Scandinavian Journal of Public Health

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Coping with unemployment: Does educational attainment make any difference?

Ulla Christensen, Lone Schmidt, Margit Kriegbaum, Charlotte rsted Hougaard and Bjrn E. Holstein
Scand J Public Health 2006; 34; 363
DOI: 10.1080/14034940500489339

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Scandinavian Journal of Public Health, 2006; 34: 363370

ORIGINAL ARTICLE

Coping with unemployment: Does educational attainment make any

difference?

ULLA CHRISTENSEN, LONE SCHMIDT, MARGIT KRIEGBAUM,

CHARLOTTE RSTED HOUGAARD & BJRN E. HOLSTEIN

Department of Social Medicine, Institute of Public Health, University of Copenhagen, Denmark

Abstract
Aims: The aim of this study was to examine the cross-sectional association between educational attainment and coping
strategies with unemployment in a random sample of 37- to 56-year-old Danish men and women in long-term
unemployment. Methods: Data were based on a survey among 575 men and 1,064 women who had been unemployed at
least 70% of the time during a three-year period (October 1996 to October 1999). The outcome measures were two scales
for coping with unemployment, one for problem-solving coping, and one for avoidant coping. Educational attainment was
measured by years of vocational training. Results: A significant association was found between low educational attainment
and low use of problem-solving coping among both men, OR51.81 (95% CI 1.192.75), and women, OR51.57 (1.13
2.18). Adjustment for cohabitation status, self rated health, economic strain, and unemployment status did not change this
association substantially. High use of avoidant coping was associated with low educational attainment among men,
OR51.57 (0.982.51). For women, medium educational attainment was significantly associated with low use of avoidant
coping, OR50.60 (0.420.85). This result was not affected by adjustment for the covariates. Conclusions: Coping strategies
are considered a potential modifier of the impact of unemployment on health and well-being. In this study, differences in
coping strategies with unemployment were associated with educational attainment.

Key Words: Coping strategies, Denmark, educational attainment, population study, unemployment

Background coping strategies such as job-seeking activities and

Unemployment has been associated with mortality
and morbidity in several studies [16]. However,
some of the negative health impacts of unemploy-
ment have shown an ambiguous social pattern.
Some studies have found high socioeconomic posi-
tion as measured by education and housing tenure to
be associated with a low risk of early cause-specific
mortality following unemployment [4,7]. Other
studies have shown unemployment and the risk of
job loss to be more strongly related to morbidity
among individuals in a higher socioeconomic posi-
tion compared with those in a lower position [89].
Coping has been considered a potential modifier
of the harmful effects of unemployment and, more
specifically, mastery-oriented and problem-focusing
retraining have been brought into focus as adequate
strategies [1011]. As an example, Arnetz et al.
found a decrease in mental well-being, measured by
the General Health Questionnaire (GHQ), and an
increase in cardiovascular risk factors measured by
serum cortisol after 2 years of unemployment among
150 blue-collar workers. Among participants show-
ing mastery-oriented coping behaviour both health
indicators were significantly improved [12]. In a
follow-up study of 1,136 workers in American car
factories Hamilton et al. found that problem-focused
action among unemployed workers correlated with
lower scores of depression after 12 months [13].
In sociological stress research, attention has
mainly been paid to the socially conditioned
distribution of stressors and the stress process [14].

Correspondence: Ulla Christensen, University of Copenhagen, Institute of Public Health, Department of Social Medicine, Panum Institute, 3 Blegdamsvej
DK-2200 Copenhagen N, Denmark. Tel: +4535327663. Fax: +4535351181. E-mail: U.Christensen@socmed.ku.dk

(Accepted 23 November 2005)

ISSN 1403-4948 print/ISSN 1651-1905 online/06/040363-8 # 2006 Taylor & Francis
DOI: 10.1080/14034940500489339

