WORKSHEET ASSIGNMENT

Topic: STRESS AND ILLNESS IN THE WORKPLACE MATRIX

2-CITESS, to include REFERENCES

*****Chapters provided below via attchment, optional*********

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AssociateLevel Material

Stress and Illness in the Workplace Matrix

Use the following table to describe the relationship between stress and health in the workplace and to identify ways to reduce stress in the workplace. If you use additional sources, include citations consistent with APA guidelines.

What is the relationship between stress and health in the workplace?

Identify a situation in which you experienced stress in the workplace or provide a fictional example.

List ways to reduce stress in the workplace from the situation or example you provided.

How do social-support systems modify stressors on an individual?

HCA/250r3

4
STRESS, BIOPSYCHOSOCIAL
FACTORS, AND ILLNESS
Psychosocial Modifiers of

Stress

Social Support
A Sense of Personal Contr

Personality As Resilience And Vulnerability
Type A Behavior and Beyon

How Stress Affects Health
Stress, Behavior, and Illness
Stress, Physiology, and Illness
Psychoneuroimmunology

Psychophysiological Disorde

Digestive System Diseases
Asthma
Recurrent Headache
Other Disorders

Stress and Cardiovascular Disorders
Hypertension
Coronary Heart Disease

Stress and Cancer

PROLOGUE
Two cataclysmic events riveted the world’s attention
within a year of each other: the enormous tsunami in the
Indian Ocean in December 2004 and hurricane Katrina,
which nearly destroyed New Orleans and surrounding

areas in August 2005. These events killed over 200,00

people and left even more injured and homeless. In
New Orleans, hundreds of thousands of people were
relocated, sometimes splitting up families, at least
temporarily. Let’s contrast Katrina’s aftermath for two
high school friends, Will and Barb, who were relocated
far apart.

The initial impact of the hurricane on them was
similar, but the amounts of stress that followed were
different—Will’s stress was not as severe as Barb’s. One
thing that helped Will was that his whole family remained
together when relocated to a nearby town where they had
relatives. The relatives provided consolation for Will’s
loss, places for him to socialize, help in getting jobs for
his parents, and assistance in getting their new house
set up. How was Will doing 2 years later? He missed
Barb, whom he hadn’t seen in over a year. But he was
making a good adjustment in his new community, had a
good relationship with his family, had begun attending a
nearby community college and dating a student he met
there, and was in good health.

Barb was not so fortunate, and her situation differed
from Will’s in several major ways. Her immediate family
was split up for several months until they relocated to
a distant state when one of her parents got a job there.
Barb had no extended family to help her and her parents
or to provide emotional support in their grief. Her family
lived in a cramped apartment in their new location,
and their financial situation was very difficult. And Barb

Chapter 4 / Stress, Biopsychosocial Factors, and Illness 81

had never been as outgoing as Will—she felt awkward
and insecure in making friends and meeting guys. Two
years after Katrina, she was isolated and lonely. Although
Barb graduated from high school, she then got a low-
paying job with lots of overtime, which left her with little
time or money to socialize. The stress in Barb’s life was
taking its toll: she and her parents were arguing often,
and her health was deteriorating. She had developed two
illnesses—migraine headaches and a digestive system
condition that causes abdominal pain—that worsened
when she felt stress.

Continuing issues introduced in Chapter 3, this
chapter examines in more detail the effects of stress
on health. We begin by looking at psychosocial factors
that can modify the stress people experience. Then we
consider how stress affects health and the development
of specific illnesses. And in this chapter we address
many questions about stress and illness that are of
great concern today. Why can some people experience
one traumatic event after another without ill effects,
but others cannot? Are angry and hard-driving people
more likely to have a heart attack than people who
are easygoing? Can stress delay people’s recovery from
illness?

PSYCHOSOCIAL MODIFIERS OF STRESS

People’s reactions to stress vary from one person to the
next and from time to time for the same person. These
variations often result from psychological and social
factors that seem to modify the impact of stressors on
the individual. Let’s look at some of these modifiers,
beginning with the role of social support.

SOCIAL SUPPORT
We saw in the experiences of Will and Barb how
important social ties and relationships can be during
troubled times. The social support Will got from his
family tempered the impact of his stressful loss and
probably helped him adjust. Social support refers to
comfort, caring, esteem, or help available to a person
from other people or groups (Uchino, 2004). Support can
come from many sources—the person’s spouse or lover,
family, friends, physician, or community organizations.
People with social support believe they are loved, valued,
and part of a social network, such as a family or community
organization, that can help in times of need. So, social
support refers to actions actually performed by others,
or received support. But it also refers to one’s sense or
perception that comfort, caring, and help are available

if needed—that is, perceived support. As will we see later,
received and perceived support can have different effects
on health.

Types of Social Support
What specifically does social support provide to the
person? It appears to provide four basic functions
(Cutrona & Gardner, 2004; Uchino, 2004). Emotional
or esteem support conveys empathy, caring, concern,
positive regard, and encouragement toward the person.
It provides comfort and reassurance with a sense of
belongingness and of being loved in times of stress, as
Will received from his immediate and extended family
after Katrina. Tangible or instrumental support involves direct
assistance, as when people give or lend the person money
or help out with chores in times of stress. Will’s relatives
helped his parents get jobs and set up the new house.
Informational support includes giving advice, directions,
suggestions, or feedback about how the person is doing.

A patient receiving informational support from her
physician.

82 Part II / Stress, Illness, and Coping

For example, a person who is ill might get information
from family or a physician on how to treat the illness.
Companionship support refers to the availability of others
to spend time with the person, thereby giving a feeling
of membership in a group of people who share interests
and social activities.

What type of support do people generally need and
get? The answer depends on the stressful circumstances.
For instance, Figure 4-1 shows that cancer patients find
emotional and esteem support to be especially helpful,
but patients with less serious chronic illnesses find
the different types of support equally helpful (Martin
et al., 1994). Another study had college students fill
out a questionnaire, rating the degree to which their
current relationships provided them with different types
of support, and then keep a daily record of their stress and
social experiences for 2 weeks (Cutrona, 1986). The daily
records revealed that most of the stressors were relatively
minor, such as having car trouble or an argument with
a roommate, but one-fifth of the students reported a
severe event, such as a parent’s diagnosis of cancer
or the ending of a long-term romantic relationship.
As you might expect, individuals received more social
support following stressful events than at less stressful
times. Tangible support occurred very infrequently, but
informational and emotional/esteem support occurred
often. Emotional/esteem support appeared to protect

Emotional
or esteem

Informational Tangible
0

Cancer patients

Patients with non–
life-threatening
chronic disorders

P
er

ce
n
t

of
”

m
os

t
h
el

p
fu

l”
t

yp
es

of
s

oc
ia

l
su

p
p
or

t
p
at

ie
n
ts

r
ep

or
te

Figure 4-1 Percentage of patients with cancer and with
non-life-threatening disorders (chronic headache or irritable
bowel syndrome) whose reports of the ‘‘most helpful’’ social
support they received described the emotional/esteem,
instrumental, or tangible types of support. Notice that
the cancer patients found emotional or esteem

support

especially helpful. (Data from Martin et al., 1994, Figure 1.)

individuals from negative emotional consequences of
stress.

Who Gets Social Support?
Not everyone gets the social support they need.
Many factors determine whether people receive sup-
port (Antonucci, 1985; Broadhead et al., 1983; Wortman
& Dunkel-Schetter, 1987). Some factors relate to the
potential recipients of support. People are unlikely to
receive support if they are unsociable, don’t help others,
and don’t let others know that they need help. Some
people are not assertive enough to ask for help, or feel
that they should be independent or not burden others,
or feel uncomfortable confiding in others, or don’t know
whom to ask. Other factors relate to the potential providers
of support. For instance, they may not have the resources
needed, or may be under stress and in need of help them-
selves, or may be insensitive to the needs of others. Old
age is a time when social support sometimes declines:
the elderly may exchange less support because of the
loss of a spouse or because they may feel reluctant to ask
for help if they become unable to reciprocate. Whether
people receive social support also depends on the size,
intimacy, and frequency of contact of individuals in their
social network—the people a person knows and contacts
(Cutrona & Gardner, 2004; Wills & Fegan, 2001).

How can we assess people’s social support, given the
different types of support and the complex relationships
that are involved? One highly regarded instrument is
the Social Support Questionnaire, which consists of items,
such as, ‘‘Who helps you feel that you truly have
something positive to contribute to others?’’ (Sarason
et al., 1983). For each item, the respondents list the
people they can rely on and then indicate their overall
degree of satisfaction with the support available. Using
this instrument, these researchers have found that some
people report high levels of satisfaction with support
from a small number of close friends and relatives, but
others need a large social network. (Go to .)

Gender and Sociocultural Differences in
Receiving Support
The amount of social support individuals receive appears
to depend on their gender and sociocultural group
membership. Some evidence suggests that women
receive less support from their spouses than men do and
seem to rely heavily on women friends for social support
(Greenglass & Noguchi, 1996). These gender differences
may result from the greater intimacy that seems to exist
in the friendships of females than males and may reflect
mainly differences in the emotional and esteem support

Chapter 4 / Stress, Biopsychosocial Factors, and Illness 83

ASSESS YOURSELF

How Much Emotional Support Do You Get?
Think of the 10 people to whom you

feel closest. For some of them, you may not feel a strong
bond—but they are still among the closest 10 people in
your life. Write their initials in the following spaces:

In the corresponding spaces below each of the following
four questions, rate each person on a 5-point scale, where
1 = ‘‘not at all’’ and 5 = ‘‘extremely.’’
• How reliable is this person; is this person there when

you need him or her?

• How much does this person boost your spirits when
you feel low?

• How much does this person make you feel he or she
cares about you?

• How much do feel you can confide in this person?

Add together all of the ratings you gave across all of the
people and questions. A total score between 120 and 150
is fairly typical and suggests that you can get a reasonably
good level of emotional support when you need it. (Based
on material in Schaefer, Coyne, & Lazarus 1981.)

males and females seek out and give (Heller, Price, &
Hogg, 1990). Such gender differences could also reflect
the fact that women generally respond to their own
and others’ stress with greater attention to personal
relationships (Taylor et al., 2000). Research on social
networks in the United States has revealed interesting
gender and sociocultural relationships (Gottlieb & Green,
1987): Black Americans have smaller social networks than
Whites and Hispanics, and men’s networks are larger
than women’s among Black and Hispanic groups but
not among nonminority people. Hispanics tend to focus
mainly on extended families as their networks, Whites
have broader networks of friends and coworkers, and
Blacks focus on family and church groups.

Social Support, Stress, and Health
A favorite fortune cookie read, ‘‘Friendship is to people
what sunshine is to flowers.’’ Does the social support of
friends, relatives, and other people affect our stress and
health? Social support may reduce the stress people
experience. For example, studies of job stress have
shown that the greater the social support available
to employees, the lower the psychological strain they
report (Cottington & House, 1987; LaRocco, House,
& French, 1980). Other research has found that blood
pressure during work is lower for workers who have high
social support than for those with less support (Karlin,
Brondolo, & Schwartz, 2003), and positive interactions
with spouses can reduce the effects of job stress on
cortisol levels (Ditzen et al., 2008). People with better

social support also have larger nighttime decreases in
blood pressure, suggesting better restorative processes
(Troxel et al., 2010). And social support has been asso-
ciated with reduced stress from a variety of other sources,
such as living near the damaged nuclear power plant at
Three Mile Island (Fleming et al., 1982).

Experiments have assessed people’s physiological
strain while they were engaged in a stressful activity (such
as giving a speech or performing mental arithmetic)
either alone or in the presence of one or more
individuals. Strain in these experiments is often assessed
as cardiovascular reactivity—that is, an increase in blood
pressure and/or heart rate from a baseline level. However,
other aspects of the physiological stress response,
including stress hormones such as cortisol have been
examined, as well (Uchino, 2006). We’ll consider a
few findings. First, while giving a speech, people often
show less reactivity if a supportive person is present
than if speaking alone (Lepore, Allen, & Evans, 1993;
Uchino & Garvey, 1997). Second, reactivity is lower
with a friend present than with a supportive stranger
(Christenfeld et al., 1997). Third, sometimes the presence
of supportive people can increase reactivity, especially if
their presence functions as an audience that increases
the support recipient’s worries about being evaluated
negatively (Taylor et al., 2010). Fourth, reactivity is also
lower in the presence of the person’s pet than alone
(Allen, Blascovich, & Mendes, 2002). Fifth, other findings
suggest that the benefits of social support on reactivity
may depend on the person’s personality: people who
are defensive—they avoid information or feelings that

84 Part II / Stress, Illness, and Coping

threaten their self-concept—show higher reactivity under
stress when social support is given (Westmaas &
Jamner, 2006). Similarly, hostile individuals can also
show increased reactivity during stressful activities when
accompanied by friends, perhaps because they mistrust
their friends or are concerned about being evaluated
(Holt-Lunstad et al., 2008). Finally, simply thinking about
supportive relationships before encountering a stressor
can reduce cardiovascular stress responses (Smith et al.,
2004). So, looking at the pictures of loved ones on your
desk during a stressful day at work might be more than
just a pleasant distraction.

Having social support also seems to benefit people’s
health (Cutrona & Gardner, 2004; Uchino, 2004). For
instance, a prospective study had more than 4,700 men
and women between 30 and 69 years of age report on four
aspects of social support: marital status, contacts with
family and friends, church membership, and formal and
informal group associations (Berkman & Syme, 1979).
Mortality data collected over the next 9 years revealed
that the greater the degree of social support the subjects
had, the lower the likelihood of their dying during the
period of the study. Figure 4-2 shows an example of
these findings. In each age category, individuals who
had few contacts with friends and relatives had higher
mortality rates than those with many contacts. This

20
30
10

60–69
years

40
P
er

ce
n
ta

ge
d

yi
n
g

in
9

y
ea

Low Medium

Contacts with friends and relatives

High

50–59
years

30–49
years

Figure 4-2 Percentage of adults who died within 9 years
as a function of the number of contacts with friends and
relatives and the subjects’ ages at the start of the study, in
1965. (Data from Berkman & Syme, 1979, Table 2.)

relationship applied to deaths from all causes and deaths
from several specific diseases, including cancer and heart
disease. This association is also quite strong in the case
of coronary heart disease, a leading cause of mortality
in industrialized nations. Specifically, social support is
associated with a lower risk of developing heart disease,
and among people who have already developed heart
disease social support is associated with lower risk of
additional heart attacks and death from heart

disease

(Lett et al., 2005).

Because this research is quasi-experimental, the
relationship found between social support and mortality
is correlational. How do we know whether social support
leads to better health or whether the influence is the
other way around? That is, could the people who had
less social support be less active socially because they
were already sick at the start of the study? Berkman and
Syme provided some evidence that this was not the case.
For instance, the subjects had been asked about past
illnesses at the initial interview, and those with high
levels of social support did not differ from those with low
levels of support. But better evidence comes from a sim-
ilar study of more than 2,700 adults who were medically
examined at the start of the research (House, Robbins, &
Metzner, 1982). This research found that people with less
social support had higher mortality rates and that the
initial health of those with low social support was the
same as that of those with high support. Many studies of
social support and future health have made sure that ini-
tial differences in health do not explain the prospective
association between support and health. However, the
correlational design still means that we cannot be certain
that good support causes good health. Unexamined third
variables could still play a role. For example, twin studies
demonstrate that social support and the quality of our
personal relationships are at least partially influenced
by genetic factors (Spotts, Prescott, & Kendler, 2006).
So, it is possible that genetic factors influence both
the development of social support and future health,
without support playing a direct causal role in health.

Researchers have also studied the association
between social support and the likelihood that people
will recover quickly from serious illness. Early findings
were inconsistent—probably because of variations in
research methods, such as in the way support was defined
and measured (Wallston et al., 1983; Wortman & Dunkel-
Schetter, 1987). Newer research has found more consis-
tently positive results, showing, for example, that heart
disease and surgery patients with high levels of social
support recover more quickly than comparable patients
with less support (Cutrona & Gardner, 2004; Kulik &
Mahler, 1989; Wills & Fegan, 2001). Although these find-
ings suggest that social support reduces the likelihood

Chapter 4 / Stress, Biopsychosocial Factors, and Illness 8

of illness and speeds recovery, the connection between
social support and health is not always very strong,
probably because support is only one of many factors
involved (Kobasa et al., 1985; Smith et al., 1994). Social
support appears to have a strong impact on the health
of some individuals, and a weak influence on the health
of others. For instance, some evidence indicates that the
recovery of many patients who believe they can cope with
the emotional demands of their illness does not benefit
from social support (Wilcox, Kasl, & Berkman, 1994).

How May Social Support Affect Health?
We have seen that prolonged exposure to high levels of
stress can lead to illness. To explain how social support
may influence health, researchers have proposed two
theories: the ‘‘buffering’’ and the ‘‘direct effects’’ (or ‘‘main
effects’’) hypotheses (Cutrona & Gardner, 2004; Wills &
Fegan, 2001). According to the buffering hypothesis,
social support affects health by protecting the person
against the negative effects of high stress. A graphical
illustration of the buffering hypothesis appears in
Figure 4-3a. As the graph shows, this protective function
is effective only or mainly when the person encounters a
strong stressor. Under low-stress conditions, little or no
buffering occurs. Research has shown that the buffering
process does occur (Wills & Fegan, 2001). For example, a
study of job stress found that social support had a much
stronger association with lower blood pressure during
stressful than nonstressful work times (Karlin, Brondolo,
& Schwartz, 2003).

How may buffering work? Here are two ways. First,
when people encounter a strong stressor, such as a major

financial crisis, those who have high levels of social
support may be less likely to appraise the situation
as stressful than those with low levels of support.
Individuals with high social support may expect that
someone they know will help them, such as by lending
money or giving advice on how to get it. Second, social
support may modify people’s response to a stressor after
the initial appraisal. For instance, people with high social
support might have someone provide a solution to the
problem, convince them that the problem is not very
important, or cheer them on to ‘‘look on the bright side.’’
People with little social support are much less likely to
have any of these advantages—so the negative impact of
the stress is greater for them.

The direct effects hypothesis maintains that social
support benefits health and well-being regardless of
the amount of stress people experience—the beneficial
effects are similar under high and low stressor intensities,
as depicted in Figure 4-3b. How do direct effects work?
One way is that people with high levels of social support
may have strong feelings of belongingness and self-
esteem. The positive outlook this produces may be
beneficial to health independently of stress: studies
have found lower blood pressures in daily life and in
laboratory tests among middle-aged and younger adults
with higher levels of social support regardless of stress
levels (Carels, Blumenthal, & Sherwood, 1998; Uchino
et al., 1999). Other evidence suggests that high levels of
support may encourage people to lead healthful lifestyles
(Broman, 1993; Peirce et al., 2000). People with social
support may feel, for example, that because others care
about them and need them, they should exercise, eat
well, and not smoke or drink heavily.

High

Low

Im
p
ac

t
on

h
ea

lt
h
/w

el
l-

b
ei

n
g

Low

Stressor intensity
(a)

High

High
social

support

Low
social

support
High

Low
Low

Stressor intensity
(b)

High
High
social
support
Low
social
support

Figure 4-3 Illustration of two ways social
support may benefit health and well-being.
Graph (a) illustrates the buffering hypothesis,
which proposes that social support modifies
the negative health effects of high levels of
stress. Graph (b) depicts the direct effects
hypothesis, which proposes that the health
benefits of social support occur regardless of
stress.

86 Part II / Stress, Illness, and Coping

Does Social Support Always Help?
Social support does not always reduce stress and benefit
health. Why not? For one thing, although support may
be offered or available to us, we may not perceive it as
supportive (Dunkel-Schetter & Bennett, 1990; Wilcox,
Kasl, & Berkman, 1994). This may happen because
the help is insufficient or the wrong kind, or we may
not want help. When we do not perceive help as
supportive, it is less likely to reduce our stress. For
example, when people feel the need for tangible help
or instrumental support but receive emotional support,
they find that support unhelpful and ineffective. Similarly,
when people feel the need for emotional support but
receive offers of instrumental support, they also find that
support unhelpful (Horowitz et al., 2001). Support that is
responsive to the recipient’s needs is the most beneficial
(Maisel & Gable, 2009). Further, receiving support can
sometimes convey the message to the recipient that they
are inadequate to handle their problems on their own,
resulting in lower self-esteem (Lepore et al., 2008). These
possible negative consequences of received support may
be the reason that overall the health benefits of the
general sense or perceptions that one has support is
a better predictor of future good health than is actual
received support (Uchino, 2009).

Despite the advantages of perceived support, some
intriguing research suggests that ‘‘invisible support’’
is best. By studying couples and asking each partner
separately whether they gave or received support on
a given day, Niall Bolger and his colleagues (2000)
found the most beneficial effects of support on reducing
negative mood during high stress days when the partner
reported giving support but the recipient was unaware of
it. Experimental studies have shown similar advantages
of receiving support without being aware of it (Bolger &
Amarel, 2007). Perhaps a ‘‘light touch’’ that is responsive
to the recipients’ needs without making them feel less
competent or as though they are a burden on the support
providers can maximize the benefits of support in some
instances.

Marriage is often thought to convey protective health
benefits by providing social support. Consistent with this
idea, studies have found that married people live longer
than divorced and never-married individuals (Kaplan &
Kronick, 2006; Murphy & Bennett, 2004). James Lynch
(1990) has argued that being lonely or having a ‘‘broken
heart’’ is a risk factor for heart disease because widowed,
divorced, and never-married individuals have higher
death rates from heart disease than married people
do. Some evidence indeed suggests that loneliness can
increase the risk of heart disease (Thurston & Kubzansky,
2009). But other findings suggest that marriage itself is
not the crucial factor:

• Studies have found that a health protective role of
marriage occurs mainly for men and women who think
their marital quality is high (Gallo et al., 2003; Umberson
et al., 2006).

• Research on middle-aged men and women with no
symptoms of heart disease found similar low rates of
atherosclerosis in people living with a spouse or a
partner (unmarried), but much higher rates for people
living alone, either single or widowed (Kop et al., 2005).

• Married people show lower blood pressure than do
single people, but people in unhappy marriages show
higher blood pressure than single individuals (Holt-
Lunstad et al., 2009).

• Frequent contact with a spouse, presumably a source
of social support, can protect against worsening athero-
sclerosis over time, unless the marriage is perceived as
low in quality (Janicki et al., 2005).

These findings suggest that social support, and not
specifically marriage, is the crucial factor. When it comes
to marriage and health, simply being married is not
everything; quality matters.

Last, sometimes social ties can harm a person’s
health. For one thing, strain or conflict in relationships
can increase chances of developing serious illness (De
Vogli et al., 2007), probably because as discussed in
Chapter 3 conflict in relationships evokes a strong phys-
iological stress response. Further, people with high levels
of stress and frequent social contacts are more likely
than others to develop infectious illnesses, such as
colds (Hamrick, Cohen, & Rodriguez, 2002). Also, social
ties harm health when people encourage unhealthful
behavior (Burg & Seeman, 1994; Kaplan & Toshima,
1990; Suls, 1982). We’ll look at three examples. First,
people may set a bad example—for instance, children are
more likely to start smoking and drinking if their friends
and family engage in these behaviors and less likely to
use seat belts and eat a balanced diet if friends and
family don’t. Second, people may encourage individuals
who are overweight or have high blood pressure to
eat prohibited foods, saying, ‘‘A little more cheesecake
can’t hurt’’ or ‘‘You can make up for it by dieting next
week.’’ Third, families may be overprotective toward a
person with a serious illness, such as heart disease, and
discourage the patient’s need to become more active or
to go back to work. This can interfere with rehabilitation
and make the patient increasingly dependent and
disabled.

In summary, people perceive and receive various
types of support from friends, family, and others. Social
support tends to reduce people’s stress and benefit their
health, but some types of support or other aspects of
relationships do not. (Go to .)

Chapter 4 / Stress, Biopsychosocial Factors, and Illness 87

CLINICAL METHODS AND ISSUES

Social Support, Therapy, and Cognitive Processes
Years ago, a reporter asked actress

Melina Mercouri about psychotherapy in her native
country; she replied that in Greece people don’t
need therapists, they have friends. Although her view
oversimplifies the therapy process, therapy does include
two features friends can provide: social support and
the opportunity for disclosure of negative experiences and
feelings. James Pennebaker and other researchers have
found that people’s talking or writing about traumatic
or very emotional experiences for a few sessions of
15- to 30-minutes has beneficial effects that last for
months. This reduces their stress and negative feelings
and seems to improve their health, as reflected in the
number of physician visits and episodes of chronic illness

symptoms (Pennebaker, 1990; Smyth & Pennebaker,
2001). Although the effects of disclosure on psychological
and physical health are not very large, they have
been confirmed in a meta-analysis of over 140 studies
(Frattaroli, 2006). Other research has shown that simply
describing the benefits gained from traumatic events or
the success in managing one’s stress, can have similar
effects (King & Miner, 2000; Leake, Friend, & Wadhwa,
1999). Why does disclosure help? An experiment tested
this issue with breast cancer patients and found that
the benefits of disclosure are linked to the reduced
autonomic arousal, such as heart rate, that occurs when
people express negative memories (Low, Stanton, &
Danoff-Burg, 2006).

A SENSE OF PERSONAL CONTROL
Another psychosocial factor that modifies the stress
people experience is the degree of control people feel
they have in their lives. People generally like the feeling
of having some measure of control over the things that
happen to them, and they take action when they want to
influence events directly. In doing these things, people
strive for a sense of personal control—the feeling that
they can make decisions and take effective action to
produce desirable outcomes and avoid undesirable ones
(Contrada & Goyal, 2004). Studies have found that people
who have a strong sense of personal control report
experiencing less strain from stressors (McFarlane et al.,
1983; Suls & Mullen, 1981).

Types of Control
How can feelings of personal control reduce the stress
people experience? People can use several types of
control to influence events in their lives and reduce their
stress (Cohen et al., 1986; Thompson, 1981). We’ll focus
on two. Behavioral control involves the ability to take
concrete action to reduce the impact of a stressor. This
action might reduce the intensity of the event or shorten
its duration. For example, a pregnant woman who has
taken natural childbirth classes can use special breathing
techniques during delivery that reduce the pain of labor.
Cognitive control is the ability to use thought processes
or strategies to modify the impact of a stressor, such
as by thinking about the event differently or focusing
on a pleasant or neutral thought. While giving birth,
for instance, the mother might think about the positive

meanings the baby will give to her life, or she could
focus her mind on an image, such as a pleasant day
she had at the beach. Cognitive control appears to be
especially effective in reducing stress (Cohen et al., 1986).
For example, cognitive reappraisal of stressful stimuli or
events as less threatening can reduce negative emotions
and physiological stress responses (John & Gross, 2004).

Beliefs About Oneself and Control
People differ in the degree to which they believe they
have control over their lives. Most people believe they
have at least some control, but others think they have
almost none. The latter is shown in the case study of
a chronically unemployed man named Karl, who was
referred to therapy by the Veterans Administration and
with some help

applied for a job and got it. But this did not raise
his expectancies of being able to get another job
should he have to do so. Indeed, he attributed his
success entirely to good fortune. He believed that
the employer probably was partial to veterans or just
happened to be in a good mood that day … [and]
that the occurrence of reinforcement was outside his
own personal control. (Phares, 1984, pp. 505–506)

People who believe they have control over their
successes and failures are described as possessing an
internal locus of control. That is, the control for these
events lies within themselves—they are responsible.
Other people, like Karl, who believe that their lives are
controlled by forces outside themselves, for example, by
luck, have an external locus of control (Rotter, 1966). A

88 Part II / Stress, Illness, and Coping

questionnaire called the I-E Scale is used for measuring
the degree of internality or externality of a person’s
beliefs about personal control

Another important aspect of personal control is our
sense of self-efficacy—the belief that we can succeed at
a specific activity we want to do (Bandura, 1986, 2004).
People estimate their chances of success in an activity,
such as quitting smoking or running a mile, on the basis
of their prior observations of themselves and others.
They decide whether to attempt the activity according to
two expectations:

1. Outcome expectancy—that the behavior, if properly carried
out, would lead to a favorable outcome.

2. Self-efficacy expectancy—that they can perform the behav-
ior properly.

For example, you may know that by taking and doing
well in a set of college honors courses you can graduate
with a special diploma or certificate. But if you think the
likelihood of achieving that feat as ‘‘zilch,’’ you’re not
likely to try. For people engaged in a stressful activity,
increases in heart rate and blood pressure generally
correspond to their level of mental effort in dealing
with the demands of the situation—the greater their
effort, the greater the cardiovascular reactivity (Gendolla
& Wright, 2005). People with strong self-efficacy for the
activity may be less threatened and exert less mental
effort because they know they can manage the demands
of the situation more easily. Hence, they generally
show less psychological and physiological strain than
do those with a weaker self-efficacy (Bandura, Reese, &
Adams, 1982; Bandura et al., 1985; Holahan, Holahan, &
Belk, 1984).

Determinants and Development of
Personal Control
On what basis do people judge that they have control
over things that happen in their lives? We make these
assessments by using information we gain from our
successes and failures throughout life (Bandura, 1986,
2004; DeVellis & DeVellis, 2001). Our sense of control
also develops through social learning, in which we learn by
observing the behavior of others (Bandura, 1969, 1986).
During childhood, people in the family and at school
are important others, serving as models of behavior,
agents of reinforcement, and standards for comparison.
At the other end of the life span, people tend to be
relatively external in locus of control—that is, beliefs
that chance and powerful others affect their lives are
greater in the elderly than in younger adults (Lachman,
1986). So, among adults who develop serious illnesses,
those who are elderly are more inclined to prefer having

professionals make health-related decisions for them
(Woodward & Wallston, 1987).

Gender and Sociocultural Differences in
Personal Control
Gender and sociocultural differences in personal control
often develop, depending on the social experiences
individuals have. Sometimes parents and teachers
inadvertently lead girls more than boys toward beliefs
in external control and in low self-efficacy for certain
activities (Dweck & Elliott, 1983). This socialization
may carry over to old age: among elderly cardiac
patients, men report greater self-efficacy than women
for being able to walk various distances, a common
rehabilitation behavior (Jenkins & Gortner, 1998). Self-
efficacy beliefs generally can play and important role in
the process of rehabilitation for heart patients (Woodgate
& Brawley, 2008). Because minority groups and poor
people generally have limited access to power and
economic advancement, they tend to have external locus
of control beliefs (Lundin, 1987).

When People Lack Personal Control
What happens to people who experience high levels of
stress over a long period of time and feel that nothing
they do matters? They feel helpless—trapped and unable
to avoid negative outcomes. A worker who cannot seem
to please her boss no matter what she does, a student
who cannot perform well on exams, or a patient who
is unable to relieve his severe low back pain—each of
these situations can produce apathy. As a result, these
people may stop striving for these goals, come to believe
they have no control over these and other events in their
lives, and fail to exert control even when they could
succeed. This is the condition Martin Seligman (1975)
has called learned helplessness—which he describes
as a principal characteristic of depression. Research has
shown that people can learn to be helpless by being in
uncontrollable situations that lead to repeated failure,
such as in trying to stop an unpleasant noise (Hiroto &
Seligman, 1975).

Seligman and his colleagues have extended the the-
ory of learned helplessness to explain two important
observations (Abramson, Seligman,& Teasdale, 1978).
First, being exposed to uncontrollable negative events
does not always lead to learned helplessness. Sec-
ond, depressed people often report feeling a loss in
self-esteem. The revised theory proposes that people
who experience uncontrollable negative events apply a
cognitive process called attribution, in which they make
judgments about three dimensions of the situation:

Chapter 4 / Stress, Biopsychosocial Factors, and Illness 89

This homeless woman probably sees little personal control
in her life and feels very helpless.

1. Internal-external. People consider whether the situation
results from their own personal inability to control
outcomes or from external causes that are beyond
anyone’s control. For example, suppose a boy receives
physical therapy for a serious injury but cannot seem
to meet the goals each week, which he might attribute
either to his own lack of fortitude or to the rehabilitation
program design. Either judgment may make him stop
trying. He is likely to suffer a loss of self-esteem if he
attributes the difficulty to a lack of personal strength,
but not if he attributes the difficulty to external causes.

2. Stable-unstable. People assess whether the situation
results from a cause that is long-lasting (stable) or
temporary (unstable). If they judge that it is long-lasting,
as when people develop a chronic and disabling disease,
they are more likely to feel helpless and depressed than
if they think their condition is temporary.

3. Global-specific. People consider whether the situation
results from factors that have global and wide-ranging
effects or specific and narrow effects. Individuals who

fail at stopping smoking cigarettes and make a global
judgment—for example, ‘‘I’m totally no good and weak-
willed’’—may feel helpless and depressed. But others
who fail and make a specific judgment, such as ‘‘I’m not
good at controlling this part of my life,’’ are less likely
to feel helpless.

Thus, people who tend to attribute negative events
in their lives to stable and global causes are at high risk
for feeling helpless and depressed. If their judgments are
also internal, their depressive thinking is likely to include
a loss of self-esteem as well. People who believe bad
events result from internal, stable, and global factors
while good events result from external, unstable, and
specific factors have a pessimistic explanatory style (Kamen &
Seligman, 1989). Attributing negative events to external,
unstable, and specific causes, in contrast, reflects an
optimistic explanatory or attributional style.

How does lacking personal control affect people
in real-life stressful conditions? Studies have examined
this question with college students and children. For
instance, of college students in dormitories, those who
lived on crowded floors reported more stress and less
ability to control unwanted social interaction and showed
more evidence of helplessness, such as giving up in
competitive games, than those on uncrowded floors
(Baum, Aiello, & Calesnick, 1978; Rodin & Baum, 1978).
In a study of fifth-graders, students were given an
impossible task to arrange blocks to match a pictured
design (Dweck & Repucci, 1973). Children who attributed
their failure to stable, uncontrollable factors, such as
their own lack of ability, showed poorer performance on
subsequent problems than those who attributed failure
to unstable, modifiable factors, such as a lack of effort.
Thus, the children’s attributions were linked to their
feelings of helplessness.

Personal Control and Health
There are two ways in which personal control and health
may be related. First, people who have a strong sense of
personal control may be more likely or able to maintain
their health and prevent illness than those who have
a weak sense of control. Second, once people become
seriously ill, those who have a strong sense of control may
adjust to the illness and promote their own rehabilitation
better than those who have a weak sense of control. Both
types of relationships have been examined.

To study these relationships, researchers have used
several approaches to measure people’s personal con-
trol. One of the best-developed health-related measures
of personal control is the Multidimensional Health Locus of
Control Scales (Wallston, Wallston, & DeVellis, 1978). This

90 Part II / Stress, Illness, and Coping

instrument contains 18 items divided into three scales
that assess:

1. Internal health locus of control, the belief that control for
one’s health lies within the person.

2. Powerful-others’ health locus of control, the belief that one’s
health is controlled by other people, such as physicians.

3. Chance locus of control, the belief that luck or fate controls
health.

As you can see, the powerful-others and chance
scales are directed toward assessing the degree to which
people believe important external sources have control
over their health.

Does a sense of personal control influence peo-
ple’s health? Studies have shown that pessimistic and
hopeless people—those who believe they have little
control—have poorer health habits, have more illnesses,
and are less likely to take active steps to treat their
illness than are people with a greater sense of con-
trol (Kamen & Seligman, 1989; Lin & Peterson, 1990;
Rasmussen, Scheier, & Greenhouse, 2009; Whipple et
al., 2009). Personal control can also help people adjust
to becoming seriously ill (Thompson & Kyle, 2000).
Patients with illnesses such as kidney failure or can-
cer who score high on internal or powerful-others’ health
locus of control suffer less depression than those with
strong beliefs in the role of chance (Devins et al., 1981;
Marks et al., 1986). The belief that either they or some-
one else can influence the course of their illness allows
patients to be hopeful about their future. Moreover,
patients with strong internal locus of control beliefs
probably realize they have effective ways for controlling
their stress.

Personal control also affects the efforts patients
make toward rehabilitation—in particular, feelings of
self-efficacy enhance their efforts. A study demonstrated
this with older adult patients who had serious respiratory
diseases, such as chronic bronchitis and emphysema
(Kaplan, Atkins, & Reinsch, 1984). The patients were
examined at a clinic and given individualized prescrip-
tions for exercise. And they rated on a survey their
self-efficacy—that is, their belief in their ability to per-
form specific physical activities, such as walking different
distances, lifting objects of various weights, and climbing
stairs. Correlational analyses revealed that the greater
the patients’ self-efficacy for doing physical activity, the
more they adhered to the exercise prescription.

Health and Personal Control in Old Age
Here are two things we know about elderly people who
live in nursing homes: First, they often show declines
in their activity and health after they begin living in

nursing homes. Second, residents of nursing homes
frequently have few responsibilities or opportunities
to influence their everyday lives. Could it be that the
declines in activity and health among nursing-home
residents result in part from their dependency and loss
of personal control that the nursing home procedures
seem to encourage?

Ellen Langer and Judith Rodin (1976) studied this
issue by manipulating the amount of responsibility
allowed residents of two floors of a modern, high-
quality nursing home. The residents on the two floors
were similar in physical and psychological health and
prior socioeconomic status. On one floor, residents
were given opportunities to have responsibilities—for
example, they could select small plants to care for and
were encouraged to make decisions about participating
in activities and rearranging furniture. In comparison,
residents of the other floor continued to have little
personal control. For example, they were assigned to
various activities without choice, and when they were
given plants, they were told that the staff would take
care of them. Assessments revealed that the residents
who were given more responsibility became happier and
more active and alert than the residents who had little
control. A year and a half later the residents who were
given responsibility were still happier and more active
than those who had little control (Rodin & Langer, 1977).
Moreover, comparisons of health data during these 18
months showed that the residents with responsibility
were healthier and had half the rate of mortality than the
residents with little control.

Other research with residents of a retirement home
also demonstrated the importance of personal control
for physical and psychological well-being and showed
that withdrawing opportunities for personal control may
impair people’s health (Schulz, 1976; Schulz & Hanusa,
1978). The results of these studies suggest two important
conclusions. First, personal control—even over relatively
simple or minor events—can have a powerful effect on
people’s health and psychological condition. Second,
health care workers and researchers need to consider the
nature of the personal control they introduce and what
the impact will be if it is removed.

To summarize the material on personal control,
people differ in the degree to which they believe they have
control over the things that happen in their lives. People
who experience prolonged, high levels of stress and lack
a sense of personal control tend to feel helpless. Having a
strong sense of control seems to benefit people’s health
and help them adjust to becoming seriously ill. A sense
of personal control contributes to people’s hardiness,
which is the next psychosocial modifier of stress we will
examine.

Chapter 4 / Stress, Biopsychosocial Factors, and Illness 91

PERSONALITY AS RESILIENCE AND
VULNERABILITY
Researchers have long been interested in the ways
in which some personality traits can make individuals
more resilient in the face of stressful life circumstances,
whereas other personality characteristics are sources of
vulnerability. That is, some personality factors make the
individual more able to withstand high levels of stressful
experience without becoming emotionally distressed or
physically ill, and other aspects of personality make them
more susceptible to those problems.

