty" thesis (Lewis 1966). The "culture of
poverty" described the lower-class poor as having limited
ability to defer gratification, having high incidence of
material deprivation, weak ego structure, and lack of impulse
control. African Americans were both the victims of and were
blamed for their misfortunes. Moynihan's central recommen-
dation urged the national government to set a goal of
establishing a stable Negro family structure. This implied
structural changes in the family, replacing African American
familial features with characteristics emulating the white
middle-class the so-called "functional normative model
family" (Dodson 1988). (The prevailing social climate during
this period was one of unrest, challenging the status quo, and
resisting the established societal structures. The Civil
Rights movement had gained momentum and was seen as
challenging and frightening in much of the dominant society.)
Cultural Relativity or Cultural Variant School
Responding sharply to the negative, victim-blaming stance
of the previous work, critics of the pathological model lauded
the African American family as a functioning entity in its own
right. The cultural relativity model proposed that the
African American family was a culturally different family
form, nondeviant, with values and family patterns instrumental
for combating oppressive racial, political, and economic
conditions of American society (Billingsley 1968; Dodson 1988;
Herskovits 1958; Hill 1972; Johnson 1988; Shimkin, Shimkin, &
Frate 1978; Stack 1974). Aschenbrenner (1975) described the
African American family as a cultural institution with a long
tradition whose social organization was created in the face of
adversity, and not merely adjustment to contemporary urban
Focusing on family strengths, this framework proposed
that the African American extended family and domestic units
adapted to economic marginality. Historical forces were
inimical to family formation and maintenance. Judged against
alien norms, social roles in America demanded variability from
the African American family in order to survive (McCray 1980;
Staples 1985). Structural transformation of the economy from
industrialization to a service oriented market, with an
emphasis on high technology, and a dismantling of a welfare
state were seen as responsible for African American family
problems--rather than blaming the victims (Ladner 1986).
Collins (1989) sharply criticized Moynihan's report
implicating the African American family as the source for
creating deviant societal values that ". in turn, collec-
tively shape African American cultural deficiency" (p. 877).
She and others contended that Moynihan neglected the manner in
which racism and political and economic factors shape indi-
vidual and/or group accomplishment (Collins 1989; Ladner
Countering the earlier importance placed on attitudes and
values as primary predictors of economic achievement, contem-
porary family scholars place environmental restraints on
mobility and achievement as a primary problem. Analyzing
census data, Farley & Allen (1987) claim that the majority of
African Americans in the United States remain separate and
unequal because a legacy of African American subjugation
remains. The subjugation is seen in persistent racial
inequalities in educational achievement, family structure,
occupational attainment, patterns of unemployment, income
levels, residential segregation, and distribution of wealth.
While declamations of the dominant society are assimila-
tionist, political/economic/social structures remain committed
3Rainwater and Yancy (1967) provide a more complete
analysis of the events leading to and after the publication of
the Moynihan report.
to exclusionary practices and continued subordination of
African Americans (Jaynes & Williams 1989; Young 1989).
Adaptive Responses to Society
The question becomes "what are the strengths and coping
strategies used by the African American family to counter such
obstacles?" The most discussed strength is the strong sense
of obligation to kin and the extended family structure
(Aschenbrenner 1975; McAdoo 1978; Stack 1974). Consanguinity
assumes primacy over affinal ties. As compared to white
middle-class families, the marital tie does not hold the same
status for African Americans. This is not to imply that
marriage is unimportant. The importance of marriage ties has
been shown from historical data. The statement is meant to
imply a cultural difference surrounding the meaning of
marriage. Commitment to motherhood is strong, whether or not
the mother is married, and there is a recognition that
children may not be raised necessarily in an intact family
(Aschenbrenner 1975; Peters & Massey 1983). Role flexibility
may allow for stability in the one-parent family by having
extended relatives play the role of the absent parent (Foster
1983). Extended kin ties are reinforced and maintained
through space and time by participation in rituals such as
funerals, family reunions, and regular visiting patterns
(Aschenbrenner 1975; Barnes 1981; Foster 1983; Stack 1974).
Contrary to the popular, stereotypic image of African
American men as absent from the family, African American men
are an important aspect of family life playing different roles
in the family organization. Women have participated in the
labor force since slavery, and gender roles have evolved in a
more egalitarian fashion (Foster 1983; McCray 1980; Taylor,
Chatters, Tucker, & Lewis 1990). Men may not support children
as a matter of course but are generous if asked (Aschenbrenner
1975). A review of recent literature indicates that African
American men are highly involved in parental and childrearing
roles (Taylor, Chatters, Tucker, & Lewis 1990).
Hill (1972) summarized the following characteristics as
strengths common to African American families: strong kinship
bonds, strong work orientation, adaptability of family roles,
strong achievement orientation, and strong religious orien-
tation. While also seen in white families, Hill argued that
these traits are manifested differently in African American
families due to their history of racial oppression. Other
values cited as strengths include a belief in the institution
of the family, motherhood, and childrearing; an emphasis on
strict discipline and respect for elders; and the necessity
for caring roles and mutual aid systems (Aschenbrenner 1975;
McCray 1980; Staples 1985). In a recent study focused on
middle-class African Americans, core characteristics and
values included an implicit or explicit embracing of the
dominant culture; delay of gratification; a strong sense of
self and empowerment; a sense of importance in the fact of
their Blackness; and quality of life pursuits (Coner-Edwards
& Edwards 1988).