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364 U. Christensen et al.
Yet few studies have actually focused on the
relationship between socioeconomic conditions and
coping [1517]. Of these, the study by Ross and
Mirowsky [15] showed a significant positive associa-
tion between high levels of education and use of
active problem-solving coping. Also, Christensen et
al. found a significant association between low social
class and a higher level of passive coping among men
with functional limitation due to musculoskeletal
pain [16]. In a study of coping and emotional
distress among 166 unemployed Swedish men
and women Grossi found problem-focused coping
to be less frequent among participants with low
educational attainment [18]. However, education
was only included in the study as a covariate, as
were age, gender, marital status etc., and we have
not been able to find other studies on the social
variation of coping strategies used as response to
unemployment.
Aims
If coping strategies in unemployment are associated
with socioeconomic position this may contribute to
the explanation of disparity in health among the
unemployed. The aim of this study was to examine
the cross-sectional association between educational
attainment and coping with unemployment in a
random sample of 37- to 56-year-old Danish men
and women in long-term unemployment.
Material and methods
Study population
The population for this cross-sectional study is part
of the Danish Longitudinal Study on Work,
Unemployment and Health. The sample was drawn
from the AKF Longitudinal Register at Statistics
Denmark (AKF5Amternes og Kommunernes
Forskningsinstitut [Institute of Local Government
Studies in Denmark]), which comprises information
on a 10% random sample of the Danish population
aged 15 years or older (n5408,000). The register
includes data on demographic factors, household,
housing conditions, migration, employment status,
education, income, capital assets, and transfer
incomes. The unemployed level was defined as the
sum of unemployment periods indicated in the
Central Register of Labour Market Statistics and
the register of Labour Market Policy Measures.
The present data are based on a postal survey
carried out in spring 2000 in a stratified random
sample consisting of two population groups: (1) a
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group of individuals 40 and 50 years old by 1
October 1999 (response rate 69%, n57,588);
and (2) a group of 37- to 56-year-old individuals
who had been unemployed at least 70% of the
time during the period 1 October 1996 to 1 October
1999 (response rate 57%, n52,350). Data on
non-participation were derived from the AKF
Longitudinal Registers and showed that non-
participants included a significantly higher propor-
tion of men, of non-native-born Danes, of
persons living on transfer income, and persons
with low educational attainment (untrained or
semi-skilled).
The questionnaire included variables on physical
and mental health, demographic and socioeconomic
factors, occupational environment, social relations,
health behaviours, and psychological factors such as
coping. The present study included a sub-sample of
persons who met two criteria: long-term unemploy-
ment and available data on coping with unemploy-
ment. The study population comprised 1,509
participants in group 2 and 130 in group 1, in total
575 men and 1,064 women.
Measurements
Educational attainment was measured by the highest
vocational training accomplished, and categorized
into three groups: low educational attainment (no
training or trained as semiskilled worker); medium
educational attainment (skilled worker); and high
educational attainment (theoretical education).
As recommended in the literature [1920] we
developed a specific measure of the coping strategies
in question, in this case coping with unemployment.
Based on a literature review and on personal inter-
views with workers who had lost their jobs after
a Danish plant closure [21], we developed five items
on problem-solving coping and four items on
avoidant coping. The items used a similar format
to the 66-item Ways Of Coping Questionnaire
(WOCQ) [19]. We conducted an eight-day interval
testretest of these items among 55 men and women
attending job-seeking courses. The weighted kappa
coefficients ranged from k50.82 to k50.47. The
two coping scales were further pilot-tested in a
study population drawn from the same sample as
the main survey (n5993). The pilot test showed good
distribution of scores across all the response cate-
gories. Finally, we used confirmatory factor analysis
to test the scale properties, which showed a high
goodness-of-fit-index (GFI50.95). Table I displays
the items.
The response options were: all of the time (0),
some of the time (1), a little of the time (2), not at all