Early in the development of the field of health
psychology, researchers Suzanne Kobasa and Salvatore
Maddi suggested that individual differences in personal
control provide only part of the reason why some
people who are under stress get sick whereas others
do not. They proposed that a broader array of personality
traits—called hardiness—differentiates people who do
and do not get sick under stress (Kobasa & Maddi, 1977).
Hardiness includes three characteristics: (1) Control refers
to people’s belief that they can influence events in their
lives—that is, a sense of personal control. (2) Commitment
is people’s sense of purpose or involvement in the events,
activities, and people in their lives. For instance, people
with a strong sense of commitment tend to look forward
to starting each day’s projects and enjoy getting close
to people. (3) Challenge refers to the tendency to view
changes as incentives or opportunities for growth rather
than threats to security. The concept of hardiness has
been highly influential, although more recent studies
have found conflicting results, and some evidence
indicates that tests used to measure hardiness may
simply be measuring the tendency to experience negative
affect, such as the tendency to be anxious, depressed,
or hostile (Funk, 1992). Nonetheless, the basic idea that
some personality traits make the individual resilient has
continued to be a major focus in the field, and research
supports this general hypothesis.

Sense of Coherence, Mastery, Optimism,
and Resilience
One example of a personality concept similar to hardi-
ness is sense of coherence, developed by Aaron Antonovsky
(1979, 1987). This trait involves the tendency of people
to see their worlds as comprehensible, manageable, and
meaningful. People’s sense of coherence has been linked
to reduced levels of stress and illness symptoms (Jor-
gensen, Frankowski, & Carey, 1999). A related personality
characteristic is sense of mastery (Pearlin & Schooler, 1978),
which refers to people’s general belief that they are able
to deal effectively with the events of life, rather than

being subjected to forces beyond their control. This trait
is obviously quite similar to the belief in personal control
or a general sense of self-efficacy as described previously.
Optimism is the point of view that good things are likely
to happen, and has similarities to the optimistic versus
pessimistic explanatory style described previously.
Optimists tend to experience life’s difficulties with less
distress than do pessimists (Scheier, Carver, & Bridges,
2001). They also tend to have better health habits,
better mental and physical health, and faster recovery
when they become ill than pessimists (Ouellette &
DiPlacido, 2001).

Finally, resilience refers to high levels of three inter-
related positive components of personality: self-esteem,
personal control, and optimism (Major et al., 1998).
Resilient people appraise negative events as less stress-
ful; they bounce back from adversities and recover
their strength and spirit. For example, resilient children
develop into competent, well-adjusted individuals even
when growing up under extremely difficult conditions
(Garmezy, 1983; Werner & Smith, 1982). The following
case shows what this means:

In the slums of Minneapolis … is a 10-year-old boy
who lives in a dilapidated apartment with his father,
an ex-convict now dying of cancer, his illiterate
mother, and seven brothers and sisters, two of whom
are mentally retarded. Yet his teachers describe him
as an unusually competent child who does well in his
studies and is loved by almost everyone in the school.
(Pines, 1979, p. 53)

Even when facing adversity, resilient people seem
to make use of positive emotions and find meaning in
the experience (Ong et al., 2006; Tugade & Fredrickson,
2004). Although such resilience was once considered
rare, it now appears that probably most adults move on
with their lives and do not suffer serious depression after
a trauma, such as the loss of a close relative or friend
(Bonanno, 2004).

Why are some individuals resilient and others not?
Part of the answer may lie in their genetic endowments.
Resilient people may have inherited traits, such as
relatively easy temperaments, that enable them to cope
better with stress and turmoil. Another part lies in their
experiences. Resilient people who overcome a history
of stressful events often have compensating experiences
and circumstances in their lives, such as special talents
or interests that absorb them and give them confidence,
and close relationships with friends or relatives. The
concepts of hardiness, resilience, optimism, mastery, and
coherence have a great deal in common, and research
scales used to measure these traits may be tapping
overlapping personality strengths.

92 Part II / Stress, Illness, and Coping

Personality Strengths and Health
In theory, the personality strengths we’ve discussed make
people better able to deal with stressors and less likely
to become emotionally distressed and physiologically
aroused by stressful events, leading them to remain
healthier. Given the personality assets or strengths
reflected in a sense of coherence, mastery, and optimism,
the spiraling process that can lead from stress to
illness should not take hold. Studies have generally
supported the prediction that these traits should be
associated with lower risks of physical illness. For
example, a meta-analysis of several studies of a variety
of health conditions found that, as expected, optimism
is associated with a reduced risk of developing physical
illnesses and with a more positive outcome of illness
among individuals who are already suffering from disease
(Rasmussen, Scheier, & Greenhouse, 2009). Prospective
studies have shown that optimistic people are at lower
risk of life-threatening medical conditions, such as heart
disease (Tindle et al., 2009). And a prospective study
found that people who have a strong sense of coherence
had far lower mortality rates from cardiovascular disease
and cancer over a 6-year period than people low on
this trait (Surtees et al., 2003), and sense of mastery
has similar beneficial effects over time (Surtees et al.,
2006). Taken together, positive personality traits like
optimism, mastery, and sense of coherence apparently
protect health. Although the status of the concept and
measurement of hardiness is uncertain at this time,
research on related aspects of personality has provided
clearer evidence of health benefits. Future research will
need to clarify what these personality variables are and
how they operate.

Personality Strengths and Health in Old Age
Old age is a time when very difficult life events often
occur, particularly those that involve reduced income,
failing health and disability, and the loss of one’s
spouse and close friends. Personality strengths like those
described above can be important in meeting these
difficulties. For example, older people with a strong
sense of purpose in life seem to live longer, even when
the possibly overlapping effects of negative emotions like
depression are taken into account (Boyle et al., 2009).
What other personality characteristics reflect resilience
in old age?

Elizabeth Colerick (1985) studied 70- to 80-year-old
men and women for the quality she called stamina, which
is similar to hardiness. This research was undertaken

to determine how people who do and do not have
stamina in later life deal with setbacks, such as the
loss of a loved one. She identified with questionnaires
and interviews two groups: one with high stamina
and one with low stamina. She found that stamina
in old age is characterized by ‘‘a triumphant, positive
outlook during periods of adversity,’’ as illustrated by
the following interview excerpts from two different high-
stamina people:

The key to dealing with loss is not obvious. One must
take the problem, the void, the loneliness, the sorrow
and put it on the back of your neck and use it as a
driving force. Don’t let such problems sit out there in
front of you, blocking your vision… . Use hardships in
a positive way. (p. 999)

I realize that setbacks are a part of the game. I’ve
had ’em, I have them now, and I’ve got plenty more
ahead of me. Seeing this—the big picture—puts it
all into perspective, no matter how bad things get.
(p. 999)

In contrast, low-stamina people described a negative
outlook and feelings of helplessness and hopelessness
in facing life events in old age. One woman who had
undergone surgery for colon cancer said:

I was certain that I would die on the table … never
wake up… . I felt sure it was the end. Then I woke
up with a colostomy and figured I have to stay inside
the house the rest of my life. Now I’m afraid to go
back to the doctor’s and keep putting off my checkups.
(p. 999)

In summary, people with a high degree of optimism,
mastery, coherence, or resilience—or some related
personality traits—may have some protection against
the harmful effects of stress on health. The fact that
several different labels have been given to what seem
to be very similar personality strengths with possibly
overlapping associations with future health suggests
that an organizing framework would be useful in
understanding personality as a modifier of stress. A
widely accepted framework from personality science has
been useful in this way, especially because it helps to
organize personality factors that are sources of resilience
or sources of vulnerability.

The Five-Factor Model of Personality
A general consensus has emerged among personality
researchers that five broad traits provide a reasonably
thorough description of normal variations in human

Chapter 4 / Stress, Biopsychosocial Factors, and Illness 93

personality (Costa & McCrae, 1992; Digman, 1990).
These traits, listed in Table 4.1, are useful in research
on personality (Smith & Williams, 1992; Smith &
MacKenzie, 2006). Researchers can examine correlations
of personality concepts and measures proposed as
influences on health with these basic dimensions
and their more specific components. By doing this,
researchers can create an organized and systematic
catalogue of these modifiers of stress responses. The
traits of the five-factor model also can be measured
with well-established personality scales, and these
scientifically validated instruments can be used directly
in studies of stress and health outcomes. In this way,
some of the best ways of conceptualizing and measuring
personality available to researchers can be used to
answer questions about which general dimensions of
personality modify stress and influence health. By
thinking about the traits in Table 4.1, readers can get
a general sense of how they might be described in the
five-factor system.

The personality strengths discussed above seem
to correlate consistently with emotional stability—the
opposite of neuroticism (Smith & MacKenzie, 2006).
Neuroticism and its components, such as anxiety,
sadness or depressive symptoms, and irritability, predict
earlier death and several other negative health outcomes
(Grossardt et al., 2009; Kubzansky et al., 2006; Suls &
Bunde, 2005). However, positive aspects of personality
generally predict good future health even when the
possibly overlapping effects of emotional stability versus
neuroticism are taken into account (Chida & Steptoe,
2008). Measures of personality strengths like optimism,

mastery, and sense of coherence also correlate with other
five-factor traits, especially extraversion, conscientiousness,
and openness. These five-factor model traits also predict
longevity and other health outcomes (Kern & Friedman,
2008; Taylor et al., 2009; Terracciano et al., 2008).

How does the five-factor model of personality relate
to health? The answer involves the stress responses
described in Chapter 3. Personality traits associated with
better health are generally associated with less expo-
sure to stressors at work and in relationships, less phys-
iological reactivity, better recovery, and better restoration
(Williams et al., 2010). In contrast, personality traits
linked to poor health are consistently related to greater
exposure to stressors, greater reactivity, less recovery,
and less restoration, as reflected in better sleep and lower
levels of physiological stress responses during sleep.
What’s more, traits included in the five-factor model
are also linked to one of the best known psychosocial
modifiers of stress, the Type A or B behavioral and
emotional style.

TYPE A BEHAVIOR AND BEYOND
The history of science has many stories about researchers
accidently coming upon an idea that changed their focus
and led to major discoveries. Such was the case for
bacteriologist Alexander Fleming, for instance: when
bacteria cultures he was studying developed unwanted
molds, he happened to notice some properties of the
molds that led to the discovery of penicillin. Serendipity
also led to the discovery of the ‘‘Type A’’ behavior pattern.
Cardiologists Meyer Friedman and Ray Rosenman were

Table 4.1 Traits of the Five-Factor Model of Personality

Trait Specific Characteristics

Neuroticism vs.
Emotional Stability

Tendency to experience negative emotions, such as anxiety, tension, sadness, and irritability; feeling
vulnerable and unable to cope well with stress vs. calm, even-tempered, relaxed, able to deal with
stressful situations without undue distress.

Extraversion vs.
Introversion

Outgoing, gregarious, cheerful, and talkative interpersonal style; excitement seeking; assertiveness; a
tendency to experience positive emotions vs. reserved; enjoyment of and even preference for solitude
and quiet; subdued.

Openness vs.
Closed Mindedness

Drawn to new experience; intellectual curiosity; flexibility; readiness to examine and re-consider values
and beliefs, and to try new things; ‘‘in touch’’ with feelings and aesthetic experiences vs. dislike of
change; rigid; dogmatic; narrow.

Agreeableness vs.
Antagonism

Altruistic, high empathy and concern for others; warm; forgiving helpful; trusting; cooperative;
straightforward; modest vs. cold-hearted; cynical; guarded; disingenuous; mistrusting; argumentative;
competitive; arrogant; critical.

Conscientiousness vs.
Unreliability

High self-control; organized; purposeful; self-image of being capable, prepared, competent; preference for
order; dependable; deliberate; self-disciplined; achievement striving vs. unorganized; low ambition;
lackadaisical; procrastinating.

94 Part II / Stress, Illness, and Coping

studying the diets of male heart disease victims and their
wives when one of the wives exclaimed: ‘‘If you really want
to know what is giving our husbands heart attacks, I’ll
tell you. It’s stress, the stress they receive in their work,
that’s what’s doing it’’ (Friedman & Rosenman, 1974,
p. 56). These researchers began to study this possibility
and noticed that heart patients were more likely than
nonpatients to display a pattern of behavior we now refer
to as Type A.

Defining and Measuring Behavior Patterns
The Type A behavior pattern consists of four character-
istics (Chesney, Frautschi, & Rosenman, 1985; Friedman
& Rosenman, 1974):

1. Competitive achievement orientation. Type A individuals strive
toward goals with a sense of being in competition—or
even opposition—with others, and not feeling a sense
of joy in their efforts or accomplishments.

2. Time urgency. Type A people seem to be in a constant
struggle against the clock. Often, they quickly become
impatient with delays and unproductive time, schedule
commitments too tightly, and try to do more than
one thing at a time, such as reading while eating or
watching TV.

3. Anger/hostility. Type A individuals tend to be easily
aroused to anger or hostility, which they may or may
not express overtly.

4. Vigorous Vocal Style. Type A people speak loudly, rapidly,
and emphatically, often ‘‘taking over’’ and generally
controlling the conversation.

In contrast, the Type B behavior pattern consists
of low levels of competitiveness, time urgency, and
hostility. People with the Type B pattern tend to be more
easygoing and ‘‘philosophical’’ about life—they are more
likely to ‘‘stop and smell the roses.’’ In conversations,
their speech is slower, softer, and reflects a more relaxed
‘‘give and take.’’

Type A behavior is measured in several ways. The
Structured Interview has been considered the ‘‘gold
standard’’ of Type A assessments. It consists of a series
of questions that require about 15 to 20 minutes,
and it is intended to obtain not only self-reports of
competitiveness, time urgency, and anger/hostility, but
also to obtain an actual sample of Type A versus B
behavior. The questions are asked in such a way that
Type As will reveal their competitive, impatient, hostile,
and vigorous style not simply in what they say, but
in how they say it. In contrast, Type Bs display their
more relaxed and easy-going style. The interview is time-
consuming and expensive to use, but it measures all four
Type A characteristics (competitiveness, time urgency,
anger/hostility, vocal style) better than self-report, paper
and pencil survey measures of Type A do, and its scores

are more consistently associated with health, especially
heart disease (Miller et al., 1991).

Behavior Patterns and Stress
Individuals who exhibit the Type A behavior pattern react
differently to stressors from those with the Type B pattern.
Type A individuals respond more quickly and strongly to
stressors, often interpreting them as threats to their
personal control (Glass, 1977). Type A individuals also
often choose more demanding or pressured activities at
work and in their leisure times, and they often evoke
angry and competitive behavior from others (Smith &
Anderson, 1986). Hence, they have greater exposure to
stressors, too.

We saw in Chapter 3 that the response to a
stressor—or strain—includes a physiological compo-
nent called reactivity, such as increased blood pressure,
catecholamine, or cortisol levels compared to baseline
levels. Type As often show greater reactivity to stressors
than Type Bs, especially during situations involving com-
petition, debates and arguments, or other stressful social
interactions (Contrada & Krantz, 1988; Glass et al., 1980).

Age and Developmental Differences in
Type A

Behavior

Longitudinal studies suggest that adult Type A behavior
may have its roots in the person’s early temperament,
and although behavior patterns often change over time,
many individuals exhibit the same pattern across many
years (Bergman & Magnusson, 1986; Carmelli et al.,
1991; Carmelli, Rosenman, & Chesney, 1987). Still, cross-
sectional studies have found that the Type A behavior
pattern among Americans becomes more prevalent with
age from childhood through middle age or so and then
declines (Amos et al., 1987; Moss et al., 1986). But
some of the decline in prevalence in old age could be
result of Type A individuals dying at earlier ages than
Type Bs.

Heredity also affects the development of Type A
and B behavior. Research with identical (monozygotic)
and fraternal (dizygotic) twins has found a genetic
role in the development of both temperament (Buss
& Plomin, 1975, 1986) and Type A behavior (Carmelli,
Rosenman, & Chesney, 1987; Rebollo & Boomsma,
2006). That is, identical twins are more similar to
each other in temperament and behavior patterns than
are fraternal twins. They are much more similar than
fraternal twins in their reactivity to stressors, too (Ditto,
1993; Turner & Hewitt, 1992). Demographic and genetic
variations in Type A behavior are important because
of the relationships researchers have found between
reactivity and health, such as in the development of heart
disease.

Chapter 4 / Stress, Biopsychosocial Factors, and Illness 95

If you have not read Chapter 2, The Body’s Physical
Systems, and your course has you read the modules

from that chapter distributed to later chapters, read
Module 5 (The Cardiovascular System) now.

Type A Behavior and Health
How are people’s health and behavior patterns related?
Researchers have studied this issue in two ways. First,
studies have examined whether Type A individuals are
at greater risk than Type Bs for becoming sick with any
of a variety of illnesses, such as asthma and indigestion,
but the associations appear to be weak and inconsistent
(Orfutt & Lacroix, 1988; Suls & Sanders, 1988).

Second, studies have focused on the Type A
pattern as a risk factor for coronary heart disease
(CHD)—illnesses involving the narrowing of the coronary
arteries, which supply blood to the heart muscle. This
narrowing is called atherosclerosis, and causes several
manifestations of CHD. Angina is chest pain that occurs
when the supply of oxygen carried by blood to the
heart muscle is not sufficient to meet the muscle’s
demand. When the demand exceeds the supply available
through the narrowed coronary arteries and the heart is
not getting enough oxygen, the heart muscle becomes
ischemic. If the blood supply is blocked severely enough
and for a long enough period of time, the ischemic
portion of the heart muscle dies. This is called a myocardial
infarction, or what is commonly called a ‘‘heart attack.’’
A severely ischemic heart sometimes develops a lethal
disturbance in rhythm, causing it stop pumping blood
through the body. This is the usual cause of sudden
cardiac death, where the victim dies within a few minutes
or hours of first noticing symptoms.

Dozens of studies have been done to assess the
link between Type A behavior and CHD. An example
of research on this link comes from the Western
Collaborative Group Study, a large-scale prospective
study of 3,000 39- to 59-year-old initially healthy men who
were tested for behavior patterns using the Structured
Interview (Rosenman et al., 1976). A follow-up 8 1/2 years
later showed that the Type A individuals were twice as
likely as Type Bs to have developed CHD and to have
died of CHD. Have other studies found similar results?
Yes, but the answer depends on the way Type A behavior
was measured: the link between Type A behavior and
CHD is clearest in studies using the Structured Interview (Miller
et al., 1991).

Type A’s ‘‘Deadly Emotion’’
Why would the link between Type A behavior and CHD
depend on the way behavior patterns are measured?
It could be that people are not completely honest

and accurate in describing their own behavior on self-
report surveys, whereas observational measures are
less ‘‘filtered’’ in this way. However, it also could be
the content of the measures. We saw earlier that the
Structured Interview assesses all four components of
Type A behavior well. This isn’t so for available surveys,
which assess competitive achievement and time urgency
well but measure anger/hostility much less well and do
not measure the vocal style at all. These discrepancies
prompted researchers to examine the role of individual
Type A components, which revealed that anger/hostility
is the main aspect of Type A behavior in the link with
CHD (Everson-Rose & Lewis, 2005; Smith & Gallo, 2001).
Anger/hostility seems to be Type A’s deadly emotion:
people who are chronically hostile have an increased risk
of developing CHD.

A study that supports this idea examined the records
of 255 physicians who had taken a psychological test
that included a scale for hostility while they were in
medical school 25 years earlier (Barefoot, Dahlstrom, &
Williams, 1983). For the physicians with high scores on
the hostility scale, the rates of both CHD and overall
mortality during the intervening years were several times
higher than for those with low hostility scores. The
researchers measured hostility with a widely used test,
the Cook-Medley Hostility Scale, which has 50 true/false
items, such as ‘‘It is safer to trust nobody’’ and ‘‘Some
of my family have habits that bother and annoy me very
much’’ (Cook & Medley, 1954). This scale measures anger,
as well as cynicism, suspiciousness, and other negative
traits (Friedman, Tucker, & Reise, 1995). In pursuing
anger and hostility as the toxic element within the Type
A pattern, a wide variety of self-report and behavioral
measures of these traits have been used (Smith, 1992). A
meta-analysis of the many studies of the topic found that
anger and hostility are associated with an increased risk
of CHD in initially healthy individuals (Chida & Steptoe,
2009). Further, among people who already have CHD,
anger and hostility are associated with increased risk of
poor medical outcomes, such as additional heart attacks
or death from CHD.

What links anger and hostility to the development of
CHD? Here again, the four stress processes of exposure,
reactivity, recovery, and restoration seem important.
Angry and hostile people experience more conflict
with others at home and work (Smith et al., 2004),
indicating greater stress exposure. The suspicious and
mistrusting style of hostile persons is likely to make them
cold and argumentative during interactions with others,

96 Part II / Stress, Illness, and Coping

sometimes even with friends and family members. The
resulting conflict and reduced social support may, in
turn, contribute to the maintenance or even worsening
of their hostile behavior toward others in a vicious cycle
or self-fulfilling prophecy (Smith et al., 2004). Further, in
difficult interpersonal situations in general, and at work
and with family members in particular, they show greater
physiological reactivity or strain (Brondolo et al., 2009;
Chida & Hamer, 2008; Smith & Gallo, 1999).

Further, unlike non-hostile people, hostile people do
not respond to social support with reduced physiological
reactivity during stressful situations (Holt-Lunstad et
al., 2008; Vella et al., 2008), perhaps because they are
too distrusting or worry that support providers will
evaluate them negatively. After a stressful situation,
hostile people show delayed or incomplete recovery of
their physiological stress responses, perhaps because
they are more likely to brood or ruminate about
upsetting events (Neuman et al., 2004). Also, their
sleep quality is more likely to suffer during stressful
periods (Brissette & Cohen, 2002). Combined, these
stress processes can produce a lot of wear and tear
on the cardiovascular system. As we discuss further in a
later section of this chapter, cardiovascular reactivity and
other physiological stress responses can contribute to
coronary atherosclerosis and the development of other
indications of CHD.

However, these stress processes might not be the
only link between anger/hostility and CHD. Anger and
hostility are related to several unhealthy conditions and
behaviors, such as heavier drinking, obesity, and cigarette
smoking, that put people at risk for CHD (Bunde & Suls,
2006; Nabi et al., 2009; Patterson et al., 2008). Although
anger and hostility generally are associated with CHD
even when these health behaviors and conditions
are taken into account, some evidence suggests that
they are at least part of the link between these
personality traits and health (Boyle et al., 2007; Everson
et al., 1997).

Are There Other Dangerous Aspects of the
Type A Pattern?
Anger might not be the only unhealthy Type A behavior
(Houston et al., 1992, 1997). Social dominance—the
tendency or motive to exert power, control, or influence
over other people—is also associated with coronary
atherosclerosis and CHD (Siegman et al., 2000; Smith
et al., 2008). Further, this personality trait is associated
with greater physiological reactivity or strain during
challenging interpersonal tasks and situations, like
arguments or debates, and efforts to influence other
people also evoke larger increases in blood pressure and
stress hormones (Newton, 2009; Smith et al., 2000).

As a summary of the role of psychosocial modifiers
of stress, we have seen that social support, personal
control, various personality strengths, and aspects of
the Type A and B behavior patterns are factors that can
modify the impact of stress on health. High levels of
social support, personal control, and related personality
traits, are generally associated with reduced stress
and resulting illnesses; Type A behavior, especially the
anger/hostility component, is associated with increased
stress and cardiovascular illness. The remainder of this
chapter examines health problems that are affected by
people’s experience of stress. We begin by considering
how stress leads to illness.

HOW STRESS AFFECTS HEALTH

Why does stress lead to illnesses in some individuals,
but not others? One answer: other factors influence
the effects of stress. This idea forms the basis of the
diathesis-stress model, the view that people’s vulnerability
to a physical or psychological disorder depends on the
interplay of their predisposition to the disorder (the
diathesis) and the amount of stress they experience
(Steptoe & Ayers, 2004). The predisposition can result
from organic structure and functioning, often genetically
determined, or from prior environmental conditions,
such as living in a community that promotes tobacco
use. For example, chronically high levels of stress are
especially likely to lead to CHD if the person’s body
produces high levels of cholesterol. Or students are
likely to catch cold around final exams week if their
immune system functioning is impaired. This concept
may explain why not all individuals in the following
experiment caught cold.

Researchers conducted an interesting experiment:
they gave people nasal drops that contained a ‘‘common
cold’’ virus or a placebo solution and then quarantined
them to check for infection and cold symptoms (Cohen,
Tyrrell, & Smith, 1991). Before the nasal drops were
administered, the subjects filled out questionnaires to
assess their recent stress. Of these people, 47% of those
with high stress and 27% of those with low stress
developed colds. Other studies have produced three
related findings. First, people under chronic, severe stress
are more vulnerable to catching cold when exposed to
the virus than people under less stress (Cohen et al.,
1998). Second, people who experience a lot of positive
emotions, such as feeling energetic or happy, are less likely
to catch a cold or the flu when exposed to the viruses
than people who have less of these emotions (Cohen et
al., 2006). Third, people who have sleep problems prior
to their exposure to the virus are more likely to develop
colds (Cohen et al., 2009).

Chapter 4 / Stress, Biopsychosocial Factors, and Illness 97

Stress
Behavior

Increase

Dietary fat
Tobacco use
Alcohol use
Accidents

Increase

Blood pressure
Unfavorable lipids in blood
Activated platelets in blood
Clotting factors in blood
Stress hormones (catecholamines,
corticosteroids)

Decrease

Dietary fruits and vegetables
Exercise
Sleep

Decrease

Immune function

Physiology

Figure 4-4 Summary of behavioral and phys-
iological avenues by which stress leads to ill-
ness. See text for additional information about
these avenues.

What is it about stress that leads to illness? The
causal sequence can involve two routes: (1) a direct
route, resulting from changes stress produces in the
body’s physiology, or (2) an indirect route, affecting health
through the person’s behavior. Figure 4-4 gives a summary
of these routes. Let’s look first at the behavioral route.

STRESS, BEHAVIOR, AND ILLNESS
Stress can affect behavior, which, in turn, can lead to
illness or worsen an existing condition. We can see
the behavioral links between stress and illness in many
stressful situations, such as when a family undergoes a
divorce. In many cases during the first year following the
separation, the parent who has the children is less avail-
able and responsive to them than she or he was before,
resulting in haphazard meals, less regular bedtimes, and
delays in getting medical attention, for instance.

People who experience high levels of stress tend to
behave in ways that increase their chances of becoming
ill or injured (Weidner et al., 1996; Wiebe & McCallum,
1986). For instance, compared with people with low
stress, those with high stress are more likely to eat
higher fat diets with less fruit and vegetables, engage
in less exercise, smoke cigarettes, and consume more
alcohol (Baer et al., 1987; Cartwright et al., 2003; Ng &
Jeffery, 2003). These behaviors are associated with the
development of various illnesses. In addition, stress
impairs sleep (Hall et al., 2004). And the resulting
inattention and carelessness probably play a role in
the relatively high accident rates of people under
stress. Studies have found that children and adults
who experience high levels of stress are more likely
to suffer accidental injuries at home, in sports activities,
on the job, and while driving a car than individuals under
less stress (Johnson, 1986; Quick et al., 1997). Further,

disrupted sleep can itself be stressful, and as described
previously poor sleep interferes with a key way that the
body is restored physiologically.

STRESS, PHYSIOLOGY, AND ILLNESS
Stress produces many physiological changes in the body
that can affect health, especially when stress is chronic
and severe. In Chapter 3, we discussed the concept
of allostatic load in which the strain involved in reacting
repeatedly to intense stressors produces wear and tear
on body systems that accumulate over time and lead
to illness (McEwen & Stellar, 1993). A study found that
for elderly individuals whose allostatic load increased or
decreased across a 3-year period, those with increased
loads had higher mortality rates during the next 4 years
(Karlamangla, Singer, & Seeman, 2006). Connections
have been found between illness and the degree of
reactivity people show in their cardiovascular, endocrine,
and immune systems when stressed.

Cardiovascular System Reactivity and Illness
Cardiovascular reactivity refers to physiological changes
that occur in the heart, blood vessels, and blood in
response to stressors. Before middle age, people’s degree
of cardiovascular reactivity is generally stable, showing
little change when retested with the same stressors years
later (Sherwood et al., 1997; Veit, Brody, & Rau, 1997). In
later years, cardiovascular reactivity increases with age,
which corresponds to increases in risk of cardiovascular
illness (Uchino et al., 2005, 2006).

Research has discovered links between high cardio-
vascular reactivity and the development of CHD, hyper-
tension, and stroke (Everson et al., 2001; Henderson &
Baum, 2004; Manuck, 1994). For example, high levels of

98 Part II / Stress, Illness, and Coping

job stress are associated with high blood pressure and
abnormally enlarged hearts (Schnall et al., 1990), and
people’s laboratory reactivity to stress in early adult-
hood is associated with their later development of high
blood pressure (Menkes et al., 1989) and atherosclerosis
(Matthews et al., 2006). The blood pressure reactivity
that people display in laboratory tests appears to reflect
their reactivity in daily life (Turner et al., 1994). A meta-
analysis found that greater cardiovascular reactivity and
poor cardiovascular recovery after stressors were associ-
ated with greater risk of cardiovascular disease, including
higher blood pressure, diagnosed hypertension, and
atherosclerosis (Chida & Steptoe, 2010).

Stress produces several cardiovascular changes that
relate to the development of CHD. For instance, the
blood of people who are under stress contains high
concentrations of activated platelets (Everson-Rose
& Lewis, 2005; Patterson et al., 1994) and clotting
factors that thicken the blood, which can contribute
to a heart attack (Wirtz et al., 2006). Stress also
produces unfavorable levels of cholesterol (Patterson
et al., 1995; Steptoe & Brydon, 2005) and inflammatory
substances circulating in the blood (Steptoe et al.,
2007). These changes in blood composition promote
atherosclerosis—the growth of plaques (inflamed, fatty
patches) within artery walls. These changes narrow and
stiffen the arteries, thereby increasing blood pressure
and the risk of a heart attack or stroke.

Stephen Manuck and his colleagues (1995) have
demonstrated this link between stress and atherosclero-
sis in research with monkeys. In one study, over many
months some of the subjects were relocated periodi-
cally to different living groups. This required stressful
adjustments among the animals as they sought to re-
establish the social hierarchies these animals naturally
form, especially for higher-ranking or dominant animals
to retain their status. The remaining subjects stayed in
stable living groups. The stressed monkeys who tended
to hold dominant status in their living groups devel-
oped greater atherosclerosis than the dominant animals
in the low stress condition, and greater than the lower
ranking or subordinate monkeys in either living condi-
tion. These effects were prevented when the animals
were given a drug that blocked sympathetic nervous
system excitation of the heart muscle, strongly impli-
cating the role of chronic or recurring activation of the
‘‘fight or flight’’ response in development of atheroscle-
rosis. Similar effects of experimentally manipulated
stressful living conditions on atherosclerosis have been
demonstrated in rabbits (McCabe et al., 2002). Although
human stress and cardiovascular disease probably dif-
fers somewhat from what occurs in these animals, the
ability to perform true experiments in which chronic

stress is manipulated over long periods of time pro-
vides important converging evidence to the findings of
observational studies of human stress and cardiovascular
disease.

Recent research suggests that it is not just the exci-
tatory effects of the sympathetic nervous system on the
cardiovascular system that contribute to cardiovascular
disease. If this activating system functions like the ‘‘gas
pedal’’ in activating stress responses, the parasympa-
thetic nervous system ‘‘brake’’ on such reactivity is also
important. The functioning of this stress-dampening sys-
tem can be measured though increases and decreases
in heart rate that are due to respiration; changes in the
activity of the parasympathetic nervous system cause
heart rate to slow down when we breathe out and sped
up when we breathe in. The magnitude of this change
in heart rate—sometimes called ‘‘vagal tone’’ because it
is caused by activity of the vagus nerve—is a good indi-
cator of the strength of an individual’s parasympathetic
stress dampening system. Importantly, higher vagal tone
is associated with lower risk of cardiovascular disease
(Thayer & Lane, 2007). That is, good parasympathetic
‘‘brakes’’ on stress are protective.

Endocrine System Reactivity and Illness
Part of reactivity involves activation of the adrenal glands,
both directly by sympathetic nervous system stimulation
of these glands and by the hypothalamus-pituitary-adrenal
axis as described previously. In this process, the adrenal
glands release hormones—particularly catecholamines
and corticosteroids—during stress (Henderson &
Baum, 2004; Lundberg, 1999). The increased endocrine
reactivity that people display in these tests appears to
reflect their reactivity in daily life (Williams et al., 1991).
One way in which high levels of these hormones can lead
to illness involves their effects on the cardiovascular
system. For example, an intense episode of stress
with high levels of these hormones can cause the
heart to beat erratically and may even lead to sudden
cardiac death (Williams, 2008). In addition, chronically
high levels of catecholamines and corticosteroids,
such as cortisol, can contribute the development
and progression of atherosclerosis (Lundberg, 1999;
Matthews et al., 2006). But social support may help:
people with high levels of social support tend to exhibit
lower endocrine reactivity than with those with lower
levels (Seeman & McEwen, 1996).

Stress also seems to contribute to health
through endocrine system pathways that involve fat
stored in the abdominal cavity. The metabolic syndrome
(Kyrou & Tsigos, 2009) is a set of risk factors including
high levels of cholesterol and other blood fats; elevated

Chapter 4 / Stress, Biopsychosocial Factors, and Illness 99

blood pressure; high levels of insulin in the blood or
impairments in the ability of insulin to facilitate trans-
portation of glucose out of the blood stream; and larger
fat deposits in the abdomen. The metabolic syndrome
seems to be made worse by exposure to stressors and
the related physiological stress responses, especially

heightened neuroendocrine activity. The metabolic syn-
drome also promotes chronic inflammation in the
blood stream and elsewhere, increasing the risk of
cardiovascular disease and other serious conditions,
such as diabetes (Goldbacher & Matthews, 2007; Rizvi,
2009).

If you have not read Chapter 2, The Body’s Physical
Systems, and your course has you read the modules

from that chapter distributed to later chapters, read
Module 6 (The Immune System) now.

Immune System Reactivity and Illness
The release of catecholamines and corticosteroids dur-
ing arousal affects health in another way: these stress
responses alter the functioning of the immune sys-
tem (Kemeny, 2007; Segerstrom & Miller, 2004). Brief
stressors typically activate some components of the
immune system, especially non-specific immunity, while
suppressing specific immunity. Chronic stressors, in
contrast, more generally suppress both non-specific
and specific immune functions. Chronic stressors also
increase inflammation, an important process that disrupts
immune function when it occurs on a long-term basis
(Kemeny, 2007; Segerstrom & Miller, 2004). So, rather
than a simple ‘‘up or down’’ effect of stress on this vital
system, stress dysregulates or disrupts it.

The effects of acute and chronic stress on the
immune system can be measured in many ways, such as
the extent to which immune system cells multiply or pro-
liferate in response to antigens, or the ability of such cells
to destroy foreign microorganisms or viruses. Immune
system functioning can also be measured in others ways,
such as whether or not an individual has a successful
immune response to a flu vaccination. For example,
increases in cortisol and epinephrine are associated
with decreased activity of T cells and B cells against
antigens. This decrease in lymphocyte activity appears
to be important in the development and progression of a
variety of infectious diseases and cancer (Kiecolt-Glaser
& Glaser, 1995; Vedhara et al., 1999). Among people
with cancer, those with high levels of killer-T-cell activity
have a better prognosis than those with low levels of
activity (Kemeny, 2007; Uchino et al., 2007).

Immune processes also protect the body against
cancers that result from excessive exposure to harmful
chemical or physical agents called carcinogens, which
include radiation (nuclear, X-ray, and ultraviolet types),
tobacco smoke, and asbestos (AMA, 2003). Carcinogens
can damage the DNA in body cells, which may then
develop into mutant cells and spread. Fortunately,

people’s exposure to carcinogens is generally at low
levels and for short periods of time, and most DNA
changes probably do not lead to cancer (Glaser et al.,
1985). When mutant cells develop, the immune system
attacks them with killer T cells. Actually, the body begins
to defend itself against cancer even before a cell mutates
by using enzymes to destroy chemical carcinogens or to
repair damaged DNA.

But research has shown that high levels of stress
reduce the production of these enzymes and the repair
of damaged DNA (Glaser et al., 1985; Kiecolt-Glaser &
Glaser, 1986). Given that the immune system has far-
reaching protective effects, if stress disrupts the immune
system it can affect a great variety of health conditions
from the common cold to herpes virus infections (Chida
& Mao, 2009) to cancer.

PSYCHONEUROIMMUNOLOGY
We have seen in this and earlier chapters that psycho-
logical and biological systems are interrelated—as one
system changes, the others are often affected. The recog-
nition of this interdependence and its connection to
health and illness led researchers to form a new field of
study called psychoneuroimmunology. This field focuses
on the relationships between psychosocial processes and
the activities of the nervous, endocrine, and immune sys-
tems (Ader & Cohen, 1985; Byrne-Davis & Vedhara, 2004;
Kemeny, 2007; Marsland et al., 2001). These systems form
a feedback loop: the nervous and endocrine systems send
chemical messages in the form of neurotransmitters and
hormones that increase or decrease immune function,
and cells of the immune system produce chemicals, such
as cytokines and ACTH, that feed information back to
the brain. The brain appears to serve as a control center
to maintain a balance in immune function, since too
little immune activity leaves the individual open to infec-
tion and too much activity may produce autoimmune
diseases.

100 Part II / Stress, Illness, and Coping

Emotions and Immune Function
People’s emotions—both positive and negative—play a
critical role in the balance of immune functions. Research
has shown that pessimism, depression, and stress from
major and minor events are related to impaired immune
function (Byrne-Davis & Vedhara, 2004; Leonard, 1995;
Marsland et al., 2001). For example, research compared
immune variables of caregiver spouses of Alzheimer’s
disease patients with matched control subjects and
found that the caregivers had lower immune function
and reported more days of illness over the course of
about a year (Kiecolt-Glaser et al., 1991). Another study
compared individuals who received a flu vaccination and
found that those who developed and maintained a high
level of flu antibodies over 5 months had experienced
less stress in the interim than those with fewer antibodies
(Burns, Carroll, et al., 2003).

Positive emotions can also affect immune function,
giving it a boost (Futterman et al., 1994; Stone et al.,
1994). In the study by Arthur Stone and his coworkers,
adult men kept daily logs of positive and negative events
and gave saliva samples for analyses of antibody content.
Negative events were associated with reduced antibodies
only for the day the events occurred, but positive events
enhanced antibody content for the day of occurrence and
the next two.