Contemporary Family Organization
Societal Trends Affecting Families
In spite of the strength of African American families,
family organization and structure have changed over the past
20-30 years. It is important to remember that larger societal
trends, such as an increased rate of divorces and a shifting
of emphasis away from familism toward individualism affected
both African American and white families. In a decade review
of family research in the 1980s, Berardo (1990) noted a
renewed concern that family and marriage institutions were
being severely weakened and threatened from accelerated and
pervasive social change. The African American family was at
double risk exposure to those societal threats shared by
whites and African Americans coupled with continued oppression
Major demographic trends identified in the literature
include higher divorce rates, declining rates of marriage,
later ages at first marriage, larger percentages of children
living in female-headed families, higher percentages of
children living in poverty, an increase in female-headed
families, and a higher proportion of births to unmarried
mothers (Jaynes & Williams 1989; Wilson 1987). African
American families, particularly the growing African American
underclass, have disproportionately suffered from these trends
(Jaynes & Williams 1989; Taylor, Chatters, Tucker, & Lewis
1990; Wilson 1987). For example, African American female
heads of family are less likely to marry if single, or to
remarry if divorced or widowed. Female-headed white families
are of shorter duration than African American female-headed
families (Wilson 1987). Between 1969 and 1987, the jobless
rate of African American husbands more than doubled (from 2.9%
to 7.0%). During the same period of time, the number of
unemployed African American husbands almost tripled (from
84,000 to 209,000) (Hill 1990: 87).
There are vast economic differences by race with African
Americans disproportionately over-represented among the poor.
Female-headed families are at the most profound economic
disadvantage, with African American female-headed families
being twice as likely to have poverty-level incomes than white
female-headed families (Jaynes & Williams 1989). In 1992, 13%
of all families had incomes below the poverty level. For
white families the poverty rate was 9.8%, compared to 32.7%
for African American families (US Department of Commerce
1993a: 2-3, Table 2). Female-headed families with related
children under 18 years of age below the poverty level
differed sharply by race: 42% were white and, 68% were African
American families (US Department of Commerce 1993: 93-94,
Tables 93-94). The 1993 figures showed an even greater
disparity, with 30.9% of African American families below the
poverty level, compared to 8.9% of white families (US Bureau
of the Census 1994: 48, Table 49) (Based on constant 1992
Poverty rate for all children under 18 in 1992 was 21.9%,
with African American children representing 34.6% of all poor
related children under 6 years of age. For children living in
female-householder families, 73.1% were African American,
compared to 60.5% white and 71.8% Hispanic-origin (US
Department of Commerce 1993b: x).
Causative Factor for Family Structural Changes
Throughout this chapter, I argue that social forces
directly impinge on the functioning of the family. The
contemporary African American family is also subject to these
forces. One must ask: What accounts for racial differences
between African American and white family patterns?
Two major explanations have been offered: a) systematic
and persistent differences exist because of differing cultural
norms; and b) differences are due to economic factors (Farley
& Allen 1987). Arguments pertaining to the cultural norm
explanation were presented earlier in the section describing
different values held by African Americans, particularly in
regards to marriage and gender roles.
Additional support for the cultural explanation arose
from an analysis of the 1980 census data. Independent of
household income, race was related to household extendedness.
This patterns was seen for African Americans, Hispanics and
Asians. A proposed explanation was that benefits from
extendedness may go beyond economic benefits to include
childcare, household help, and companionship (Farley & Allen
1987). However, due to the type of data used in the study, it
was impossible to verify values and attitudes regarding
extendedness that might play a role in this finding.
Economic and structural factors have been strongly
implicated in several studies. In an extensive study on the
position of African Americans in American society since the
eve of WWII, the most salient factors explaining racial
differences in family structure were differences in income and
employment, greater (relative) economic independence of
African American women, and a more limited pool of African
American men who are good marriage prospects (Jaynes &
Williams 1989). Staples (1985) agreed with the premise that
for African American women, the quality of potential mates was
poor due to fewer African American men obtaining gainful
employment. Higher rates of male unemployment were due to
a) changes in the work setting (i.e., service orientation,
less industry), b) greater competition with white women for
jobs, c) increased functional illiteracy in men secondary to
the reality of blocked opportunities, and d) less access to
the personal networks used by white men to secure employment.
Using a "male marriageable pool index" (MMPI), Wilson (1987)
argued that the sharp rise of African American female-headed
families directly related to increasing African American male
Additional factors cited in the literature as contri-
buting to alterations in family structure have included:
a) increased societal acceptance of non-marital sex,
b) increased use of abortion and birth control, c) a welfare
system that requires men to be absent, d) decreased self-
esteem of African American men related to economic/psycho-
logical alienation, e) longer duration in poverty for African
American families, f) increased incarceration of African
American men in prison and mental institutions, g) a long-
standing African American male shortage resulting from
differential mortality rates, and h) fewer opportunities to
create stable African American family homes due to decreased
economic opportunities (Jaynes & Williams 1989; Ladner 1986;
Taylor, Chatters, Tucker, & Lewis 1990).
The question regarding African American/white differences
in family structure is not answered solely by the cultural or
the economic explanations. Rather, both explanations appear
to contribute to the observed differences (Tienda & Angel
1982; Farley & Allen 1987). Analysis of the 1980 census data
indicates that race differences in family organization
diminished as economic differences by race lessened. "African
American-white differences in economic well-being, political
power, and social standing--more so than differences in values
and predispositions--explain the observed race differences in
family organization and process" (Farley & Allen 1987: 187).