Table I. Items on coping with unemployment.
Problem-solving coping
Try to find work or start own business
Demand courses or further education
Talk with other unemployed persons
Try to arrange my daily life so it feels like a workday
Approach people who can help me to find a new job
Avoidant coping
Avoid thinking about my working options
Avoid being seen by neighbours or others whom I do not know too
well
I keep my worries about my attachments to the labour market by
myself
I blame myself that I am unemployed
(3). The sum score for the problem-solving subscale
ranged from 0 to 15, dichotomized into the top tertile
(scoring w6 for men and w5 for women) versus
others. The sum score for the avoidant coping
subscale ranged from 0 to 12, dichotomized into the
bottom quartile (scoring v7 for men and v8 for
women) versus the others. We performed sensitivity
analyses with a range of alternative cut-off points
which confirmed that the bottom quartile of the
avoidant coping scale separated participants who
used avoidance coping to a high degree and that the
top tertile of the problem-solving scale separated
participants who used problem-solving coping to a
low degree.
Covariates
Well-being during unemployment depends strongly
on economic conditions [2224]. We calculated a
cumulative scale on economic strain based on three
items on the consequences of unemployment during
the first 12 months of unemployment (lower income,
reduction in daily consumption, moving to a less
expensive residence). The participants were categor-
ized into four groups: no economic strain (0), lower
income (1), lower income and reduction in daily
consumption (2), lower income, reduction in daily
consumption and moving to a less expensive
residence (3).
Other covariates were cohabitation status (living
with or without a partner); self-rated health (excel-
lent/very good/good versus poor/very poor); eco-
nomic activity at the time of the survey categorized
into economic active (employed/on maternity or
educational leave) versus economic inactive (unem-
ployed, long-term sick leave, or receiver of social
welfare benefits). Finally, age was dichotomized into
3749 years and w50 years old.
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Coping with unemployment 365
Statistical analyses
The analyses of the association between educational
attainment and the two measures of coping included
three steps: (1) bivariate contingency tables, (2)
analyses of whether the covariates were associated
with the determinant and the two coping scales, and
(3) multivariate analyses by logistic regression
analyses, stratified by sex. The covariates were
included in the model in a stepwise manner in order
to test their potential mediating role. Model 1 was
adjusted for age only and models 25 also for
cohabitation status, self-rated health, financial
strain, and present unemployment status. There
was no statistical interaction between educational
attainment and the covariates.
All analyses were performed in SAS, version 8.02
and the factor analysis was calculated using proc
calis and the macro polychor.sas [25].
Results
Descriptive statistics
Table II shows that, among men, participants with
low educational attainment used problem-solving
coping less often and avoidant coping more often
than participants with higher educational attain-
ment. Among women, participants with low educa-
tional attainment used problem-solving coping less
often than the better educated. Furthermore,
women with medium educational attainment used
less avoidant coping.
Educational attainment and low use of problem-solving
coping
Table III shows multivariate logistic regression
analyses of the association between educational
attainment and low use of problem-solving coping.
Among men, the age adjusted model 1 demonstrated
an odds ratio of 1.81 (95% CI 1.192.75) for
participants with low and 1.48 (0.942.33) for
participants with medium educational attainment.
Inclusion of cohabitation status in the model
attenuated the association and inclusion of the
remaining covariates strengthened the association
again so that OR for low use of problem-solving
coping in the final model was 1.70 (1.102.63)
for participants with low educational attainment.
Living alone and experiencing no financial strain
were also associated with low use of problem-solving
coping.
Among women, the age adjusted OR for low use of
problem-solving coping was 1.57 (1.132.18) for
366 U. Christensen et al.

Table II. Low use of problem-solving coping, high use of avoidant coping, and covariates by educational attainment: 37- to 56-year-old
Danish men and women with unemployment w70% during the preceding three years (percentages).

Problem- Self-rated Economic

Age solving Avoidant health: strain: less
5057 coping: coping: Cohabitation: poor or consumption/ Employment
Educational years low high no fair health change in status:
attainment n old (%) use (%) use (%) partner (%) (%) housing (%) inactive (%)

Men
High attainment 238 44.1 24.8 17.2 42.0 12.2 55.9 52.3
Medium attainment 146 49.3 32.9 18.5 43.2 23.3 55.5 48.6
Low attainment 191 31.9 37.2 24.6 48.7 27.8 57.1 69.6