Some stressful situations start with a crisis, and the
ensuing emotional states tend to continue and suppress
immune processes over an extended period of time.
This was demonstrated with healthy elderly individuals
who were taking part in a longitudinal study of the aging
process (Willis et al., 1987). These people were asked
to contact the researchers as soon as they were able if
they experienced any major crisis, such as the diagnosis
of a serious illness in or the death of a spouse or child;
15 of them did so. A month after the crisis, and again
months later, the researchers assessed the people’s
cortisol and lymphocyte blood concentrations, recent
diets, weights, and psychological distress. Because the
subjects were already participating in the longitudinal
study, comparable data were available from a time prior
to the crisis. Analysis of these data revealed that lym-
phocyte concentrations, caloric intake, and body weight
decreased, and cortisol concentrations and psycholog-
ical distress increased, soon after the crisis. By the time
of the last assessment several months later, however, all
of these measures had returned almost to the precrisis
levels. Similarly, a study found that people who become
unemployed show impaired immune function that
recovers after they get a new job (Cohen et al., 2007).

When people react to short-term, minor events, such
as doing difficult math problems under time pressure,

changes in the number and activity of immune cells
occur for fairly short periods of time—minutes or hours
(Delahanty et al., 1996). The degree of change depends
on which immune system component is measured and
the event’s characteristics—long-lasting and intense
interpersonal events seem to produce especially large
immune reductions (Herbert & Cohen, 1993). Of course,
immune system reactivity varies from one person to the
next, but a person’s degree of response to a type of event
seems to be much the same when tested weeks apart
(Marsland et al., 1995). This suggests that an individual’s
reaction to specific stressors is fairly stable over time.

One key process of the immune system—
inflammation—is receiving increased attention because
it is implicated in a wide variety of serious medical
conditions (Gouin et al., 2008; Libby et al., 2009; Steptoe
et al., 2007). Stress can evoke increases in inflammatory
substances in the blood, as can chronic levels of
negative affect (Howren et al., 2009; Steptoe et al., 2007).
Inflammation, in turn, can contribute to atherosclerosis,
rheumatoid arthritis and other chronic conditions, and
seems to generally accelerate age-related diseases. One
puzzling question in this area is the fact that one stress
response, the release of cortisol, generally decreases
inflammation. But emerging perspectives suggest that
under conditions of chronic stress the immune system
becomes less sensitive to the normal anti-inflammatory
effects of cortisol, so that inflammatory responses
remain activated and can eventually damage health
(Segerstrom & Miller, 2004).

Psychosocial Modifiers of Immune
System Reactivity
As we’ve seen, psychosocial factors in people’s lives may
modify the stress they experience. Such factors seem to
affect immune system responses, too. For instance, social
support affects the immune function of people under
long-term, intense stress. People who have strong social
support have stronger immune systems and smaller
immune impairments in response to stress than others
with less support (Kennedy, Kiecolt-Glaser, & Glaser,
1990; Levy et al., 1990).

A related psychosocial modifier is disclosure—
describing one’s feelings about stressful events. An
experiment with college students examined the effect
of expressing such feelings on blood levels of antibodies
against the Epstein-Barr virus, a widespread virus that
causes mononucleosis in many of those who are infected
(Esterling et al., 1994). The students were randomly
assigned to three conditions that met in three weekly
20-minute sessions when they either described verbally
or in writing a highly stressful event they had experienced

Chapter 4 / Stress, Biopsychosocial Factors, and Illness 101

Reprinted with permission of United Features Syndicate, Inc.

or wrote about a trivial (non–stress-related) topic, such
as the contents of their bedrooms. The students in
each condition had the same level of immune control
against the virus before the study. But blood samples
taken a week after the last session revealed that immune
control improved substantially in the verbal condition,
moderately in the written condition, and declined slightly
in the control (trivial topic) condition, as Figure 4-5
depicts. Other research has found that describing feelings
about stressful events is more effective in enhancing
immune function in cynically hostile people than in
nonhostile individuals (Christensen et al., 1996).

The influence of optimism on immune function
appears to depend on whether the stress is short-term or
chronic (Segerstrom, 2005). Optimism is often associated
with better immune functioning, but sometimes worse,
perhaps because optimists persist in physiologically tax-
ing efforts to influence or control stressful circumstances.

Verbal Written Control
–5

0
5
10

30
P
er
ce
n
ta

ge
c

h
an

ge
i
n
i
m

m
u
n
e

co
n
tr

Figure 4-5 Percent change in immune control against the
Epstein-Barr virus, as reflected in blood concentrations of
specific antibodies, for subjects having sessions for verbal
expression of stress feelings, written expression of stress
feelings, or a control condition. (Based on data from Esterling
et al., 1994, Figure 3.)

Optimism has also been associated with lower levels of

inflammation (Roy et al., 2010). (Go to .)

Lifestyles and Immune Function
Do people’s lifestyles affect the functioning of their
immune systems? Some evidence suggests that they
do. People with generally healthful lifestyles—including
exercising, getting enough sleep, eating balanced meals,
and not smoking—show stronger immune functioning
than those with less healthful lifestyles (Kusaka, Kondou,
& Morimoto, 1992). Other studies have found that
sleeping poorly can impair immune function the next
day (Irwin et al., 1994), and people who smoke are
more susceptible than those who don’t to catching colds
(Cohen et al., 1993).

Conditioning Immune Function
Research on psychoneuroimmunology with animals has
revealed that the influence of psychological processes
on immune function is not limited to the effects of
stress. The impact may be far more broad and pervasive.
Robert Ader and Nicholas Cohen (1975, 1985) have shown
that immune suppression can be conditioned. In their original
research, they were actually studying how animals learn
to dislike certain tastes. The procedure used a single
conditioning trial: the subjects (rats) received saccharin-
flavored water to drink (which they seemed to like) and
then got an injection of a drug that induces nausea.
To see whether the rats’ subsequent dislike of the taste
depended on its strength, some subjects received more
saccharin flavoring than others in this conditioning trial.
Over the next several weeks, the drug was not used,
but the animals continued to receive saccharin- flavored
water. During this time, the researchers noticed a curious
thing: a number of rats had fallen ill and died—and these
animals tended to be the ones that had consumed the
greatest amount of saccharin in the conditioning trial.

102 Part II / Stress, Illness, and Coping

HIGHLIGHT

Stress and Wound Healing
We usually think of the central task of

the immune systems as the detection and destruction
of foreign invaders or antigens and the destruction of
abnormal cells. But an equally important function of
the immune system is wound healing. Whether wounds
result from accidental injuries or are intentional as
in surgery, the immune system plays the key role in
repairing the injured tissue, as well as keeping the site
from becoming infected. If stress can impair the immune
system, can it also interfere with wound healing? A
study by Janice Kiecolt-Glaser and her colleagues (2005)
suggests it can. Married couples came to the hospital on
two occasions. Both times, small blisters were created on
participants’ arm with a precise suction device. During
one of the hospital admissions the couples engaged
in a supportive marital interaction task, and during the
other they discussed a marital disagreement or conflict.

Blister healing was measured over about two weeks after
both admissions to the hospital. The blister wounds
healed more slowly after marital conflicts than after
more supportive marital interactions, and they healed
more slowly for couples whose interactions included
high level of hostile behavior toward each other. In other
studies, tape is applied to the skin and then stripped off,
creating an abrasion. A variety of stressors, including
examinations and stressful interviews, and negative
affect appear to delay healing of these experimental
wounds (Bosch et al., 2007; Robles, 2007). Interventions
that reduce stress, such as exercise or written disclosure
about past traumas, can facilitate wound healing after
such procedures (Emery et al., 2005; Weinman et al.,
2008). These results may have important implications for
patients undergoing surgery.

How did these deaths relate to immune suppres-
sion? Since the nausea-inducing drug used in the condi-
tioning trial was also known to suppress immune function
temporarily, Ader and Cohen hypothesized that the con-
tinued intake of saccharin water served as a conditioned
stimulus, suppressing the ability of the rats to fight
infection. Subsequent experiments by these researchers
and others confirmed this hypothesis and demonstrated
that conditioning can raise or lower immune function and
can influence both antibody-mediated and cell-mediated
immune processes (Kusnecov, 2001). Similar condition-
ing effects have been demonstrated in humans, such
as cancer patients who receive medications that impair
immune function.

PSYCHOPHYSIOLOGICAL DISORDERS

The word psychosomatic has a long history, and was
coined to refer to symptoms or illnesses that are
caused or aggravated by psychological factors, mainly
emotional stress (Sarafino, 2004b). Although many
professionals and the general public still use this term,
the concept has undergone some changes and now
has a new name: psychophysiological disorders, which
refers to physical symptoms or illnesses that result
from the interplay of psychosocial and physiological
processes. This definition clearly uses a biopsychosocial
perspective. We will discuss several illnesses traditionally

classified as psychosomatic. Some of these illnesses will
be examined in greater detail in later chapters.

DIGESTIVE SYSTEM DISEASES
Several psychophysiological disorders can afflict the
digestive system. Ulcers and inflammatory bowel
disease are two illnesses that involve wounds in
the digestive tract that may cause pain and bleeding
(AMA, 2003). Ulcers are found in the stomach and the
duodenum, or upper section of the small intestine.
Inflammatory bowel disease, which includes ulcerative
colitis and Crohn disease, can occur in the colon (large
intestine) and the small intestine. Another illness,
irritable bowel syndrome, produces abdominal pain,
diarrhea, and constipation (AMA, 2003). Although these
diseases afflict mainly adults, similar symptoms occur in
childhood (Blanchard et al., 2008).

Most ulcers are produced by a combination of gastric
juices eroding the lining of the stomach and duodenum
that has been weakened by bacterial infection (AMA,
2003). But stress plays a role, too (Levenstein, 2002).
In a classic study, a patient (called Tom) agreed to
cooperate in a lengthy and detailed examination of
gastric function (Wolf & Wolff, 1947). Tom was unique
in that many years earlier, at the age of 9, he had had
a stomach operation that left an opening to the outside
of the body. This opening, which provided the only way
he could feed himself, was literally a window through

Chapter 4 / Stress, Biopsychosocial Factors, and Illness 103

which the inside of his stomach could be observed.
When Tom was subjected to stressful situations, his
stomach-acid production greatly increased. When he
was under emotional tension for several weeks, there
was a pronounced reddening of the stomach lining.
Another study reported similar effects with a 15-month-
old girl who had a temporary stomach opening. Her
highest levels of acid secretion occurred when she was
angry (Engel, Reichsman, & Segal, 1956). The physical
causes of inflammatory bowel disease and irritable bowel
syndrome are not well known (AMA, 2003). Stress is
related to flare-ups of these illnesses, but its specific
role is currently unclear (Blanchard, 2008; Kiank et al.,
2010).

ASTHMA
Asthma is a respiratory disorder in which inflammation,
spasms, and mucous obstruct the bronchial tubes and
lead to difficulty in breathing, with wheezing or coughing.
This ailment is prevalent around the world—in the United
States it afflicts about 6% of the population and is
more common in children than in adults (AAFA, 2010).
Asthma attacks appear to result from some combination
of three factors: allergies, respiratory infections, and
biopsychosocial arousal, such as from stress or exercise
(AAFA, 2010; Lehrer et al., 2002). In most cases, the cause
of an attack is largely physical, but sometimes it may be
largely psychosocial.

Professionals working with hospitalized children
have noticed that the asthma symptoms of many children
decrease shortly after admission to the hospital, but
reappear when they return home (Purcell, Weiss, & Hahn,
1972). Are these children allergic to something in their
own houses, such as dust, that isn’t in the hospital?
This question was tested with asthmatic children who
were allergic to house dust (Long et al., 1958). Without
the children knowing, the researchers vacuumed the
children’s homes and then sprayed the collected dust
from each house into their individual hospital rooms.
The result: none of the children had respiratory difficulty
when exposed to their home dust, which suggests
that psychosocial factors may be involved. Findings of
other research indicate that stress can trigger asthma
attacks (Lehrer et al., 2002; Miller & Wood, 1994;
Sarafino, 1997). Several psychosocial factors have been
implicated in the development of asthma, the occurrence
of asthma attacks, and the inflammatory processes that
worsen asthma, including adversity during childhood
and family patterns that involve stress or low social
support (Chen et al., 2010; Marin et al., 2009; Miller
et al., 2009; Scott et al., 2008). A meta-analysis of
this research indicated that the association between

stress-related psychosocial factors and asthma is bi-
directional; stress and negative emotions can contribute
to the development and worsening of asthma, and having
asthma can contribute to future stress and negative
emotion (Chida, Hamer, & Steptoe, 2008).

RECURRENT HEADACHE
Many people suffer chronically from intense headaches.
Although there are many types of recurrent headache,
two of the most common are called tension-type and
migraine headache. Tension-type (or muscle contraction)
headache seems to be caused by a combination of
a central nervous system dysfunction and persistent
contraction of the head and neck muscles (AMA, 2003;
Holroyd, 2002). The pain it produces is a dull and steady
ache that often feels like a tight band of pressure around
the head. Recurrent tension-type headaches occur twice
a week or more, and may last for hours, days, or weeks
(Dalessio, 1994).

Migraine headache seems to result from dilation
of blood vessels surrounding the brain and a dysfunction
in the brainstem and trigeminal nerve that extends
throughout the front half of the head (AMA, 2003;
Goadsby, 2005; Holroyd, 2002). The pain often begins
on one side of the head near the temple, is sharp
and throbbing, and lasts for hours or, sometimes,
days (Dalessio, 1994). Sometimes migraines begin with
or follow an aura, a set of symptoms that signal an
impending headache episode. These symptoms usually
include sensory phenomena, such as seeing lines or
shimmering in the visual field. This may be accompanied
by dizziness, nausea, and vomiting. Recurrent migraine is
marked by periodic debilitating symptoms, which occur
about once a month, with headache-free periods in
between (Dalessio, 1994).

Most adults and children have headaches at least
occasionally, and tension-type headaches are common
(AMA, 2003). The prevalence of migraine varies widely
across cultures, but is about 10% overall, is far greater
in females than males, and increases with age from
childhood to middle age, and then declines (Stewart,
Shechter, & Rasmussen, 1994). Many children experience
their first headaches in the preschool years, and chronic
headaches have been reported in boys and girls as young
as 6 years of age (Andrasik, Blake, & McCarran, 1986).
Figure 4-6 presents a drawing by an 11-year-old girl
named Meghan to describe her experience of migraine
headache pain.

What triggers headaches? They often are brought
on by hormonal changes, missing a meal, sunlight,
sleeping poorly, and consuming certain substances,
such as alcohol or chocolate. Research has also shown

104 Part II / Stress, Illness, and Coping

Figure 4-6 Drawing by 11-year-old Meghan of her
experience of migraine headache pain. The lower
left-hand corner has a self-portrait with a dramatic
facial expression. When a headache begins, Meghan
typically retreats to her bedroom ‘‘to ride out the
storm,’’ lying down in a darkened room. (From
Andrasik, Blake, & McCarran, 1986, Figure 18.1.)

that stressors—particularly the hassles of everyday
living—are common triggers of migraine and tension-
type headaches (Köhler & Haimerl, 1990; Nash &
Thebarge, 2006; Robbins, 1994). Yet some patients with
chronic headache have attacks when they are not under
great stress, and others fail to have headaches when
they are under stress. Stress appears to be one of many
factors that produce headaches, but the full nature of
these causes is not yet known.

OTHER DISORDERS
There are several other psychophysiological disorders
for which stress appears to be involved in triggering
or aggravating episodes. One of these illnesses is
rheumatoid arthritis—a chronic and very painful disease
that produces inflammation and stiffness of the small
joints, such as in the hands. It afflicts about 1% of
the American population, and its victims are primarily
women (AF, 2006), and stress seems to play a role in
arthritis inflammation, pain, and limitations in physical
activity (Parrish et al., 2008). Another disorder, called
dysmenorrhea, affects millions of women. It is characterized
by painful menstruation, which may be accompanied by
nausea, headache, and dizziness (AMA, 2003; Calhoun &
Burnette, 1983). A third stress-related problem involves
skin disorders, such as hives, eczema, and psoriasis, in which
the skin develops rashes or becomes dry and flakes or
cracks (AMA, 2003). In many cases, specific allergies

are identified as contributing to episodes of these skin
problems.

Although current evidence implicates both biologi-
cal and psychosocial causes for each of the psychophys-
iological disorders we have considered, the evidence is
sketchy and the nature of the interplay of these factors is
unclear. The remainder of this chapter focuses on the role
of stress in the development of cardiovascular disorders
and cancer.

STRESS AND CARDIOVASCULAR
DISORDERS

Earlier in this chapter, we saw that psychosocial
modifiers of stress can affect health—for instance, the
risk of developing CHD is greater for chronically angry
and hostile people. Such findings suggest that stress
may be a factor in the development of cardiovascular
disorders, the number-one cause of death in the United
States and many other countries. We’ll look more closely
at the role of stress in hypertension and CHD.

HYPERTENSION
Hypertension—the condition of having high blood
pressure consistently over several weeks or more—is
a major risk factor for CHD, stroke, and kidney disease

Chapter 4 / Stress, Biopsychosocial Factors, and Illness 105

(AHA, 2010; NKF, 2006). In the United States, nearly 30%
of adults are classified as hypertensive, having blood
pressures at or above 140 (systolic) over 90 (diastolic).
By comparison, the hypertension rates elsewhere are
(Hajjar, Kotchen, & Kotchen, 2006):

• Australia, 21%–32%

• Canada, 20%

• Europe, 44% (across several nations)

• Worldwide, 26%.

Because lesser elevations in blood pressure are now
known to increase risk substantially, current guidelines
designate less than 120/80 as ‘‘normal,’’ or conveying
little risk, as shown in Table 4.2. Prevalence rates for
hypertension increase in adulthood, particularly after
about 40 years of age (NCHS, 2009a). Some cases
of hypertension are caused by, or are secondary to,
disorders of other body systems or organs, such as the
kidneys or endocrine system. Secondary hypertension
can usually be cured by medical procedures. But the vast
majority—over 90%—of hypertensive cases are classified
as primary or essential hypertension, in which the causes of
the high blood pressure are unknown.

To say that the causes for essential hypertension are
unknown is somewhat misleading. In cases of essential
hypertension, physicians are unable to identify any
biomedical causes, such as infectious agents or organ
damage. But many risk factors are associated with the
development of hypertension—and there is evidence
implicating the following as some of the risk factors for
hypertension (AHA, 2010; Hajjar, Kotchen, & Kotchen,
2006):

• Obesity

• Dietary elements, such as high salt, fats, and cholesterol

• Excessive alcohol use

• Physical inactivity

• Family history of hypertension

• Psychosocial factors, such as chronic stress, anger, and
anxiety

Stress, Emotions, and Hypertension
People’s occupations provide sources of stress that can
have an impact on their blood pressure. Traffic controllers
at airports provide an example. Sidney Cobb and Robert
Rose (1973) compared the medical records of thousands
of men employed as air traffic controllers or as second-
class airmen, separating the data for different age groups,
since blood pressure increases with age. Comparisons for
each age group revealed prevalence rates of hypertension
among traffic controllers that were several times higher
than for airmen. The researchers also compared the
records of traffic controllers who experienced high and
low levels of stress, as measured by the traffic density at
the air stations where they worked. Figure 4-7 depicts
the results: for each age group, prevalence rates of
hypertension were higher for traffic controllers working
at high-stress locations than for those at low-stress sites.

Aspects of social environments, such as crowding
and aggression, are also linked to stress and hyperten-
sion. Experiments with animals have shown that living in
crowded, aggressive conditions induces chronic hyper-
tension (Henry et al., 1993). Research with humans
compared people living in crowded and uncrowded
neighborhoods to see if these living conditions influ-
ence blood pressure (Fleming et al., 1987). The people
from the two types of neighborhoods were similar in

60
50
40
30
20
10
0

H
yp

er
te

n
si

on
p

re
va

le
n
ce

(
p
er

1
,0

0
0

s
u
b
je

ct
s)

25–29 30–34 35–39 40–44 45–49

Age in years

Low
stress

High
stress

Figure 4-7 Prevalence of hypertension per 1,000 air traffic
controllers as a function of stress and age. Hypertension
rates increase with age and stress. (Data from Cobb & Rose,
1973, Table 3.)

Table 4.2 Blood Pressure Categories
(values in mm Hg units)

Category Systolic Diastolic

Normal (recommended) Less than 120 and Less than 80
Prehypertension 120–139 or 80–89
Hypertension: Stage 1 140–159 or 90–99
Hypertension: Stage 2 160 or higher or 100 or higher

Source: AHA, 2010.

106 Part II / Stress, Illness, and Coping

important characteristics, such as age, gender, and fam-
ily income. While working on a stressful cognitive task,
the subjects showed greater increases in heart rate and
systolic and diastolic pressure if they lived in crowded
neighborhoods. Other research has found that psycho-
logical stress and high cardiovascular reactivity to stress
may be a risk factor for, or even a cause of, hyperten-
sion (Chida & Steptoe, 2010; Sparrenberger et al., 2009;
Tuomisto et al., 2005). Taken together, the evidence sug-
gests that chronic stress plays a role in the development
of hypertension.

Studies on pessimism, anger, and hostility have
revealed important links to the development of hyperten-
sion; we’ll consider three. First, blood pressure is higher
in pessimistic than optimistic individuals (Räikkönen et
al., 1999). Second, people who are hypertensive are more
likely to be chronically hostile and resentful than are
normotensive people, those with normal blood pressure
(Diamond, 1982). Anger is also associated with higher
nighttime blood pressure (Beatty & Matthews, 2009).
Third, resting blood pressure is higher among individuals
who ruminate or dwell on events that provoke anger than
among people who don’t ruminate (Hogan & Linden,
2004).

Interestingly, the effects of stress on blood pressure
can complicate the medical diagnosis of hypertension.
Some people become anxious when medical profession-
als measure their blood pressure, producing an elevated
reading that actually is not representative of their usual
blood pressure levels, leading to a false diagnosis of
hypertension. If undetected, this ‘‘white coat hyper-
tension’’ can lead to unnecessary medical treatment
(McGrady & Higgins, 1990; Ogedegbe et al., 2008).

Stress and Sociocultural Differences in
Hypertension
The impact of stress on hypertension may be particularly
relevant for Black people in the United States, who have
a much higher prevalence rate of high blood pressure
than Whites do (NCHS, 2009a). In a study of Black and
White people in Detroit, the highest blood pressure
readings found were those of Blacks living in high-stress
areas of the city—neighborhoods that were crowded and
had high crime rates and low incomes (Harburg et al.,
1973). But Blacks and Whites who lived in low-stress
areas had similar blood pressures. Two other findings
suggest that perceived racism is a stressor that plays
a major role in the high rates of hypertension among
African Americans. First, Black women’s blood pressure
reactivity to stressors is higher among those who feel that
racial discrimination underlies the mistreatment they’ve
experienced than those who do not (Guyll, Matthews,
& Bromberger, 2001). Second, blood pressure in waking
daily life is higher among Black men and women who
perceive frequent racism in their lives than those who do
not (Steffen et al., 2003).

Few cases of essential hypertension are likely to
be caused by emotional factors alone (Schneiderman
& Hammer, 1985). Most cases of high blood pressure
probably involve several of the determinants listed earlier

in this section. (Go to .)

CORONARY HEART DISEASE
Epidemiologists have studied the distribution and
frequency of CHD over many decades in many different
cultures. The data they have collected suggest that

HIGHLIGHT

Does Acculturation Increase Blood Pressure?
Does adapting to living in a new West-

ern culture put people at risk for hypertension? To answer
this question, Patrick Steffen and his colleagues (2006)
performed a meta-analysis on blood pressure data from
125 studies that had compared people who were or
were not living in a new Western culture. This analysis
revealed several interesting findings. First, blood pres-
sure was substantially higher among people adapting to
a new culture. Second, the higher blood pressures were
not the result of differences in body weight or cholesterol
levels. Third, the impact of acculturation on blood pres-
sure was greater for men than for women and greater for
people who relocated from rural to urban areas than from

urban to rural. Fourth, the impact of adapting to a new
culture decreased with time: the effect of acculturation
on blood pressure was far greater in the first months
after relocating than after several years. Acculturation is
stressful, but people adapt in time. The stress of accul-
turation has also been linked to risk for developing the
metabolic syndrome (Peek et al., 2009), which combines
high blood pressure with high cholesterol, abdomi-
nal fat, and impaired glucose metabolism. Hence, the
health risks of acculturation may extend beyond hyper-
tension to include other cardiovascular diseases and
diabetes.

Chapter 4 / Stress, Biopsychosocial Factors, and Illness 107

CHD is, to some extent, a disease of modernized
societies—that is, the incidence rate of heart disease
is higher in technologically advanced countries than in
other nations (Susser, Hopper, & Richman, 1983). In
advanced societies, people live long enough to become
victims of CHD, which afflicts mainly older individuals,
and are more likely than those in less developed
countries to have certain risk factors for CHD, such
as obesity and low levels of physical activity. Last, the
psychosocial stressors of advanced societies are different
from those in other societies and may be more conducive
to the development of heart disease. For instance, people
in less advanced societies may have more social support
to protect them from the effects of stress and perceive
less reason for anger and hostility, which we’ve already
seen can increase the risk of CHD.

The link between stress and CHD has considerable
support (Williams, 2008). For example, job stress, conflict
in close relationships, post-traumatic stress disorder,
and stress-related personality factors such as anger and
optimism predict the development of CHD, as indicated
by myocardial infarctions or death from CHD (Chida
& Steptoe, 2009; Dedert et al., 2010; De Vogli et al.,
2007; Eller et al., 2009; Kubzansky et al., 2009; Tindle et
al., 2009). Associations between stress and myocardial
infarctions or death from CHD could occur across various
phases of the disease. Stress could contribute to the
initiation and progression of atherosclerosis, even years
before the first symptoms and other outward indications
of CHD occur. Later, in the presence of advanced
atherosclerosis, stress could contribute to the occurrence
of ischemia, myocardial infarction, or disturbances in the
rhythm of the heart that reveal clinically apparent CHD.
Still later, stress could contribute to worrisome health
outcomes for people with established CHD, such as
additional heart attacks or coronary death.

Research has supported each of these possibilities.
For example, anger is associated with stiffness in
arteries that indicate very early signs of atherosclerosis
(Shimbo et al., 2007). Also, research has found higher
levels of atherosclerosis in the arteries of African
American women who perceived high levels of stress,
unfair treatment, and racial discrimination in their
lives than those who did not (Troxel et al., 2003).
Also, experiences of high demand and low control in
dealing with daily stressors is associated with greater
progression of atherosclerosis over time (Kamarck et
al., 2007). Later in the development of CHD, a variety
of stressful events and negative emotions such as
episodes of anger can precipitate heart attacks in people
with advanced atherosclerosis (Bhattacharyya & Steptoe,
2007). Finally, anger, depression, and stressful aspects
of neighborhoods have all been found to predict poor

medical outcomes, including recurring heart attacks
and death, in CHD patients (Chida & Steptoe, 2009;
Nicholson, Kuper, & Hemingway, 2006; Scheffler et al.,
2008).

What processes link stress and CHD? We’ve
discussed three processes already (Kop, 2003; Williams,
2008). First, stress evokes increases in lipids and inflam-
matory substances in the blood, cardiovascular reactiv-
ity, and increases in catecholamine and corticosteroid
release by the endocrine glands. These physiological
responses, especially if they become chronic, can dam-
age the arteries and heart, promote atherosclerosis, and
lead to the development of hypertension. These same
physiological processes can cause advanced and unsta-
ble coronary artery plaques to rupture, causing a blood
clot that can close off an artery that otherwise brings
blood and oxygen to the heart muscle. This is the most
common cause of a myocardial infarction or heart attack.
Second, stress can cause cardiac arrhythmia, especially
if the heart is susceptible to ischemia. When severe,
arrhythmias can cause a cardiac episode and sudden
death. Third, stress is associated with cigarette smok-
ing and high levels of alcohol use, for example, which
are behavioral risk factors for CHD. In later chapters
we will examine in greater detail various risk factors and
issues relating to CHD and the next stress-related illness,
cancer.

STRESS AND CANCER

The idea that stress and other psychosocial factors con-
tribute to the development of cancer has a long history.
The physician Galen, who practiced in Rome during the
second century A.D., believed that individuals who were
sad and depressed, or ‘‘melancholy,’’ were more likely to
develop cancer than those who were happy, confident,
and vigorous (Sklar & Anisman, 1981). Similar ideas have
appeared in the writings of physicians in later eras. Cancer
is a term that refers to a broad class of disease in which
cells multiply and grow in an unrestrained manner. As
such, cancer does not refer to a single illness, but to
dozens of disease forms that share this characteristic
(ACS, 2009). It includes, for instance, leukemias, in which
the bone marrow produces excessive numbers of white
blood cells, and carcinomas, in which tumors form in
the tissue of the skin and internal organ linings. Some
cancers take longer to develop or follow more irregular
courses in their development than others do.

Does stress play a role in cancer? Early evidence
linking stress and cancer came from research using retro-
spective methods (Sklar & Anisman, 1981). This research

108 Part II / Stress, Illness, and Coping

generally had cancer patients fill out life events ques-
tionnaires to assess the stress they experienced during
the year or so preceding the diagnosis. Although some
studies found that the appearance of cancer was associ-
ated with self-reported high levels of prior stress, others
did not (Steptoe & Ayers, 2004). And problems with retro-
spective methods cloud the interpretation of the results
of these studies. Because the cancer diagnoses were
typically made years after the disease process started, the
patients’ cancers were probably present prior to and dur-
ing the year for which they reported high levels of stress.
Also, the patients’ perceptions or recollections of prior
stress may have been distorted by their knowledge that
they have cancer. More recent, better designed research
using prospective or longitudinal approaches has also
produced inconsistent results, but a meta-analysis of
the large number of available studies indicated that
stress-related psychosocial factors predicted the initial
occurrence of cancer, as well as the medical course of the

disease, including survival and death from cancer (Chida
et al., 2008).

The effects of stress on cancer are probably influ-
enced by many factors. If stress plays a causal role in
cancer development or progression, it may do so by
impairing the immune system’s ability to combat the
disease and by increasing behavioral risk factors, such
as smoking cigarettes. As in the case of CHD, cancer
progresses in a complex manner. Cancer progression
eventually involves the recruitment of a blood supply
to permit growth of the tumor beyond early stages,
called angiogenesis. Further, cancer can spread beyond
the tissue where it originally occurred, a process called
metastasis. Recent research has begun to identify ways
in which physiological stress responses can influence
angiogenesis and metastasis, as well as the health
behavior and immune system mechanisms tradition-
ally thought to link stress and cancer (Antoni et al.,
2006).

SUMMARY

Researchers have identified several psychosocial factors
that modify the impact of stress on the individual.
One of these factors is social support—the comfort,
caring, esteem, or help a person actually receives or
simply perceives as available from others. There are four
basic types of support: emotional or esteem, tangible or
instrumental, informational, and companionship. Whether
people receive social support depends on characteristics
of the recipients and of the providers of support and on
the composition and structure of the social network. Social
support appears to reduce the stress people experience and
to enhance their health. The greater people’s social support,
the lower their mortality rates and likelihood of becoming
ill. These benefits seem to accrue in accordance with the
buffering and direct effects hypotheses. That is, social
support may buffer a person against the negative effects of
high levels of stress and may enhance health regardless of
the level of stress by simply providing encouragement for
leading healthful lifestyles, for instance.

Another psychosocial modifier of stress is people’s
sense of personal control over events in their lives, such as
through behavioral and cognitive control. Personal control
includes beliefs about one’s locus of control—that is,
whether control is internal or external to the person—and
self-efficacy. People acquire a sense of personal control
from their successes and failures and through the process
of social learning. Individuals who experience prolonged,
high levels of stress and have a weak sense of personal
control tend to feel helpless. The cognitive process of
attribution seems to be important in the development of
learned helplessness. A strong sense of personal control
tends to benefit people’s health and help them adjust to a

serious illness if it occurs. Hardiness and similar personality
traits are additional psychosocial modifiers of stress that
may help people remain healthy when under stress, and
the five-factor model of personality can help to organize
the growing list of personality traits that modify stress.

One other psychosocial modifier of stress is people’s
tendency toward either the Type A or the Type B behavior
pattern. The Type A behavior pattern consists of four
characteristics: competitive achievement orientation, time
urgency, anger or hostility, and a vigorous or controlling
vocal style. Compared with Type Bs, Type A individuals
respond more quickly and strongly to stressors both in
their overt behaviors and in their physiological reactivity.
Anger/hostility is the component of this pattern that is
most closely associated with the development of coronary
heart disease (CHD) and hypertension.

Chronic stress may affect health in two ways. First,
it may increase health-compromising behaviors, such as
alcohol and cigarette use. Second, it produces changes
in the body’s physical systems, as when the endocrine
system releases catecholamines and corticosteroids, which
can cause damage to the heart and blood vessels
and impair immune system functioning. The physical
effects of stress can even impair healing of wounds.
Psychoneuroimmunology is the field of study that focuses
on how psychosocial processes and the nervous, endocrine,
and immune systems are interrelated. Stress also plays a
role in many psychophysiological disorders, such as ulcers,
inflammatory bowel disease, irritable bowel syndrome,
asthma, and tension-type and migraine headache. In
addition, stress is strongly implicated in the development
of hypertension and CHD, and may also affect cancer.

Chapter 4 / Stress, Biopsychosocial Factors, and Illness 109
KEY TERMS

social support
buffering hypothesis
direct effects hypothesis
personal control
behavioral control
cognitive control
locus of control

self-efficacy
learned helplessness
hardiness
Type A behavior pattern
Type B behavior pattern
coronary heart disease

(CHD)

psychoneuroimmunology
psychophysiological

disorders
ulcers
inflammatory bowel

disease

irritable bowel syndrome
asthma
tension-type headache
migraine headache
hypertension

Note: If you read Modules 5 and 6 (from Chapter 2)
with the current chapter, you should include the terms

terms for those modules.

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5
COPING WITH AND REDUCING
STRESS
Coping With Stress
What is Coping?
Functions and Methods of Coping

Reducing the Potential for Stress
Enhancing Social Support
Improving One’s Personal Control
Organizing One’s World Better
Exercising: Links to Stress and Health
Preparing for Stressful Events

Reducing Stress Reactions: Stress
Management
Medication
Behavioral and Cognitive Methods
Massage, Meditation, and Hypnosis

Using Stress Management to Reduce
Coronary Risk
Modifying Type A Behavior
Treating Hypertension

PROLOGUE
One morning while taking a shower before going to
psychology class, Cicely felt a small lump in her breast.
She was sure it had not been there before. It didn’t
hurt, but she was momentarily alarmed—her mother
had had breast cancer a few years before. ‘‘It could be a

pimple or some other benign growth,’’ she thought. Still,
it was very worrisome. She decided not to consult her
physician about it yet because as she thought, ‘‘it may not
be anything.’’ Over the next several days, she anxiously
examined the lump daily. This was a very stressful time
for her, and she slept poorly. After a week without the
lump changing, she decided to take action and see her
physician.

Another young woman, Beth, had a similar experi-
ence. Finding a lump on her breast alarmed her, but she
didn’t deal with the stress as rationally as Cicely did.
Beth’s initial fright led her to reexamine her breast just
once, and in a cursory way. She told herself, ‘‘There isn’t
really a lump on my breast, it’s just a rough spot,’’ and
convinced herself that she should not touch it because,
she thought, ‘‘That will only make it worse.’’ During the
next few months, Beth worried often about the ‘‘rough
spot’’ and avoided touching it, even while washing. She
became increasingly moody, slept poorly, and developed
many more headaches than usual. Beth finally men-
tioned the ‘‘rough spot’’ to a friend who convinced her to
have her physician examine it.

People vary in the ways they deal with stress.
Sometimes people confront a problem directly and
rationally, as Cicely did, and sometimes they do not.
For these two women, the way they dealt with their stress
had the potential for affecting their health. Because Beth
did not face up to the reality of the lump, she delayed
seeking medical attention and experienced high levels

Chapter 5 / Coping With and Reducing Stress 111

of stress for a long time. If the lump were malignant,
delaying treatment would allow the cancer to progress
and spread. As we have seen, prolonged stress can have
adverse health effects even in healthy people.

In this chapter we discuss the ways people can and
do deal with stress. Through this discussion, you will find
answers to questions you may have about the methods
people use in handling stress. Are some methods for
coping with stress more effective than others? How can
people reduce the potential for stress in their lives? When
people encounter a stressor, how can they reduce the
strain it produces?

COPING WITH STRESS

Individuals of all ages experience stress and try to deal
with it. During childhood years, people learn ways to
manage feelings of stress that arise from the many
fearful situations they experience (Sarafino, 1986). For
instance, psychologist Lois Murphy (1974, p. 76) has
described the progress and setbacks a 4-year-old named
Molly had made in dealing with the terror she felt during
thunderstorms. In her last steps at gaining control over
her fear, she experienced two storms a few months apart.
During the first storm, she awoke and didn’t cry, ‘‘but I
just snuggled in my bed,’’ she said later. In the second
storm, she showed no outward fear and comforted her
frightened brother, saying, ‘‘I remember when I was a
little baby and I was scared of thunder and I used to
cry and cry every time it thundered.’’ Like most children,
Molly became better able to cope with the stress of
storms as she grew older. What’s more, in the last steps
of her progress she showed pride in having mastered
her fear.

WHAT IS COPING?
Because the emotional and physical strain that accom-
panies stress is uncomfortable, people are motivated to
do things to reduce their stress. These ‘‘things’’ are what
is involved in coping.

What is coping? Several definitions of coping exist
(Lazarus & Folkman, 1984). We’ll use a definition based
on how we defined stress in Chapter 3, when we saw
that stress involves a perceived discrepancy between the
demands of the situation and the resources of the person.
Coping is the process by which people try to manage the
perceived discrepancy between the demands and resources
they appraise in a stressful situation. Notice the word
manage in this definition. It indicates that coping efforts
can be quite varied and do not necessarily lead to a
solution of the problem. Although coping efforts can be

aimed at correcting or mastering the problem, they may
also simply help the person alter his or her perception of
a discrepancy, tolerate or accept the harm or threat, or
escape or avoid the situation (Lazarus & Folkman, 1984;
Carver & Connor-Smith, 2010). For example, a child who
faces a stressful exam in school might cope by feeling
nauseated and staying home.

We cope with stress through our cognitive and
behavioral transactions with the environment. Suppose
you are overweight and smoke cigarettes, and your
physician has asked you to lose weight and stop smoking
because several factors place you at very high risk for
developing heart disease. This presents a threat—you
may become disabled or die—and is stressful, especially
if you don’t think you can change your behavior. How
might you cope with this? Some people would cope by
seeking information about ways to improve their ability to
change. Other people would simply find another doctor
who is not so directive. Others would attribute their
health to fate or ‘‘the will of God,’’ and leave the problem
‘‘in His hands.’’ Still others would try to deaden this and
other worries with alcohol, which would add to the risk.
People use many different methods to try to manage
the appraised discrepancy between the demands of the
situation and their resources.