Clearly, African American family organization reflects
differing historical circumstances, cultural values and
practices that are suggestive of African heritage, and current
socio/economic/political forces that have created multiple
barriers to opportunities. The resources and strengths of the
African American family is seen in its survival and
resilience. The last section of the chapter specifically
addresses the topics of social networks and patterns of
support for African American families.
Social Networks and the Provision of Support
Social network analysis developed with Elizabeth Bott's
work in England (1957) and J. Clyde Mitchell's work in Africa
(1969b). How network members provide support to others has
continued to be a topic of interest for anthropologists and
sociologists. Much of the work on network composition and the
provision of support has focused on kin ties. However, two
distinct research agendas emerged one concentrating on
the white family and one concentrating on the African American
family. The African American literature concentrated on
patterns of assistance from kin, and support was viewed for
the most part as instrumental (Aschenbrenner 1973; Ball 1983;
Stack 1974). Existence of mutual help was considered from the
perspective of extended kin buffering the family from economic
disparities, and from the perspective that there was a greater
cultural emphasis on kinship among African Americans (Malson
1982). Therefore, stronger kin ties should be found at all
The literature that focused on whites took a broader
perspective, looking at support provision in a variety of
situations (Antonucci & Depner 1982; Bott 1969; Fiore, Becker,
& Coppel 1983; Hammer 1981; LaRocco, House, & French 1980).
For both races, few studies have examined the different
aspects of support (such as emotional support, instrumental
support, and perception of support from network members)
concurrently. Until recently, even fewer studies compared
differences between African American and white networks.
Social Networks of African American Families
Attention has turned again recently to the "demise" of
the African American family with much emphasis being placed on
the trends of single-parent families, poverty (particularly in
regards to the effects on children), absent fathers, and
environmental deprivation that may be weakening the extended
family's ability to assist others (Billingsley 1990; Jaynes &
Williams 1989). Yet there is minimal research that
investigates whether support is adequate or available to
families facing unexpected, long-term crisis situations, such
as in the case of chronic childhood illness.
Social network research with African American families
has focused predominantly on urban, lower class, extended
families (Aschenbrenner 1973; Hays & Mindel 1973; Lindblad-
Goldberg, & Dukes 1985; Martineau 1977; Stack 1974). An
occasional study used rural populations (Dressler 1985; Gaudin
& Davis 1985; Hofferth 1984) or middle-class African American
families (Barnes 1981; McAdoo 1978). Research questions asked
whether African American family life existed in urban, ghetto
areas and whether the ties between members of extended
families served to buffer individuals against the severe
effects of racism and poverty.
There has been a strong emphasis on the value of extended
families for African Americans. It has been believed gener-
ally that African American families have supportive extended
families and kin ties that are lacking in white families.
Ethnographic research has documented the strength of these
extended families, and detailed the extensive exchange
patterns between kin and friends in which members of extended
households shared economic aid and other forms of instrumental
assistance, such as housing, resources, and household tasks
(Aschenbrenner 1973; Stack 1974). Fictive kin were as
important as blood kin in the provision of support (Johnson &
Barer 1990; Scott & Black 1989; Stack 1974; Ulbrich & Warheit
Stack (1974) interpreted these exchange networks as a
resilient response to the socioeconomic conditions of poverty
and unemployment. Economic deprivation mitigated against the
maintenance of nuclear families. Extended families were
described as having expanded units of reciprocity, thereby
being more flexible economic units (Aschenbrenner 1973).
Extendedness is recognized as an effective mechanism for
pooling limited resources, hence increasing economic benefits
(such as stability, access to a wider pool of resources).
"Doubling up" in extended households is generally a less
expensive method of providing for needy relatives, as compared
to direct cash transfers (Taylor, Chatters, Tucker, & Lewis
McAdoo (1978) found similar behavior in a study of
African American middle-income, urban and suburban families.
Her research indicated that extended help patterns are
culturally rather than solely economically based. She
extended the study in 1980 to ascertain whether the mother's
differential involvement within her wider family was based on
whether she was head of the household or if she was married.
Her findings indicated that both single and married mothers
were deeply involved in the kin-help exchange networks,
including the use of fictive kin. Additional research
confirmed that marital status did not alter sources of support
or satisfaction with support (Brown & Gary 1985; Taylor 1986).
Family members and extended kin remained major sources of
support after divorce (Brown & Gary 1985).
Later and larger, representative studies also indicated
the importance of kin ties to receiving support (Hatchett &
Jackson 1993). Frequent interactions with family members,
close familial relationships, and having an available pool of
relatives predicted the probability of receiving support,
regardless of gender (Taylor 1986). A more recent study
compared the level of familial involvement between adults
labeled as support-deficients (those who had never received
assistance) and self-reliants (those reporting they had never
needed help). Findings from multivariate analysis indicated
the self-reliants reported significantly higher familial
involvement (Taylor 1990). Findings from the representative
National Survey of Black Americans (NSBA) indicated that there
was an overwhelming perception of family solidarity among
African Americans. Geographical distances to both immediate
and other kin members were fairly close, and frequented aid
from kin was reported, Women reported more receiving more aid
than did men, as well as having more frequent interactions
with kin. Summary of the findings indicated that subjective
closeness with kin was the most influential predictor of
frequency of interaction with kin, and aid received from kin
(Hatchett & Jackson 1993).