Women
High attainment 357 26.1 25.8 28.3 34.7 15.4 54.1 44.9
Medium attainment 369 35.2 29.5 19.0 24.7 14.6 55.3 41.0
Low attainment 338 35.8 34.6 27.5 28.4 27.8 49.4 59.1

participants with low educational attainment and
1.24 (0.891.72) for participants with medium
educational attainment. This association did not
change much when the remaining covariates were
included in the model. Living alone, poor self-rated
health, and no financial strain were associated with
low use of problem-solving coping.
Educational attainment and high use of avoidant coping
Table IV gives the results for high use of avoidant
coping. Among men, participants with low educa-
tional attainment used avoidant coping more,
OR51.57 (0.982.51). This association attenuated
after inclusion of the covariates with an OR51.44
(0.882.35) in the final model. Poor self-rated
health was associated with high use of avoidant
coping.
Among women, the medium category of educa-
tional attainment had a lower use of avoidant coping,
OR50.60 (0.420.85) in the age-adjusted model,
and 0.63 (0.440.90) in the final model. Further,
poor self-rated health, high financial strain, and not
being employed presently were associated with high
use of avoidant coping.
Discussion
Low use of problem-solving coping was significantly
associated with low educational attainment for both
men and women in this study. Although the
estimates were slightly attenuated in different direc-
tions for men and women when covariates such as
cohabitation status, self-rated health, and economic
strain were included in the regression models,
the association remained significant. High use of
avoidant coping was associated with low educational
attainment for men, while women with medium
educational attainment used avoidant coping less
often.
The robust association between educational
attainment and problem-solving coping in our study
corresponds with the assumption that variations in
mastery-oriented attitudes may partly be related to
the social contexts within which individuals are
located [14]. Grossi also found less problem-solving
coping among unemployed men and women with
low educational attainment [18] but showed that less
use of problem-solving coping strategies interacted
significantly with financial strain. Grossis findings
suggest that this coping strategy was less frequent
among individuals with low financial strain coupled
with low educational level. Our results do not
support either an interaction between education
and economic strain or a mediating effect of
financial strain between vocational training and
coping strategies in unemployment. In our study,
having no financial strain was associated with low
use of problem-solving coping among both men and
women, while among women high financial strain
was also associated with high use of avoidant coping.
The dual role of financial strain was also shown by
Vinokur and Schul among 2,243 unemployed men
and women [24]. While on the one hand financial
strain increased job-search motivation and job-
search intensity, on the other hand it also decreased
activity by increasing depressive symptoms.
The main focus of this study was the association
between coping and educational attainment, but we
did find different patterns of avoidant coping among
men and women. Based on 50 studies reported
between 1990 and 2000 Tamres et al. performed a

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 Coping with unemployment 367

Table III. Odds ratios for low use of problem-solving coping by educational attainment and age (model 1), adjusted for cohabitation status
(model 2), self-rated health (model 3), economic strain (model 4), and unemployment status (model 5): 37- to 56-year-old Danish men and
women with unemployment w70% during the preceding three years.

Model 1 Model 2 Model 3 Model 4 Model 5

Men (OR 95% CI) (OR 95% CI) (OR 95% CI) (OR 95% CI) (OR 95% CI)

Educational attainment
High attainment 1 1 1 1 1
Medium attainment 1.48 1.77 1.47 1.48 1.51
(0.942.33) (1.162.70) (0.932.33) (0.932.35) (0.942.40)
Low attainment 1.81 1.48 1.76 1.78 1.70
(1.192.75) (0.942.34) (1.152.69) (1.162.74) (1.102.63)
Cohabitation status
With partner 1 1 1 1
Without partner 1.71 1.71 1.83 1.75
(1.202.46) (1.192.45) (1.272.65) (1.202.54)
Self-rated health
Excellent/very good/good 1 1 1
Fair/poor 1.05 1.11 1.04
(0.671.63) (0.711.74) (0.661.65)
Economic strain
No economic strain 1 1
Economic strain low income 0.96 0.97
(0.551.68) (0.551.71)
Economic strain less 0.50 0.50
consumption (0.290.97) (0.290.88)
Economic strain change in 0.56 0.54
housing (0.281.10) (0.281.08)
Employment status
Economically active 1
Economically inactive 1.38
(0.932.05)
Women