The coping process is not a single event. Because
coping involves continuous transactions with the envi-
ronment, the process is best viewed as a dynamic series
of appraisals and reappraisals that adjust to shifts in
person–environment relationships. And so, in coping
with the threat of serious illness, people who try to
change their lifestyles may receive encouragement and
better relationships with their physician and family. But
individuals who ignore the problem are likely to expe-
rience worse and worse health and relations with these
people. Each shift in one direction or the other is affected
by the transactions that preceded it and affects subse-
quent transactions (Lazarus & Folkman, 1984).

FUNCTIONS AND METHODS OF COPING
You have probably realized by now that people have many
ways for coping with stress. Because of this, researchers
have attempted to organize coping approaches on the
basis of their functions and the methods they employ.
(Go to .)

Functions of Coping
According to Richard Lazarus and his colleagues, coping
can serve two main functions (Lazarus, 1999; Lazarus &
Folkman, 1984). It can alter the problem causing the stress
or it can regulate the emotional response to the problem.

112 Part II / Stress, Illness, and Coping

ASSESS YOURSELF

Your Focuses in Coping
Think about a very stressful personal

crisis or life event you experienced in the last year—the
more recent and stressful the event, the better for
this exercise. How did you handle this situation and
your stress? Some of the ways people handle stressful
experiences are listed below. Mark an ‘‘X’’ in the space
preceding each one you used.

Tried to see a positive side to it
Tried to step back from the situation and be
more objective
Prayed for guidance or strength
Sometimes took it out on other people when I
felt angry or depressed
Got busy with other things to keep my mind off
the problem
Decided not to worry about it because I figured
everything would work out fine
Took things one step at a time

Read relevant material for solutions and considered
several alternatives
Drew on my knowledge because I had a similar
experience befo

Talked to a friend or relative to get advice on
handling the problem
Talked with a professional person (e.g., doctor,
clergy, lawyer, teacher, counselor) about ways
to improve the situation
Took some action to improve the situation

Of the first six ways listed, count how many you
marked; these are examples of ‘‘emotion-focused’’ ways.
How many of the second six—‘‘problem-focused’’—ways
did you mark? When you read the upcoming text
material entitled Functions of Coping, answer these
questions: Did you use mostly emotion- or problem-
focused methods? Why, and what functions did your
methods serve? (Based on material in Billings & Moos, 1981.)

Emotion-focused coping is aimed at controlling the
emotional response to the stressful situation. People can
regulate their emotional responses through behavioral and
cognitive approaches. Examples of behavioral approaches
include using alcohol or drugs, seeking emotional social
support from friends or relatives, and engaging in
activities, such as sports or watching TV, which distract
attention from the problem. Cognitive approaches involve
how people think about the stressful situation. In one
cognitive approach, people redefine the situation to put a
good face on it, such as by noting that things could be
worse, making comparisons with individuals who are less
well off, or seeing something good growing out of the
problem. We can see this approach in two statements of
women with breast cancer (Taylor, 1983):

What you do is put things into perspective. You find
out that things like relationships are really the most
important things you have—the people you know
and your family—everything else is just way down
the line. It’s very strange that it takes something so
serious to make you realize that. (p. 1163)

The people I really feel sorry for are these young gals.
To lose a breast when you’re so young must be awful.
I’m 73; what do I need a breast for? (p. 1166)

People who want to redefine a stressful situation can
generally find a way to do it since there is almost always

some aspect of one’s life that can be viewed positively
(Taylor, 1983).

Other emotion-focused cognitive processes include
strategies Freud called ‘‘defense mechanisms,’’ which
involve distorting memory or reality in some way (Cramer,
2000). For instance, when something is too painful to
face, the person may deny that it exists, as Beth did
with the lump on her breast. This defense mechanism is
called denial. In medical situations, individuals who are
diagnosed with terminal diseases often use this strategy
and refuse to believe they are really ill. This is one way
by which people cope by using avoidance strategies. But
strategies that promote avoidance of the problem are
helpful mainly in the short run, such as during an early
stage of a prolonged stress experience (Suls & Fletcher,
1985). This is so for individuals who are diagnosed with
a serious illness, for instance. As a rule of thumb, the
effectiveness of avoidance-promoting methods seems to
be limited to the first couple of weeks of a prolonged
stress experience. Thereafter, coping is better served by
giving the situation attention.

People tend to use emotion-focused approaches
when they believe they can do little to change the
stressful conditions (Lazarus & Folkman, 1984). An
example of this is when a loved one dies—in this
situation, people often seek emotional support and
distract themselves with funeral arrangements and

Chapter 5 / Coping With and Reducing Stress 113

chores at home or at work. Other examples can be
seen in situations in which individuals believe their
resources are not and cannot be adequate to meet the
demands of the stressor. A child who tries very hard to
be the ‘‘straight A’’ student his or her parents seem to
want, but never succeeds, may reappraise the situation
and decide, ‘‘I don’t need their love.’’ Coping methods
that focus on emotions are important because they
sometimes interfere with getting medical treatment or
involve unhealthful behaviors, such as using cigarettes,
alcohol, and drugs to reduce tension. People often use
these substances in their efforts toward emotion-focused
coping (Wills, 1986).

Problem-focused coping is aimed at reducing the
demands of a stressful situation or expanding the
resources to deal with it. Everyday life provides many
examples of problem-focused coping, including quitting
a stressful job, negotiating an extension for paying some
bills, devising a new schedule for studying (and sticking
to it), choosing a different career to pursue, seeking
medical or psychological treatment, and learning new
skills. People tend to use problem-focused approaches
when they believe their resources or the demands of
the situation are changeable (Lazarus & Folkman, 1984).
For example, caregivers of terminally ill patients use
problem-focused coping more in the months prior to the
death than during bereavement (Moskowitz et al., 1996).

To what extent do people use problem-focused and
emotion-focused approaches in coping with stress in
their lives? Andrew Billings and Rudolf Moos (1981)
studied this issue by having nearly 200 married couples
fill out a survey. The respondents described a recent
personal crisis or negative life event that happened
to them and then answered questions that were very
similar to the ones you answered in the self-assessment
exercise. The outcomes of this research revealed some
interesting relationships. Both the husbands and the
wives used more problem-focused than emotion-focused
methods to cope with the stressful event. But the wives
reported using more emotion-focused approaches than
the husbands did. People with higher incomes and
educational levels reported greater use of problem-
focused coping than those with less income and
education. Last, individuals used much less problem-
focused coping when the stress involved a death in the
family than when it involved other kinds of problems,
such as illness or economic difficulties.

Can problem-focused and emotion-focused coping
be used together? Yes, and they often are. For instance,
a study had patients with painful arthritis keep track of
their daily use of problem- and emotion-focused coping
(Tennen et al., 2000). Most often, they used the two
types of coping together; but when they used only one

Sometimes people don’t cope effectively with stress.
Reprinted courtesy of Bunny Hoest.

type, three-quarters of the time it was problem-focused
coping. We can see an example of both types of coping
in a man’s experience when a coworker accused him
of not sending out the appropriate letters for a job. In
describing how he reacted to this stressful situation, he
said he first confirmed that the coworker’s accusation

was not true, that everything [letters] had gone out.
There’s always a chance you might be wrong so I
checked first. Then I told him. No, everything had
gone out. My immediate reaction was to call him on
the carpet first. He doesn’t have any right to call me on
something like this. Then I gave it a second thought
and decided that that wouldn’t help the situation.
(Kahn et al., cited in Lazarus & Folkman, 1984, p. 155)

This example shows problem-focused coping in confirm-
ing that the letters had gone out, and emotion-focused
coping in controlling his angry impulse ‘‘to call him on
the carpet.’’

Coping Methods and Measurement
What specific methods—that is, skills and stra-
tegies—can people apply in stressful situations to alter
the problem or regulate their emotional response?
Researchers have described about 400 methods and
incorporated sets of them into dozens of instruments
to assess overall coping and categories of coping types

114 Part II / Stress, Illness, and Coping

Table 5.1 Methods of Coping with Stressful Situations (listed alphabetically)
Assistance seekingp Hiding feelingse Positive reappraisale

Avoidancee Humore Prayinge

Confrontive assertionp Increased activitye Resigned acceptancee

Deniale Information seekingp Seeking meaninge

Direct actionp Intrusive thoughtse Self-criticisme

Discharge (venting)e Logical analysisp Substance usee

Distraction (diverting attention)e Physical exercisee Wishful thinkinge

Emotional approache Planful problem solvingp Worrye

Note: Superscripted letters refer to the method’s most likely function, p = problem-focused
and e = emotion-focused coping, but some methods may serve either function.
Source: Skinner et al., 2003, Table 3.

(Skinner et al., 2003). Table 5.1 lists two dozen coping
methods that are easy to conceptualize, without stating
definitions, to give you a sense of the great variety of
possible methods people can use.

Unfortunately, instruments to measure coping
haven’t been very useful so far. They were typically
developed with the expectation that the scores would
predict mental or physical health, but they don’t (Coyne
& Racioppo, 2000; Skinner et al., 2003). And they don’t
seem to be very accurate in measuring people’s cop-
ing. Most measures of coping are retrospective, asking
respondents about the methods used in the past week,
month, or more. Do you remember exactly how you coped
2 weeks ago with a stressful event, such as a poor grade
on a test or an argument with a close friend? A study
tested the accuracy issue by having people report daily
for a month on the coping strategies they used with the
most negative event that occurred that day (Todd et al.,
2004). The subjects used a list with descriptions of 16
strategies that comprise a widely used coping survey for
the daily reports; at the end of the study they filled out
the survey to report on the whole month. Comparisons
of daily and full-month reports showed weak correspon-
dence for about half of the coping methods, suggesting
that assessments of coping pertaining to more than the
past week or so are inaccurate for many methods.

Researchers are currently working to identify the
coping methods that are most important—those that can
be measured accurately and are related to psychological
and health outcomes, such as people’s development of
and recovery from illnesses. Let’s look at some directions
that look promising (Folkman & Moskowitz, 2004; Carver
& Connor-Smith, 2010).

1. Engaging positive emotions. One approach for
coping with stress involves the use of positive emotions
to soften or balance against feelings of distress. For
instance, Susan Folkman (1997; Folkman & Moskowitz,
2004) has found that individuals who were caring for
a dying spouse or partner and then lost that person
report both positive and negative emotions occurring

together during times of great stress. As an example, a
gay man described the difficulty of tending for his partner
during the extreme sweating episodes he, like many AIDS
patients, had many times each day and noted that he
feels ‘‘proud, pleased that I can comfort him … . We are
still making our love for each other the focal point’’
(Folkman, 1997, p. 1213).

2. Finding benefits or meaning. People who are trying
to cope with severe stress often search for benefits or
meaning in the experience, using beliefs, values, and
goals to give it a positive significance (Folkman, 1997;
Sears, Stanton, & Danoff-Burg, 2003). They find benefits
or meaning in many ways, such as

when people whose loved ones have died from
a disease become advocates for research on that
disease; finding that new or closer bonds with others
have been formed because of having experienced or
survived a natural disaster together; or finding that
the event has clarified which goals or priorities are
important and which are not (Folkman, 1997, p. 1215).

A meta-analysis of over 80 studies found partial support
for a role of benefit finding in coping: it was associated
with less depression and greater feelings of well-being,
but was not related to anxiety and self-reports of physical
health (Helgeson, Reynolds, & Tomich, 2006).

3. Engaging in emotional approach. In emotional
approach, people cope with stress by actively processing
and expressing their feelings (Stanton et al., 2000). To
assess emotional approach, people rate how often they
engage emotional processing (in such activities as, ‘‘I take
time to figure out what I’m really feeling’’ and ‘‘I delve
into my feelings to get a thorough understanding of
them’’) and emotional expression (‘‘I take time to express
my emotions’’). Emotional approach probably includes
the method of disclosure of negative experiences and
feelings we discussed in Chapter 4 as a way of reducing
stress and enhancing health.

4. Accommodating to a stressor. Another way to cope
is to adapt or adjust to the presence of the stressor and

Chapter 5 / Coping With and Reducing Stress 115

carry on with life (Carver & Connor-Smith, 2010, Morling
& Evered, 2006). For instance, people with chronic pain
conditions may come to accept that the pain is present
and engage in everyday activities as best as they can.

Research has found psychological and health ben-
efits for each of these of coping methods (Folkman
& Moskowitz, 2004). For example, researchers tested
women with breast cancer for emotional approach soon
after medical treatment and for psychological and health
status 3 months later (Stanton et al., 2000). They found
that high levels of emotional expression were associated
with improved self-perceived health, increased vigor,
fewer medical visits for cancer-related problems, and
decreased distress. But high levels of emotional process-
ing were linked with increased distress. It may be that
emotional processing includes or leads to rumination, in
which people have intrusive thoughts and images that per-
petuate their stress (Baum, 1990). For example, people
may think repeatedly about how they or others are to
blame for their problems or have ‘‘flashbacks’’ of painful
or angry events. People who often ruminate take longer
for their blood pressure to decrease after starting to
think about arousing events and report having poorer
health habits and health than individuals who seldom
have such thoughts (Gerin et al., 2006; Nowack, 1989).

Using and Developing Methods
of Coping
No single method of coping is uniformly applied or
effective with all stressful situations (Ilfeld, 1980; Pearlin
& Schooler, 1978). Four issues about people’s patterns
in using different coping methods should be mentioned.
First, people tend to be consistent in the way they cope
with a particular type of stressor—that is, when faced
with the same problem, they tend to use the same
methods they used in the past (Stone & Neale, 1984).
Second, people seldom use just one method to cope with
a stressor. Their efforts typically involve a combination
of problem- and emotion-focused strategies (Tennen
et al., 2000). Third, the methods people use in coping
with short-term stressors may be different from those
they use under long-term stress, such as from a serious
chronic illness (Aldwin & Brustrom, 1997). Fourth,
although the methods people use to cope with stress
develop from the transactions they have in their lives,
a genetic influence is suggested by the finding that
identical twins are more similar than fraternal twins in
the coping styles they use (Busjahn et al., 1999).

Psychologists assume that coping processes change
across the life span. But the nature of these changes
is unclear because there is little research, espe-
cially longitudinal studies, charting these changes

(Aldwin & Brustrom, 1997; Lazarus & Folkman, 1984).
Some aspects of the changes in coping that occur in
the early years are known. Infants and toddlers being
examined by their pediatricians are likely to cope by try-
ing to stop the examination (Hyson, 1983). We saw earlier
in the case of Molly that young children develop coping
skills that enable them to overcome many of their fears,
making use of her expanding cognitive abilities. Over
the next several years, children come to rely increasingly
on cognitive strategies for coping (Brown et al., 1986;
Miller & Green, 1984). So, for example, they learn to
think about something else to distract themselves from
stress. More and more, they regulate their feelings with
emotion-focused methods, such as playing with toys or
watching TV, especially when they can’t do anything to
solve the problem, such as a serious illness in their
parents (Compas et al., 1996).

Few studies have examined changes in methods of
coping from adolescence to old age. One study used
interviews and questionnaires to compare the daily
hassles and coping methods of middle-aged and elderly
men and women (Folkman et al., 1987). The middle-
aged individuals used more problem-focused coping,
whereas the elderly people used more emotion-focused
approaches. Why do adults use less problem-focused
and more emotion-focused coping as they get older?
These changes probably result at least in part from
differences in what people must cope with as they age.
The elderly individuals in this study were retired from full-
time work and reported more stress relating to health
than did the middle-aged people did, who reported
more stress relating to work, finances, and family and
friends. The stressors encountered in middle age are
more changeable than those in old age. But the age
groups also differed in outlook: regardless of the source
of stress, the elderly people appraised their problems
as less changeable than the middle-aged individuals
did. As we saw earlier, people tend to use problem-
focused approaches when they believe the situation is
changeable, and rely on emotion-focused coping when
they do not.

Because most adults are married or partnered,
adults’ coping strategies usually operate and develop
jointly as a system, with each member’s coping processes
being shared by and influencing the other’s (Berg &
Upchurch, 2007). This sharing and social influence in
coping may be clearest when a couple copes with long-
term major stressors, such the diagnosis, treatment, and
future course of a life-threatening or disabling illness in
one or both of them. Their psychological adjustment to
the stressors will depend on the type of illness, whether
their joint coping strategies are effective, and the quality
of their relationship.

116 Part II / Stress, Illness, and Coping

Gender and Sociocultural Differences
in Coping
Studies of gender differences in coping have generally
found that men are more likely to report using problem-
focused strategies and women are more likely to report
using emotion-focused strategies in dealing with stress-
ful events (Marco, 2004). But when the men and women
are similar in occupation and education, no gender
differences are found (Greenglass & Noguchi, 1996).
These results suggest that societal sex roles play an
important role in the coping patterns of men and women.

Billings and Moos (1981) found that people with
higher incomes and educational levels report greater use
of problem-focused coping than those with less income
and education. This finding suggests that the social
experiences of disadvantaged people lead many of them
to believe they have little control over events in their
lives. In general, disadvantaged individuals—a category
that typically includes disproportionately more minority
group members—are more likely to experience stressful
events and less likely to cope with them effectively than
other people are (Marco, 2004). Thus, people in Asian
cultures and African- and Hispanic-Americans tend to
use more emotion-focused and less problem-focused
coping than White Americans do.

We have examined many ways people cope with
stress. Each method can be effective and adaptive for the
individual if it neutralizes the current stressor and does
not increase the likelihood of future stressful situations.

In the next section, we consider how people can reduce
the potential for stress for themselves and for others.

REDUCING THE POTENTIAL FOR STRESS

Can people become ‘‘immune’’ to the impact of stress
to some extent? Some aspects of people’s lives can
reduce the potential for stressors to develop and help
individuals cope with problems when they occur. Efforts
taken that prevent or minimize stress are called proactive
coping, and they typically use problem-focused methods
(Carver & Connor-Smith, 2010). We will look at several

proactive coping methods. (Go to .)

ENHANCING SOCIAL SUPPORT
We have all turned to others for help and comfort when
under stress at some time in our lives. If you have ever
had to endure troubled times on your own, you know
how important social support can be. But social support
is not only helpful after stressors appear, it also can
help avert problems in the first place. Consider, for
example, the tangible support newlyweds receive, such
as items they will need to set up a household. Without
these items, the couple would be saddled either with the
financial burden of buying the items or with the hassles
of not having them.

HIGHLIGHT

Does Religiousness Reduce Stress
and Enhance Health?

Here’s an intriguing finding: religiousness—that is, people’s
personal involvement in a religion—is associated with
lower anxiety and depression, better physical health,
and longer life (Chida, Steptoe, & Powell, 2009; Mas-
ters, 2004). Some reasons for this link have been
proposed—for instance, some religions promote healthy
lifestyles, such as by preaching against smoking, and
religious meetings provide social contact and support.
To the extent that these processes happen, they are likely
to reduce stress and enhance health. But keep in mind
three issues. First, some people are involved in a reli-
gion for utilitarian reasons, such as to promote status
or political goals, and their stress reactions do not seem
to benefit from their involvement (Masters et al., 2004).
Second, social contact appears to play a strong role

in health benefits of religious involvement (Nicholson,
Rose, & Bobak, 2010). Third, the link between religious-
ness and lower mortality applies to people who were
initially healthy, not to individuals who were already sick
(Chida, Steptoe, & Powell, 2009).

One other reason for the link between religiousness
and health that some people have proposed is that
religious people may receive direct help from their God,
especially if others pray for their health. This idea has
been disconfirmed. A meta-analysis on data from 14
studies on the role of people’s praying to help another
person found no impact of that prayer on the object
person’s health or life condition (Masters, Spielmans, &
Goodson, 2006). The health or life conditions of people
who are or are not the objects of prayer are not different.

Chapter 5 / Coping With and Reducing Stress 117

Although people in all walks of life can lack the social
support they need, some segments of the population
have less than others (Antonucci, 1985; Broadhead et al.,
1983; Ratliff-Crain & Baum, 1990). For instance:

• Men tend to have larger social networks than women, but
women seem to use theirs more effectively for support.

• Many elderly individuals live in isolated conditions and
have few people on whom to rely.

• Network size is related to social prestige, income, and
education—the lower these variables are for individuals,
the smaller their social networks tend to be.

Furthermore, the networks of people from lower
socioeconomic classes are usually less diverse than
those of people from higher classes—that is, lower-
class networks contain fewer nonkin members. In
contemporary American society, the traditional sources
of support have shifted to include greater reliance on
individuals in social and helping organizations. This is
partly because extended family members today have
different functions and live farther apart than they did
many decades ago (Pilisuk, 1982).

Social support is a dynamic process. People’s needs
for, giving of, and receipt of support change over time.
Unfortunately, people who experience high levels of
chronic stress, such as when their health declines
severely, often find that their social support resources
deteriorate at the same time (Kaplan et al., 1997; Lepore,
1997; Wortman & Dunkel-Schetter, 1987). These results
are disheartening because they suggest that people
whose need for social support is greatest may be unlikely
to receive it.

Teachers can help enhance children’s social support by
having them work together.

People can enhance their ability to give and receive
social support by joining community organizations,
such as social, religious, special interest, and self-
help groups. These organizations have the advantage
of bringing together individuals with similar problems
and interests, which can become the basis for sharing,
helping, and friendship. In the United States, there
are many widely known self-help groups, including
Alcoholics Anonymous and Parents without Partners,
and special-interest groups, including the American
Association of Retired People and support groups for
people with specific illnesses, such as arthritis or AIDS.
Although groups like these are helpful, we don’t yet
know which ones work best for specific problems (Hogan,
Linden, & Najarian, 2002). People are most likely to join
a support group for a serious illness if it is embarrassing
or stigmatizing, such as AIDS or breast cancer (Davison,
Pennebaker, & Dickerson, 2000). Isolated people of all
ages—especially the elderly—with all types of difficulties
should be encouraged to join suitable organizations.

Communities can play a valuable role in enhancing
people’s resources for social support by creating pro-
grams to help individuals develop social networks, such
as in occupational and religious settings, and by provid-
ing facilities for recreation and fitness, arranging social
events, and providing counseling services. But social
support may not be effective if the recipient interprets it
as a sign of inadequacy or believes his or her personal
control is limited by it. Providing effective social support

requires sensitivity and good judgment. (Go to .)

IMPROVING ONE’S PERSONAL CONTROL
When life becomes stressful, people who lack a strong
sense of personal control may stop trying, thinking, ‘‘Oh,
what’s the use.’’ Instead of feeling they have power
and control, they feel helpless. For instance, people
with a painful and disabling chronic illness may stop
doing physical therapy exercises. When seriously ill
patients who feel little personal control face a new
severe stressor, they show more emotional distress than
others who feel more control (Benight et al., 1997).
The main psychological help such people need is to
bolster their self-efficacy and reduce their passiveness
and helplessness (Smith & Wallston, 1992). A pessimistic
outlook increases people’s potential for stress and can
have a negative effect on their health.

How can a person’s sense of control be enhanced?
The process can begin very early. Parents, teachers, and
other caregivers can show a child their love and respect,
provide a stimulating environment, encourage and
praise the child’s accomplishments, and set reasonable
standards of conduct and performance that he or she can

118 Part II / Stress, Illness, and Coping

HIGHLIGHT

The Amish Way of Social Support in Bereavement
The Amish people in North America

form a conservative religious sect that settled in Pennsyl-
vania in the 18th century. Amish families generally live in
colonies that now exist in many states and Canada. These
families have a strongly religious orientation and a seri-
ous work ethic that revolves around farming. Their way
of life is quite distinctive: they wear uniquely simple and
uniform clothing; speak mainly a Pennsylvania-German
dialect; and reject modern devices, using horse-driven
buggies instead of automobiles, for example. Their social
lives require their adherence to strict rules of conduct
and obedience to patriarchal authority.

One feature of Amish life is that community
members give assistance to one another in all times
of need. Their way of dealing with death provides a
good example, as Kathleen Bryer (1986) has studied
and described. Before death, a person who is seriously
ill receives care from his or her family. This generally
occurs at home, rather than in a hospital. The Amish
not only expect to give this care, but see it as a positive
opportunity. A married woman who was asked about
caring for a dying relative replied, ‘‘Oh yes, we had the

An Amish funeral procession. The
Amish provide social support to
one another in many ways, particularly
after a member dies.

chance to take care of all four of our old parents before
they died. We are both so thankful for this’’ (p. 251).
Death typically occurs in the presence of the family.

Upon someone’s death, the Amish community
swings into action. Close neighbors notify other members
of the colony, and the community makes most of
the funeral arrangements. The family receives visits of
sympathy and support from other Amish families, some
of whom come from other colonies far away and may
not even know the bereaved family. In contrast to the
social support most Americans receive in bereavement,
Amish supportive efforts do not end shortly after the
funeral—they continue at a high level for at least a
year. Supportive activities include evening and Sunday
visiting, making items and scrapbooks for the family, and
organized quilting projects that create fellowship around
a common task. Moreover, Amish individuals often give
extraordinary help to bereaved family members. For
instance, the sister of one widower came to live with
him and care for his four children until he remarried. The
community encourages widowed individuals to remarry
in time, and they often do so.

regard as challenges, rather than threats. At the other
end of the life span, nursing homes and families can
allow elderly people to do things for themselves and
have responsibilities, such as in cleaning, cooking, and
arranging social activities. One woman described the
prospect of living with her children in the following way:
‘‘I couldn’t stand to live with my children, as much as
I love them, because they always want to take over my
life’’ (Shupe, 1985). For people with serious illnesses,
health psychologists can help patients with little control
by training them in effective ways to cope with stress
(Thompson & Kyle, 2000).

ORGANIZING ONE’S WORLD BETTER
‘‘Where did I put my keys?’’ you have surely heard
someone ask frantically while running late to make an

appointment. People often feel stress because they are
running late or believe they don’t have enough time to do
the tasks of the day. They need to organize their worlds
to make things happen efficiently. This can take the
form of keeping an appointment calendar, designating
certain places for certain items, or putting materials in
alphabetized file folders, for instance. Organizing one’s
world reduces frustration, wasted time, and the potential
for stress.

An important approach for organizing one’s time is
called time management. It consists of three elements
(Lakein, 1973). The first element is to set goals. These
goals should be reasonable or obtainable ones, and
they should include long-term goals, such as graduating
from college next year, and short-term ones, such as
getting good grades. The second element involves

Chapter 5 / Coping With and Reducing Stress 119

making daily To Do lists with priorities indicated, keeping
the goals in mind. These lists should be composed each
morning or late in the preceding day. Each list must be
written—trying to keep the list in your head is unreliable
and makes setting priorities difficult. The third element
is to set up a schedule for the day, allocating estimated
time periods to each item in the list. If an urgent new
task arises during the day, the list should be adjusted to
include it.

EXERCISING: LINKS TO STRESS AND HEALTH
You have probably heard from TV, radio, magazine, and
newspaper reports that exercise and physical fitness
can protect people from stress and its harmful effects
on health. These reports cite a wide range of benefits
of exercising, from increased intellectual functioning
and personal control to decreased anxiety, depression,
hostility, and tension. Do exercise and fitness reduce the
potential for stress and its effects on health?

Correlational and retrospective studies of this
question have found that people who exercise or are
physically fit often report less anxiety, depression, and
tension in their lives than do people who do not exercise
or are less fit (Dishman, 1986; Holmes, 1993). Although
these results are consistent with the view that exercise
and fitness reduce stress, there are two problems in
interpreting them. First, the reduction in self-reported
stress and emotion may have resulted partly from a
placebo effect—that is, the subjects’ expectations that
psychological improvements would occur (Desharnais
et al., 1993). Second, the results of correlational research
do not tell us what causes what. Do exercise and fitness
cause people to feel less stress? Or are people more likely
to exercise and keep fit if they feel less stress and time
pressures in their lives? Fortunately, there is stronger
evidence for the beneficial effects of exercise and fitness
on stress and health.

An experiment by Bram Goldwater and Martin Collis
(1985) examined the effects of 6-week exercise programs
on cardiovascular fitness and feelings of anxiety in
healthy 19- to 30-year-old men who were randomly
assigned to one of two groups. In one group, the men
worked out 5 days a week in a vigorous fitness program,
including swimming and active sports, such as soccer;
the second group had a more moderate program with
less demanding exercise activities. Compared with the
men in the moderate program, those in the vigorous
program showed greater gains in fitness and reductions
in anxiety. Other experiments have shown similar
beneficial effects of exercise on depression and anxiety
with men and women, particularly if the programs last
at least 2 or 3 months (Babyak et al., 2000; Phillips,
Kiernan, & King, 2001).

Research has also assessed the role of exercise
on stress and cardiovascular function. Although most
studies were correlational, finding that people who
exercise or are physically fit show less reactivity to
stressors and are less likely to be hypertensive than
individuals who do not exercise or are less fit, some
used experimental methods (Blumenthal, Sherwood
et al., 2002; Dimsdale, Alpert, & Schneiderman, 1986).
We’ll consider two experiments. First, healthy young
adults who had sedentary jobs and had not regularly
engaged in vigorous physical activity in the previous year
were recruited (Jennings et al., 1986). During the next 4
months, these people spent 1 month at each of four levels
of activity, ranging from below normal (which included
2 weeks of rest in a hospital) to much above-normal
activity (daily vigorous exercise for 40 minutes). Heart
rate and blood pressure were measured after each month.
The much above-normal level of activity reduced heart
rate by 12% and systolic and diastolic blood pressure
by 8% and 10% compared with the normal sedentary
activity level. Below-normal activity levels did not alter
heart rate or blood pressure. Second, researchers had
undergraduates experience a stress condition and then
engage in moderate exercise or sit quietly for 3 minutes
(Chafin, Christenfeld, & Gerin, 2008). Measures taken
soon after revealed that exercise enhanced recovery from
stress: the individuals who exercised had lower blood
pressure levels than those who sat.

Do exercise and fitness prevent people from develop-
ing stress-related illnesses? The results of several studies
suggest they do (Phillips, Kiernan, & King, 2001). For
example, one study used prospective methods by first
assessing the subjects’ recent life events and fitness,
and then having them keep records concerning their
health over the next 9 weeks (Roth & Holmes, 1985).
The results revealed that individuals who reported high
levels of stress had poorer subsequent health if they
were not fit; stress had little impact on the health of fit
subjects. Overall, the evidence is fairly strong that engag-
ing in regular exercise can promote health by reducing
stress.

PREPARING FOR STRESSFUL EVENTS
In this and previous chapters we have discussed many
types of stressful events, ranging from being stuck in
traffic, to starting day care or school, being overloaded
with work, going through a divorce, and experiencing
a disaster. Preparing for these events can reduce the
potential for stress. For instance, parents can help
prepare a child for starting day care by taking the child
there in advance to see the place, meet the teacher, and
play for a while (Sarafino, 1986).

120 Part II / Stress, Illness, and Coping

Irving Janis (1958) pioneered the psychological study
of the need to prepare people for stressful events, such
as surgery. In general, research on preparing for surgery
indicates that the higher the patients’ preoperative fear, the
worse their postoperative adjustment and recovery tend to
be, as reflected in the following measures (Anderson &
Masur, 1983; Johnson, 1983):

• The patient’s self-reported pain

• The amount of medication taken to relieve pain

• Self-reported anxiety or depression

• The length of stay in the hospital after surgery

• Ratings by hospital staff of the patient’s recovery or
adjustment

These outcomes suggest that preparing patients
to help them cope with their preoperative concerns
should enhance later adjustment and recovery. The most
effective methods for preparing people psychologically
for the stress of surgery attempt to enhance the patients’
feelings of control (Anderson & Masur, 1983; Mathews
& Ridgeway, 1984). To promote behavioral control, for
example, patients learn how to reduce discomfort or
promote rehabilitation through specific actions they can
take, such as by doing leg exercises to improve strength
or deep breathing exercises to reduce pain. For cognitive
control, patients learn ways to focus their thoughts on
pleasant or beneficial aspects of the surgery, rather
than the unpleasant aspects. And for informational control,
patients receive information about the procedures and/or
sensations they will experience.

Although receiving preparatory information is usu-
ally helpful, sometimes it can have the opposite
effect—for instance:

The Los Angeles City Council had placed cards in the
city elevators assuring riders that they should stay
calm, since ‘‘there is little danger of the car dropping
uncontrollably or running out of air.’’ … A year later
the cards had to be removed because of complaints
from elevator riders that the message made them
anxious. (Thompson, 1981, p. 96)

Also, having too much information can be confusing
and actually arouse fear. Young children often become
more anxious when they receive a great deal of
information about the medical procedures they will
undergo (Miller & Green, 1984). With children in dental
or medical settings, it is generally best not to give a lot
of detail. Describing some sensory experiences to expect
is especially helpful, such as the sounds of equipment or
the tingly feeling from the dental anesthetic.

In summary, we have discussed several methods
that are helpful in reducing the potential for stress

and, thereby, benefiting health. These methods take
advantage of the stress-moderating effects of social
support, personal control, exercise, being well organized,
and being prepared for an impending stressor. In the next
section, we consider ways to reduce the reaction to stress
once it has begun.

REDUCING STRESS REACTIONS: STRESS
MANAGEMENT

People acquire coping skills through their experiences,
which may involve strategies they have tried in the past
or methods they have seen others use. But sometimes
the skills they have learned are not adequate for a current
stressor because it is so strong, novel, or unrelenting.
When people cannot cope effectively, they need help
in learning new and adaptive ways of managing stress.
The term stress management refers to any program of
behavioral and cognitive techniques that is designed to
reduce psychological and physical reactions to stress.
Sometimes people use pharmacological approaches under
medical supervision to reduce emotions, such as anxiety,
that accompany stress.

MEDICATION
Of the many types of drugs physicians prescribe to
help patients manage stress, we will consider two:
benzodiazepines and beta-blockers, both of which reduce
physiological arousal and feelings of anxiety (AMA, 2003;
Kring et al., 2010). Benzodiazepines, which include drugs
with the trade names Valium and Xanax, activate a
neurotransmitter that decreases neural transmission
in the central nervous system. Beta-blockers, such as
Inderal, are used to reduce anxiety and blood pressure.
They block the activity stimulated by epinephrine and
norepinephrine in the peripheral nervous system. Beta-
blockers cause less drowsiness than benzodiazepines,
probably because they act on the peripheral rather than
central nervous system. Although many people use drugs
for long-term control of stress and emotions, using drugs
for stress should be a temporary measure. For instance,
they might be used during an acute crisis, such as in the
week or two following the death of a loved one, or while
the patient learns new psychological methods for coping.

BEHAVIORAL AND COGNITIVE METHODS
Psychologists have developed methods they can train
people to use in coping with stress. Some of these
techniques focus mainly on the person’s behavior, and

Chapter 5 / Coping With and Reducing Stress 121

some emphasize the person’s thinking processes. People
who use these methods usually find them helpful.

Relaxation
The opposite of arousal is relaxation—so relaxing should
be a good way to reduce stress. ‘‘Perhaps so,’’ you say,
‘‘but when stress occurs, relaxing is easier said than
done.’’ Actually, relaxing when under stress is not so hard
to do when you know how. One way people can learn
to control their feelings of tension is called progressive
muscle relaxation (or just progressive relaxation), in which
they focus their attention on specific muscle groups
while alternately tightening and relaxing these muscles
(Sarafino, 2001).

The idea of teaching people to relax their skeletal
muscles to reduce psychological stress was introduced
many years ago by Edmund Jacobson (1938). He found
that muscle tension could be reduced much more
if individuals were taught to pay attention to the
sensations as they tense and relax individual groups
of muscles. Although today there are various versions of
the progressive muscle relaxation technique, they each
outline a sequence of muscle groups for the person to
follow. For example, the sequence might begin with the
person relaxing the hands, then the forehead, followed
by the lower face, the neck, the stomach, and, finally,
the legs. For each muscle group, the person first tenses
the muscles for 7–10 seconds, and then relaxes them
for about 15 seconds, paying attention to how the

muscles feel. This is usually repeated for the same muscle
group two or three times in a relaxation session, which
generally lasts 20 or 30 minutes. The tensing action is
mainly important while the person is being trained, and
can be eliminated after he or she has mastered the
technique (Sarafino, 2001). Relaxation works best in a
quiet, nondistracting setting with the person lying down
or sitting on comfortable furniture.

Stress management is applied mainly with adults,
but children also experience stress without being able
to cope effectively. Fortunately, many behavioral and
cognitive methods are easy to learn and can be adapted
so that an adult can teach a young child to use them
(Siegel & Peterson, 1980). Relaxation exercises provide
a good example. An adult could start by showing the
child what relaxing is like by lifting and then releasing
the arms and legs of a rag doll, allowing them to fall
down. Then, the adult would follow a protocol, or script,
giving instructions like those in Table 5.2. When children
and adults first learn progressive muscle relaxation, they
sometimes don’t relax their muscles when told to do
so. Instead of letting their arms and legs fall down, they
move them down. They may also tense more muscles
than required—for example, tightening facial muscles
when they are asked to tense hand muscles. These errors
should be pointed out and corrected.

Often, after individuals have thoroughly mastered
the relaxation procedure, they can gradually shorten the
procedure so they can apply a very quick version in
times of stress, such as when they are about to give a

Table 5.2 Progressive Muscle Relaxation Protocol for Children

1. ‘‘OK. Let’s raise our arms and put them out in front. Now make a fist with both your hands, really hard. Hold the fist tight
and you will see how your muscles in your hands and arms feel when they are tight.’’ (hold for 7–10

seconds)

‘‘That’s very good. Now when I say relax, I want the muscles in your hands and arms to become floppy, like the rag
doll, and your arms will drop to your sides. OK, relax.’’ (about 15 seconds)

2. ‘‘Let’s raise our legs out in front of us. Now tighten the muscles in your feet and legs, really hard. Make the muscles really
tight, and hold it.’’ (7–10 seconds)

‘‘Very good. Now relax the muscles in your feet and legs, and let them drop to the floor. They feel so good. So calm
and relaxed.’’ (15 seconds)

3. ‘‘Now let’s do our tummy muscles. Tighten your tummy, really hard—and hold it.’’ (7–10 seconds)
‘‘OK. Relax your tummy, and feel how good it feels. So comfortable.’’ (15 seconds)

4. ‘‘Leave your arms at your side, but tighten the muscles in your shoulders and neck. You can do this by moving your
shoulders up toward your head. Hold the muscles very tightly in your shoulders and neck.’’ (7–10 seconds)

‘‘Now relax those muscles so they are floppy, and see how good that feels.’’ (15 seconds)
5. ‘‘Let’s tighten the muscles in our faces. Scrunch up your whole face so that all of the muscles are tight—the muscles in

your cheeks, and your mouth, and your nose, and your forehead. Really scrunch up your face, and hold it.’’ (7–10 seconds)
‘‘Now relax all the muscles in your face—your cheeks, mouth, nose, and forehead. Feel how nice that is.’’ (15

seconds)
6. ‘‘Now I want us to take a very, very deep breath—so deep that there’s no more room inside for more air. Hold the air in.

