General and Specific Avoidance Coping: The Development and Validation of a New Scale. A thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy by Leendert Johannes (Lehan) Stemmet University of Canterbury College of Science 2013 1 “In our privileged lives, we are uniquely smart enough to have invented these stressors and uniquely foolish enough to have let them, too often, dominate our lives. Surely we have the potential to be uniquely wise enough to banish their stressful hold.” – Robert M. Sapolsky “In every life we have some trouble When you worry you make it double Don't worry, be happy......” - Bobby McFerrin “The significant problems we have cannot be solved at the same level of thinking with which we created them.” - Albert Einstein “Facing your fears builds strength, but running away from them makes for an excellent cardio workout” - Anonymous “When the only tool you have is a hammer, every problem begins to resemble a nail.” - Abraham Maslow “Hakuna Matata” – A Swahili phrase meaning “there are no worries.” - Made famous by the movie “The Lion King” i Acknowledgements God has stood by me in ways beyond understanding and beyond words – Thank You Lord, Soli Deo Gloria! “I can do all this through Him who gives me strength.” – Philippians 4:13. “Trust in the Lord with all your heart and lean not on your own understanding; in all your ways submit to Him, and He will make your paths straight.” – Proverbs 3:5-6. My wife, Fredericka - your love inspired me and you stood by me, putting up with my many long nights and weekends of doing research and listening to my theories. Thank you for your patience and incredible support, many laughs and for believing in me. This is for us! My parents, through their lives, taught me in ways they may not even be aware of, that there is no reason why one should not aspire to reach your full potential – no matter what obstacles life may throw our way. Prof Derek Roger – I have searched high and low for someone willing to supervise a project of this nature... and struck gold when we met up. It has been an honour and a privilege to work with someone as renowned as you are and of your calibre. Dr Joana Kuntz – thank you for your friendly and exceptionally efficient guidance, advice and pointers, your attention to detail and fresh take on some of the theories. To everyone at the University of Canterbury and Department of Psychology - thank you for the friendly and unwavering service, from administrative support to answering questions about ethics, despite having personal and professional challenges during and after the Canterbury earthquakes. Your resilience is both admired and appreciated! Dr Jo Borrill for your assistance with data collection in the UK and how avoidance coping relates to your field of interest and research – your willingness to share your experience and information about deliberate self-harm has been invaluable. ii Prof Gloria García de la Banda, Ana Coll and Jacobo Picardo in Spain, and Prof Pilar Matud in the Canary Islands, for the Spanish translation of the new avoidance scale, scale distribution, data collection and data capturing, as well as your excitement about my project. Dr Willem Fourie, Dean of the Faculty of Nursing and Health Studies and Ethics Chair at Manukau Institute of Technology (MIT): thank you for your support during the institutional ethics application. Thank you to Lila Pulsford for helping with participant recruitment at MIT and the Faculty of Business for providing a temporary office space. Dr John Ingram, Senior Scientist at The New Zealand Institute for Plant & Food Research Ltd, and Dr James Davidson, Clinical Head of the Chemical Pathology Department at LabPlus – thank you for your advice about the intricacies of measuring physiological and neuroendocrine responses. Thank you also to many experts all over the world who have shared their knowledge with me over a cup of coffee, in discussion groups, and emails. I stand in awe of your knowledge and experience and feel humbled by your generosity to share your knowledge and experience. Thank you to the hundreds of voluntary participants from all over the world who have taken the time to contribute unselfishly to the numerous surveys I have sent out and the experiments I have conducted, for the interviews and for your opinions. My extended family, friends, fellow students, colleagues, teachers and mentors – past and present – thank you for the many years of support, laughs, sharing ideas and keeping me in line, for keeping me accountable to reach the goals I told you I have set for myself. The journey continues! iii CONTENTS List of Tables ................................................................................................................... x List of Figures ................................................................................................................ xii Abstract ......................................................................................................................... xiii List of Abbreviations ................................................................................................... xiv Chapter 1: Introduction and Literature Review ......................................................... 1 1.1 Introduction ............................................................................................................. 1 1.2 Defining Stress ........................................................................................................ 3 1.3 General Coping and Coping Scales ......................................................................... 4 1.3.1 The Ways of Coping Checklist (WCC) ............................................................ 4 1.3.2 The Ways of Coping Questionnaire (WCQ) .................................................... 5 1.3.3 Coping Orientation to Problems Experienced (COPE) .................................... 6 1.3.4 Multidimensional Coping Inventory (MCI) ..................................................... 7 1.3.5 Coping Inventory for Stressful Situations (CISS) ............................................ 8 1.3.6 Coping Strategy Indicator (CSI) ....................................................................... 8 1.3.7 Coping Responses Inventory (CRI).................................................................. 9 1.3.8 Mainz Coping Inventory (MCI-R) ................................................................. 10 1.3.9 Coping Styles Questionnaire (CSQ) .............................................................. 11 1.3.10 Cross-Cultural Coping Scale (CCCS) ......................................................... 12 1.4 Avoidance Coping Scales ..................................................................................... 14 1.4.1 Cognitive-Behavioral Avoidance Scale (CBAS) ........................................... 14 1.4.2 Cognitive Avoidance Scale (CAQ) ............................................................... 16 1.4.3 Multidimensional Experiential Avoidance Questionnaire (MEAQ) ............. 17 1.5 Avoidance Coping – Psychological and Physical Health ..................................... 19 1.6 The Neuropsychophysiological Link .................................................................... 22 1.7 Avoidance Coping in Occupational Settings ........................................................ 24 1.8 Conclusions ........................................................................................................... 27 1.9 A Brief Overview of the Following Chapters ....................................................... 29 Chapter 2: General and Specific Avoidance Questionnaire Development .............. 31 2.1 Introduction ........................................................................................................... 31 2.2 Scenarios and Life Domains Study ....................................................................... 31 2.3 Avoidance Coping Scale Refinement ................................................................... 35 iv 2.3.1 The Sample ..................................................................................................... 35 2.3.2 The Procedure: Exploratory Factor Analysis ................................................. 36 2.3.3 Oblique Rotation, One Factor, Two Factors and Four Factors. ..................... 39 2.3.4 Further Subsample Analyses for a Final General and Specific Avoidance Questionnaire. .............................................................................. 39 2.3.5 Reliability Analysis ........................................................................................ 41 2.4 Descriptive Statistics ............................................................................................. 44 2.4.1 Factor Correlations ......................................................................................... 44 2.4.2 Sample and Gender Differences ..................................................................... 45 2.5 Source of the items ............................................................................................... 48 2.6 Discussion and Conclusions .................................................................................. 48 Chapter 3: Confirmatory Factor Analysis ................................................................. 51 3.1 Introduction ........................................................................................................... 51 3.2 Model Fit Indices .................................................................................................