Educational attainment
High attainment 1 1 1 1 1
Medium attainment 1.24 1.28 1.29 1.31 1.30
(0.891.72) (0.921.77) (0.931.79) (0.941.83) (0.931.82)
Low attainment 1.57 1.60 1.51 1.49 1.51
(1.132.18) (1.152.22) (1.082.10) (1.062.08) (1.072.11)
Cohabitation status
With partner 1 1 1 1
Without partner 1.35 1.36 1.52 1.53
(1.011.79) (1.021.81) (1.132.05) (1.132.06)
Self-rated health
Excellent/very good/good 1 1 1
Fair/poor 1.64 1.72 1.79
(1.182.28) (1.232.40) (1.272.51)
Economic strain
No economic strain 1 1
Economic strain low income 1.00 0.99
(0.661.53) (0.651.52)
Economic strain less 0.56 0.55
consumption (0.370.85) (0.370.84)
Economic strain change in 0.44 0.44
housing (0.220.88) (0.220.87)
Employment status
Economically active 1
Economically inactive 0.90
(0.681.19)

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368 U. Christensen et al.

Table IV. Odds ratios for high use of avoidant coping by educational attainment and age (model 1), adjusted for cohabitation status (model
2), self-rated health (model 3), economic strain (model 4), and unemployment status (model 5): 37- to 56-year-old Danish men and women
with unemployment w70% during the preceding three years.

Model 1 Model 2 Model 3 Model 4 Model 5

Men (OR 95% CI) (OR 95% CI) (OR 95% CI) (OR 95% CI) (OR 95% CI)

Educational attainment
High attainment 1 1 1 1 1
Medium attainment 1.09 1.09 1.03 1.04 1.08
(0.641.87) (0.641.83) (0.601.77) (0.611.80) (0.631.87)
Low attainment 1.57 1.55 1.44 1.44 1.44
(0.982.51) (0.972.49) (0.892.33) (0.892.33) (0.882.35)
Cohabitation status
With partner 1 1 1 1
Without partner 1.15 1.12 1.11 1.10
(0.761.74) (0.741.70) (0.731.68) (0.721.68)
Self-rated health
Excellent/very good/good 1 1 1
Fair/poor 1.62 1.60 1.57
(1.002.62) (0.982.60) (0.952.57)
Economic strain
No economic strain 1 1
Economic strain low income 0.96 0.97
(0.491.88) (0.491.90)
Economic strain less 0.89 0.87
consumption (0.471.70) (0.461.66)
Economic strain change in 1.31 1.29
housing (0.622.77) (0.612.74)
Employment status
Economically active 1
Economically inactive 1.16
(0.741.83)

Women

Educational attainment
High attainment 1 1 1 1 1
Medium attainment 0.60 0.61 0.62 0.62 0.63
(0.420.85) (0.430.87) (0.430.88) (0.440.89) (0.440.90)
Low attainment 0.97 0.99 0.92 0.92 0.88
(0.691.35) (0.711.38) (0.661.29) (0.661.30) (0.621.24)
Cohabitation status
With partner 1 1 1 1
Without partner 1.38 1.39 1.28 1.23
(1.021.86) (1.031.88) (0.941.74) (0.901.68)
Self-rated health
Excellent/very good/good 1 1 1
Fair/poor 1.69 1.65 1.48
(1.202.37) (1.172.32) (1.042.10)
Economic strain
No economic strain 1 1
Economic strain low income 0.81 0.81
(0.501.30) (0.501.31)
Economic strain less 1.15 1.15
consumption (0.741.80) (0.731.79)
Economic strain change in 1.84 1.85
housing (0.973.48) (0.973.51)
Employment status
Economically active 1
Economically inactive 1.57
(1.172.12)