The Consequences of Support and the Need for Reciprocity
Although aspects of support were beneficial, there were
negative consequences to receiving assistance. Failure to
reciprocate harmed kin and non-kin relationships and sometimes
resulted in shunning or ostracism (Scott & Black 1989).' Help
obligated the individual to a pattern of reciprocal assistance
which, at times, had the negative effect of limiting potential
opportunities for upward mobility (Stack 1974). Belle (1982)
found that although mutual aid networks were critical survival
strategies against poverty, the networks were not voluntarily
chosen by those who could find other means for escaping the
effects of poverty. Increased emotional distress and stress
have been reported in women participating in networks with
extensive social ties (Belle 1982; Lindblad-Goldberg & Dukes
Findings from network studies of African American
families documented active networks of informal ties to non-
residential kin, friends, and neighbors (Ball 1983; Belle
1982; Martineau 1977). Ball (1983) found that requests for
assistance with a real problem were as frequent to friends as
to kin outside the family. Higher levels of SES were
4Reciprocity and its relationship to the receipt of
support is detailed in "There Are No Free Gifts! Social
Support and the Need for Reciprocity" (Williams, In press).
associated with larger networks and the probability of
receiving support (Campbell & Lee 1990; Taylor 1986, 1990).
Network studies began to use representative, national
survey data to re-evaluate the importance of extended kin and
friend ties. During times of crisis, immediate family members
were heavily relied upon (Taylor, Chatters, & May 1988).
Other studies noted the importance of both formal and informal
helpers (non-professional helpers, notably non-kin, immediate
and extended kin), with the mother being the most utilized
category of informal helper (Neighbors and Jackson 1984;
Chatters, Taylor, & Neighbors 1989).
These findings contrasted with the earlier ethnographic
work of Aschenbrenner (1975) and Stack (1974). The unrepre-
sentativeness of the ethnographic accounts might account for
the discrepancy. The ethnographic studies also focused more
on everyday life rather than on serious personal problems.
Definitions of what constitutes a "serious problem" may also
account for variation.
Comparisons Between African American and White Social Networks
Findings in the literature are inconsistent regarding the
differences between provision of support for African American
and white families. Some studies documented larger kin
networks for African Americans as compared to whites, (Ball,
Warheit, Vandiver, & Holzer 1979; Cross 1990; Gaudia & Davies
1985; Hays & Mindel 1973; Hogan, Hao, & Parrish 1990). The
larger kin networks appeared to provide greater amounts of
assistance (Hays & Mindel 1973; Hogan, Hao, & Parrish 1990;
Johnson & Barer 1990). Compared to elderly whites, elderly
inner-city African Americans expanded their networks by
mobilizing relatives on the periphery of the kinship network
(nieces, nephews and cousins), and created fictional kin
(Johnson & Barer 1990). For some situations, the greater
amount of help was associated with a more pronounced tendency
for African Americans to be living with adult kin (Hogan, Hao,
& Parrish 1990). Constrained social opportunities and unequal
access to resources were cited as factors related to stronger
helping African American neighbor networks (Lee & Campbell
1990; Lee, Campbell, & Miller, 1989).
However, the assumptions that African Americans receive
more support than whites and have larger kin networks have not
been universally reported. Silverstein and Waite (1993)
failed to confirm previous studies that suggested a support
advantage for African Americans with economic and social
variables controlled. Using representative data from the 1985
General Social Survey, Marsden (1987) looked at the aspects of
interpersonal networks in which Americans discuss "important
matters." Overall findings indicated that the networks are
small, kin-centered, relatively dense, and homogeneous.
Whites had the largest networks (mean size 3.1), African
Americans the smallest (mean size 2.25), and Hispanics and
others fell in between. Cross (1990) compared the social
networks of a national sample of African American, white, and
ethnic-white mothers. Ethnic-white mothers had the highest
number of kin in their networks overall, followed by white
mothers, and then African American mothers. This held for
both one-parent and two-parent families in all three groups.
In a study of parents of chronically ill children, Williams
(1993) compiled social network inventories of those
individuals important or helpful to the parents during the
time of their children' illnesses. The networks of white
parents were twice as large as those of the African American
parents, although the African American parents perceived the
individuals in their networks to be slightly more supportive.
In a national sample of rural, low SES mothers, African
American mothers had greater numbers of kin in their networks,
and the networks were more durable, but those networks
provided less help and fewer persons to call on than did white
networks. These African American mothers perceived and
received less support from informal social networks (Gaudin &
Davies 1985). Similar results were found in another
nationally representative sample of African American and white
American mothers (Hogan, Hao, & Parish 1990). Matching
African American and white samples on marital status and kin
proximity, African Americans received less substantial income
support than whites. Although African American mothers
received free child care from co-residential kin, only 1/3 of
African American mothers, compared to 2/3 of white mothers,
reported adequate access to child care. In another study,
requests for assistance with major problem resolution were
seen more in whites than African Americans, although African
Americans were more likely to have a geographically proximate
close relative than were whites (Ball, Warheit, Vandiver, &
Holzer 1979). A possible explanation was that whites may have
perceived greater resource availability for them than did
Relationship Between Patterns of Support and Family Structure
The variable of family structure appeared to play a
determining role in the provision of support for African
Americans and whites. Cross (1990) found that African Ameri-
can two-parent mothers were similar to ethnic white two-parent
mothers in the areas of financial, emotional, and work-related
support. In the areas of practical, financial, and emotional
support, white two-parent mothers received the most support.