(use a shorter time: 6–8 seconds)
‘‘That’s good. Now slowly let the air out. Very slowly, until it’s all out … . And now breathe as you usually do.’’ (15

seconds)

Source: From Sarafino, 1986, pp. 112–113.

122 Part II / Stress, Illness, and Coping

speech (Sarafino, 2001). This quick version might have
the following steps: (1) taking a deep breath, and letting it
out; (2) saying to oneself, ‘‘Relax, feel nice and calm’’; and
(3) thinking about a pleasant thought for a few seconds.
In this way, relaxation methods can be directly applied
to help people cope with everyday stressful events.

Research has demonstrated that progressive muscle
relaxation is highly effective in reducing stress (Carlson
& Hoyle, 1993; Jain et al., 2007; Lichstein, 1988).
What’s more, people who receive training in relaxation
show less cardiovascular reactivity to stressors and
stronger immune function (Lucini et al., 1997; Sherman
et al., 1997).

Systematic Desensitization
Although relaxation is often successful by itself in
helping people cope, it is frequently used in conjunction
with systematic desensitization, a useful method for
reducing fear and anxiety (Sarafino, 2001). This method
is based on the view that fears are learned by classical
conditioning—that is, by associating a situation or object
with an unpleasant event. This can happen, for example, if
a person associates visits to the dentist with pain, thereby
becoming ‘‘sensitized’’ to dentists. Desensitization is
a classical conditioning procedure that reverses this
learning by pairing the feared object or situation with
either pleasant or neutral events, as Figure 5-1 outlines.
According to Joseph Wolpe (1958, 1973), an originator
of the desensitization method, the reversal comes about
through the process of counterconditioning, whereby the
‘‘calm’’ response gradually replaces the ‘‘fear’’ response.
Desensitization has been used successfully in reducing
a variety of children’s and adults’ fears, such as fear
of dentists, animals, high places, public speaking, and
taking tests (Lichstein, 1988; Sarafino, 2001).

An important feature of the systematic desensitiza-
tion method is that it uses a stimulus hierarchy—a graded
sequence of approximations to the conditioned stimulus,
the feared situation. The purpose of these approxima-
tions is to bring the person gradually in contact with
the source of fear in about 10 or 15 steps. To see how a
stimulus hierarchy might be constructed, we will look at
the one in Table 5.3 that deals with the fear of dentists.
The person would follow the instructions in each of the
14 steps. As you can see, some of the steps involve
real-life, or in vivo, contacts with the feared situation,
and some do not. Two types of non–real-life contacts, of
varying degrees, can be included. One type uses imaginal
situations, such as having the person think about calling
the dentist. The other involves symbolic contacts, such
as by showing pictures, films, or models of the feared
situation.

Reverse Conditioning

CS
Dentist

US
Pain

CS
Dentist

US
Pleasant
or neutral

event

Classical Conditioning of Fear

UR
Fear

UR
Calm

Figure 5-1 Classical conditioning in learning to fear
dental visits and in reversing this learning. In conditioning
the fear, the unconditioned stimulus (US) of pain elicits
the unconditioned response (UR) of fear automatically.
Learning occurs by pairing the dentist, the conditioned
stimulus (CS), with the US so that the dentist begins to
elicit fear. The reverse conditioning pairs the feared dentist
with a US that elicits calm.

The systematic desensitization procedure starts by
having the person do relaxation exercises. Then the steps
in a hierarchy are presented individually, while the person
is relaxed and comfortable (Sarafino, 2001). The steps
follow a sequence from the least to the most fearful for
the individual. Each step may elicit some wariness or fear
behavior, but the person is encouraged to relax. Once
the wariness at one step has passed and the person is
calm, the next step in the hierarchy can be introduced.
Completing an entire stimulus hierarchy and reducing
a fairly strong fear can be achieved fairly quickly—it is
likely to take several hours, divided into several separate
sessions. In one study with dental-phobic adults who
simply imagined each step in a hierarchy, the procedure
successfully reduced their fear in six 1 1/2-hour sessions
(Gatchel, 1980). Individual sessions for reducing fears in
children are usually much shorter than those used with
adults, especially for a child who is very young and has a
short attention span.

Chapter 5 / Coping With and Reducing Stress 123

Table 5.3 Example of a Stimulus Hierarchy for a Fear of Dentists

1. Think about being in the dentist’s waiting room, simply accompanying someone else who is there for an examination.
2. Look at a photograph of a smiling person seated in a dental chair.
3. Imagine this person calmly having a dental examination.
4. Think about calling the dentist for an appointment.
5. Actually call for the appointment.
6. Sit in a car outside the dentist’s office without having an appointment.
7. Sit in the dentist’s waiting room and hear the nurse say, ‘‘The hygienist is ready for you.’’
8. Sit in the examination room and hear the hygienist say, ‘‘I see one tooth the dentist will need to look at.’’
9. Hear and watch the drill run, without its being brought near the face.

10. Have the dentist pick at the tooth with an instrument, saying, ‘‘That doesn’t look good.’’
11. See the dentist lay out the instruments, including a syringe to administer an anesthetic.
12. Feel the needle touch the gums.
13. Imagine having the tooth drilled.
14. Imagine having the tooth pulled.

Biofeedback
Biofeedback is a technique in which an electromechani-
cal device monitors the status of a person’s physiological
processes, such as heart rate or muscle tension, and
immediately reports that information back to the indi-
vidual. This information enables the person to gain
voluntary control over these processes through operant
conditioning. If, for instance, the person is trying to
reduce neck-muscle tension and the device reports
that the tension has just decreased, this information
reinforces whatever efforts the individual made to
accomplish this decrease.

Biofeedback has been used successfully in treat-
ing stress-related health problems. For example, an
experiment found that patients suffering from chronic

headaches who were given biofeedback regarding muscle
tension in their foreheads later showed less tension in
those muscles and reported having fewer headaches
than subjects in control groups (Budzynski et al., 1973).
What’s more, these benefits continued at a follow-up
after 3 months. Biofeedback and progressive muscle
relaxation are effective for treating headache and many
other stress-related disorders (Gatchel, 2001; Nestoriuc,
Rief, & Martin, 2008). Both biofeedback and progressive
muscle relaxation techniques can help reduce stress, but
some individuals may benefit more from one method
than the other.

According to Virginia Attanasio, Frank Andrasik,
and their colleagues (1985), children may be better
candidates for biofeedback treatment than adults. In
treating recurrent headache with biofeedback, these

A biofeedback procedure for forehead
muscle tension. One way to give feedback
regarding the status of the muscles is
with audio speakers, such as by sounding
higher tones for higher levels of tension.

124 Part II / Stress, Illness, and Coping

researchers noticed that children seem to acquire
biofeedback control faster and show better overall
improvement than adults. Part of this observation has
been confirmed in research: the headaches of children
and adults improve with biofeedback, but children’s
headaches improve more (Nestoriuc, Rief, & Martin,
2008; Sarafino & Goehring, 2000). Why? Attanasio and
her coworkers have offered some reasons. First, although
a small proportion of children are frightened initially
by the equipment and procedures, most are more
enthusiastic than adults, often regarding biofeedback
as a game. In fact, some children become so interested
and motivated in the game that their arousal interferes
with relaxation if the therapist does not help them remain
calm. Second, children are usually less skeptical about
their ability to succeed in biofeedback training and to
benefit from doing so. Adults often say, ‘‘Nothing else
I’ve ever tried has worked, so why should biofeedback?’’
This difference in skepticism may reflect differences in
experience: adults are likely than children to have had
more failure experiences with other treatments. Third,
children may be more likely than adults to practice their
training at home, as they are instructed to do.

Although children have characteristics that make
them well suited to biofeedback methods, they also
have some special difficulties (Attanasio et al., 1985).
For one thing, children—particularly those below the
age of 8—have shorter attention spans than adults.
If biofeedback sessions last more than 20 minutes or
so, it may be necessary to divide each session into
smaller units with brief breaks in between. A related
problem is that children sometimes perform disruptive
behaviors during a session, disturbing the electrodes and
wires or interrupting to talk about tangential topics, for
instance. The therapist can reduce the likelihood of these
unwanted behaviors, such as by providing rewards for
being cooperative. Clearly, the difficulties some children
have in biofeedback training can usually be overcome.

Modeling
People learn not just by doing, but also by observing.
They see what others do and the consequences of
the behavior these models perform. As a result, this
kind of learning is called modeling, and sometimes
‘‘observational’’ or ‘‘social’’ learning. People can learn
fears and other stress-related behavior by observing
fearful behavior in other individuals. In one study,
children (with their parents’ permission) learned to fear
a Mickey Mouse figure by watching a short film showing
a 5-year-old boy’s fear reaction to plastic figures of
Mickey Mouse and Donald Duck (Venn & Short, 1973).
This learned fear reaction was pronounced initially—but
declined a day or two later.

Since people can learn stressful reactions by observ-
ing these behaviors in others, modeling should be
effective in reversing this learning and helping people
cope with stressors, too. A large body of research has
confirmed that it is effective (Sarafino, 2001; Thelen et
al., 1979). The therapeutic use of modeling is similar to
the method of desensitization: the person relaxes while
watching a model calmly perform a series of activities
arranged as a stimulus hierarchy—that is, from least
to most stressful. The modeling procedure can be pre-
sented symbolically, using films or videotapes, or in vivo,
with real-life models and events. Using symbolic pre-
sentations, for example, researchers have shown that
modeling procedures can reduce the stress 4- to 17-year-
old hospitalized children experience and improve their
recovery from surgery (Melamed, Dearborn, & Hermecz,
1983; Melamed & Siegel, 1975). But the child’s age and
prior experience with surgery were also important fac-
tors in the results. Children under the age of 8 who
had had previous surgery experienced increased anxiety
rather than less. These children may benefit from other
methods to reduce stress, such as activities that simply
distract their attention. (Go to .)

Approaches Focusing on Cognitive Processes
Because stress results from cognitive appraisals that
are frequently based on a lack of information, mis-
perceptions, or irrational beliefs, some approaches to
modify people’s behavior and thought patterns have
been developed to help them cope better with the stress
they experience. These methods guide people toward a
‘‘restructuring’’ of their thought patterns (Lazarus, 1971).
Cognitive restructuring is a process by which stress-
provoking thoughts or beliefs are replaced with more
constructive or realistic ones that reduce the person’s
appraisal of threat or harm.

What sorts of irrational beliefs do people have that
increase stress? Two leading theorists have described a
variety of erroneous thought patterns that some people
use habitually and frequently that lead to stress; we’ll
consider two from each theorist. The beliefs described
by Albert Ellis (1962, 1977, 1987) include:

• Can’t-stand-itis—as in, ‘‘I can’t stand not doing well on a
test.’’

• Musterbating—for instance, ‘‘People must like me, or I’m
worthless.’’

And the beliefs described by Aaron Beck (1976; Beck et
al., 1990) include:

• Arbitrary inference (drawing a specific conclusion from
insufficient, ambiguous, or contrary evidence). For
example, a husband might interpret his wife’s bad mood

Chapter 5 / Coping With and Reducing Stress 125

CLINICAL METHODS AND ISSUES

The Case of ‘‘Bear’’
We’ve seen that people’s thought pro-

cesses can affect their stress. Appraisals of stress are
often based on thoughts that are not rational. To illus-
trate how irrational thoughts can increase stress and
lead to psychological problems, consider the case of a
college baseball player, nicknamed ‘‘Bear,’’

who was not hitting up to expectations, and was
very depressed about his poor performance. In
talking with Bear, it quickly became apparent
that his own expectations were unrealistic. For
instance, Bear wanted to hit the ball so hard that
it would literally be bent out of shape (if someone
happened to find it in the next county!). After a
particularly bad batting session, he would go home
and continue to practice until he was immobilized
with exhaustion. Simply put, he believed that if an

athlete was not performing well, this could only
mean he was not trying hard enough. (Rimm &
Masters, 1979, p. 40)

Bear’s therapy involved progressive muscle relax-
ation and cognitive methods to help him realize two
important things: First, although motivation and desire
increase performance, they do so only up to a point,
after which additional motivation impairs performance.
Second, although hitting very well is ‘‘nice,’’ hitting
moderately well is not ‘‘terrible’’ or ‘‘intolerable.’’ These
realizations restructured Bear’s thinking about his per-
formance, and his batting average increased dramati-
cally. Similar methods can help people reduce irrational
thoughts that lead to their debilitating feelings of anxiety
and depression (Sarafino, 2001).

as meaning she is unhappy with something he did when
she is actually just preoccupied with another matter.

• Magnification (greatly exaggerating the meaning or impact
of an event). For instance, a recently retired per-
son diagnosed with arthritis might describe it as a
‘‘catastrophe.’’

These ways of thinking affect stress appraisal pro-
cesses, increasing the appraisal of threat or harm because
the perspectives are so extreme. The circumstances that
are the bases of these thoughts are not ‘‘good,’’ but
they’re probably not as bad as the thoughts imply.

A widely used cognitive restructuring approach to
change maladaptive thought patterns is called cognitive
therapy (Beck, 1976; Beck et al., 1990). Although it was
developed originally to treat psychological depression, it
is also being applied today for anxiety. Cognitive therapy
attempts to help clients see that they are not responsible
for all of the problems they encounter, the negative
events they experience are usually not catastrophes,
and their maladaptive beliefs are not logically valid. For
instance, the following dialogue shows how a therapist
tried to counter the negative beliefs a woman named
Sharon had.

THERAPIST: … what evidence do you have that all this is
true? That you are ugly, awkward? Or that it is not
true? What data do you have?

SHARON: Comparing myself to people that I consider to
be extremely attractive and finding myself lacking.

THERAPIST: So if you look at that beautiful person, you’re
less?

SHARON: Yeah.

THERAPIST: Or if I look at that perfect person, I’m less. Is
that what you’re saying? …

SHARON: Yeah. I always pick out, of course, the most
attractive person and probably a person who spends
3 hours a day on grooming and appearance… . I don’t
compare myself to the run-of-the-mill… . (Freeman,
1990, p. 83)

One technique cognitive therapy uses, called hypoth-
esis testing, has the person treat an erroneous belief as
a hypothesis and test it by looking for evidence for
and against it in his or her everyday life. Research
has shown that cognitive therapy is clearly effective
in treating depression (Hollon, Shelton, & Davis, 1993;
Robins & Hayes, 1993) and appears to be a very
promising approach for treating anxieties (Chambless
& Gillis, 1993).

Another cognitive approach is designed to help
clients solve problems in their lives. By a ‘‘problem’’ we
mean a life circumstance, such as being stuck in traffic or
feeling a worrisome chest pain, that requires a response
based on thinking and planning. People experience stress
when they face a problem and don’t know what to do or
how to do it. In problem-solving training, clients learn a
strategy for identifying, discovering, or inventing effective
or adaptive ways to address problems in everyday life

126 Part II / Stress, Illness, and Coping

(D’Zurilla, 1988; Nezu, Nezu, & Perri, 1989). They learn
to watch for problems that can arise, define a problem
clearly and concretely, generate a variety of possible
solutions, and decide on the best course of action.
Evidence indicates that problem-solving training reduces
anxiety and other negative emotions (D’Zurilla, 1988;
Elliott, Berry, & Grant, 2009).

Stress-inoculation training is an approach that uses
a variety of methods that are designed to teach people
skills for alleviating stress (Meichenbaum & Cameron,
1983; Meichenbaum & Turk, 1982). The training involves
three phases in which the person (1) learns about the
nature of stress and how people react to it; (2) acquires
behavioral and cognitive skills, such as relaxation and
seeking social support; and (3) practices coping skills
with actual or imagined stressors. The methods used in
stress-inoculation training are well-thought-out, include
a number of well-established techniques, and are useful
for people who anticipate a stressful event, such as
surgery (Dale, 2004). (Go to .)

Multidimensional Approaches
The coping difficulties individuals have are often multi-
dimensional and multifaceted. As a result, one particular
technique may not be sufficient in helping a client,
and the most effective intervention usually draws upon
many techniques. When designing a multidimensional
approach, the program for helping an individual cope
better with stress would be tailored to the person’s spe-
cific problems (Sarafino, 2001). The program may make
use of any of the methods we have considered, many
methods that would take this discussion too far afield,
and the methods we are about to examine.

MASSAGE, MEDITATION, AND HYPNOSIS
Three additional techniques have been used in stress
management. The first two we will consider—massage
and meditation—are often classified as relaxation meth-
ods. The third technique—hypnosis—seems to produce
an altered state of consciousness in which mental functioning
differs from its usual pattern of wakefulness. Some peo-
ple believe that meditation and massage are other ways
by which we can alter consciousness.

Massage
Massage has several forms that vary in the degree of
pressure applied. Some forms of massage use soothing
strokes with light pressure, others involve a rubbing
motion with moderate force, and others use a kneading or
pounding action. Deep tissue massage uses enough pressure
to penetrate deeply into muscles and joints. Infants seem
to prefer light strokes, but adults tend to prefer more force
(Field, 1996). When seeking a massage therapist, it is a
good idea to ask about licensing and certification.

Massage therapy can reduce anxiety and depression
(Moyer, Rounds, & Hannum, 2004). It also increases
the body’s production of a hormone called oxytocin that
decreases blood pressure and stress hormone levels
(Holt-Lunstad, Birmingham, & Light, 2008). And it helps
reduce hypertension, some types of pain, and asthma
symptoms; and some evidence indicates that it may
bolster immune function (Field, 1996, 1998).

Meditation
Transcendental meditation is a method in the practice of yoga
that was promoted by Maharishi Mahesh Yogi as a means

CLINICAL METHODS AND ISSUES

Treating Insomnia
Insomnia often results from stress, as

when people can’t sleep because they worry about their
jobs or health. People who show evidence of maladaptive
behaviors or arousal that persistently interfere with
sleep, thereby leading to daytime distress or impaired
function, are candidates for cognitive–behavioral therapy
for insomnia (Smith & Perlis, 2006). Many people with
insomnia have a medical condition, such as cancer or
arthritis, which is stressful because of its prognosis
or the disability or symptoms it produces. A meta-
analysis on data from 23 experiments found that
cognitive–behavioral therapy is very effective in treating

insomnia (Irwin, Cole, & Nicassio, 2006). Using sleep
medication for the first few weeks of treatment enhances
the long-term success of this therapy (Morin et al., 2009).

What methods do cognitive–behavioral approaches
use for insomnia? Behavioral methods include relaxation
and sleep restriction, which involves setting a regular
routine for sleeping and not using the bed as a place
for reading or working. Cognitive methods include
restructuring beliefs, such as that not sleeping will ‘‘wreck
tomorrow,’’ and using fantasies about being in a relaxing
place, such as on a beach or in a forest.

Chapter 5 / Coping With and Reducing Stress 127

of improving physical and mental health and reducing
stress (Benson, 1984, 1991; Nystul, 2004). Individuals
using this procedure are instructed to practice it twice
a day, sitting upright but comfortably relaxed with eyes
closed, and mentally repeating a word or sound (such as
‘‘om’’), called a mantra, to prevent distracting thoughts
from occurring.

Psychologists and psychiatrists have advocated sim-
ilar meditation methods for reducing stress. For example,
Herbert Benson has recommended that the person:

Sit quietly in a comfortable position and close your
eyes … . Deeply relax all your muscles … . Become
aware of your breathing. As you breathe out, say the
word one silently to yourself … . Maintain a passive
attitude and permit relaxation to occur at its own
pace. Expect other thoughts. When these distracting
thoughts occur, ignore them by thinking, ‘‘Oh well,’’
and continue repeating, ‘‘One.’’ (1984, p. 332)

The purpose of this procedure is to increase the
person’s ability in the face of a stressor to make a ‘‘relax-
ation response,’’ which includes reduced physiological
activity, as an alternative to a stress response. According
to Benson, the relaxation response enhances health,
such as by reducing blood pressure, and may be achieved
in many different ways. For example, a religious person
might find that a meditative prayer is the most effective
method for bringing forth the relaxation response.

Although meditation helps people relax, it has a
broader purpose: to develop a clear and mindful awareness,
or ‘‘insight’’ regarding the essence of one’s experiences,
unencumbered by cognitive or emotional distortions
(Hart, 1987; Solé-Leris, 1986). Jon Kabat-Zinn (1982;
Kabat-Zinn, Lipworth, & Burney, 1985) has emphasized
the mindful awareness component of meditation to
help individuals who suffer from chronic pain to detach

themselves from the cognitive and emotional distortions
they have with their pain. He trains patients to pay close
attention to their pain and other sensations without
reacting toward them in any way, thereby enabling the
people to be aware of the pain itself with no thoughts
or feelings about it. Using this technique leads to
a reduction in the patients’ reports of physical and
psychological discomfort.

Many people believe that meditation enables people
to reach a state of profound rest, as is claimed by popular
self-help books (for example, Forem, 1974). Some studies
have found lower anxiety and blood pressure among
meditators than nonmeditators, but the research was
quasi-experimental (Jorgensen, 2004). Other research
findings are more important here. First, Buddhist
monks in Southeast Asia can dramatically alter their
body metabolism and brain electrical activity through
meditation (Benson et al., 1990). Second, people’s blood
pressure decreases while they meditate (Barnes et al.,
1999). Third, stress management interventions using
meditation alleviate stress effectively in people’s daily
lives (Chiesa & Serretti, 2009; Jain et al., 2007; Jorgensen,
2004; Williams, Kolar et al., 2001). Fourth, practicing
meditation on a regular basis appears to reduce blood
pressure and enhance immune function (Barnes, Treiber,

& Johnson, 2004; Davidson et al., 2003). (Go to .)

Hypnosis
The modern history of hypnosis began with its being
called ‘‘animal magnetism’’ and ‘‘Mesmerism’’ in the 18th
and 19th centuries. The Austrian physician Franz Anton
Mesmer popularized its use in treating patients who had
symptoms of physical illness, such as paralysis, without
a detectable underlying organic disorder. Today, hypnosis
is considered to be an altered state of consciousness

HIGHLIGHT

Can Increasing Positive Emotions Enhance Health?
Did you know that, on average, winners

of the Nobel Prize and Academy Award live longer
than their colleagues who don’t receive these honors?
Maybe the reason for the winners’ longer lives is that
they experience more positive emotions because of the
respect and prestige their work receives. People who
have relatively high levels of positive affect experience
less negative emotion when under stress (Ong et al.,
2006) and better health: they have fewer illnesses and
live longer than people who have low levels of positive
emotions (Pressman & Cohen, 2005).

We’ve seen that stress management can reduce
negative emotions, but can it increase positive emo-
tions? Some evidence indicates that it can (Chesney
et al., 2005). Interventions that include training in
relaxation, meditation, and methods to enhance social
support, stress-appraisal processes, and problem- and
emotion-focused coping with stress reduce people’s
negative emotions and increase their positive affect,
and the effects on positive emotions last for at least
a year.

128 Part II / Stress, Illness, and Coping

that is induced by special techniques of suggestion
and leads to varying degrees of responsiveness to
directions for changes in perception, memory, and
behavior (Moran, 2004).

People differ in suggestibility, or the degree to which
they can be hypnotized. Perhaps 15–30% of the general
population is easily and deeply hypnotizable (Evans,
1987; Hilgard, 1967). Suggestibility appears to change
with age, being particularly strong among children
between the ages of about 7 and 14, and then declining
in adolescence to a level that remains stable throughout
adulthood (Hilgard, 1967; Place, 1984). People who are
reasonably suggestible can often learn to induce a hyp-
notic state in themselves—a process called self-hypnosis.
Usually they learn to do this after they have experienced
hypnosis under the supervision of a skilled hypnotist.

Because individuals who have been hypnotized
usually claim that it is a relaxing experience, researchers
have examined whether it can reduce stress. These
studies have generally found that hypnosis is helpful
in stress management, but not necessarily more
effective than other relaxation techniques (Moran, 2004;
Wadden & Anderton, 1982). Other research has revealed
that people who received training in and practiced
regularly either hypnosis or relaxation showed enhanced
immune function weeks later (Kiecolt-Glaser et al., 2001;
McGrady et al., 1992).

In summary, we have seen that many different
behavioral and cognitive methods, massage, meditation,
and hypnosis offer useful therapeutic approaches for
helping people cope with stress. Research is also
revealing more and more clearly the important benefits
of stress management in preventing illness.

USING STRESS MANAGEMENT TO
REDUCE CORONARY RISK

Of the many risk factors that have been identified
for CHD, a few of them—such as age and family
history—are beyond the control of the individual. But
many risk factors for CHD are directly linked to the
person’s experiences and behavior, which should be
modifiable. One of these risk factors is stress, and
stress management interventions appear to produce
cardiovascular improvements and prolong life in CHD
patients (Orth-Gomér et al., 2009). Let’s now consider
how stress management methods can be applied to
reduce the risk of developing CHD.

MODIFYING TYPE A BEHAVIOR
When the Type A behavior pattern was established
as a risk factor for CHD, researchers began to study

ways to modify Type A behavior to reduce coronary
risk. One approach used a multidimensional program
that included progressive muscle relaxation, cognitive
restructuring, and stress-inoculation training (Roskies,
1983; Roskies et al., 1986). An experiment randomly
assigned Type A men to the multidimensional program
or to one of two physical exercise programs, aerobic
training (mostly jogging) or weight-training, each lasting
10 weeks. Then the men were tested for Type A
behavior and cardiovascular reactivity (blood pressure
and heart rate) to stressors, such as doing mental
arithmetic, to compare with measures taken earlier.
One finding can be seen in Figure 5-2: the hostility
component of Type A behavior decreased markedly in
the multidimensional program but not in the exercise
groups. These benefits can be quite durable: another
study found that improvements in Type A behavior with
a similar intervention were maintained at a 2-year follow-
up (Karlberg, Krakau, & Undén, 1998).

Other research has demonstrated the usefulness
of stress-inoculation training and relaxation in helping
people control their anger (Novaco, 1975, 1978). The
subjects first learned about the role of arousal and
cognitive processes in feelings of anger. Then they
learned muscle relaxation along with statements—like
those in Table 5.4—they could say to themselves at
different times in the course of angry episodes, such as
at the point of ‘‘impact and confrontation.’’ The program
improved the subjects’ ability to control their anger,
as measured by self-reports and their blood pressure

3.2

3.4

3.6

3.8
Weight-training

Aerobic

Multidimensional

4.0

H
os

ti
li
ty

s
co

Before
treatment

Timing of structured interview

After
treatment

Figure 5-2 Hostility of Type A men measured by the
Structured Interview method before and after a 10-week
multidimensional, aerobic exercise, or weight-training treat-
ment program. (Data from Roskies et al., 1986, Table 4.)

Chapter 5 / Coping With and Reducing Stress 129

Table 5.4 Examples of Anger Management Self-Statements Rehearsed in Stress-Inoculation Training

Preparing for Provocation
This could be a rough situation; but I know how to deal with it. I can work out a plan to handle this. Easy does it. Remember, stick
to the issues and don’t take it personally. There won’t be any need for an argument. I know what to do.

Impact and Confrontation
As long as I keep my cool, I’m in control of the situation. You don’t need to prove yourself. Don’t make more out of this than you
have to. There is no point in getting mad. Think of what you have to do. Look for the positives and don’t jump to conclusions.

Coping with Arousal
Muscles are getting tight. Relax and slow things down. Time to take a deep breath. Let’s take the issue point by point. My anger is a
signal of what I need to do. Time for problem solving. He probably wants me to get angry, but I’m going to deal with it constructively.

Subsequent Reflection

a. Conflict unresolved. Forget about the aggravation. Thinking about it only makes you upset. Try to shake it off. Don’t let it interfere with
your job. Remember relaxation. It’s a lot better than anger. Don’t take it personally. It’s probably not so serious.

b. Conflict resolved. I handled that one pretty well. That’s doing a good job. I could have gotten more upset than it was worth. My pride
can get me into trouble, but I’m doing better at this all the time. I actually got through that without getting angry.

Source: From Novaco, 1978, p. 150.

when provoked in the laboratory. Many studies have
confirmed the success of interventions using cognitive
and behavioral methods in decreasing anger (Del Vecchio
& O’Leary, 2004; DiGiuseppe & Tafrate, 2003), and
research has shown that such interventions reduce both
hostility and diastolic (resting) blood pressure in patients
with CHD and mild hypertension (Gidron, Davidson, &
Bata, 1999; Larkin & Zayfert, 1996).

Does decreasing Type A behavior with stress man-
agement techniques decrease the incidence of CHD?
Researchers studied this issue with over 1,000 patients
who had suffered a heart attack and who agreed to par-
ticipate in the study for 5 years (Friedman et al., 1986;
Powell & Friedman, 1986). The patients were not selected
on the basis of their exhibiting Type A behavior, and they
continued to be treated by their own physicians through-
out the study. The subjects were randomly assigned to
two intervention groups and a control group. One inter-
vention, called cardiac counseling, presented information,
such as about the causes of heart disease and the impor-
tance of altering standard coronary risk factors, such as
cigarette smoking (Type A behavior was not discussed).
The other intervention, called the Type A/cardiac group,
included the same cardiac counseling plus a multidimen-
sional program, including progressive muscle relaxation
and cognitive restructuring techniques, to modify Type
A behavior. The results revealed that the Type A/cardiac
group showed a much larger decrease in Type A behavior
(measured with Structured Interview and questionnaire
methods) than those in the other groups and had
substantially lower rates of cardiac morbidity and
mortality (Friedman et al., 1986). For example, subse-
quent heart attacks occurred in about 13% of the Type
A/cardiac subjects, 21% of the cardiac counseling sub-
jects, and 28% of the control subjects during the 4 1/2-year
follow-up.

Research has shown that pharmacological
approaches can reduce hostility and Type A behavior
(Kamarck et al., 2009; Schmieder et al., 1983). Although
using drugs may not be the treatment of choice for most
people with high levels of anger or Type A behavior,
it may be appropriate for those who are at coronary
risk who do not respond to behavioral and cognitive
interventions (Chesney, Frautschi, & Rosenman, 1985).

TREATING HYPERTENSION
As we discussed in Chapter 4, essential hypertension is
an important risk factor for CHD. Patients with diagnosed
hypertension usually receive medical treatment that
includes a prescription drug, such as a diuretic, and advice
to control their body weight, exercise regularly, and
reduce their intake of cholesterol, sodium, caffeine, and
alcohol (AHA, 2010). Sometimes physicians and others
urge hypertensive patients ‘‘to try to relax’’ when hassles
occur, but untrained people who make an effort to relax
often end up raising their blood pressure rather than
lowering it (Suls, Sanders, & Labrecque, 1986).

Because the development of essential hypertension
has been linked to the amount of stress people expe-
rience, researchers have examined the utility of stress
management techniques in treating high blood pressure.
The findings suggest three conclusions. First, using a sin-
gle technique, such as relaxation, to lower blood pressure
often provides only limited success; stress management
methods are more effective when combined in multidi-
mensional programs (Larkin, Knowlton, & D’Alessandri,
1990; Spence et al., 1999). Second, if an intervention uses
a single technique, meditation seems to be more effective
than other methods (Rainforth et al., 2007). Third, a meta-
analysis by Wolfgang Linden and Laura Chambers (1994)

130 Part II / Stress, Illness, and Coping

of dozens of studies found that multidimensional programs
consisting of behavioral and cognitive methods for stress
management are highly effective—as effective as diuretic
drugs—in reducing blood pressure. It is now clear that
psychological approaches have considerable value in
treating hypertension, making effective treatment possi-
ble without drugs or with lower doses for most patients.

In an effort to improve the health of employees,
many large companies have introduced voluntary stress
management programs for their workers. Studies of
these programs have found that they produce improve-
ments in workers’ psychological and physiological
stress (Alderman, 1984; Richardson & Rothstein, 2008;

Sallis et al., 1987). Despite the success of stress
management programs in reducing coronary risk by
modifying Type A behavior and lowering blood pressure,
they are not yet widely applied—partly because the
evidence supporting the use of these programs is
relatively new, and partly because they cost money
to run. Also, many people who could benefit from
stress management programs don’t join one when it
is available, drop out before completing the program, or
don’t adhere closely to its recommendations, such as to
practice relaxation techniques at home (Alderman, 1984;
Hoelscher, Lichstein, & Rosenthal, 1986).

SUMMARY

Coping is the process by which people try to manage the
real or perceived discrepancy between the demands and
resources they appraise in stressful situations. We cope
with stress through transactions with the environment
that do not necessarily lead to solutions to the problems
causing the stress.

Coping serves two functions. (1) Emotion-focused
coping regulates the person’s emotional response to
stress—for example, by using alcohol or seeking social
support, and through cognitive strategies, such as denying
unpleasant facts. (2) Problem-focused coping reduces the
demands of a stressor or expands the resources to deal
with it, such as by learning new skills. People tend to use
emotion-focused coping when they believe they cannot
change the stressful conditions; they use problem-focused
coping when they believe they can change the situation.
Adults report using more problem-focused than emotion-
focused coping approaches when dealing with stress.
People tend to use a combination of methods in coping
with a stressful situation.

Coping changes across the life span. Young children’s
coping is limited by their cognitive abilities, which improve
throughout childhood. During adulthood, a shift in coping
function occurs as people approach old age—they rely less
on problem-focused and more on emotion-focused coping.
Elderly people tend to view the stressors they experience
as less changeable than middle-aged individuals do.

People can reduce the potential for stress in their
lives and others’ lives in several ways. First, they can
increase the social support they give and receive by joining

social, religious, and special-interest groups. Second,
they can improve their own and others’ sense of personal
control and hardiness by giving and taking responsibility.
Also, they can reduce frustration and waste less time
by organizing their world better, such as through time
management. And by exercising and keeping fit, they
can reduce the experience of stress and the impact it
has on their health. Last, they can prepare for stressful
events, such as a medical procedure, by improving their
behavioral, cognitive, and informational control.

Sometimes the coping skills individuals have learned
are not adequate for dealing with a stressor that is very
strong, novel, or unrelenting. A variety of techniques are
available to help people who are having trouble cop-
ing effectively. One technique is pharmacological, that is,
using prescribed drugs, such as beta-blockers. Stress man-
agement methods include progressive muscle relaxation,
systematic desensitization, biofeedback, modeling, and
several cognitive approaches. Cognitive therapy attempts
to modify stress-producing, irrational thought patterns
through the process of cognitive restructuring. Stress-
inoculation training and problem solving training are
designed to teach people skills to alleviate stress and
achieve personal goals. Beneficial effects on people’s stress
have been found for all of the behavioral and cognitive
stress management methods, particularly relaxation. Mas-
sage, meditation, and hypnosis have shown promise for
reducing stress, too. Stress management techniques can
reduce coronary risk by modifying Type A behavior and by
treating hypertension.

KEY TERMS

coping
emotion-focused coping
problem-focused coping
time management

stress management
progressive muscle

relaxation
systematic desensitization

biofeedback
modeling
cognitive restructuring

cognitive therapy
problem-solving training
stress-inoculation training

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Motivating
and Rewarding
Employees

CHAPTER

10.1

Define
and

explain
motivation.

Compare
and

contrast
early theories

of
motivation.

10.2

Discuss
current issues

in
motivating
employees.

10.4

10.3

Compare
and

contrast
contemporary

theories of
motivation.

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Best Practices at Best Buy
Do traditional workplaces reward long hours instead of efficient hours? Wouldn’t it make
more sense to have a workplace in which “people can do whatever they want, whenever they
want, as long as the work gets done?” Well, that’s the approach that Best Buy is taking.1 And
this radical workplace experiment, which obviously has many implications for employee
motivation, has been an interesting and enlightening journey for the company.

In 2002, then-CEO Brad Anderson (now the company’s vice chairman) introduced a carefully
crafted program called ROWE (Results-Only Work Environment). ROWE was the inspiration of
two HRM managers at Best Buy, Cali Ressler and Jody Thompson (in photo below), who had been
given the task of taking a flexible work program that was in effect at corporate headquarters in
Minnesota and developing it for everyone in the company. Ressler and Thompson said,
“We realized that the flexible work program was successful as employee engagement was up,
productivity was higher, but the problem was the participants were being viewed as ‘not working.’
” And that’s a common reaction from managers who don’t really view flexible work employees
as “really working because they aren’t in the office working traditional hours.” The two women
set about to change that by creating a program in which “everyone would be evaluated solely on
their results, not on how long they worked.”

The first thing to understand about ROWE is that it’s not about schedules. Instead, it’s about
changing the work culture of an organization, which is infinitely more difficult than changing
schedules. With Anderson’s blessing and support, they embarked on this journey to overhaul the
company’s corporate workplace.

The first step in implementing ROWE was a culture audit at company headquarters, which
helped them establish a baseline for how employees perceived their work environment. After four
months, the audit was repeated. During this time, Best Buy executives
were being educated about ROWE and what it was all about. Obvi-
ously, it was important to have their commitment to the program.
The second phase involved explaining the ROWE philosophy to
all the corporate employees and training managers on how to
maintain control in a ROWE workplace. In the third phase,
work unit teams were free to figure out how to implement the
changes. Each team found a different way to keep the flexi-
bility from spiraling into chaos. For instance, the public rela-
tions team got pagers to make sure someone was always
available in an emergency. Some employees in the
finance department use software that turns voice mail
into e-mail files accessible from anywhere, making it
easier for them to work at home. Four months
after ROWE was implemented, Ressler and
Thompson followed up with another culture
check to see how everyone was doing.

So what’s the bottom line for Best Buy?
From 2005 to 2007, productivity jumped
41 percent and voluntary turnover fell to
8 percent from 12 percent. And employ-
ees say that the freedom has changed
their lives. “They don’t know if they
work fewer hours—they’ve stopped
counting—but they are more produc-
tive.” As Ressler and Thompson stated,
“Work isn’t a place you go—it’s some-
thing you do.”

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Compare
and
contrast
early theories
of
motivation.
10.2
10.1
Define
and
explain
motivation.

Successful managers understand that what motivates them personally may have little or no

effect on others. Just because you’re motivated by being part of a cohesive work team, don’t

assume everyone is. Or just because you’re motivated by your job doesn’t mean that every-

one is. Effective managers who get employees to put forth maximum effort know how and

why those employees are motivated and tailor motivational practices to satisfy their needs

and wants. Motivating and rewarding employees is one of the most important and challeng-

ing activities that managers do. To get employees to put forth maximum work effort, managers

need to know how and why they’re motivated. That’s what we discuss in this chapter.

What Is Motivation?
Several CEOs were attending a meeting where the topic was “What do employ-
ees want?”2 Each CEO took turns describing the benefits they provided and
how they gave out free M&Ms every Wednesday and offered their employees
stock options and free parking spaces. However, the meeting’s main speaker
made the point that “employees don’t want M&Ms; they want to love what they

do.” Half expecting his audience to laugh, the speaker was pleasantly surprised
as the CEOs stood up one-by-one to agree. They all recognized that “the value in

their companies comes from the employees who are motivated to be there.”
These CEOs understand how important employee motivation is. Like them, all man-

agers need to be able to motivate their employees. That requires understanding what motiva-
tion is. Let’s begin by pointing out what motivation is not. Why? Because many people
incorrectly view motivation as a personal trait; that is, they think some people are motivated
and others aren’t. Our knowledge of motivation tells us that we can’t label people that way
because individuals differ in motivational drive and their overall motivation varies from situ-
ation to situation. For instance, you’re probably more motivated in some classes than in others.