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meta-analysis of gender differences in coping beha-
viour [26]. Among stressors examined were also
work environment, dismissal, and downsizing.
Women were significantly more likely than men to
use active coping, to seek social support for
instrumental reasons, and to engage in general
problem-focused coping. In a study among 157
unemployed men and women, Leana and Feldman
found that men relied more on problem-focused
activities such as job-seeking while women more
often used a symptom-focused coping strategy such
as seeking social support [27]. In the present study
we found no gender differences in the association
between educational attainment and low use of
problem-solving coping. This is in accordance with
our finding in a previous study on the association
between occupational social class and coping
responses in infertility among 2,250 Danish men
and women [17]. In this study we found a significant
difference in the association between social class and
active-confronting coping but there were no gender
differences. Thus, although gender differences have
been found in coping behaviour, socioeconomic
position seems to influence this difference.
The fact that only women with medium educa-
tional attainment less often used avoidant coping
compared with women with low and high educa-
tional attainment corresponds with other studies,
which have shown that individuals with a high
socioeconomic position tend to be more likely to
use problem-focused coping strategies or to have an
active coping style. However, most of these studies
also show that problem-focused coping either has no
effect on or in some cases can exacerbate psycholo-
gical symptoms when conditions of unemployment
or job insecurity do not change despite active
problem-solving [8,9,14,28]. So it seems that
unemployment and fear of job loss have an
unfavourable effect on mental health among indivi-
duals with higher socioeconomic position [8,9,28]
and this may influence their coping behaviour.
One of the advantages of this study was the
selected study sample of persons who had been
exposed to the same extent of long-term unemploy-
ment during the three-year observation period. Yet,
because of the steady decline in the Danish
unemployment rate in the years before we collected
data on coping, 45% of the male participants
and 53% of the female participants had been re-
employed when the survey was carried out. Because
of the cross-sectional design we cannot exclude the
risk of potential bias, i.e. the way the participants
answered the coping questions may have been
influenced by their current status on the labour
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Coping with unemployment 369
market. However, controlling for unemployment
status in the analyses did not affect the estimates.
The aim of the study was to examine how
educational attainment was associated with coping
strategies measured in accordance with Lazarus and
Folkmans concept. We used a distinction between
two essential coping strategies, which correspond
with other studies on coping with unemployment
[13,23,26] and which were developed from inter-
views with unemployed Danish workers [21].
Further, it complied with the measurement strategy
proposed by Folkman and Lazarus, i.e. that studies
on coping should refer to a specific stressor and that
the relevant measure of coping should be developed
in relation to that specific stressor. In this way, our
measurement has similarities to the measure devel-
oped by Brenner et al., which has been used in other
studies from Scandinavia [18,2930].
Conclusion
Coping strategies are considered a potential modifier
of the impact of unemployment on health and well-
being. In a sub-sample of persons exposed to long-
term unemployment, coping with unemployment
was associated with educational attainment. Further
studies on how social factors are associated with
coping strategies may contribute to the explanation
of disparity in health among the unemployed. Also,
gender differences in this association should be taken
into consideration.
Acknowledgements
Financial funding for the Danish Longitudinal Study
on Work, Unemployment and Health was received
from the Danish Research Councils (j.nr.9801268).
The authors would like to thank Lars Iversen for his
valuable advice and support in the preliminary phase
of this study.
References
[1] Morris JK, Cook DG, Shaper AG. Loss of unemployment
and mortality. Br Med J 1994;308:11359.
[2] Iversen L, Andersen O, Kragh Andersen P, Christoffersen K,
Keiding N. Unemployment and mortality in Denmark,
19701980. Br Med J 1987;295:87984.