In contrast, African American single mothers were the most
disadvantaged of the three groups in all functional areas of
support. For African American single mothers, the level of
need outstripped the level of support.
Hofferth (1984) argued that the apparent relationship
between race and extendedness was due to family structure
differences between African American and white female family
heads. Using a national sample, she defined kin participation
narrowly on the basis of exchange of finances and/or extended
living arrangements. White single parents participated in kin
networks more than African American single parents, but the
relationship was weak. African American two-parent families
were more likely to participate in kin networks than white
two-parent families. White families were more likely than
African American families to receive money from kin, regard-
less of marital status. African American female-headed
families were less likely to receive financial assistance than
white female-headed families. Thus, they appeared to benefit
less from a kin network than white female-headed families.
Helping Traditions in African American Communities
As has been seen throughout this chapter, the practice of
mutual aid has been an integral component of African American
lives from slavery to modern times. The helping tradition has
extended historically from the family through a religious
consciousness, fictive kin, and a racial consciousness to
permeate all areas of life in the African American community.
This is now under scrutiny. Martin and Martin (1985) cite the
following factors as contributing to the demise of mutual aid:
a) decreased male/female cooperation, b) a lack of reinforce-
ment of helping values by the schools or wider community,
c) bourgeoisie (individualistic, social-status seeking) and
street ideologies fighting against the values of helping, d) a
decline in racial consciousness making it difficult to trans-
fer helping values, and e) a historical decline of self-help
traditions after the initiation of social welfare programs
started in the New Deal era.
Their argument runs counter to much of the previously
cited work that shows the existence of the helping tradition.
Further studies are needed to identify if, given the contem-
porary social problems, mutual aid patterns are effective in
protecting individuals from institutional assaults beyond
their control. Assistance continues to exist, but to what
degree? Additional data are also needed to determine whether
patterns of support occur within each social class and for
each household type. Income appears to assume a primary role
in determining patterns of support, but this area of consi-
deration is new and needs further study.
Research on African American families is difficult to
summarize. Studies have used different methods and different
data bases. Only recently have studies begun to use large
representative samples. The problem is that, for many of
those studies, the data were collected for purposes other than
the intent of the subsequent analysis. For example, census
data do not answer questions regarding attitudes or need. Few
studies have combined quantitative and qualitative methods for
a broader perspective on issues such as network functions and
importance of network ties.
The African American family as an institution cannot be
studied in isolation. Macro and micro level influences must
be examined together. In spite of the problems and historical
challenges addressed in this chapter, the African American
family is alive and viable. There is great diversity in the
family unit and such diversity as social class status and
household type must be considered while examining any
phenomena pertinent to family life. Research must concentrate
on individuals in all social strata and not be lured into
focusing on the problems most visible, such as the extreme
poverty of the underclass. To do so would imply that there is
a "standard" African American family.
This chapter focuses on describing the contemporary
African American family. It reviewed historical social forces
that impacted family life, described theoretical paradigms
regarding the structure and viability of African American
family life, and summarized research concerning the provision
of support from social networks. Whenever pertinent, it
compared the African American family to white families. The
next chapter concludes the literature review section. It
reviews the literature on coping and offers a detailed
description of the theoretical framework used for the
Although the term "coping" is used a lot, few people
agree on what it is, how it works, and particularly, how to
measure it. In this chapter I review part of the litera-
ture--the part most germane to my research. I follow the
transactional model of stress and coping proposed by Lazarus
and Folkman (1984). In their model, coping is a process
separate from its outcomes. I argue against the traditional
stance in anthropology that defines coping implicitly as a
First, I present Lazarus and Folkman's model and findings
pertinent to the model. Next, I summarize research on how
families experiencing childhood chronic illness appear to
cope. In the final section I offer a critique of the
Review of the Literature
Coping: Definitions in the Literature
It is an understatement to say that coping is poorly
defined in the literature. Social support, another
frequently-used construct, suffers from a plethora of
definitions and typologies, while studies of coping often lack
any definition at all (see Table 4.1). It is assumed that the
reader knows what coping is and which dimensions of the
construct are being measured.
There are notable exceptions. Table 4.2, "Comparisons of
Coping Definitions," shows examples of how coping has been
defined. The most frequently cited definition is that offered
by Lazarus and his colleagues (Folkman 1984; Folkman et al.
1986; Folkman & Lazarus 1980; Lazarus 1982; Lazarus & Folkman
1984). They define coping as "constantly changing cognitive
and behavioral efforts to manage specific external and/or
internal demands that are appraised as taxing or exceeding the
resources of the person" (Lazarus & Folkman 1984, p. 141). As
seen in Table 4.2, many of the definitions are similar to or
evolve from the model proposed by Lazarus and Folkman (1984).
There are several key concepts in the definition. First,
coping is a process. The process involves conscious psycholo-
gical cognitions and behaviors, presumed to have protective
qualities. The process begins with appraisal. Coping arises
from a situation of psychological stress stress arising
from an observed stimulus--response relationship (as opposed
to either a stimulus or a response uniquely defining stress).