Motivation refers to the process by which a person’s efforts are energized, directed, and
sustained toward attaining a goal.3 This definition has three key elements: energy, direction,
and persistence.4

The energy element is a measure of intensity or drive. A motivated person puts forth
effort and works hard. However, the quality of the effort must be considered as well as its
intensity. High levels of effort don’t necessarily lead to favorable job performance unless
the effort is channeled in a direction that benefits the organization. Effort that’s directed
toward, and consistent with, organizational goals is the kind of effort we want from employ-
ees. Finally, motivation includes a persistence dimension. We want employees to persist in
putting forth effort to achieve those goals.

Motivating high levels of employee performance is an important organizational concern, and
managers keep looking for answers. For instance, a recent Gallup poll found that a large
majority of U.S. employees—some 73 percent—are not excited about their work. As the
researchers stated, “These employees are essentially ‘checked out.’ They’re sleepwalking through
their workday, putting time, but not energy or passion, into their work.”5 It’s no wonder then that
both managers and academics want to understand and explain employee motivation.

What Do the Early Theories of Motivation
Say?
The 1950s and 1960s were a fruitful time for the development of
motivation concepts. Four specific theories formulated during this period
are probably still the best-known explanations of employee motivation

although they’ve been criticized and questioned. These include the hierarchy
of needs theory, Theories X and Y, the two-factor theory, and the three-needs

theory. Although more valid explanations of motivation have been developed,

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percent of workers cited
“lack of recognition” as a
key reason for leaving a job.

percent of administrative
professionals prefer verbal
forms of recognition.

percent of organizations say
flextime boosts employee
morale.

percent of U.S. workers say
they “live to work” rather
than “work to live.”

percent of French workers
say they “live to work.”

40
42
76

percent of Gen Y workers
say that they expect to work
for two to five employers

during their lifetime.
75

22
16

CHAPTER 10 | MOTIVATING AND REWARDING EMPLOYEES 267

you should know these early theories for at least two reasons. First, they represent the
foundation from which contemporary theories grew. Second, practicing managers regularly
use these theories and their terminology in explaining employee motivation. Let’s take a
look at them.

What Is Maslow’s Hierarchy of Needs Theory?
Having a car to get to work is a necessity for many workers. When two crucial employees
of Taleo/Vurv Technology in Jacksonville, Florida, had trouble getting to work, the owner
decided to buy two inexpensive used cars for the employees. He said, “I felt that they
were good employees and a valuable asset to the company.” One of the employees who
got one of the cars said, “It wasn’t the nicest car. It wasn’t the prettiest car. But boy did
my overwhelming feeling of dread go from that to enlightenment. The 80-hour weeks we
worked after that never meant anything. It was give and take. I was giving and the com-
pany was definitely giving back.”7 This company understood employee needs (reliable
transportation being an essential need for employees to be able to get to work) and their
impact on motivation. The first motivation theory we’re going to look at addresses
employee needs.

The best-known motivation theory is probably Abraham Maslow’s hierarchy of needs
theory.8 Maslow was a psychologist who proposed that within every person is a hierarchy
of five needs:

1. Physiological needs: Food, drink, shelter, sex, and other physical requirements.
2. Safety needs: Security and protection from physical and emotional harm, as well as

assurance that physical needs will continue to be met.
3. Social needs: Affection, belongingness, acceptance, and friendship.
4. Esteem needs: Internal esteem factors such as self-respect, autonomy, and achieve-

ment and external esteem factors such as status, recognition, and attention.
5. Self-actualization needs: Growth, achieving one’s potential, and self-fulfillment; the

drive to become what one is capable of becoming.

Maslow argued that each level in the needs hierarchy must be substantially satisfied
before the next need becomes dominant (see Exhibit 10-1). An individual moves up the needs

motivation
The process by which a person’s efforts are
energized, directed, and sustained toward
attaining a goal.

percent of German and
U.K. workers say they “live
to work.”15

Self-
actualization

Esteem

Social

Safety

Physiological

EXHIBIT 10-1 Maslow’s Hierarchy of Needs

Source: Motivation and Personality, 2nd ed., by A. H. Maslow, 1970. Reprinted by
permission of Prentice Hall, Inc., Upper Saddle River, New Jersey.

hierarchy of needs theory
Maslow’s theory that there is a hierarchy of five
human needs: physiological, safety, social,
esteem, and self-actualization.

reason why people leave a
company is a bad relation-
ship with their boss.

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268 PART FOUR | LEADING

hierarchy from one level to the next. In addition, Maslow
separated the five needs into higher and lower levels.
Physiological and safety needs were considered lower-
order needs; social, esteem, and self-actualization needs
were considered higher-order needs. Lower-order needs
are predominantly satisfied externally while higher-order
needs are satisfied internally.

How does Maslow’s theory explain motivation? Man-
agers using Maslow’s hierarchy to motivate employees do
things to satisfy employees’needs. But the theory also says
that once a need is substantially satisfied, an individual
isn’t motivated to satisfy that need. Therefore, to motivate
someone, you need to understand what need level that per-
son is on in the hierarchy and focus on satisfying needs at
or above that level.

Maslow’s need theory has received wide recognition,
especially among practicing managers. Its popularity
probably can be attributed to the theory’s intuitive logic

and ease of understanding.9 But Maslow provided no empirical support for his theory, and
several studies that sought to validate it could not.10

What Are McGregor’s Theory X and Theory Y?
“If you’re not a fan of in-your-face management, don’t work here.” That’s how one manu-
facturing plant manager described his managerial style.11 And it’s a perfect description of
what Douglas McGregor called a Theory X manager.

Douglas McGregor is best known for proposing two assumptions about human nature:
Theory X and Theory Y.12 Very simply, Theory X is a negative view of people that assumes
workers have little ambition, dislike work, want to avoid responsibility, and need to be
closely controlled to work effectively. Theory Y is a positive view that assumes employees
enjoy work, seek out and accept responsibility, and exercise self-direction. McGregor
believed that Theory Y assumptions should guide management practice and proposed that
participation in decision making, responsible and challenging jobs, and good group relations
would maximize employee motivation.

Unfortunately, there’s no evidence to confirm that either set of assumptions is valid or that
being a Theory Y manager is the only way to motivate employees. For instance, Jen-Hsun
Huang, founder of NVIDIA Corporation, an innovative and successful microchip manufac-
turer, has been known to use both reassuring hugs and tough love in motivating employees. But
he has little tolerance for screw-ups. “In one legendary meeting, he’s said to have ripped into a
project team for its tendency to repeat mistakes. ‘Do you suck?’ he asked the stunned employ-
ees. ‘Because if you suck, just get up and say you suck.’”13 His message, delivered in classic
Theory X style, was that if you need help, ask for it. It’s a harsh approach, but it worked.

What Is Herzberg’s Two-Factor Theory?

Frederick Herzberg’s two-factor theory (also called motivation-hygiene theory) proposes that
intrinsic factors are related to job satisfaction, while extrinsic factors are associated with job dis-
satisfaction.14 Herzberg wanted to know when people felt exceptionally good (satisfied) or bad
(dissatisfied) about their jobs. (These findings are shown in Exhibit 10-2.) He concluded that
the replies people gave when they felt good about their jobs were significantly different from
the replies they gave when they felt badly. Certain characteristics were consistently related to
job satisfaction (factors on the left side of the exhibit), and others to job dissatisfaction (factors
on the right side). When people felt good about their work, they tended to cite intrinsic factors
arising from the job itself such as achievement, recognition, and responsibility. On the other
hand, when they were dissatisfied, they tended to cite extrinsic factors arising from the job con-
text such as company policy and administration, supervision, interpersonal relationships, and
working conditions.

Linda Lang, chief executive officer of the
Jack in the Box fast food chain, is a
Theory Y manager. She has a positive
view of human nature and assumes that
people enjoy work and accept
responsibility. Lang fosters a team
approach and encourages employees
to contribute to decision making.
Describing her management style as
collaborative rather than directive, Lang
motivates employees by giving them
responsibility and challenging jobs, and
establishing good group relationships. In
this photo, Lang visits with an employee
in the company’s “Innovation Center,” a
test kitchen where employees work on
procedures for preparing their products.

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CHAPTER 10 | MOTIVATING AND REWARDING EMPLOYEES 269

In addition, Herzberg believed that the data suggested that the opposite of satisfac-
tion was not dissatisfaction, as traditionally had been believed. Removing dissatisfying
characteristics from a job would not necessarily make that job more satisfying (or motivat-
ing). As shown in Exhibit 10-3, Herzberg proposed that a dual continuum existed: The
opposite of “satisfaction” is “no satisfaction,” and the opposite of “dissatisfaction” is “no
dissatisfaction.”

Again, Herzberg believed that the factors that led to job satisfaction were separate and
distinct from those that led to job dissatisfaction. Therefore, managers who sought to elim-
inate factors that created job dissatisfaction could keep people from being dissatisfied but
not necessarily motivate them. The extrinsic factors that create job dissatisfaction were
called hygiene factors. When these factors are adequate, people won’t be dissatisfied, but

Theory X
The assumption that employees dislike work, are
lazy, avoid responsibility, and must be coerced
to work.

Theory Y
The assumption that employees are creative,
enjoy work, seek responsibility, and can exercise
self-direction.

Motivators Hygiene Factors

Achievement
Recognition
Work itself
Responsibility
Advancement
Growth

Supervision
Company policy
Relationship with supervisor
Working conditions
Salary
Relationship with peers
Personal life
Relationship with employees
Status
Security

Extremely
Satisfied

Neutral Extremely
Dissatisfied

EXHIBIT 10-2 Herzberg’s Two-Factor Theory

Traditional View

Satisfaction Dissatisfaction

Motivators

Satisfaction No satisfaction

Herzberg’s View
Hygiene factors

No dissatisfaction Dissatisfactiondi ti f ti Di ti f t

EXHIBIT 10-3 Contrasting Views of Satisfaction–Dissatisfaction

two-factor theory
Herzberg’s motivation theory, which proposes
that intrinsic factors are related to job
satisfaction and motivation, whereas extrinsic
factors are associated with job dissatisfaction.

hygiene factors
Factors that eliminate job dissatisfaction but
don’t motivate.

10.3
Compare
and
contrast
contemporary
theories of
motivation.

270 PART FOUR | LEADING

they won’t be satisfied (or motivated) either. To motivate people, Herzberg suggested
emphasizing motivators, the intrinsic factors having to do with the job itself.

Herzberg’s theory enjoyed wide popularity from the mid-1960s to the early 1980s,
despite criticisms of his procedures and methodology. Although some critics said his the-
ory was too simplistic, it has influenced how we currently design jobs.

What Is McClelland’s Three-Needs Theory?
David McClelland and his associates proposed the three-needs theory, which says there are
three acquired (not innate) needs that are major motives in work.16 These three needs include
the need for achievement (nAch), which is the drive to succeed and excel in relation to a set
of standards; the need for power (nPow), which is the need to make others behave in a way
that they would not have behaved otherwise; and the need for affiliation (nAff), which is the
desire for friendly and close interpersonal relationships. Of these three needs, the need for
achievement has been researched the most.

People with a high need for achievement are striving for personal achievement rather than
for the trappings and rewards of success. They have a desire to do something better or more
efficiently than it’s been done before.17 They prefer jobs that offer personal responsibility for
finding solutions to problems, in which they can receive rapid and unambiguous feedback on
their performance in order to tell whether they’re improving, and in which they can set moder-
ately challenging goals. High achievers avoid what they perceive to be very easy or very diffi-
cult tasks. Also, a high need to achieve doesn’t necessarily lead to being a good manager,
especially in large organizations. That’s because high achievers focus on their own accomplish-
ments while good managers emphasize helping others accomplish their goals.18 McClelland
showed that employees can be trained to stimulate their achievement need by being in situations
where they have personal responsibility, feedback, and moderate risks.19

The other two needs in this theory haven’t been researched as extensively as the need
for achievement. However, we do know that the best managers tend to be high in the need
for power and low in the need for affiliation.20

How Do the Contemporary Theories
Explain Motivation?
The theories we look at in this section represent current explanations of
employee motivation. Although these theories may not be as well known as
those we just discussed, they are supported by research.21 These contempo-
rary motivation approaches include goal-setting theory, job design theory,

equity theory, and expectancy theory.

From the Past to the Present• •
Deciding how work tasks should be performed has long
been of interest to managers.15 From scientific manage-
ment’s attempts to find the “one best way” to do work to
the Hawthorne Studies that attempted to unravel patterns
of human behavior at work, researchers have been curious
about the ideal approach to work design. In the 1950s, Fred-
erick Herzberg and his associates began research to
“discover the importance of attitudes toward work and the
experiences both good and bad, that workers reported.” He
wanted to know the kinds of things that made people at
their work happy and satisfied or unhappy and dissatisfied.
What he discovered changed the way we view job design.
The fact that job dissatisfaction and job satisfaction were the

results of different aspects of the work environment was
critical. Herzberg’s two-factor theory gave practicing man-
agers insights into both job context and job content. And if
you wanted to motivate employees, you’d better focus
more on the job content aspects (the motivators) than on
the job context aspects (the hygiene factors).

In addition, Herzberg’s research stimulated additional
interest in work design. The Job Characteristics model, for one,
built upon Herzberg’s findings in identifying the five core job
dimensions, especially autonomy. As managers and organiza-
tions continue to search for work designs that will energize
and engage employees, Herzberg’s study of when people
felt good and felt bad at work continues as a classic.

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CHAPTER 10 | MOTIVATING AND REWARDING EMPLOYEES 271

What Is Goal-Setting Theory?
Before a big assignment or major class project presentation, has a teacher ever encouraged
you to “Just do your best”? What does that vague statement, “do your best,” mean? Would
your performance on a class project have been higher had that teacher said you needed to
score a 93 percent to keep your A in the class? Research on goal-setting theory addresses
these issues, and the findings, as you’ll see, are impressive in terms of the effect that goal
specificity, challenge, and feedback have on performance.22

There is substantial research support for goal-setting theory, which says that specific
goals increase performance and that difficult goals, when accepted, result in higher per-
formance than do easy goals. What does goal-setting theory tell us?

First, working toward a goal is a major source of job motivation. Studies on goal
setting have demonstrated that specific and challenging goals are superior motivating
forces.23 Such goals produce a higher output than does the generalized goal of “do your
best.” The specificity of the goal itself acts as an internal stimulus. For instance, when a
sales rep commits to making eight sales calls daily, this intention gives him a specific goal
to try to attain.

Next, will employees try harder if they have the opportunity to participate in the setting
of goals? Not always. In some cases, participatively set goals elicit superior performance;
in other cases, individuals performed best when their manager assigned goals. However,
participation is probably preferable to assigning goals when employees might resist accept-
ing difficult challenges.24

Finally, we know that people will do better if they get feedback on how well they’re pro-
gressing toward their goals because feedback helps identify discrepancies between what
they’ve done and what they want to do. But all feedback isn’t equally effective. Self-generated
feedback—where an employee monitors his or her own progress—has been shown to be a
more powerful motivator than feedback coming from someone else.25

need for affiliation (nAff)
The desire for friendly and close interpersonal
relationships.

need for power (nPow)
The need to make others behave in a way that
they would not have behaved otherwise.

need for achievement (nAch)
The drive to succeed and excel in relation to a
set of standards.

three-needs theory
McClelland’s theory, which says that three
acquired (not innate) needs—achievement,
power, and affiliation—are major motives at work.

goal-setting theory
The proposition that specific goals increase
performance and that difficult goals, when
accepted, result in higher performance than
do easy goals.

Working toward a goal is a major source
of motivation for Mary Kay Cosmetics’
independent beauty consultants. They
set their own specific sales goals for
achieving different categories of
rewards. In this photo, Sean Key, vice
president of sales development for Mary
Kay, celebrates the accomplishment of
LaChelle Seleski, who set a challenging
sales goal that motivated her to produce
a high output for becoming a career car
program qualifier. Starting her Mary Kay
business as a college student, Seleski has
consistently set and met ambitious sales
goals and has earned the use of five
Mary Kay career cars.

motivators
Intrinsic factors that have to do with the job
itself and serve to motivate individuals.

272 PART FOUR | LEADING

Three other contingencies besides feedback influence the goal-performance
relationship: goal commitment, adequate self-efficacy, and national culture.

First, goal-setting theory assumes that an individual is committed to the goal. Commit-
ment is most likely when goals are made public, when the individual has an internal locus
of control, and when the goals are self-set rather than assigned.26

Next, self-efficacy refers to an individual’s belief that he or she is capable of perform-
ing a task.27 The higher your self-efficacy, the more confidence you have in your ability to
succeed in a task. So, in difficult situations, we find that people with low self-efficacy are
likely to reduce their effort or give up altogether, whereas those with high self-efficacy will
try harder to master the challenge.28 In addition, individuals with high self-efficacy seem to
respond to negative feedback with increased effort and motivation, whereas those with low
self-efficacy are likely to reduce their effort when given negative feedback.29

Finally, the value of goal-setting theory depends on the national culture. It’s well adapted
to North American countries because its main ideas align reasonably well with those cul-
tures. It assumes that subordinates will be reasonably independent (not a high score on
power distance), that people will seek challenging goals (low in uncertainty avoidance), and
that performance is considered important by both managers and subordinates (high in as-
sertiveness). Don’t expect goal setting to lead to higher employee performance in countries
where the cultural characteristics aren’t like this.

Exhibit 10-4 summarizes the relationships among goals, motivation, and performance.
Our overall conclusion is that the intention to work toward hard and specific goals is a pow-
erful motivating force. Under the proper conditions, it can lead to higher performance. How-
ever, there is no evidence that such goals are associated with increased job satisfaction.30

How Does Job Design Influence Motivation?
Because managers want to motivate individuals on the job, we need to look at ways to design
motivating jobs. If you look closely at what an organization is and how it works, you’ll find
that it’s composed of thousands of tasks. These tasks are, in turn, aggregated into jobs. We
use the term job design to refer to the way tasks are combined to form complete jobs. The
jobs that people perform in an organization should not evolve by chance. Managers should
design jobs deliberately and thoughtfully to reflect the demands of the changing environ-
ment, the organization’s technology, and employees’ skills, abilities, and preferences.31 When
jobs are designed like that, employees are motivated to work hard. What are the ways that
managers can design motivating jobs?32 We can answer that with the job characteristics
model (JCM) developed by J. Richard Hackman and Greg R. Oldham.33

EXHIBIT 10-4 Goal-Setting Theory

Committed
to Achieving

Accepted

Goals
Motivation

(intention to work
toward goal)

Participation
in Setting

National
Culture

Self-Efficacy

• Goals are public
• Individual has internal
locus of control
• Self-set

goals

• Specific
• Difficult

Higher Performance
Plus

Goal Achievement

Self-Generated
Feedback on

Progress

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CHAPTER 10 | MOTIVATING AND REWARDING EMPLOYEES 273

According to Hackman and Oldham, any job can be described in terms of the follow-
ing five core job dimensions:

1. Skill variety. The degree to which the job requires a variety of activities so the
worker can use a number of different skills and talents

2. Task identity. The degree to which the job requires completion of a whole and identi-
fiable piece of work

3. Task significance. The degree to which the job affects the lives or work of other people
4. Autonomy. The degree to which the job provides freedom, independence, and dis-

cretion to the individual in scheduling the work and in determining the procedures
to be used in carrying it out

5. Feedback. The degree to which carrying out the work activities required by the job
results in the individual’s obtaining direct and clear information about the effective-
ness of his or her performance

Exhibit 10-5 presents the model. Notice how the first three dimensions—skill variety,
task identity, and task significance—combine to create meaningful work. What we mean is
that if these three characteristics exist in a job, we can predict that the person will view his
or her job as being important, valuable, and worthwhile. Notice, too, that jobs that possess
autonomy give the job incumbent a feeling of personal responsibility for the results and that,
if a job provides feedback, the employee will know how effectively he or she is performing.

job characteristics model (JCM)
A framework for analyzing and designing jobs
that identifies five core job dimensions, their
interrelationships, and their impact on
outcomes.

job design
The way tasks are combined to form complete
jobs.

Critical
psychological

states

Personal
and work
outcomes

Experienced
meaningfulness of

the work

Experienced
responsibility for

outcomes of the work

Knowledge of the
actual results of the

work activities

High internal
work motivation

High-quality
work performance

High satisfaction
with the work

Low absenteeism
and turnover

Employee
growth-need

strength

Core job
dimensions

Skill variety

Task identity

Task significance

Autonomy

Feedback

EXHIBIT 10-5 Job Characteristics Model

self-efficacy
An individual’s belief that he or she is capable
of performing a task.

Source: J. R. Hackman, “Work Design,” in J. R. Hackman and J. L. Suttle (ed.), Improving Life at Work (Glenview, IL: Scott,
Foresman, 1977), p. 129. With permission of the authors.

274 PART FOUR | LEADING

From a motivational point of view, the JCM suggests that internal rewards are obtained
when an employee learns (knowledge of results through feedback) that he or she personally
(experienced responsibility through autonomy of work) has performed well on a task that
he or she cares about (experienced meaningfulness through skill variety, task identity, and/or
task significance). The more these three conditions characterize a job, the greater the
employee’s motivation, performance, and satisfaction and the lower his or her absenteeism
and the likelihood of resigning. As the model shows, the links between the job dimensions
and the outcomes are moderated by the strength of the individual’s growth need (the person’s
desire for self-esteem and self-actualization). Individuals are more likely to experience the
critical psychological states and respond positively when their jobs include the core dimen-
sions than are individuals with a low growth need. This distinction may explain the mixed
results with job enrichment (vertical expansion of a job by adding planning and evaluation
responsibilities): Individuals with low growth need don’t tend to achieve high performance
or satisfaction by having their jobs enriched.

The JCM provides significant guidance to managers for job design for both individuals and
teams.34 The suggestions shown in Exhibit 10-6, which are based on the JCM, specify the types
of changes in jobs that are most likely to improve in each of the five core job dimensions.

What Is Equity Theory?
Do you ever wonder what kind of grade the person sitting next to you in class makes on a test
or on a major class assignment? Most of us do! Being human, we tend to compare ourselves
with others. If someone offered you $50,000 a year on your first job after graduating from
college, you’d probably jump at the offer and report to work enthusiastic, ready to tackle
whatever needed to be done, and certainly satisfied with your pay. How would you react,
though, if you found out a month into the job that a coworker—another recent graduate, your
age, with comparable grades from a comparable school, and with comparable work experi-
ence—was getting $55,000 a year? You’d probably be upset! Even though in absolute terms,
$50,000 is a lot of money for a new graduate to make (and you know it!), that suddenly isn’t
the issue. Now you see the issue as what you believe is fair—what is equitable. The term
equity is related to the concept of fairness and equitable treatment compared with others who
behave in similar ways. There’s considerable evidence that employees compare themselves
to others and that inequities influence how much effort employees exert.35

Equity theory, developed by J. Stacey Adams, proposes that employees compare what they
get from a job (outcomes) in relation to what they put into it (inputs) and then compare their
inputs-outcomes ratio with the inputs-outcomes ratios of relevant others (Exhibit 10-7). If an
employee perceives her ratio to be equitable in comparison to those of relevant others, there’s
no problem. However, if the ratio is inequitable, she views herself as underrewarded or overre-
warded. When inequities occur, employees attempt to do something about it.36 The result might

Combine tasks

Form natural work units

Establish client relationships

Expand jobs vertically

Open feedback channels

Suggested Action

Skill variety
Task identity
Task significance
Autonomy
Feedback

Core Job Dimension

EXHIBIT 10-6 Guidelines for Job Redesign

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CHAPTER 10 | MOTIVATING AND REWARDING EMPLOYEES 275

be lower or higher productivity, improved or reduced quality of
output, increased absenteeism, or voluntary resignation.

The referent—the other persons, systems, or selves individ-
uals compare themselves against in order to assess equity—is an
important variable in equity theory.37 Each of the three referent
categories is important. The “persons” category includes other
individuals with similar jobs in the same organization but also
includes friends, neighbors, or professional associates. Based on
what they hear at work or read about in newspapers or trade jour-
nals, employees compare their pay with that of others. The “system”
category includes organizational pay policies, procedures, and
allocation. The “self ” category refers to inputs-outcomes ratios
that are unique to the individual. It reflects past personal experi-
ences and contacts and is influenced by criteria such as past jobs
or family commitments.

Originally, equity theory focused on distributive justice,
which is the perceived fairness of the amount and allocation of
rewards among individuals. More recent research has focused on
looking at issues of procedural justice, which is the perceived
fairness of the process used to determine the distribution of
rewards. This research shows that distributive justice has a greater
influence on employee satisfaction than procedural justice, while
procedural justice tends to affect an employee’s organizational
commitment, trust in his or her boss, and intention to quit.38 What
are the implications for managers? They should consider openly
sharing information on how allocation decisions are made, follow
consistent and unbiased procedures, and engage in similar prac-
tices to increase the perception of procedural justice. By increas-
ing the perception of procedural justice, employees are likely to
view their bosses and the organization as positive even if they’re
dissatisfied with pay, promotions, and other personal outcomes.

PERCEIVED RATIO COMPARISON* EMPLOYEE’S ASSESSMENT

Inequity (underrewarded)

Equity

Inequity (overrewarded)

*Person A is the employee, and Person B is a relevant other or referent.

Outcomes A
Inputs A

> Outcomes B
Inputs B

Outcomes A
Inputs A

= Outcomes B
Inputs B

Outcomes A
Inputs A

< Outcomes B Inputs B

EXHIBIT 10-7 Equity Theory Relationships

referent
The persons, systems, or selves against which
individuals compare themselves to assess
equity.equity theory

The theory that an employees compares his or
her job’s input-outcomes ratio with that of
relevant others and then corrects any inequity.

job enrichment
The vertical expansion of a job by adding
planning and evaluation responsibilities.

procedural justice
Perceived fairness of the process used to
determine the distribution of rewards.

distributive justice
Perceived fairness of the amount and
allocation of rewards among individuals.

Right orWrong?

The 14-member investment and operations staff of the Missouri State
Employees’ Retirement System (MOSERS) received almost $300,000 in
bonuses in 2008 even though the pension fund lost almost $1.8 billion.39

One person, the organization’s chief investment officer, received over a
third of that amount.Organization officials said the payments were based
on the fund outperforming the market and that by setting goals and
awarding bonuses, they can retain talented employees and improve per-
formance. The state’s governor called the bonuses “unconscionable.”
What do you think? What ethical issues do you see in this situation? What
would you do?

276 PART FOUR | LEADING

How Does Expectancy Theory Explain Motivation?
The most comprehensive explanation of how employees are motivated is Victor Vroom’s
expectancy theory.40 Although the theory has its critics,41 most research evidence
supports it.42

Expectancy theory states that an individual tends to act in a certain way based on
the expectation that the act will be followed by a given outcome and on the attractive-
ness of that outcome to the individual. It includes three variables or relationships (see
Exhibit 10-8):

1. Expectancy or effort-performance linkage is the probability perceived by the
individual that exerting a given amount of effort will lead to a certain level of
performance.

2. Instrumentality or performance-reward linkage is the degree to which the individual
believes that performing at a particular level is instrumental in attaining the desired
outcome.

3. Valence or attractiveness of reward is the importance that the individual places on the
potential outcome or reward that can be achieved on the job. Valence considers both
the goals and needs of the individual.

This explanation of motivation might sound complicated, but it really isn’t. It can be
summed up in the questions: How hard do I have to work to achieve a certain level of per-
formance, and can I actually achieve that level? What reward will performing at that level
of performance get me? How attractive is the reward to me, and does it help me achieve my
own personal goals? Whether you are motivated to put forth effort (that is, to work hard) at
any given time depends on your goals and your perception of whether a certain level of per-
formance is necessary to attain those goals. Let’s look at an example. Your third author had
a student many years ago who went to work for IBM as a sales rep. Her favorite work
“reward” was having an IBM corporate jet fly into Springfield, Missouri, to pick up her
best customers and her and take them for a weekend of golfing at some fun location. But to
get that particular “reward,” she had to achieve a certain level of performance, which
involved exceeding her sales goals by a specified percentage. How hard she was willing to
work (that is, how motivated she was to put forth effort) was dependent on the level of per-
formance that had to be met and the likelihood that if she achieved at that level of perform-
ance she would receive that reward. Since she “valued” that reward, she always worked hard
to exceed her sales goals. And the performance-reward linkage was clear because her hard
work and performance achievements were always rewarded by the company with the
reward she valued (access to a corporate jet).

The key to expectancy theory is understanding an individual’s goal and the linkage
between effort and performance, between performance and rewards, and finally, between
rewards and individual goal satisfaction. It emphasizes payoffs, or rewards. As a result, we have
to believe that the rewards an organization is offering align with what the individual wants.
Expectancy theory recognizes that there is no universal principle for explaining what motivates
individuals and thus stresses that managers understand why employees view certain outcomes

CBAIndividualeffort
Individual

performance
Organizational

rewards
Individual

goals

= Effort–performance linkage (expectancy)

= Performance–reward linkage (instrumentality)

= Attractiveness (valence)

EXHIBIT 10-8 Expectancy Model

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CHAPTER 10 | MOTIVATING AND REWARDING EMPLOYEES 277

as attractive or unattractive. After all, we want to reward individuals with those things they value
positively. Also, expectancy theory emphasizes expected behaviors. Do employees know what
is expected of them and how they’ll be evaluated? Finally, the theory is concerned with percep-
tions. Reality is irrelevant. An individual’s own perceptions of performance, reward, and goal
outcomes, not the outcomes themselves, will determine his or her motivation (level of effort).

How Can We Integrate the Contemporary Motivation
Theories?
Many of the ideas underlying the contemporary motivation theories are complementary,
and you’ll understand better how to motivate people if you see how the theories fit
together.43 Exhibit 10-9 presents a model that integrates much of what we know about

High
nAch

Performance
Evaluation

Criteria

Objective
Performance
Evaluation

System

Reinforcement

Dominant
Needs

Goals
Direct

Behavior

Ability
Job

Design

Individual
Effort

Individual
Performance

Organizational
Rewards

Individual
Goals

Job
Design

Equity
Comparison

:
A BII
A BO O

EXHIBIT 10-9 Integrating Contemporary Theories of Motivation

expectancy theory
The theory that an individual tends to act in a
certain way, based on the expectation that the
act will be followed by a given outcome and
on the attractiveness of that outcome to the
individual.IS

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6-
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Discuss
current issues
in
motivating
employees.
10.4

278 PART FOUR | LEADING

motivation. Its basic foundation is the expectancy model. Let’s work through the model,
starting on the left.

The individual effort box has an arrow leading into it. This arrow flows from the
individual’s goals. Consistent with goal-setting theory, this goals-effort link is meant to
illustrate that goals direct behavior. Expectancy theory predicts that an employee will
exert a high level of effort if he or she perceives that there is a strong relationship between
effort and performance, performance and rewards, and rewards and satisfaction of per-
sonal goals. Each of these relationships is, in turn, influenced by certain factors. You can
see from the model that the level of individual performance is determined not only by the
level of individual effort but also by the individual’s ability to perform and by whether
the organization has a fair and objective performance evaluation system. The performance-
reward relationship will be strong if the individual perceives that it is performance (rather
than seniority, personal favorites, or some other criterion) that is rewarded. The final
link in expectancy theory is the rewards-goal relationship. The traditional need theories
come into play at this point. Motivation would be high to the degree that the rewards an
individual received for his or her high performance satisfied the dominant needs consis-
tent with his or her individual goals.

A closer look at the model also shows that it considers the achievement-need, reinforce-
ment, equity, and JCM theories. The high achiever isn’t motivated by the organization’s
assessment of his or her performance or organizational rewards; hence the jump from effort
to individual goals for those with a high nAch. Remember that high achievers are internally
driven as long as the jobs they’re doing provide them with personal responsibility, feedback
and moderate risks. They’re not concerned with the effort-performance, performance-reward,
or rewards-goals linkages.

Reinforcement theory is seen in the model by recognizing that the organization’s
rewards reinforce the individual’s performance. If managers have designed a reward sys-
tem that is seen by employees as “paying off ” for good performance, the rewards will rein-
force and encourage continued good performance. Rewards also play a key part in equity
theory. Individuals will compare the rewards (outcomes) they have received from the
inputs or efforts they made with the inputs-outcomes ratio of relevant others. If inequities
exist, the effort expended may be influenced.

Finally, the JCM is seen in this integrative model. Task characteristics (job design)
influence job motivation at two places. First, jobs that are designed around the five job
dimensions are likely to lead to higher actual job performance because the individual’s
motivation will be stimulated by the job itself—that is, they will increase the linkage
between effort and performance. Second, jobs that are designed around the five job dimen-
sions also increase an employee’s control over key elements in his or her work. Therefore, jobs
that offer autonomy, feedback, and similar task characteristics help to satisfy the individual
goals of employees who desire greater control over their work.

What Current Motivation Issues Do
Managers Face?

Understanding and predicting employee motivation is one of the most
popular areas in management research. We’ve introduced you to several
motivation theories. However, even current studies of employee motivation
are influenced by some significant workplace issues—cross-cultural chal-

lenges, motivating unique groups of workers, and designing appropriate
rewards programs.

How Does Country Culture Affect Motivation Efforts?
In today’s global business environment, managers can’t automatically assume that
motivational programs that work in one geographic location are going to work in others.
Most current motivation theories were developed in the United States by Americans and
about Americans.44 Maybe the most blatant pro-American characteristic in these theories

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CHAPTER 10 | MOTIVATING AND REWARDING EMPLOYEES 279

is the strong emphasis on individualism and achievement. For instance, both goal-setting
and expectancy theories emphasize goal accomplishment as well as rational and indi-
vidual thought. Let’s look at the motivation theories to see if there’s any cross-cultural
transferability.

Maslow’s need hierarchy argues that people start at the physiological level and then
move progressively up the hierarchy in order. This hierarchy, if it has any application at all,
aligns with American culture. In countries like Japan, Greece, and Mexico, where
uncertainty avoidance characteristics are strong, security needs would be on top of the
need hierarchy. Countries that score high on nurturing characteristics—Denmark, Sweden,
Norway, the Netherlands, and Finland—would have social needs on top.45 We would
predict, for instance, that group work will be more motivating when the country’s culture
scores high on the nurturing criterion.

Another motivation concept that clearly has an American bias is the achievement need.
The view that a high achievement need acts as an internal motivator presupposes two cul-
tural characteristics—a willingness to accept a moderate degree of risk (which excludes
countries with strong uncertainty avoidance characteristics) and a concern with performance
(which applies almost singularly to countries with strong achievement characteristics). This
combination is found in Anglo-American countries like the United States, Canada, and
Great Britain.46 On the other hand, these characteristics are relatively absent in countries
such as Chile and Portugal.

Equity theory has a relatively strong following in the United States. That’s not
surprising given that U.S.-style reward systems are based on the assumption that work-
ers are highly sensitive to equity in reward allocations. In the United States, equity is
meant to closely link pay to performance. However, recent evidence suggests that in
collectivist cultures, especially in the former socialist countries of Central and Eastern
Europe, employees expect rewards to reflect their individual needs as well as their per-
formance.47 Moreover, consistent with a legacy of communism and centrally planned
economies, employees exhibited a greater “entitlement” attitude—that is, they expected
outcomes to be greater than their inputs.48 These findings suggest that U.S.-style pay
practices may need to be modified in some countries in order to be perceived as fair by
employees.

Despite these cross-cultural differences in motivation, don’t assume there are no
cross-cultural consistencies, because there are some. For instance, the desire for interest-
ing work seems important to almost all workers, regardless of their national culture. In a
study of seven countries, employees in Belgium, Britain, Israel, and the United States

Most motivational theories were
developed in the United States, where
cultural characteristics favor
individualism and a high achievement
need. Motivating employees in countries
with these cultural characteristics differs
from motivating workers in countries such
as China that value relationships and
collectivism. For the Chinese factory
workers shown here, taking a break from
work to laugh and visit with coworkers
and to soak their feet in tubs of
traditional herbal medicine may be the
motivators that satisfy their physiological,
safety, and social needs.

280 PART FOUR | LEADING

Developing Your Skill
About the Skill
Because a simple, all-encompassing set of motivational
guidelines is not available, the following suggestions draw
on the essence of what we know about motivating
employees.

Steps in Practicing the Skill
1 Recognize individual differences. Almost every

contemporary motivation theory recognizes that
employees are not homogeneous. They have different
needs. They also differ in terms of attitudes, personality,
and other important individual variables.

2 Match people to jobs. A great deal of evidence
shows the motivational benefits of carefully matching
people to jobs. People who lack the necessary skills to
perform successfully will be at a disadvantage.

3 Use goals. You should ensure that employees have
hard, specific goals and feedback on how well they’re
doing in pursuit of those goals. In many cases, these
goals should be participatively set.

4 Ensure that goals are perceived as attainable. Re-
gardless of whether goals are actually attainable, em-
ployees who see goals as unattainable will reduce
their effort. Be sure, therefore, that employees feel
confident that increased efforts can lead to achiev-
ing performance goals.

5 Individualize rewards. Because employees have
different needs, what acts as a reinforcer for one may
not do so for another. Use your knowledge of employee
differences to individualize the rewards over which you
have control. Some of the more obvious rewards that
you can allocate include pay, promotions, autonomy,
and the opportunity to participate in goal setting and
decision making.

6 Link rewards to performance. You need to make
rewards contingent on performance. Rewarding factors
other than performance will only reinforce the impor-
tance of those other factors. Key rewards such as pay
increases and promotions should be given for the attain-
ment of employees’ specific goals.

7 Check the system for equity. Employees should
perceive that rewards or outcomes are equal to the
inputs given. On a simplistic level, experience, ability,
effort, and other obvious inputs should explain differences
in pay, responsibility, and other obvious outcomes.

8 Don’t ignore money. It’s easy to get so caught up in
setting goals, creating interesting jobs, and providing
opportunities for participation that you forget that
money is a major reason why most people work. Thus,
the allocation of performance-based wage increases,
piece-work bonuses, employee stock ownership plans,
and other pay incentives are important in determining
employee motivation.

ranked “interesting work” number one among 11 work goals. It was ranked either second
or third in Japan, the Netherlands, and Germany.49 Similarly, in a study comparing
job-preference outcomes among graduate students in the United States, Canada, Aus-
tralia, and Singapore, growth, achievement, and responsibility were rated the top three
and had identical rankings.50 Both studies suggest some universality to the importance of
intrinsic factors identified by Herzberg in his two-factor theory. Another recent study
examining workplace motivation trends in Japan also seems to indicate that Herzberg’s
model is applicable to Japanese employees.51

How Can Managers Motivate Unique Groups
of Workers?
Motivating employees has never been easy! Employees come into organizations with different
needs, personalities, skills, abilities, interests, and aptitudes. They have different expectations
of their employers and different views of what they think their employer has a right to expect
of them. And they vary widely in what they want from their jobs. For instance, some employ-
ees get more satisfaction out of their personal interests and pursuits and only want a weekly
paycheck—nothing more. They’re not interested in making their work more challenging or
interesting or in “winning” performance contests. Others derive a great deal of satisfaction in

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CHAPTER 10 | MOTIVATING AND REWARDING EMPLOYEES 281

their jobs and are motivated to exert high levels of effort. Given these differences, how can
managers do an effective job of motivating the unique groups of employees found in today’s
workforce? One thing is to understand the motivational requirements of these groups includ-
ing diverse employees, professionals, and contingent workers.