[3] Martikainen PT, Valkonen T. Excess mortality of unem-
ployed men and women during a period of rapidly increasing
unemployment. Lancet 1996:90912.
[4] Voss M, Nylen L, Floderus B, Diderichsen F, Terry PD.
Unemployment and early cause-specific mortality: a study
based on the Swedish Twin Registry. Am J Public Health
2004;95:215561.
[5] Bartley M, Sacker A, Clarke P. Employment status, employ-
ment conditions, and limiting illness: Prospective evidence
370 U. Christensen et al.
from the British household panel survey 19912001. J
Epidemiol Community Health 2004;58:5016.
[6] Viinamaki H, Koskela K, Niskanen L. The impact of
unemployment on psychosomatic symptoms and mental
well-being. Int J Soc Psychiatry 1993;39:26673.
[7] Johansson SE, Sundquist J. Unemployment is an important
risk factor for suicide in contemporary Sweden: An 11-year
follow-up study of a cross-sectional sample of 37,789 people.
Public Health 1997;111:415.
[8] Domenighetti G, DAvanzo B, Bisig B. Health effects of job
insecurity among employees in the Swiss general population.
Int J Health Serv 2000;30:47790.
[9] Wiggins RD, Schofield P, Sacker A, Head J, Bartley M.
Social position and minor psychiatric morbidity over time in
the British Household Panel Survey 19911998. J Epidemiol
Community Health 2004;58:77987.
[10] Brenner S-O, Starrin B. Unemployment and health in
Sweden: Public issues and private troubles. J Soc Issues
1988;44:12540.
[11] Caplan RD, Vinokur AD, Price RH, van Ryn M. Job
seeking, reemployment, and mental health: A randomized
field experiment in coping with job loss. J Appl Psychol
1989;75:75969.
[12] Arnetz BB, Brenner S-O, Levi L, Hjelm R, Petterson I-L,
Wasserman J, Petrini B, Eneroth P, Kallner A,
Kvetnansky R, Vigas M. Neuroendocrine and immunologic
effects of unemployment and job insecurity. Psychother
Psychosom 1991;55:7680.
[13] Hamilton VL, Hoffman WS, Broman CL, Rauma D.
Unemployment, distress, and coping: A panel study of
autoworkers. J Pers Soc Psychol 1993;65:23447.
[14] Thoits PA. Stress, coping, and social support processes:
where are we? What next? J Health Soc Behav 1995;(Extra
Issue):5379.
[15] Ross CE, Mirowsky J. Explaining the social depression:
control and problem solving or support and talking? J
Health Soc Behav 1989;30:20619.
[16] Christensen U, Schmidt L, rsted Hougaard C,
Holstein BE. Socioeconomic position and variations in
coping strategies with musculoskeletal pain: a cross-sectional
study of 1,287 40- and 50-year-old men and women.
(Submitted)
Downloaded from http://sjp.sagepub.com by taman mihaela on October 13, 2009
[17] Schmidt L, Christensen U, Holstein B. The social epide-
miology of coping with infertility. Hum Reprod
2005;20:104452.
[18] Grossi G. Coping and emotional distress in a sample of
Swedish unemployed. Scand J Psychol 1999;40:15765.
[19] Folkman S, Lazarus RS. Manual for the Ways of Coping
Questionnaire. Palo Alto: Consulting Psychologists Press;
1988.
[20] Costa PT, Somerfield MR, McCrae RR. Personality and
coping: a reconceptualization. In: Zeidner M, Endler NS,
editors. Handbook of coping: Theory, research, applications.
New York: Wiley; 1996. p 4461.
[21] Iversen L. Company closedowns, unemployment and health.
Doctoral thesis (in Danish). Copenhagen, University of
Copenhagen: FADL; 1990.
[22] Goul Andersen J. Coping with long-term unemployment:
Economic security, labour market integration and well-
being. Results from a Danish Panel Study, 19941999.
CCWS Working Paper No. 2002;233. Aalborg: Aalborg
University; 2002.
[23] Leana CR, Feldman DC. Individual responses to job loss:
Empirical findings from two field studies. Hum Relations
1990;43:115581.
[24] Vinokur AD, Schul Y. The web of coping resources
and pathways to reemployment following a job loss.
J Occup Health Psychol 2002;7:6883.
[25] [available at:http://ftp.sas.com/techsup/download/stat/poly-
chor.html]
[26] Tamres LK, Janicki D, Helgeson VS. Sex differences in
coping behavior: A meta-analytic review and an examination
of relative coping. Pers Soc Psychol 2002;6:230.
[27] Leana CR, Feldman DC. Gender differences in responses to
unemployment. J Vocational Behav 1991;38:6577.
[28] Turner JB. Economic context and the health effects of
unemployment. J Health Soc Behav 1995;36:21329.
[29] Brenner S-O, Arnetz B, editors. Stress Research Reports
No.170 (in Swedish). Stockholm: Laboratory for Clinical
Stress Research; 1983.
[30] Brenner S-O, Petterson I-L, Levi L, Arnetz B. Stress
reactions in relation to threat of job loss and actual
unemployment. Stress Research Reports No.210 (in
Swedish). Stockholm: National Institute of Psychosocial
Environmental Medicine; 1988.