Coping is different from its outcomes. Coping implies
efforts to manage demands, whether or not those efforts are
deemed "successful" (Folkman 1984). Previous research efforts
confounded coping with effective outcomes (Folkman 1984; Klein
Examples of Coping Literature That Fail to Define Coping
Baskin, Forehand, & Saylor 1985
Brickman et al. 1982
Commerford et al. 1990
Fife, Norton, & Groom 1987
McCubbin & Figley, Vol. 1, 1983;
Figley & McCubbin, Vol. II, 1983
Two series volume with multiple
Heller & Swindle 1983
Kupst et al. 1982
Kupst & Schulman 1988
Lavee, McCubbin, & Olson 1987
Longitudinal studies of parental
Refers to Lazarus & Folkman model
(1984), labels "sense of
coherence" as a coping resource
and measures coping by a family
coping instrument. Never clearly
Levental, Nerenz, & Steele 1984
model of how people
and cope with health
No clear definition of
into planning and
Mattlin, Wethington, & Kessler 1990
McCubbin et al. 1983
Uses the model of Lazarus/Folkman
but does not offer a definition.
Discusses coping patterns but does
not offer a definition of coping.
Special series to integrate the
progress made in coping process
research with the challenges of
behavioral research. Most
articles did not define coping,
Miller, Leinbach & Brody
Vitaliano, Katon, Jaiuro & Russo
Johnson, Lauver & Nail
Leventhal, Leventhal, Shacham &
Revenson & Fulton
Table 4.1 continued
Reiss & Oliveri 1983
Spinetta et al. 1988
Van Dongen-Melman, Pruyn, Van
Zanen, & Sanders-Woudstra 1986
Wortman & Silver 1989
Wyckoff & Erickson 1987
Differentiates between environ-
mental and personal coping
resources but does not define
Used a self-report measure of
coping: "how one coped"
Comparisons of Coping Definitions
Chesler & Barbarin 1987
Davis & Nakeo 1990
Kupst et al. 1984
Lazarus & Folkman 1984
McCubbin et al. 1980
Murphy & Moriarty 1976
Pearlin & Schooler 1978
(also used in Pearlin
Aneshensel 1986; Pearlin 1989)
". people's efforts to meet the
challenge present by stressful life
situations" (p. 91).
". the degree to which a person
is able to deal with the hardships
of his/her life circumstances"
"Coping meant both what people did
in their attempts to master the
situation and the adequacy of their
coping" (p. 151).
"Constantly changing cognitive and
behavioral efforts to manage
specific external and/or internal
demands that are appraised as
taxing or exceeding the resources
of the person" (p. 141).
". process of achieving a
balance in the family system which
facilitates organization and unity
and promotes individual growth and
development" (p. 865).
"To cope is to manage stress
successfully, and coping responses
are presumed to reduce distress
and/or improve one's situation"
(p. 114). [Distinguishes between
coping resources, styles, and
". a general term to include
defense mechanisms, active ways of
solving problems, and methods for
handling stress that do not come
under the heading of defense
mechanisms and problem-solving
methods" (p. 5).
". behavior that protects
& people from being psychologically
harmed by problematic social
experience" (p. 2).
"Adaptation under very difficult
situations" (p. 44). [Per White
Table 4.2 continued
Stone & Neale 1984
". what the person does about
the stress situation. Coping
mechanisms include an individual's
attempts to directly alter the
threatening conditions themselves
and the attempts to change only his
appraisals of them so that he need
not feel threatened" (p. 345).
Summarizes two classical approaches
to the coping literature:
a) "In the context of such a
physiologic/endocrinologic view of
stress, coping is a process that
modulates the neuro-endocrinologic
functioning" (p. 2303). [Per the
model of Hans Selye.]
b) "In the interactionist view
S. coping is any action or
belief that modifies some aspect of
the appraisal and evaluation
process" (p. 2303). [Per the model
of Richard Lazarus.]
"Those behaviors and thoughts which
are consciously used by an
individual to handle or control the
effects of anticipating or
experiencing a stressful situation"
". sum total of all strategies
and patterns employed to deal with
a significant threat to the
family's stability" (p. 290).
Focuses specifically on the family.
"Adaptation under relatively
difficult conditions" (p. 49).
1983). For example, if a person drank alcohol to excess in
response to a loss, then that person would have been evaluated
as "not coping well."
Anthropological Use of Coping
The concepts of coping and adaptation are used widely in
anthropology. In general, adaptation is associated with day
to day adjustments, while coping implies responses to a cri-
sis--something beyond the ordinary, like disasters, migration,
Still, coping is not defined clearly by anthropologists
and is generally discussed as a strategy rather than as a
process (Colson 1979; Colson 1991; Downing, Gitu, & Kamau
1989; Huss-Ashmore 1989). Hansen (1986) referred to coping
strategies as conscious plans. Coping strategies, tactics
(behavior), and buffering mechanisms (relationships or factors
that function to promote adaptation and human survival) he
said are ways that people react to and adapt to crisis.
Implicit in the use of coping and adaptation is the idea
of a successful outcome some positive adjustment to the
environment. Colson (1991), for example, says that people who
survive displacement prove that they have coping abilities.
There is a value-ladened linkage between survival and coping
in this statement. The person who migrates to another
location is thus successful with coping; the refugee who turns
back then is not seen as a survivor. The efforts are not as
important as the outcome.
Consistent with the conflating of coping and outcomes,
anthropologists also lump the coping process with components
of that process, such as cognitive appraisal. Colson (1979)
is an exception. In discussing how self-reliant societies
deal with changing environmental conditions, she notes that
the first coping device is an assessment of those conditions.