MOTIVATING A DIVERSE WORKFORCE. To maximize motivation among today’s
workforce, managers need to think in terms of flexibility. For instance, studies tell us
that men place more importance on having autonomy in their jobs than do women. In
contrast, the opportunity to learn, convenient and flexible work hours, and good
interpersonal relations are more important to women.52 Having the opportunity to be
independent and to be exposed to different experiences is important to Gen Y employ-
ees whereas older workers may be more interested in highly structured work opportu-
nities.53 Managers need to recognize that what motivates a single mother with two
dependent children who’s working full time to support her family may be very
different from the needs of a single part-time employee or an older employee who is
working only to supplement his or her retirement income. A diverse array of rewards is
needed to motivate employees with such diverse needs. Many of the work/life balance
programs (see Chapter 2) that organizations have implemented are a response to the
varied needs of a diverse workforce. In addition, many organizations have developed
flexible work arrangements that recognize different needs. These types of programs
may become even more popular as employers look for ways to help employees cope
with high fuel prices. For instance, a compressed workweek is a workweek where
employees work longer hours per day but fewer days per week. The most common
arrangement is four 10-hour days (a 4-40 program). However, organizations could
design whatever schedules they wanted to fit employees’ needs. Another alternative is
flexible work hours (also known as flextime), which is a scheduling system in which
employees are required to work a specific number of hours a week but are free to vary
those hours within certain limits. In a flextime schedule, there are certain common
core hours when all employees are required to be on the job, but starting, ending, and
lunch-hour times are flexible. According to a survey by Hewitt Associates, 75 percent
of large companies now offer flextime benefits. Another survey by Watson Wyatt of
mid- and large-sized companies found that flexible work schedules was the most
commonly offered benefit.54

In Great Britain, McDonald’s is experimenting with an unusual program—dubbed
the Family Contract—to reduce absenteeism and turnover at some of its restaurants. Under
this Family Contract, employees from the same immediate family can fill in for one
another for any work shift without having to clear it first with their manager.55 This
type of job scheduling, which can be effective in motivating a diverse workforce, is called
job sharing—the practice of having two or more people split a full-time job. Although
something like McDonald’s Family Contract may be appropriate for a low-skilled job,
other organizations might offer job sharing to professionals who want to work but don’t
want the demands and hassles of a full-time position. For instance, at Ernst & Young,
employees in many of the company’s locations can choose from a variety of flexible work
arrangements including job sharing.

Another alternative made possible by information technology is telecommuting.
Here, employees work at home but are linked by technology to the workplace. It’s

compressed workweek
A workweek in which employees work longer
hours per day but fewer days per week.

telecommuting
A job approach in which employees work at
home but are linked by technology to the
workplace.

job sharing
When two or more people split (share) a full-
time job.

flexible work hours (flextime)
A scheduling system in which employees are
required to work a certain number of hours per
week but are free, within limits, to vary the hours
of work.IS

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282 PART FOUR | LEADING

estimated that some 12 percent (and maybe even as high as 15 percent) of the U.S.
workforce is part of this “distributed workforce.”57 For example, around 40 percent of
IBM’s workforce has no physical office space. The number is even higher for Sun
Microsystems where nearly 50 percent of employees work off-site.58 Since many jobs
can be done at off-site locations, this approach might be close to the ideal job for many
people as there is no commuting, the hours are flexible, there’s freedom to dress as you
please, and there are little or no interruptions from colleagues. However, keep in mind
that not all employees embrace the idea of telecommuting. Some workers relish the in-
formal interactions at work that satisfy their social needs as well as being a source of
new ideas.

Do flexible work arrangements motivate employees? Although such arrangements
might seem highly motivational, both positive and negative relationships have been found.
For instance, a recent study looking at the impact of telecommuting on job satisfaction found
that job satisfaction initially increased as the extent of telecommuting increased, but as the
number of hours spent telecommuting increased, job satisfaction started to level off,
decreased slightly, and then stabilized.59

MOTIVATING PROFESSIONALS. In contrast to a generation ago, the typical employee
today is more likely to be a professional with a college degree than a blue-collar factory
worker. What special concerns should managers be aware of when trying to motivate a
team of engineers at Intel’s India Development Center, software designers at SAS Institute
in North Carolina, or a group of consultants at Accenture in Singapore?

Professionals are different from nonprofessionals.60 They have a strong and long-term
commitment to their field of expertise. To keep current in their field, they need to regularly
update their knowledge, and because of their commitment to their profession they rarely
define their workweek as 8 A.M. to 5 P.M. five days a week.

What motivates professionals? Money and promotions typically are low on their
priority list. Why? They tend to be well paid and enjoy what they do. In contrast, job
challenge tends to be ranked high. They like to tackle problems and find solutions. Their
chief reward is the work itself. Professionals also value support. They want others to
think that what they’re working on is important. That may be true for all employees,

MANAGING DIVERSITY | Developing Employee Potential:
The Bottom Line of Diversity

One of a manager’s more important goals is helping
employees develop their potential.56 This is particularly
important in managing talented diverse employees who
can bring new perspectives and ideas to the business but
who may find that the workplace environment is not as con-
ducive as it could be to accepting and embracing these
different perspectives. For instance, managers at Bell Labs
have worked hard to develop an environment in which the
ideas of diverse employees are encouraged openly.

What can managers do to ensure that their diverse
employees have the opportunity to develop their poten-
tial? One thing they can do is make sure that diverse role
models are in leadership positions so that others see the
opportunities to grow and advance. Giving motivated,
talented, hard-working, and enthusiastic diverse employ-
ees opportunities to excel in decision-making roles can be
a powerful motivator to other diverse employees to work
hard to develop their own potential. A mentoring program

in which diverse employees are given the opportunity to
work closely with organizational leaders can be a powerful
tool. At Silicon Graphics, for instance, new employees
become part of a mentoring group called “Horizons.”
Through this mentoring group, diverse employees have the
opportunity to observe and learn from key company deci-
sion makers.

Another way for managers to develop the potential of
their diverse employees is to offer developmental work
assignments that provide a variety of learning experiences
in different organizational areas. Employees who are pro-
vided the opportunity to learn new processes and new
technology are more likely to excel at their work and to
stay with the company. These types of developmental
opportunities are particularly important for diverse employ-
ees because it empowers them with tools that are critical to
professional development.

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CHAPTER 10 | MOTIVATING AND REWARDING EMPLOYEES 283

but professionals tend to be focused on their work as their central life interest, whereas
nonprofessionals typically have other interests outside of work that can compensate for
needs not met on the job.

MOTIVATING CONTINGENT WORKERS. As full-time jobs have been eliminated
through downsizing and other organizational restructurings, the number of openings for
part-time, contract, and other forms of temporary work have increased. Contingent
workers don’t have the security or stability that permanent employees have, and they
don’t identify with the organization or display the commitment that other employees do.
Temporary workers also typically get little or no benefits such as health care or
pensions.61

There’s no simple solution for motivating contingent employees. For that small set of
individuals who prefer the freedom of their temporary status, the lack of stability may not
be an issue. In addition, temporariness might be preferred by highly compensated physi-
cians, engineers, accountants, or financial planners who don’t want the demands of a full-
time job. But these are the exceptions. For the most part, temporary employees are not
temporary by choice.

What will motivate involuntarily temporary employees? An obvious answer is the
opportunity to become a permanent employee. In cases in which permanent employees
are selected from a pool of temps, the temps will often work hard in hopes of becoming
permanent. A less obvious answer is the opportunity for training. The ability of a
temporary employee to find a new job is largely dependent on his or her skills. If an
employee sees that the job he or she is doing can help develop marketable skills, then
motivation is increased. From an equity standpoint, when temps work alongside
permanent employees who earn more and get benefits too for doing the same job, the
performance of temps is likely to suffer. Separating such employees or perhaps
minimizing interdependence between them might help managers counteract potential
problems.62

How Can Managers Design Appropriate
Rewards Programs?
Blue Cross of California, one of the nation’s largest health insurers, pays bonuses to doc-
tors serving its health maintenance organization members based on patient satisfaction and
other quality standards. FedEx’s drivers are motivated by a pay system that rewards them
for timeliness and how much they deliver.63 There’s no doubt that employee rewards pro-
grams play a powerful role in motivating appropriate employee behavior. Some of the more
popular rewards programs include open-book management, employee recognition, and
pay-for-performance.

HOW CAN OPEN-BOOK MANAGEMENT PROGRAMS MOTIVATE EMPLOYEES? Within
24 hours after managers of the Heavy Duty Division of Springfield Remanufacturing
Company (SRC) gather to discuss a multipage financial document, every plant employ-
ee will have seen the same information. If the employees can meet shipment goals,
they’ll all share in a large year-end bonus.64 Many organizations of various sizes involve
their employees in workplace decisions by opening up the financial statements (the
“books”). They share that information so that employees will be motivated to make
better decisions about their work and better able to understand the implications of what
they do, how they do it, and the ultimate impact on the bottom line. This approach is
called open-book management and many organizations are using it.65 At Best Buy, the

open-book management
A motivational approach in which an
organization’s financial statements (the
“books”) are shared with all employees.IS

284 PART FOUR | LEADING

“Donuts with Darren” sessions (held when Darren
Jackson was the company’s chief f inancial officer)
were so popular that more than 600 employees regu-
larly took part. His presentations covered the finan-
cials and the basics of finance.66

The goal of open-book management is to get
employees to think like an owner by seeing the impact
their decisions have on financial results. Since many
employees don’t have the knowledge or background to
understand the financials, they have to be taught how
to read and understand the organization’s financial
statements. Once employees have this knowledge, how-
ever, managers need to regularly share the numbers with
them. By sharing this information, employees begin to
see the link between their efforts, level of performance,
and operational results.

HOW CAN MANAGERS USE EMPLOYEE RECOGNI-
TION PROGRAMS? Employee recognition programs consist of personal attention and
expressions of interest, approval, and appreciation for a job well done.67 They can take
numerous forms. For instance, Kelly Services introduced a new version of its points-
based incentive system to better promote productivity and retention among its employ-
ees. The program, called Kelly Kudos, gives employees more choices of awards and
allows them to accumulate points over a longer time period. It’s working. Participants
generate three times more revenue and hours than employees not receiving points.68

Most managers, however, use a far more informal approach. For example, when Julia
Stewart, currently the president and CEO of IHOP International, was president of
Applebee’s Restaurants, she would frequently leave sealed notes on the chairs of
employees after everyone had gone home.69 These notes explained how important
Stewart thought the person’s work was or how much she appreciated the completion of
a project. Stewart also relied heavily on voice mail messages left after office hours to
tell employees how appreciative she was for a job well done. And recognition doesn’t
have to come only from managers. Some 35 percent of companies encourage coworkers
to recognize peers for outstanding work efforts.70 For instance, managers at Yum!
Brands Inc. (the Kentucky-based parent of food chains Taco Bell, KFC, and Pizza Hut)
were looking for ways to reduce employee turnover. They found a successful customer-
service program involving peer recognition at KFC restaurants in Australia. Workers
there spontaneously rewarded fellow workers with “Champs cards, an acronym for
attributes such as cleanliness, hospitality, and accuracy.” Yum! implemented the pro-
gram in other restaurants around the world, and credits the peer recognition with reduc-
ing hourly employee turnover from 181 percent to 109 percent.71

A recent survey of organizations found that 84 percent had some type of program to
recognize worker achievements.72 And do employees think these programs are impor-
tant? You bet! A survey of a wide range of employees asked them what they considered
the most powerful workplace motivator. Their response? Recognition, recognition, and
more recognition!73

Consistent with reinforcement theory (see Chapter 8), rewarding a behavior with
recognition immediately following that behavior is likely to encourage its repetition. And
recognition can take many forms. You can personally congratulate an employee in pri-
vate for a good job. You can send a handwritten note or e-mail message acknowledging
something positive that the employee has done. For employees with a strong need for
social acceptance, you can publicly recognize accomplishments. To enhance group
cohesiveness and motivation, you can celebrate team successes. For instance, you can do
something as simple as throw a pizza party to celebrate a team’s accomplishments.
Some of these things may seem simple, but they can go a long way in showing
employees they’re valued.

USAA chief executive Josue Robles,
Jr., personally thanked employees during
a celebration after the firm was ranked
number one for customer service by
Business Week magazine. Personal
recognition is a powerful tool in motivating
employees at USAA, a financial services
provider for the military community.
Employees are recognized frequently for
educational achievements and
community and customer service during
breakfasts, luncheons, and parties; through
articles in USAA’s weekly newsletter; and
during the firm’s weekly television
program. The company gives employees
“thank you” note stationery so they can
express their appreciation and gratitude
to coworkers for their help at work.

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CHAPTER 10 | MOTIVATING AND REWARDING EMPLOYEES 285

HOW CAN MANAGERS USE PAY-FOR-PERFORMANCE TO MOTIVATE EMPLOYEES?
Here’s a survey statistic that may surprise you: Forty percent of employees see no clear
link between performance and pay.74 You have to think: What are the companies where
these employees work paying for? They’re obviously not clearly communicating per-
formance expectations.75 Pay-for-performance programs are variable compensation
plans that pay employees on the basis of some performance measure.76 Piece-rate pay
plans, wage incentive plans, profit-sharing, and lump-sum bonuses are examples. What
differentiates these forms of pay from more traditional compensation plans is that
instead of paying a person for time on the job, pay is adjusted to reflect some perform-
ance measure. These performance measures might include such things as individual
productivity, team or work group productivity, departmental productivity, or the overall
organization’s profit performance.

Pay-for-performance is probably most compatible with expectancy theory. Individuals
should perceive a strong relationship between their performance and the rewards they receive
for motivation to be maximized. If rewards are allocated only on nonperformance factors—
such as seniority, job title, or across-the-board pay raises—then employees are likely to
reduce their efforts. From a motivation perspective, making some or all an employee’s pay
conditional on some performance measure focuses his or her attention and effort toward
that measure, then reinforces the continuation of the effort with a reward. If the employee,
team, or organization’s performance declines, so does the reward. Thus, there’s an incentive
to keep efforts and motivation strong.

Pay-for-performance programs are popular. Some 80 percent of large U.S. compa-
nies have some form of variable pay plan.77 These types of pay plans have also been
tried in other countries such as Canada and Japan. About 30 percent of Canadian
companies and 22 percent of Japanese companies have company-wide pay-for-
performance plans.78

Do pay-for-performance programs work? For the most part, studies seem to
indicate that they do. For instance, one study found that companies that used pay-

for-performance programs performed
better financially than those that
did not.79 Another study showed

that pay-for-performance

pay-for-performance programs
Variable compensation plans that pay
employees on the basis of some performance
measure.

Pfizer, the largest research-based
pharmaceutical company in the world,
uses a pay-for-performance
compensation system to recognize the
hard work, effort, and commitment of
employees like the scientists shown here
in a cancer research laboratory. Part of
the company’s performance-related
pay program includes merit-based pay
and an annual bonus as a percentage
of an employee’s salary. For Pfizer, pay
for performance reflects the high value
the company places on its employees in
achieving its mission of being a global
leader in health care.

employee recognition programs
Programs that consist of personal attention and
expressions of interest, approval, and
appreciation for a job well done.IS

286 PART FOUR | LEADING

programs with outcome-based incentives had a positive impact on sales, customer satisfac-
tion, and profits.80 If an organization uses work teams, managers should consider group-
based performance incentives that will reinforce team effort and commitment. But whether
these programs are individual based or team based, managers need to ensure that they’re
specific about the relationship between an individual’s pay and his or her expected level of
appropriate performance. Employees must clearly understand exactly how performance—
theirs and the organization’s—translates into dollars on their paychecks.81

A FINAL NOTE ON EMPLOYEE REWARDS PROGRAMS. During times of economic and
financial uncertainty, managers’ abilities to recognize and reward employees are often
severely constrained. It’s hard to keep employees productive during challenging times,
even though it’s especially critical. It’s not surprising, then, that employees feel less
connected to their work. In fact, a recent study by the Corporate Executive Board
found that declining employee engagement has decreased overall productivity by 3 to
5 percent.82 But there are actions managers can take to maintain and maybe even increase
employees’ motivation levels. One is to clarify each person’s role in the organization.
Show them how their efforts are contributing to improving the company’s overall
situation. It’s also important to keep communication lines open and use two-way
exchanges between top-level managers and employees to soothe fears and concerns. The
key with taking any actions is continuing to show workers that the company cares about
them. As we said at the beginning of the chapter, the value in companies comes from
employees who are motivated to be there. Managers have to give employees a reason to
want to be there.

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ApplicationsReview and

Chapter Summary

CHAPTER 10 | MOTIVATING AND REWARDING EMPLOYEES 287

The job characteristics model says there are five
core job dimensions (skill variety, task identity, task
significance, autonomy, and feedback) that are used
to design motivating jobs.

Equity theory focuses on how employees com-
pare their inputs-outcomes ratios to relevant others’
ratios. A perception of inequity will cause an
employee to do something about it. Procedural justice
has a greater influence on employee satisfaction than
does distributive justice.

Expectancy theory says that an individual tends
to act in a certain way based on the expectation that
the act will be followed by a desired outcome.
Expectancy is the effort-performance linkage (how
much effort do I need to exert to achieve a certain
level of performance); instrumentality is the
performance-reward linkage (achieving at a certain
level of performance will get me what reward); and
valence is the attractiveness of the reward (is the
reward what I want).

10.4 Discuss current issues in motivating employees.
Most motivational theories were developed in the
United States and have a North American bias. Some
theories (Maslow’s need hierarchy, achievement need,
and equity theory) don’t work well for other cultures.
However, the desire for interesting work seems
important to all workers and Herzberg’s motivator
(intrinsic) factors may be universal.

Managers face challenges in motivating unique
groups of workers. A diverse workforce is looking for
flexibility. Professionals want job challenge and
support, and are motivated by the work itself. Contin-
gent workers want the opportunity to become perma-
nent or to receive skills training.

Open-book management is when financial state-
ments (the books) are shared with employees who have
been taught what they mean. Employee recognition
programs consist of personal attention, approval, and
appreciation for a job well done. Pay-for-performance
programs are variable compensation plans that pay
employees on the basis of some performance measure.

10.1 Define and explain motivation. Motivation is the
process by which a person’s efforts are energized,
directed, and sustained toward attaining a goal.

The energy element is a measure of intensity or
drive. The high level of effort needs to be directed in
ways that help the organization achieve its goals.
Employees must persist in putting forth effort to
achieve those goals.

10.2 Compare and contrast early theories of motivation.
According to Maslow’s theory, individuals move up the
hierarchy of five needs (physiological, safety, social,
esteem, and self-actualization) as needs are substan-
tially satisfied. A need that’s substantially satisfied no
longer motivates.

A Theory X manager believes that people don’t
like to work or won’t seek out responsibility so they
have to be threatened and coerced to work. A Theory
Y manager assumes that people like to work and seek
out responsibility, so they will exercise self-motivation
and self-direction.

Herzberg’s two-factor theory proposed that
intrinsic factors associated with job satisfaction were
what motivated people. Extrinsic factors associated
with job dissatisfaction simply kept people from
being dissatisfied.

McClelland’s three-needs theory proposed three
acquired needs that are major motives in work need for
achievement, need for affiliation, and need for power.

10.3 Compare and contrast contemporary theories of
motivation. Goal-setting theory says that specific
goals increase performance and difficult goals, when
accepted, result in higher performance than do easy
goals. Important points in goal-setting theory include
intention to work toward a goal is a major source of
job motivation; specific hard goals produce higher
levels of output than generalized goals; participation
in setting goals is probably preferable to assigning
goals, but not always; feedback guides and motivates
behavior, especially self-generated feedback; and
contingencies that affect goal setting include goal
commitment, self-efficacy, and national culture.

To check your understanding of learning outcomes 10.1 – 10.4 , go to

mymanagementlab.com and try the chapter questions.

288 PART FOUR | LEADING

1. I try to perform my best at work. 1 2 3 4 5

2. I spend a lot of time talking to other people. 1 2 3 4 5

3. I would like a career where I have very little supervision. 1 2 3 4 5

4. I would enjoy being in charge of a project. 1 2 3 4 5

5. I am a hard worker. 1 2 3 4 5

6. I am a “people” person. 1 2 3 4 5

7. I would like a job where I can plan my work schedule myself. 1 2 3 4 5

8. I would rather receive orders than give them. 1 2 3 4 5

9. It is important to me to do the best job possible. 1 2 3 4 5

10. When I have a choice, I try to work in a group instead of by myself. 1 2 3 4 5

11. I would like to be my own boss. 1 2 3 4 5

12. I seek an active role in the leadership of a group. 1 2 3 4 5

Understanding Yourself

What Are My Dominant Needs?
This instrument was designed to deal with flaws in previous attempts to measure four
individual needs: achievement, affiliation, autonomy, and power. These are defined as
follows:

Achievement—The desire to excel and to improve on past performance.

Affiliation—The desire to interact socially and to be accepted by others.

Autonomy—The desire to be self-directed.

Power—The desire to influence and direct others.

INSTRUMENT This test contains 20 statements that may describe you and the types of
things you may like to do. For each statement, indicate your agreement or disagreement
using the following scale:

1 = Strongly disagree

2 = Disagree

3 = Neither agree nor disagree

4 = Agree

5 = Strongly agree

Understanding the Chapter
1. Most of us have to work for a living, and a job is a

central part of our lives. So why do managers have to
worry so much about employee motivation issues?

2. Contrast lower-order and higher-order needs in
Maslow’s needs hierarchy.

3. What role would money play in (a) the hierarchy of
needs theory, (b) two-factor theory, (c) equity theory,
(d) expectancy theory, and (e) motivating employees
with a high nAch?

4. What are some of the possible consequences of
employees perceiving an inequity between their inputs
and outcomes and those of others?

5. What are some advantages of using pay-for-performance
programs to motivate employee performance? Are there
drawbacks? Explain.

6. Many job design experts who have studied the
changing nature of work say that people do their
best work when they’re motivated by a sense of pur-
pose rather than by the pursuit of money. Do you
agree? Explain your position. What are the implica-
tions for managers?

7. Could managers use any of the motivation theories or
approaches to encourage and support workforce diver-
sity efforts? Explain.

8. Can an individual be too motivated? Discuss.

9. Do some additional research on ROWE discussed in
the chapter opener. Write up your findings in a report.
Be sure to cite your information.

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CHAPTER 10 | MOTIVATING AND REWARDING EMPLOYEES 289

13. I push myself to be “all that I can be.” 1 2 3 4 5

14. I prefer to do my work and let others do theirs. 1 2 3 4 5

15. I like to work at my own pace on job tasks. 1 2 3 4 5

16. I find myself organizing and directing the activities of others. 1 2 3 4 5

17. I try very hard to improve on my past performance at work. 1 2 3 4 5

18. I try my best to work alone on a work assignment. 1 2 3 4 5

19. In my work projects, I try to be my own boss. 1 2 3 4 5

20. I strive to be “in command” when I am working in a group. 1 2 3 4 5

Source: T. M. Heckert, G. Cuneio, A. P. Hannah, P. J. Adams, H. E. Droste, M. A. Mueller, H. A. Wallis, C. M. Griffin,
and L. L. Roberts, “Creation of a New Needs Assessment Questionnaire,” Journal of Social Behavior and Personality
(March 2000), pp. 121–36.

SCORING KEY Add up items 1, 5, 9, 13, and 17. These represent your achievement
score. The affiliation score is made up of items 2, 6, 10, 14, and 18 (reverse score 14 and
18). The autonomy score is items 3, 7, 11, 15, and 19. The power score is items 4 (reverse
score), 8, 12, 16, and 20. Scores for each will range from 5 to 25.

ANALYSIS AND INTERPRETATION The higher a score, the more dominant that need is for
you. For comparative purposes, the researchers used this test with approximately 350 college
graduates who averaged 28 years of age. Their average scores were 22.6 for achievement;
16.1 for affiliation; 20.0 for autonomy; and 17.7 for power.

290 PART FOUR | LEADING

FYIA (For Your Immediate Action)

La Mexican Kitchen

To: Linda Bustamante, Operations Manager
From: Matt Perkins, Shift Supervisor

Re: Staff Turnover

HELP! We’ve been having a difficult time keeping our food servers for any length of

time. It seems like I just get them trained and they leave. And we both know that our

servers are a key element in our company’s commitment to excellent customer service.

We can have the best food in town (and do!) but if our servers aren’t motivated to

provide excellent service, we won’t have any customers.

Although these positions pay minimum wage, you and I both know a motivated

server can make additional money from tips. But it seems that this isn’t enough to

motivate them to stay. So what would you recommend? Could you jot down some

ideas about how to better motivate our food servers and send those to me? Thanks!

This fictionalized company and message were created for educational purposes only. It is not meant to reflect
positively or negatively on management practices by any company that may share this name.

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Published by Prentice Hall. Copyright © 2011 by Pearson Education, Inc.

CASE APPLICATION

It gets over 777,000 applicants a year. Andit’s no wonder! With a massage every otherweek, on-site laundry, swimming pool and
spa, free delicious all-you-can-eat gourmet
meals, what more could an employee want?
Sounds like an ideal job, doesn’t it? However,
at Google, many people are demonstrating by
their decisions to leave the company that all
those perks (and these are just a few) aren’t
enough to keep them there. As one analyst said,
“Yes, Google’s making gobs of money. Yes, it’s full of smart people. Yes, it’s a wonderful place to work. So why
are so many people leaving?”

Google has been in the top 10 list of “Best Companies to Work For” by Fortune magazine for three years
running and was number one on the list for two of those three years. But make no mistake. Google’s execu-
tives decided to offer all these fabulous perks for several reasons: to attract the best knowledge workers it can
in an intensely competitive, cutthroat market; to help employees work long hours and not have to deal with
time-consuming personal chores; to show employees they’re valued; and to have employees remain Googlers
(the name used for employees) for many years. But a number of Googlers have jumped ship and given up
these fantastic benefits to go out on their own.

For instance, Sean Knapp and two colleagues, brothers Bismarck and Belsasar Lepe, came up with an idea
on how to handle Web video. They left Google, or as one person put it, “expelled themselves from paradise to start
their own company.” When the threesome left the company, Google really wanted them and their project to stay.
Google offered them a “blank check.” But the trio realized they would do all the hard work and Google would own
the product. So off they went, for the excitement of a start-up.

If this were an isolated occurrence, it would be easy to write off. But it’s not. Other talented Google employees
have done the same thing. In fact, there are so many of them who have left that they’ve formed an informal alumni
club of ex-Googlers turned entrepreneurs.

Discussion Questions

1. What’s it like to work at Google? (Hint: Go to Google’s Web site and click on “About Google.” Find the section
on Jobs at Google and go from there.) What’s your assessment of the company’s work environment?

2. Google is doing a lot for its employees, but obviously not enough to retain several of its talented employees.
Using what you’ve learned from studying the various motivation theories, what does this situation tell you
about employee motivation?

3. What do you think is Google’s biggest challenge in keeping employees motivated?

4. If you were managing a team of Google employees, how would you keep them motivated?

Sources: R. Levering and M. Moskowitz, “And the Winners Are…” Fortune, February 2, 2009, pp. 67+; A. Lashinsky, “Where Does Google Go
Next?” CNNMoney.com, May 12, 2008; K. Hafner, “Google Options Make Masseuse a Multimillionaire,” New York Times Online, November 12,
2007; Q. Hardy, “Close to the Vest,” Forbes, July 2, 2007, pp. 40–42; K. J. Delaney, “Start-Ups Make Inroads with Google’s Work Force,” Wall
Street Journal Online, June 28, 2007; and “Perk Place: The Benefits Offered by Google and Others May Be Grand, but They’re All Business,”
Knowledge @ Wharton, http://knowledge.wharton.upenn.edu/article (March 21, 2007).

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Leadership
and
Trust

CHAPTER

11.

Define
leader

and

leadership.

Compare
and

contrast
early

leadership
theories.

11.

Describe
modern views
of leadership
and the issues
facing today’s

leaders.

11.

Discuss
trust as the

essence
of

leadership.

11.

Describe
the

four major
contingency
leadership
theories.

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Employees First
It might seem kind of strange to be talking about putting employees first
in a chapter on leadership. However, at HCL Technologies, the “employee
first” philosophy has helped catapult the company from peripheral player
to center stage in the intensely competitive IT industry.1

HCL Technologies is headquartered in the world’s largest democracy, so
it’s quite fitting that the Noida, India–based company is attempting a radical
experiment in workplace democracy. CEO Vineet Nayar is committed to
creating a company where the job of company leaders is to enable people to
find their own destiny by gravitating to their strengths. His goals for the

“Employee First” program include creating a
unique employee experience, inverting the

organizational structure, and increasing
transparency. The workplace reforms the
company implemented involved better
communication with the CEO and a pay
scheme that gives workers more job

security. A major part of the workplace
changes was this pay scheme, which the
company referred to as “trust pay.” Unlike the standard IT industry practice
of having 30 percent of its engineers’ pay variable (that is, dependent on
performance), the company decided to pay higher fixed salaries that included
all of what would have been the variable component—essentially trusting

that employees would deliver performance meriting that pay. These changes
have helped the company grow and, more importantly, become a talent

magnet. (The company’s attrition rate dropped to below 15 percent.)
And in 2008, HCL won an award for its innovative workforce

management approaches.
How does Nayar view leadership? Although he believes

that the command-and-control dictatorship approach is the
easiest management style, he also thinks it’s not the most
productive. In his corporate democracy, employees can
write a “trouble ticket” on anyone in the company. Anyone
with trouble tickets has to respond, just as if it was a
customer who had problems and needed some response.
Nayar also believes that leaders should be open to criticism.
He volunteered to share the information from his 360-degree
performance feedback for all employees to see. One year,

his team of 81 managers who rated him gave him a 3.6 out
of 5 for how well he keeps projects running on schedule, one

of his lowest scores—and everyone at HCL was able to see
the score. Nayar’s scores, along with ratings for the company’s
top 20 managers, are published on the company’s intranet for any

employee to see. Employees also can see their own supervisor’s
scores. Although a lot of people said he was crazy for publicizing

managers’ “grades” and communicating his own weaknesses, Nayar
believed that it was a good way to increase his accountability as a
leader to his employees. Such an environment requires a lot of trust
between leaders and followers.

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11.1
Define
leader

and
leadership.

Compare
and
contrast
early
leadership
theories.
11.2
294

Vineet Nayar is a good example of what it takes to be an effective leader in today’s organi-

zations. He has created a workplace environment in which employees feel like they’re heard

and trusted. It’s important for managers in all organizations to be seen as effective

leaders.

Why is leadership so important? Because it’s the leaders in organizations who make things

happen. But what makes leaders different from nonleaders? What’s the most appropriate

style of leadership? What makes leaders effective? These are just some of the topics we’re

going to address in this chapter.

Who Are Leaders, and What Is Leadership?
Let’s begin by clarifying who leaders are and what leadership is. Our definition
of a leader is someone who can influence others and who has managerial
authority. Leadership is a process of leading a group and influencing that
group to achieve its goals. It’s what leaders do.

Are all managers leaders? Because leading is one of the four manage-
ment functions, yes, ideally, all managers should be leaders. Thus, we’re going

to study leaders and leadership from a managerial perspective.2 However, even
though we’re looking at these from a managerial perspective, we’re aware that

groups often have informal leaders who emerge. Although these informal leaders may
be able to influence others, they have not been the focus of most leadership research and are
not the types of leaders we’re studying in this chapter.

Leaders and leadership, like motivation, are organizational behavior topics that have
been researched a lot. Most of that research has been aimed at answering the question:
“What is an effective leader?” We’ll begin our study of leadership by looking at some early
leadership theories that attempted to answer that question.

What Do Early Leadership Theories Tell
Us About Leadership?
People have been interested in leadership since they started coming together
in groups to accomplish goals. However, it wasn’t until the early part of the
twentieth century that researchers actually began to study it. These early

leadership theories focused on the leader (trait theories) and how the leader
interacted with his or her group members (behavioral theories).

What Traits Do Leaders Have?
Ask the average person on the street what comes to mind when he or she thinks of leadership.
You’re likely to get a list of qualities such as intelligence, charisma, decisiveness, enthusiasm,
strength, bravery, integrity, and self-confidence. These responses represent, in essence, trait
theories of leadership. The search for traits or characteristics that differentiate leaders from
nonleaders dominated early leadership research efforts. If the concept of traits were valid,
all leaders would have to possess specific characteristics.

However, despite the best efforts of researchers, it proved impossible to identify a set of
traits that would always differentiate a leader (the person) from a nonleader. Maybe it was a bit
optimistic to think that there could be consistent and unique traits that would apply universally
to all effective leaders, no matter whether they were in charge of Toyota Motor Corporation, the
Moscow Ballet, the country of Brazil, a local collegiate chapter of Alpha Chi Omega, or Ted’s
Malibu Surf Shop. However, later attempts to identify traits consistently associated with
leadership (the process, not the person) were more successful. The seven traits shown to be
associated with effective leadership are described briefly in Exhibit 11-1.3

Researchers eventually recognized that traits alone were not sufficient for identifying
effective leaders since explanations based solely on traits ignored the interactions of leaders

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leader
Someone who can influence others and who
has managerial authority.

trait theories of leadership
Theories that isolate characteristics (traits) that
differentiate leaders from nonleaders.

leadership
The process of leading a group and influencing
that group to achieve its goals.

C H A P T E R 1 1 | L E A D E R S H I P A N D T R U S T 295

and their group members as well as situational factors. Possessing the appropriate traits only
made it more likely that an individual would be an effective leader. Therefore, leadership
research from the late 1940s to the mid-1960s concentrated on the preferred behavioral styles
that leaders demonstrated. Researchers wondered whether there was something unique in
what effective leaders did—in other words, in their behavior.

What Behaviors Do Leaders Exhibit?
It was hoped that the behavioral theories of leadership approach would provide more
definitive answers about the nature of leadership, and if successful, also have practical
implications quite different from those of the trait approach. If trait research had been
successful, it would have provided a basis for selecting the right people to assume formal
leadership positions in organizations. In contrast, if behavioral studies were to turn up
critical behavioral determinants of leadership, people could be trained to be leaders, which
is precisely the premise behind management development programs.

A number of studies looked at behavioral styles. We’ll briefly review three of the most
popular: Kurt Lewin’s studies at the University of Iowa, the Ohio State studies, and the
University of Michigan studies. Then we’ll see how the concepts developed in those
studies were used in a grid created for appraising leadership styles.

WHAT DID THE UNIVERSITY OF IOWA STUDIES TELL US ABOUT LEADERSHIP BEHAVIOR?
One of the first studies of leadership behavior was done by Kurt Lewin and his associates at
the University of Iowa.4 In their studies, the researchers explored three leadership behaviors
or styles: autocratic, democratic, and laissez-faire. An autocratic style is that of a leader
who typically tends to centralize authority, dictate work methods, make unilateral decisions,
and limit employee participation. A leader with a democratic style tends to involve employees

1. Drive. Leaders exhibit a high effort level. They have a relatively high desire for achievement,
they are ambitious, they have a lot of energy, they are tirelessly persistent in their activities,
and they show initiative.

2. Desire to lead. Leaders have a strong desire to influence and lead others. They demonstrate the
willingness to take responsibility.

3. Honesty and integrity. Leaders build trusting relationships with followers by being truthful or
nondeceitful and by showing high consistency between word and deed.

4. Self-confidence. Followers look to leaders for an absence of self-doubt. Leaders, therefore, need to
show self-confidence in order to convince followers of the rightness of their goals and decisions.

5. Intelligence. Leaders need to be intelligent enough to gather, synthesize, and interpret large
amounts of information, and they need to be able to create visions, solve problems, and
make correct decisions.

6. Job-relevant knowledge. Effective leaders have a high degree of knowledge about the company,
industry, and technical matters. In-depth knowledge allows leaders to make well-informed deci-
sions and to understand the implications of those decisions.

7. Extraversion. Leaders are energetic, lively people. They are sociable, assertive, and rarely silent
or withdrawn.

Sources: Based on S. A. Kirkpatrick and E. A. Locke, “Leadership: Do Traits Really Matter?” Academy of Management
Executive (May 1991), pp. 48–60; and T. A. Judge, J. E. Bono, R. Ilies, and M. W. Gerhardt, “Personality and Leadership:
A Qualitative and Quantitative Review,” Journal of Applied Psychology (August 2002), pp. 765–80.

EXHIBIT 11-1 Traits Associated with Leadership

behavioral theories of leadership
Theories that isolate behaviors that differentiate
effective leaders from ineffective leaders.

autocratic style
A leader who centralizes authority, dictates
work methods, makes unilateral decisions, and
limits employee participation.

democratic style
A leader who involves employees in

decision

making, delegates authority, encourages
participation in deciding work methods, and
uses feedback to coach employees.

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Democratic-participatory style describes
the leadership of Francisco Gonzalez,
chairman and CEO of BBVA, a global
banking group based in Spain. Gonzalez
involves employees in decision making
and promotes teamwork as the key to
generating customer value. With BBVA
continuing its global expansion, the
company needs to fill a growing number
of management positions. It identifies
managerial talent whose style is
participatory by using a survey that
allows employees to evaluate each
other based on work habits, assuring that
future leaders are democratic rather
than autocratic.Gonzalez is shown here
at a BBVA technology event during a
presentation of the bank’s strategic
innovation and transformation plan.

in decision making, delegates authority, encourages participation in deciding
work methods and goals, and uses feedback as an opportunity to coach
employees. The democratic style can be further classified in two ways:
consultative and participative. A democratic-consultative leader seeks
input and hears the concerns and issues of employees but makes the final decision
him- or herself. In this capacity, the democratic-consultative leader is using the
input as an information-seeking exercise. A democratic-participative leader
often allows employees to have a say in what’s decided. Here, decisions are
made by the group, with the leader providing one input to that group. Finally,
the laissez-faire style generally gives his or her employees complete freedom
to make decisions and to complete their work in whatever way they see fit.
A laissez-faire leader might simply provide necessary materials and answer
questions.

Lewin and his associates wondered which one of the three leadership styles was most
effective. On the basis of their studies of leaders from boys’ clubs, they concluded that the
laissez-faire style was ineffective on every performance criterion when compared with both
democratic and autocratic styles. Quantity of work done was equal in groups with demo-
cratic and autocratic leaders, but work quality and group satisfaction were higher in
democratic groups. The results suggest that a democratic leadership style could contribute
to both good quantity and high quality of work.