Although she linked coping behaviors and appraisal as the same
process, she recognized the importance of some type of
Efficacy of coping behaviors has not been evaluated in
terms of outcomes. Nor has efficacy been linked to specific
functions of coping by anthropologists, who tend to deal with
society or community-level aggregate measures and not with
individual differences in response to the environment over
time. The model proposed by Lazarus and Folkman offers the
best alternative approach.
Historical Approaches to the Study of Coping
The first studies of coping were done by physiologists,
concentrating on stress responses.' Selye (1956) pioneered
'In Chapter 1 of their book, Lazarus & Folkman (1984)
review the concept of stress and how it has been
systematically conceptualized over the years. Pearlin (1989)
reviews stress from a sociological perspective. He urges for
a critical analysis of stress and coping that includes the
"structural contexts of stress" (e.g. social institutions and
statues, gender, race, and ethnicity).
the study of bodily defenses against noxious stimuli. His
theoretical model, "The General Adaptation Syndrome," was
widely used for years. Interest in stress shifted to interest
in coping with stress. Animal models focused on the concepts
of arousal, activation, or "drive" and the relationship to
coping. Coping was defined as acts that control aversive
environmental conditions, resulting in lowered psychophysio-
logical disturbance (usually acts of avoidance and escape
behavior). Minimal attention was paid to the complexities in
human cognitive-emotional functioning (Lazarus & Folkman
Studies of human coping were grounded in the psycho-
analytic ego psychology model where cognition played a major
role. In this model, coping was defined as processes
(acts/thoughts) that individuals used to solve problems
(Lazarus & Folkman 1984). The processes were differentiated
into a hierarchy of strategies that went from the lowest ego
processes (psychotic levels of functioning), to ego defenses
(neurotic modes of adaptation), to the highest level of mature
ego processes (Lazarus & Folkman 1984). For example, in a
much cited study, Vaillant (1977) used a hierarchy of ego
defenses to classify coping styles of male college students
who were followed longitudinally. Unfortunately, defining
coping to cognition ignores the importance of behaviors and
Another intrapsychic approach to coping has been to
conceptualize it as a personality trait (Billings & Moos
1981). Emphasis is placed primarily on the properties of the
person, with little notice given to the context of the
situation (Folkman et al. 1986). The assumption of this
approach is that personality traits or styles dispose
individuals to cope in predictable ways over the life course.
Wheaton (1983) investigated psychiatric outcomes using
personality traits. Kobasa, Maddi, and Courington (1981)
studied personality characteristics as mediators of the
The use of personality traits or styles has been widely
criticized. Attributional styles and traits influence how a
person responds to life events and may be related to coping,
yet they do not describe the coping process (Stone & Neale
1984). Additionally, data are lacking on how traits mediate
an outcome with respect to stressors (Rutter 1981).
Traits have had very modest predictive value with respect
to actual coping behavior. Surgical patients were interviewed
pre-operatively about specific behaviors toward the threat of
surgery and were also administered a standard trait assessment
test. No correlations were found between the traits and the
behaviors. The behavior process measure alone predicted the
outcome variables of speed and ease of surgical recovery
better than either the trait measure alone or in combination
with the behavior measure (Cohen & Lazarus 1973).
The unidimensional qualities of traits ignores the
complexity and variability in coping (Lazarus & Folkman 1984).
Limiting coping to an analysis of traits reduces the idea of
coping to the maintenance of psychological equilibrium and
does not include active problem-solving behavior directed at
avoiding or changing the situation (Billings & Moos 1981).
Models of Coping
research efforts expanded to view coping as a multi-
dimensional construct. Cognitions, behaviors, and contextual
factors became important variables. Conceptually there was a
shift towards thinking that change per se may not be suffi-
cient or necessary for the experience of stress (Menaghan
1983a). Research moved from naturalistic observation
(Mechanic 1962) to process oriented research based on larger,
representative samples (Folkman et al. 1986; Mattlin,
Wethington, & Kessler 1990). However, most studies continued
to be cross-sectional and to ignore outcome variables.
The Lazarus/Folkman model of stress, appraisal and coping
In this model, coping and cognitive appraisal are two
processes that mediate stressful person-environmental
relations and adaptational outcomes (Folkman, Lazarus, Dunkle-
Schetter, De Longis, & Gruen 1986). Psychological stress is
defined as "a particular relationship between the person and
the environment that is appraised by the person as taxing or
exceeding his or her resources and endangering his or her
well-being" (Lazarus & Folkman 1984: 19)(see Figure 4.1).
There are three main features in this process approach to
coping. Actual behavior is observed and assessed, not what
the individual says he or she would usually do or should do.
Coping occurs within a specific context--that is, under
particular conditions to which coping thoughts and actions are
directed. Lastly, the process model indicates change. Coping
thoughts and actions alter over time as the contextual circum-
Coping does not occur randomly. It occurs in direct
response to continuous appraisals and reappraisals of the
changing person-environmental relationships. Cognitive
appraisal is a process that determines why and to what extent
interactions between a person and the environment are relevant
to his or her well-being or are stressful (Folkman et al.
1986). Understanding cognitive appraisal is a step toward
explaining the processes between the encounter and the
Primary appraisal is an evaluative process to determine
whether the person has anything at stake in the encounter. An
irrelevant appraisal implies that the encounter carries no
implication for a person's well-being. If the outcome of an
encounter is construed as positive then it is seen as a be-
nign/positive appraisal. Stress appraisals include harm/loss,
(no action needed)
(no action needed)
Physical (health, energy, stamina)
Social (social support from social network)
Psychological (beliefs, morale, problem-solving skills)
Emotion-Focused Information Seeking Problem-Focused
Inhibition of Action
Schematic Representation of
Lazarus and Folkman Model (1984)
threat, and challenge. Harm/loss situations are those in
which some damage (physical and/or psychological) has
occurred. Threat implies harms or losses that are anticipated
in the future, thus allowing for anticipatory coping.
Contrasting threat, with its associated negative emotions such
as loss and fear, are challenge appraisals. Challenge
appraisals focus on positive emotions and on the potential for
gain/growth in an encounter. Challenge also initiates
anticipatory coping (Lazarus & Folkman 1984).
Lazarus and Folkman emphasize that challenge and threat
appraisals are not opposite ends of a continuum. They can
occur simultaneously (ex. job promotion) even though their
cognitive components (potential harm vs. potential mastery)
and their affective components (positive vs. negative
emotions) differ. Appraisals can shift from challenge to
threat and vice versa. Marris (1974) argues that meaning is
a crucial organizing principle of human behavior and as such,
makes sense of action by providing reasons for it. Meaning is
"a structure which relates purposes to expectations so as to
organize actions--whether the actions are taken or only
thought about" (Marris 1974: vii). Clearly, meaning is
essential to appraisal and to coping efforts.
The benign/positive appraisal is the least well-developed
aspect of primary appraisal. The distinction between
benign/positive and challenge appraisal is whether or not the
situation (person-environmental transaction) will tax the
resources of the individual (Folkman 1984). I believe that
challenge appraisals implicitly reflect a sense of motivation
and immediacy in action. Challenge and threat indicate that
some degree of vulnerability or jeopardy is present, and
something needs to be done to manage the situation.
Secondary appraisal includes the evaluative process that
looks at available coping strategies, the likelihood that any
given coping option will accomplish what it is supposed to,
and the possibility that one could apply a particular strategy
effectively. Primary appraisals of what is at stake and
secondary appraisal of coping options jointly determine the
significance of the stress, as well as the strength and
quality or content of the emotional reaction. Reappraisal
follows an earlier appraisal and refers to a changed appraisal
based on new information from the environmental and/or the
person (Lazarus & Folkman 1984).
Both personal and situational factors influence
appraisal. Two important person factors are beliefs and
commitments. Beliefs can be generalized (such as with
religion) or specific (such as belief in one person). Beliefs
color the individual's perception of an event. Beliefs
regarding control (i.e., can the individual control outcomes
of importance) influence primary appraisal (Folkman 1986).
Rotter's theory of locus of control (1966) is applicable to
Lazarus and Folkman's model. Under conditions of ambiguity or
novelty, these generalized control expectancies are thought to
have their greatest influences (Folkman 1986). In situations
of environmental ambiguity, situational cues are minimal;
inference is needed to understand the situation; and, hence,
person factors have more influence in determining the meaning
of the situation (Folkman 1986). Conversely, in situations
with minimal ambiguity, situational factors play a more
important role than beliefs/person factors. "One's belief in
one's ability to control an event influences how that event is
appraised and, through appraisal, subsequent coping activity"
(Lazarus & Folkman 1984: 77).
Sims and Baumann (1972) used the locus of control theory
to compare coping with tornado threats in two different
sections of the country (Illinois and Alabama). People living
in the area of highest frequencies of tornado-caused deaths
(Alabama) internalized their sense of control over events,
exhibited fatalism and passivity, and were inattentive to
organized warning systems. Illinoisans were more action-
oriented, objective, rational, and displayed features of an
external locus of control. While psychological attitudes are
only one factor in the outcome of the number of deaths due to
tornados, this study was an interesting application of the
model discussed above.
Commitments refer to values, choices, and/or goals and
serve to determine what is at stake in a stressful encounter,
thus underlying choices people make. Together commitments and
beliefs influence appraisal by a) determining how an encounter
will influence well-being, b) shaping a person's understanding
of the event, subsequently affecting the person's emotions and
coping efforts, and c) providing the basis for evaluating
outcomes (Lazarus & Folkman 1984).
Situational factors work in concert with person factors
to determine the extent to which any event is stressful.
Situational factors include novelty, predictability, event
uncertainty, and the temporal factors of imminence, duration,
and temporal uncertainty. Coping is determined both by
resources and by constraints that mitigate the use of
resources (Lazarus & Folkman 1984).
The coping model used by Lazarus and Folkman distin-
guishes two functions of coping: problem-focused coping and
emotion-focused coping. Problem-focused coping is defined as
"coping that is directed at managing or altering the problem
causing the distress," while emotion-focused coping is "coping
that is directed at regulating emotional response to the
problem" (Lazarus & Folkman 1984: 150). In most stressful
situations, both forms of coping are used, and the appraisal
of the encounter (e.g., whether one has the potential for
control) determines the relative proportion of each form used.
Situations that are appraised as unchangeable favor emotion-
focused coping, while problem-focused forms of coping are more
apparent when encounters are appraised as amenable to change
(Folkman & Lazarus 1980; Lazarus & Folkman 1984; Folkman 1986;
Folkman et al. 1986).
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