Later studies of autocratic and democratic styles of leadership showed mixed results. For
example, democratic leadership styles sometimes produced higher performance levels than au-
tocratic styles, but at other times they produced group performance that was lower than or equal
to that of autocratic styles. Nonetheless, more consistent results were generated when a meas-
ure of employee satisfaction was used.

Group members’ satisfaction levels were generally higher under a democratic leader
than under an autocratic one.5 Did this finding mean that managers should always exhibit a
democratic style of leadership? Two researchers, Robert Tannenbaum and Warren Schmidt,
attempted to provide that answer.

Tannenbaum and Schmidt developed a continuum of leader behaviors (see Exhibit 11-2).
The continuum illustrates that a range of leadership behaviors, all the way from boss centered
(autocratic) on the left side of the model to employee centered (laissez-faire) on the right side
of the model, is possible. In deciding which leader behavior from the continuum to use,
Tannenbaum and Schmidt proposed that managers look at forces within themselves (such as
comfort level with the chosen leadership style), forces within the employees (such as readi-
ness to assume responsibility), and forces within the situation (such as time pressures). They
suggested that managers should move toward more employee-centered styles in the long run
because such behavior would increase employees’ motivation, decision quality, teamwork,
morale, and development.

This dual nature of leader behaviors—that is, focusing on the work to be done and
focusing on the employees—is also a key characteristic of the Ohio State and University of
Michigan studies.

WHAT DID THE OHIO STATE STUDIES SHOW? The most comprehensive and replicated of
the behavioral theories resulted from research that began at Ohio State University in the
late 1940s.7 These studies sought to identify independent dimensions of leader behavior.
Beginning with more than 1,000 dimensions, the researchers eventually narrowed the list
down to two categories that accounted for most of the leadership behavior described by
employees. They called these two dimensions initiating structure and consideration.

Initiating structure refers to the extent to which a leader is likely to define and structure
his or her role and those of employees in the search for goal attainment. It includes behavior
that attempts to organize work, work relationships, and goals. For example, the leader who is
characterized as high in initiating structure assigns group members to particular tasks, expects
workers to maintain definite standards of performance, and emphasizes meeting deadlines.

Consideration is defined as the extent to which a leader has job relationships charac-
terized by mutual trust and respect for employees’ ideas and feelings. A leader who is high

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C H A P T E R 1 1 | L E A D E R S H I P A N D T R U S T 297

Manager
makes

decision and
announces it

Manager
“sells”

decision

Manager
presents
ideas and

invites
questions

Manager
presents
tentative
decision

subject to
change

Manager
defines
limits;

asks group
to make
decision

Manager
presents
problem,

gets
suggestions,

makes
decision

Manager
permits

employees
to function

within
defined
limits

Autocratic Participative

Consultative Democratic

Laissez-faire

Use of authority
by the manager

Area of freedom
for employees

Boss-centered
leadership

Employee-centered
leadership

EXHIBIT 11-2 Continuum of Leader Behavior

in consideration helps employees with personal problems, is friendly and approachable,
and treats all employees as equals. He or she shows concern for his or her followers’
comfort, well-being, status, and satisfaction.

Extensive research based on these definitions found that a leader who is high in initiat-
ing structure and consideration (a high-high leader) achieved high employee performance and
satisfaction more frequently than one who rated low on either consideration, initiating struc-
ture, or both. However, the high-high style did not always yield positive results. For example,
leader behavior characterized as high on initiating structure led to greater rates of grievances,
absenteeism, and turnover, and lower levels of job satisfaction for workers performing routine
tasks. Other studies found that high consideration was negatively related to performance rat-
ings of the leader by his or her manager. In conclusion, the Ohio State studies suggested that
the high-high style generally produced positive outcomes, but enough exceptions were found
to indicate that situational factors needed to be integrated into the theory.

HOW DID THE UNIVERSITY OF MICHIGAN STUDIES DIFFER? Leadership studies undertak-
en at the University of Michigan’s Survey Research Center, at about the same time as those
being done at Ohio State, had similar research objectives: to locate the behavioral character-
istics of leaders that were related to performance effectiveness. The Michigan group also

laissez-faire style
A leader who generally gives employees
complete freedom to make decisions and to
complete their work however they see fit.

initiating structure
The extent to which a leader defines and
structures his or her role and the roles of
employees to attain goals.

consideration
The extent to which a leader has job
relationships characterized by mutual trust,
respect for employees’ ideas, and regard for
their feelings.

Source: Adapted and reprinted by permission of the Harvard Business Review. An exhibit from “How to Choose a Leadership Pattern,” by
R. Tannenbaum and W. Schmidt, May–June 1973. Copyright© 1973 by the President and Fellows of Harvard College; all rights reserved.

298 PA R T F O U R | L E A D I N G

From the Past to the Present• •
Both the Ohio State and Michigan studies have added a lot
to our understanding of effective leadership.8 Prior to the
completion of these studies, it was widely thought by
researchers and practicing managers that one style of lead-
ership was good and another bad. However, as the research
showed, both leader behavior dimensions—job-centered
and employee-centered in the Michigan studies, and initiat-
ing structure and consideration in the Ohio State studies—
are necessary for effective leadership. That dual focus of
“what” a leader does still holds today. Leaders are expected

to focus on both the task and on the people he or she is
leading. Even the later contingency leadership theories
used the people/task distinction to define a leader’s style.
Finally, these early behavioral studies were important for the
“systematic methodology they introduced and the increased
awareness they generated concerning the importance of
leader behavior.” Although the behavioral theories may not
have been the final chapter in the book on leadership, they
“served as a springboard for the leadership research that
followed.”

11.3
Describe
the
four major
contingency
leadership
theories.

came up with two dimensions of leadership behavior, which they labeled employee oriented
and production oriented.9 Leaders who were employee oriented emphasized interpersonal
relations; they took a personal interest in the needs of their employees and accepted individual
differences among members. Leaders who were production oriented, in contrast, tended to
emphasize the technical or task aspects of the job, were concerned mainly with accomplishing
their group’s tasks, and regarded group members as a means to that end.

The conclusions of the Michigan researchers strongly favored leaders who were
employee oriented. Employee-oriented leaders were associated with higher group produc-
tivity and higher job satisfaction. Production-oriented leaders were associated with lower
group productivity and lower worker satisfaction.

WHAT IS THE MANAGERIAL GRID? The behavioral dimensions from these early leadership
studies provided the basis for the development of a two-dimensional grid for appraising
leadership styles. This managerial grid used the behavioral dimensions “concern for people”
and “concern for production” and evaluated a leader’s use of these behaviors, ranking them
on a scale from 1 (low) to 9 (high).10 Although the grid (shown in Exhibit 11-3) had 81 potential
categories into which a leader’s behavioral style might fall, only five styles were named:
impoverished management (1,1), task management (9,1), middle-of-the-road management
(5,5), country club management (1,9), and team management (9,9). Of these five styles, the
researchers concluded that managers performed best when using a 9,9 style. Unfortunately,
the grid offered no answers to the question of what made a manager an effective leader; it
only provided a framework for conceptualizing leadership style. In fact, there’s little substan-
tive evidence to support the conclusion that a 9,9 style is most effective in all situations.11

Leadership researchers were discovering that predicting leadership success involved
something more complex than isolating a few leader traits or preferable behaviors. They
began looking at situational influences. Specifically, which leadership styles might be
suitable in different situations and what were these different situations?

What Do the Contingency Theories
of Leadership Tell Us?
“The corporate world is f illed with stories of leaders who failed to
achieve greatness because they failed to understand the context they were
working in . . .”12 In this section we examine four contingency theories—

Fiedler, Hersey-Blanchard, leader-participation, and path-goal. Each
looks at defining leadership style and the situation, and attempts to answer

the if-then contingencies (that is, if this is the context or situation, then this
is the best leadership style to use).

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C H A P T E R 1 1 | L E A D E R S H I P A N D T R U S T 29

What Was the First Comprehensive Contingency
Model?
The first comprehensive contingency model for leadership was developed by Fred Fiedler.13

The Fiedler contingency model proposed that effective group performance depended upon
properly matching the leader’s style and the amount of control and influence in the situation.
The model was based on the premise that a certain leadership style would be most effective in
different types of situations. The keys were (1) define those leadership styles and the different
types of situations and then (2) identify the appropriate combinations of style and situation.

Fiedler proposed that a key factor in leadership success was an individual’s basic leader-
ship style, either task oriented or relationship oriented. To measure a leader’s style, Fiedler
developed the least-preferred co-worker (LPC) questionnaire. This questionnaire contained
18 pairs of contrasting adjectives—for example, pleasant–unpleasant, cold–warm, boring–
interesting, or friendly–unfriendly. Respondents were asked to think of all the coworkers they
had ever had and to describe that one person they least enjoyed working with by rating him or

managerial grid
A two-dimensional grid for appraising
leadership styles.

employee oriented
A leader who emphasizes the people aspects.

production oriented
A leader who emphasizes the technical or task
aspects.

Fiedler contingency model
Leadership theory that proposes that effective
group performance depends on the proper
match between a leader’s style and the
degree to which the situation allowed the
leader to control and influence.

least-preferred co-worker (LPC)
questionnaire
A questionnaire that measures whether a
leader was task or relationship oriented.

1 2 3 4 5 6 7 8 9

Concern for Production

1
2
3
4
5
6
7
8
9

C
o
n
c
e
rn

f
o
r

P
e
o
p
le

(1,9) Country Club Management
Thoughtful attention
to needs of people for
satisfying relationship
leads to a comfortable,
friendly organization
atmosphere and work
tempo.

(9,9) Team Management
Work accomplished is
from committed people;
interdependence through
a “common stake” in
organization purpose leads
to relationships of trust
and respect.

(5,5) Middle of the Road Management
Adequate organization
performance is possible
through balancing the
necessity to get out
work with maintaining
morale of people at a
satisfactory level.

(1,1) Impoverished Management
Exertion of minimum effort
to get required work done
is appropriate to sustain
organization membership.

(9,1) Task Management
Efficiency in operations
results from arranging
conditions of work in
such a way that human
elements interfere to a
minimum degree.

EXHIBIT 11-3 The Managerial Grid

Source: Adapted and reprinted by permission of the Harvard Business Review. An exhibit
from “Breakthrough in Organization Development,” by R. R. Blake, J. A. Mouton,
L. B. Barnes, and L. E. Greine, November–December 1964, p. 136. Copyright© 1964 by the
President and Fellows of Harvard College; all rights reserved.

300 PA R T F O U R | L E A D I N G

I II III IV V VI VII VIII

Good Good Good Good Poor Poor Poor Poor

High High High HighLow Low Low Low

Strong Weak Strong Weak Strong Weak Strong Weak

Category

Leader–member
relations

Task structure

Position power

Good

Poor Favorable Moderate Unfavorable

Performance Task oriented

Relationship oriented

Highly
Favorable Moderate

Highly
Unfavorable

EXHIBIT 11-4 The Fiedler Model

her on a scale of 1 to 8 for each of the sets of adjectives (the 8 always described the positive
adjective out of the pair and the 1 always described the negative adjective out of the pair).

If the leader described the least preferred coworker in relatively positive terms (in other
words, a “high” LPC score—a score of 64 or above), then the respondent was primarily
interested in good personal relations with coworkers and the style would be described as
relationship oriented. In contrast, if you saw the least preferred coworker in relatively
unfavorable terms (a low LPC score—a score of 57 or below), you were primarily interested in
productivity and getting the job done; thus, your style would be labeled as task oriented. Fiedler
did acknowledge that a small number of people might fall in between these two extremes and
not have a cut-and-dried leadership style. One other important point is that Fiedler assumed a
person’s leadership style was fixed regardless of the situation. In other words, if you were a
relationship-oriented leader, you’d always be one, and the same for task-oriented.

After an individual’s leadership style had been assessed through the LPC, it was time
to evaluate the situation in order to be able to match the leader with the situation. Fiedler’s
research uncovered three contingency dimensions that defined the key situational factors in
leader effectiveness. These were:

� Leader-member relations: the degree of confidence, trust, and respect employees had
for their leader; rated as either good or poor.

� Task structure: the degree to which job assignments were formalized and structured;
rated as either high or low.

� Position power: the degree of influence a leader had over activities such as hiring, firing,
discipline, promotions, and salary increases; rated as either strong or weak.

Each leadership situation was evaluated in terms of these three contingency variables, which
when combined produced eight possible situations that were either favorable or unfavorable for
the leader. (See the bottom of the chart in Exhibit 11-4). Situations I, II, and III were classified
as highly favorable for the leader. Situations IV, V, and VI were moderately favorable for the
leader. And situations VII and VIII were described as highly unfavorable for the leader.

Once Fiedler had described the leader variables and the situational variables, he had every-
thing he needed to define the specific contingencies for leadership effectiveness. To do so, he
studied 1,200 groups where he compared relationship-oriented versus task-oriented leader-
ship styles in each of the eight situational categories. He concluded that task-oriented leaders

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situational leadership theory (SLT)
A leadership contingency theory that focuses
on followers’ readiness.

performed better in very favorable situations and in very
unfavorable situations. (See the top of Exhibit 11-4 where
performance is shown on the vertical axis and situation
favorableness is shown on the horizontal axis.) On the
other hand, relationship-oriented leaders performed better
in moderately favorable situations.

Because Fiedler treated an individual’s leadership
style as fixed, there were only two ways to improve
leader effectiveness. First, you could bring in a new
leader whose style better fit the situation. For instance,
if the group situation was highly unfavorable but was led
by a relationship-oriented leader, the group’s perform-
ance could be improved by replacing that person with a
task-oriented leader. The second alternative was to
change the situation to fit the leader. This could be done
by restructuring tasks; by increasing or decreasing the
power that the leader had over factors such as salary
increases, promotions, and disciplinary actions; or by
improving the leader-member relations.

Research testing the overall validity of Fiedler’s model has shown considerable evi-
dence to support the model.14 However, his theory wasn’t without criticisms. The major one
is that it’s probably unrealistic to assume that a person can’t change his or her leadership style
to fit the situation. Effective leaders can, and do, change their styles. Another is that the
LPC wasn’t very practical. Finally, the situation variables were difficult to assess.15 Despite
its shortcomings, the Fiedler model showed that effective leadership style needed to reflect
situational factors.

How Do Followers’ Willingness and Ability
Influence Leaders?
Paul Hersey and Ken Blanchard developed a leadership theory that has gained a strong
following among management development specialists.16 This model, called situational
leadership theory (SLT), is a contingency theory that focuses on followers’ readiness.
Before we proceed, there are two points we need to clarify: Why a leadership theory
focuses on the followers, and what is meant by the term readiness.

The emphasis on the followers in leadership effectiveness reflects the reality that it is
the followers who accept or reject the leader. Regardless of what the leader does, the group’s
effectiveness depends on the actions of the followers. This is an important dimension that
has been overlooked or underemphasized in most leadership theories. And readiness, as
defined by Hersey and Blanchard, refers to the extent to which people have the ability and
willingness to accomplish a specific task.

SLT uses the same two leadership dimensions that Fiedler identified: task and relation-
ship behaviors. However, Hersey and Blanchard go a step further by considering each as either
high or low and then combining them into four specific leadership styles described as follows:

� Telling (high task–low relationship): The leader defines roles and tells people what,
how, when, and where to do various tasks.

� Selling (high task–high relationship): The leader provides both directive and supportive
behavior.

� Participating (low task–high relationship): The leader and followers share in decision
making; the main role of the leader is facilitating and communicating.

� Delegating (low task–low relationship): The leader provides little direction or support.

C H A P T E R 1 1 | L E A D E R S H I P A N D T R U S T 301

Once successful as a general interest
magazine, Reader’s Digest has steadily
lost readers, advertising revenues, and
profits since the 1990s. The three women
shown here were hired by the
magazine’s publishers to lead a change
in the magazine’s direction from a
general-interest format aimed at a
broad audience to a narrower reader
base that holds conservative social
values. Leading the change are, from
left, Eva Dillon, president of the
magazine, related books, and Web sites
division; Peggy Northrop, U.S. editor-
in-chief; and Mary Berner, president
and chief executive of Reader’s Digest
Association. According to Fiedler’s
contingency model, the success of these
leaders depends on the match between
their leadership style and the influences
of their situation.

readiness
The extent to which people have the ability
and willingness to accomplish a specific task.IS

B
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1-
25

6-
14

37
9-

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percent of organizations
haven’t thought about tai-
loring leadership develop-

ment activities to accommodate
managerial diversity.

percent of workers want a
leader who can create a
shared vision.

percent of women prefer a
female boss; only 13 percent
of men do.

percent of companies have a
defined set of qualities they
look for when hiring leaders.

percent of company leaders
report they’ve used a lead-
ership coach or mentor.

The final component in the model is the four stages of follower readiness:

� R1: People are both unable and unwilling to take responsibility for doing something.
Followers aren’t competent or confident.

� R2: People are unable but willing to do the necessary job tasks. Followers are motivated
but lack the appropriate skills.

� R3: People are able but unwilling to do what the leader wants. Followers are competent,
but don’t want to do something.

� R4: People are both able and willing to do what is asked of them.

SLT essentially views the leader-follower relationship as like that of a parent and a child.
Just as a parent needs to relinquish control when a child becomes more mature and responsible,
so, too, should leaders. As followers reach higher levels of readiness, the leader responds not
only by decreasing control over their activities but also decreasing relationship behaviors. The
SLT says if followers are at R1 (unable and unwilling to do a task), the leader needs to use the
telling style and give clear and specific directions; if followers are at R2 (unable and willing),
the leader needs to use the selling style and display high task orientation to compensate for the
followers’ lack of ability and high relationship orientation to get followers to “buy into” the
leader’s desires; if followers are at R3 (able and unwilling), the leader needs to use the partic-
ipating style to gain their support; and if employees are at R4 (both able and willing), the
leader doesn’t need to do much and should use the delegating style.

SLT has intuitive appeal. It acknowledges the importance of followers and builds on the
logic that leaders can compensate for ability and motivational limitations in their followers.
However, research efforts to test and support the theory generally have been disappointing.18

Possible explanations include internal inconsistencies in the model as well as problems with
research methodology. Despite its appeal and wide popularity, we have to be cautious about
any enthusiastic endorsement of SLT.

How Participative Should a Leader Be?
Back in 1973, Victor Vroom and Phillip Yetton developed a leader-participation model that
related leadership behavior and participation to decision making.19 Recognizing that task
structures have varying demands for routine and nonroutine activities, these researchers
argued that leader behavior must adjust to reflect the task structure. Vroom and Yetton’s model
was normative. That is, it provided a sequential set of rules to be followed in determining
the form and amount of participation in decision making in different types of situations.
The model was a decision tree incorporating seven contingencies (whose relevance could be
identified by making yes or no choices) and five alternative leadership styles.

More recent work by Vroom and Arthur Jago has revised that model.20 The new model
retains the same five alternative leadership styles but expands the contingency variables to twelve—
from the leader’s making the decision completely by himself or herself to sharing the problem
with the group and developing a consensus decision. These variables are listed in Exhibit 11-5.

percent of their time is what
senior executives are believed
to spend on leadership devel-

opment activities.

percent of global organiza-
tions say they have a process
in place to identify potential

leaders.

72
23
68
51

1. Importance of the decision
2. Importance of obtaining follower commitment to the decision
3. Whether the leader has sufficient information to make a good decision
4. How well structured the problem is
5. Whether an autocratic decision would receive follower commitment
6. Whether followers “buy into” the organization’s goals
7. Whether there is likely to be conflict among followers over solution alternatives
8. Whether followers have the necessary information to make a good decision
9. Time constraints on the leader that may limit follower involvement

10. Whether costs to bring geographically dispersed members together are justified
11. Importance to the leader of minimizing the time it takes to make the decision
12. Importance of using participation as a tool for developing follower decision skills

Source: S. P. Robbins and T. A. Judge, Organizational Behavior 13th ed. (Upper Saddle River, NJ: Prentice Hall, 2009), p. 400.

EXHIBIT 11-5 Contingency Variables in the Revised Leader-Participation Model

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leader-participation model
A leadership contingency theory that’s based
on a sequential set of rules for determining how
much participation a leader uses in decision
making according to different types of
situations.

path-goal theory
A leadership theory that says the leader’s job is
to assist followers in attaining their goals and to
provide direction or support needed to ensure
that their goals are compatible with the
organization’s or group’s goals.

Shelley Roberts, managing director
of Tiger Airways, is an achievement-
oriented leader. She accepted the
challenging goal of guiding the
Singapore-based budget airline
through an expansion in Australia, a
market dominated by the established
Qantas Airlines. Roberts earned a
reputation as a high achiever through
successful senior leadership positions in
both airline and airport management.
She was a senior executive at Britain’s
low-budget EasyJet airline when it
entered the European market and
successfully competed against carriers
like British Airways. In this photo, Roberts
and the West Tigers’ rugby club
members pull a plane out of its hanger
during the launch of the Tiger Airways
new route between Melbourne and
Sydney.

Research on the original leader-participation model was encouraging.21 But, unfor-
tunately, the model is far too complex for the typical manager to use regularly. In fact,
Vroom and Jago have developed a computer program to guide managers through all the
decision branches in the revised model. Although we obviously can’t do justice to this
model’s sophistication in this discussion, it has provided us with some solid, empirically
supported insights into key contingency variables related to leadership effectiveness.
Moreover, the leader-participation model conf irms that leadership research should be
directed at the situation rather than at the person. That is, it probably makes more sense
to talk about autocratic and participative situations than autocratic and participative leaders.
As House does in his path-goal theory (discussed next), Vroom, Yetton, and Jago argue
against the notion that leader behavior is inflexible. The leader-participation model
assumes that the leader can adapt his or her style to different situations.22

How Do Leaders Help Followers?
Currently, one of the most respected approaches to understanding leadership is path-goal
theory, which states that the leader’s job is to assist followers in attaining their goals and
to provide direction or support needed to ensure that their goals are compatible with the
goals of the group or organization. Developed by Robert House, path-goal theory takes
key elements from the expectancy theory of motivation (see Chapter 10).23 The term
path-goal is derived from the belief that effective leaders clarify the path to help their
followers get from where they are to the achievement of their work goals and make the
journey along the path easier by reducing roadblocks and pitfalls.

House identified four leadership behaviors:

� Directive leader: Lets subordinates know what’s expected of them, schedules work to
be done, and gives specific guidance on how to accomplish tasks.

� Supportive leader: Shows concern for the needs of followers and is friendly.
� Participative leader: Consults with group members and uses their suggestions before

making a decision.
� Achievement oriented leader: Sets challenging goals and expects followers to perform

at their highest level.

In contrast to Fiedler’s view
that a leader couldn’t
change his or her
behavior, House
a s s u m e d
that lead-
ers are flex-
ible and
can display
any or all of these leadership
styles depending on the situation.

As Exhibit 11-6 illustrates, path-goal
theory proposes two situational or contin-
gency variables that moderate the leadership behavior-
outcome relationship: those in the environment that are outside the control of the follower
(factors including task structure, formal authority system, and the work group) and
those that are part of the personal characteristics of the follower (including locus of
control, experience, and perceived ability). Environmental factors determine the type
of leader behavior required if subordinate outcomes are to be maximized; personal

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characteristics of the follower determine how the environment and leader behavior are inter-
preted. The theory proposes that a leader’s behavior won’t be effective if it’s redundant with
what the environmental structure is providing or is incongruent with follower characteristics. For
example, some predictions from path-goal theory are:

� Directive leadership leads to greater satisfaction when tasks are ambiguous or stressful
than when they are highly structured and well laid out. The followers aren’t sure what to
do, so the leader needs to give them some direction.

� Supportive leadership results in high employee performance and satisfaction when
subordinates are performing structured tasks. In this situation, the leader only needs to
support followers, not tell them what to do.

� Directive leadership is likely to be perceived as redundant among subordinates with high
perceived ability or with considerable experience. These followers are quite capable so
they don’t need a leader to tell them what to do.

� The clearer and more bureaucratic the formal authority relationships, the more leaders
should exhibit supportive behavior and deemphasize directive behavior. The organiza-
tional situation has provided the structure as far as what is expected of followers, so the
leader’s role is simply to support.

� Directive leadership will lead to higher employee satisfaction when there is substantive
conflict within a work group. In this situation, the followers need a leader who will take
charge.

� Subordinates with an internal locus of control will be more satisfied with a participative
style. Because these followers believe that they control what happens to them, they
prefer to participate in decisions.

� Subordinates with an external locus of control will be more satisfied with a directive
style. These followers believe that what happens to them is a result of the external
environment so they would prefer a leader who tells them what to do.

� Achievement-oriented leadership will increase subordinates’ expectancies that effort will
lead to high performance when tasks are ambiguously structured. By setting challenging
goals, followers know what the expectations are.

• Locus of control
• Experience
• Perceived ability

• Task structure
• Formal authority system
• Work group

• Directive
• Supportive
• Participative
• Achievement oriented

• Performance
• Satisfaction

Leader behavior

Environmental contingency
factors

Outcomes

Employee contingency factors

EXHIBIT 11-6 Path-Goal Model

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Describe
modern views
of leadership
and the issues
facing today’s
leaders.

11.4

C H A P T E R 1 1 | L E A D E R S H I P A N D T R U S T 305

transformational leaders
Leaders who stimulate and inspire (transform)
followers to achieve extraordinary outcomes.

transactional leaders
Leaders who lead primarily by using social
exchanges (or transactions).

Research on the path-goal model is generally encouraging. Although not every study
has found support, the majority of the evidence supports the logic underlying the theory.24

In summary, an employee’s performance and satisfaction are likely to be positively influ-
enced when the leader chooses a leadership style that compensates for shortcomings in
either the employee or the work setting. However, if the leader spends time explaining tasks
that are already clear or when the employee has the ability and experience to handle them
without interference, the employee is likely to see such directive behavior as redundant or
even insulting.

What Is Leadership Like Today?
What are the latest views of leadership and what issues do today’s leaders
have to deal with? In this section, we’re going to look at three contemporary
views of leadership: transformational-transactional leadership, charismatic-
visionary leadership, and team leadership. In addition, we’ll discuss
some issues that leaders have to face in leading effectively in today’s
environment.

What Do the Three Contemporary Views
of Leadership Tell Us?
Remember our discussion at the beginning of this chapter where we said that leadership
studies have long had the goal of describing what it takes to be an effective leader. That
goal hasn’t changed! Even the contemporary views of leadership are interested in answer-
ing that question. These views of leadership have a common theme: leaders who inspire
and support followers.

HOW DO TRANSACTIONAL LEADERS DIFFER FROM TRANSFORMATIONAL LEADERS? Many
early leadership theories viewed leaders as transactional leaders; that is, leaders who lead
primarily by using social exchanges (or transactions).Transactional leaders guide or motivate
followers to work toward established goals by exchanging rewards for their productivity.25

But there’s another type of leader—a transformational leader—who stimulates and inspires
(transforms) followers to achieve extraordinary outcomes. Examples include Jim Goodnight of
SAS Institute and Andrea Jung of Avon. They pay attention to the concerns and developmental
needs of individual followers; they change followers’ awareness of issues by helping those
followers look at old problems in new ways; and they are able to excite, arouse, and inspire
followers to exert extra effort to achieve group goals.

Transactional and transformational leadership shouldn’t be viewed as opposing
approaches to getting things done.26 Transformational leadership develops from transactional
leadership. It produces levels of employee effort and performance that go beyond what would
occur with a transactional approach alone. Moreover, transformational leadership is more
than charisma since the transformational leader attempts to instill in followers the ability to
question not only established views but those views held by the leader.27

The evidence supporting the superiority of transformational leadership over transactional
leadership is overwhelmingly impressive. For instance, studies that looked at managers in
different settings, including the military and business, found that transformational leaders
were evaluated as more effective, higher performers, more promotable than their transac-
tional counterparts, and more interpersonally sensitive.28 In addition, evidence indicates
that transformational leadership is strongly correlated with lower turnover rates and
higher levels of productivity, employee satisfaction, creativity, goal attainment, and follower
well-being.29

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HOW DO CHARISMATIC LEADERSHIP AND VISIONARY LEADERSHIP DIFFER?
Jeff Bezos, founder and CEO of Amazon.com, is a person who exudes
energy, enthusiasm, and drive.30 He’s fun-loving (his legendary laugh has
been described as a flock of Canadian geese on nitrous oxide), but has
pursued his vision for Amazon.com with serious intensity and has demon-
strated an ability to inspire his employees through the ups and downs of a
rapidly growing company. Bezos is what we call a charismatic leader—
that is, an enthusiastic, self-confident leader whose personality and actions
influence people to behave in certain ways.

Several authors have attempted to identify personal characteristics of the
charismatic leader.31 The most comprehensive analysis identified five such
characteristics: they have a vision, the ability to articulate that vision, willing-
ness to take risks to achieve that vision, sensitivity to both environmental
constraints and follower needs, and behaviors that are out of the ordinary.32

There’s an increasing body of evidence that shows impressive correla-
tions between charismatic leadership and high performance and satisfaction
among followers.33 Although one study found that charismatic CEOs had no
impact on subsequent organizational performance, charisma is still believed
to be a desirable leadership quality.34

If charisma is desirable, can people learn to be charismatic leaders?
Or are charismatic leaders born with their qualities? Although a small number of experts
still think that charisma can’t be learned, most believe that individuals can be trained to
exhibit charismatic behaviors.35 For example, researchers have succeeded in teaching
undergraduate students to “be” charismatic. How? They were taught to articulate a far-
reaching goal, communicate high performance expectations, exhibit confidence in the
ability of subordinates to meet those expectations, and empathize with the needs of their
subordinates; they learned to project a powerful, confident, and dynamic presence; and
they practiced using a captivating and engaging voice tone. The researchers also trained
the student leaders to use charismatic nonverbal behaviors including leaning toward the
follower when communicating, maintaining direct eye contact, and having a relaxed pos-
ture and animated facial expressions. In groups with these “trained” charismatic leaders,
members had higher task performance, higher task adjustment, and better adjustment to
the leader and to the group than did group members who worked in groups led by non-
charismatic leaders.

One last thing we should say about charismatic leadership is that it may not always be
necessary to achieve high levels of employee performance. It may be most appropriate when
the follower’s task has an ideological purpose or when the environment involves a high
degree of stress and uncertainty.36 This may explain why, when charismatic leaders surface,
it’s more likely to be in politics, religion, or wartime; or when a business firm is starting up
or facing a survival crisis. For example, Martin Luther King Jr. used his charisma to bring
about social equality through nonviolent means; and Steve Jobs achieved unwavering
loyalty and commitment from Apple’s technical staff in the early 1980s by articulating a
vision of personal computers that would dramatically change the way people lived.

Although the term vision is often linked with charismatic leadership, visionary leader-
ship is different since it’s the ability to create and articulate a realistic, credible, and attrac-
tive vision of the future that improves upon the present situation.37 This vision, if properly
selected and implemented, is so energizing that it “in effect jump-starts the future by calling
forth the skills, talents, and resources to make it happen.”38

An organization’s vision should offer clear and compelling imagery that taps into
people’s emotions and inspires enthusiasm to pursue the organization’s goals. It should be
able to generate possibilities that are inspirational and unique and offer new ways of doing
things that are clearly better for the organization and its members. Visions that are clearly
articulated and have powerful imagery are easily grasped and accepted. For instance,
Michael Dell created a vision of a business that sells and delivers customized PCs
directly to customers in less than a week. The late Mary Kay Ash’s vision of women as
entrepreneurs selling products that improved their self-image gave impetus to her cos-
metics company, Mary Kay Cosmetics.

Amazon.com founder and CEO Jeff
Bezos is a charismatic leader who has
the energy, optimism, enthusiasm,
confidence, and drive to set and pursue
goals for risky new ventures and to inspire
his employees to work hard to achieve
them. Starting his company in 1994 with
the vision of providing consumers with
the service of an online bookstore, Bezos
has built Amazon into the largest retailer
on the Web. He reinvented the company
by introducing a product innovation, the
Kindle electronic reader, that began with
his long-term vision of “every book, ever
printed, in any language, all available in
less than 60 seconds.”

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WHAT ABOUT LEADERS AND TEAMS? Because leadership is
increasingly taking place within a team context and more organ-
izations are using work teams, the role of the leader in guiding
team members has become increasingly important. The role of
team leader is different from the traditional leadership role, as J.
D. Bryant, a supervisor at Texas Instruments’ Forest Lane plant
in Dallas, discovered.39 One day he was contentedly overseeing a
staff of 15 circuit board assemblers. The next day he was told that
the company was going to use employee teams and he was to
become a “facilitator.” He said, “I’m supposed to teach the teams
everything I know and then let them make their own decisions.”
Confused about his new role, he admitted, “There was no clear
plan on what I was supposed to do.” What is involved in being a
team leader?

Many leaders are not equipped to handle the change to
employee teams. As one consultant noted, “Even the most capa-
ble managers have trouble making the transition because all the
command-and-control type things they were encouraged to do
before are no longer appropriate. There’s no reason to have any
skill or sense of this.”40 This same consultant estimated that
“probably 15 percent of managers are natural team leaders;
another 15 percent could never lead a team because it runs
counter to their personality—that is, they’re unable to sublimate
their dominating style for the good of the team. Then there’s that
huge group in the middle: Team leadership doesn’t come natu-
rally to them, but they can learn it.”41

The challenge for many managers is learning how to become
an effective team leader. They have to learn skills such as
patiently sharing information, being able to trust others and to give up authority, and under-
standing when to intervene. And effective team leaders have mastered the difficult balancing
act of knowing when to leave their teams alone and when to get involved. New team leaders
may try to retain too much control at a time when team members need more autonomy, or
they may abandon their teams at times when the teams need support and help.42

One study looking at organizations that had reorganized themselves around employee
teams found certain common responsibilities of all leaders. These included coaching,
facilitating, handling disciplinary problems, reviewing team and individual performance,
training, and communication.43 However, a more meaningful way to describe the team
leader’s job is to focus on two priorities: (1) managing the team’s external boundary and
(2) facilitating the team process.44 These priorities entail four specific leadership roles as
shown in Exhibit 11-7.

What Issues Do Today’s Leaders Face?
It’s not easy being a chief information officer (CIO) today. As the person responsible for
managing a company’s information technology activities, there are a lot of external and
internal pressures. Technology continues to change rapidly—almost daily, it sometimes
seems. Business costs continue to rise. Rob Carter, CIO of FedEx, is on the hot seat facing
such challenges.45 He’s responsible for all the computer and communication systems that
provide around-the-clock and around-the-globe support for FedEx’s products and services.
If anything goes wrong, you know who takes the heat. However, Carter has been an effective
leader in this seemingly chaotic environment.

charismatic leaders
Enthusiastic, self-confident leaders whose
personalities and actions influence people
to behave in certain ways.

Right orWrong?

The definition of “friend” on social networking sites such as Facebook

and MySpace is so broad that even strangers may tag you. But it doesn’t

feel weird because nothing really changes when a stranger does this.

However, what if your boss, who isn’t much older than you are, asks you

to be a friend on these sites? What then? What are the implications if you

refuse the offer? What are the implications if you accept? What ethical

issues might arise because of this? What would you do?

visionary leadership
The ability to create and articulate a realistic,
credible, and attractive vision of the future that
improves on the present situation.IS

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Leading effectively in today’s environment is unlikely to involve such challenges
for most leaders. However, twenty-first-century leaders do face some important leader-
ship issues. In this section, we look at these issues including empowering employees,
cross-cultural leadership, and emotional intelligence and leadership. We’ll also look at
gender differences in leadership in the “Managing Diversity” box.

WHY DO LEADERS NEED TO EMPOWER EMPLOYEES? As we’ve described in different
places throughout the text, managers are increasingly leading by not leading; that is, by
empowering their employees. Empowerment involves increasing the decision-making dis-
cretion of workers. Millions of individual employees and employee teams are making the
key operating decisions that directly affect their work. They’re developing budgets, schedul-
ing workloads, controlling inventories, solving quality problems, and engaging in similar
activities that until very recently were viewed exclusively as part of the manager’s job.46 For
instance, at The Container Store, any employee who gets a customer request has permission
to take care of it. The company’s cochairman Garret Boone says, “Everybody we hire, we
hire as a leader. Anybody in our store can take an action that you might think of typically
being a manager’s action.”47

One reason more companies are empowering employees is the need for quick deci-
sions by those people who are most knowledgeable about the issues—often those at lower
organizational levels. If organizations want to successfully compete in a dynamic global
economy, employees have to be able to make decisions and implement changes quickly.
Another reason is that organizational downsizings left many managers with larger spans
of control. In order to cope with the increased work demands, managers had to empower
their people. Although empowerment is not a universal answer, it can be beneficial when
employees have the knowledge, skills, and experience to do their jobs competently.

Technology also has contributed to the increases in employee empowerment. Managers
face unique challenges in leading empowered employees who aren’t physically present in
the workplace as the “Technology and the Manager’s Job” box discusses.

DOES NATIONAL CULTURE AFFECT LEADERSHIP? One general conclusion that surfaces
from leadership research is that effective leaders do not use a single style. They adjust their
style to the situation. Although not mentioned explicitly, national culture is certainly an
important situational variable in determining which leadership style will be most effective.
What works in China isn’t likely to be effective in France or Canada. For instance, one
study of Asian leadership styles revealed that Asian managers preferred leaders who were
competent decision makers, effective communicators, and supportive of employees.48

National culture affects leadership style because it influences how followers will
respond. Leaders can’t (and shouldn’t) just choose their styles randomly. They’re
constrained by the cultural conditions their followers have come to expect. Exhibit 11-8
provides some findings from selected examples of cross-cultural leadership studies.

Effective
Team Leadership

Roles

Coaches
Liaisons with

external constituents

Conflict managers Troubleshooters

EXHIBIT 11-7 Team Leader Roles

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Published by Prentice Hall. Copyright © 2011 by Pearson Education, Inc.

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VIRTUAL LEADERSHIP

H
ow do you lead people who are physi-

cally separated from you and with

whom your interactions are primarily

written digital communications?49 That’s the

challenge of being a virtual leader. And unfor-

tunately, leadership research has been

directed mostly at face-to-face and verbal sit-

uations. But we can’t ignore the reality that

today’s managers and their employees are

increasingly being linked by technology rather

than by geographic proximity. So what guid-

ance can be provided to leaders who must

inspire and motivate dispersed employees?

It’s easy to soften harsh words in face-

to-face communication with nonverbal action.

A smile or a comforting gesture can go a long

way in lessening the blow behind strong

words like disappointed, unsatisfactory,

inadequate, or below expectations. That non-

verbal component doesn’t exist in online

interactions. The structure of words in a dig-

ital communication also has the power to

motivate or demotivate the receiver. A man-

ager who inadvertently sends a message in

short phrases or in ALL CAPS may get a very

different response than if the message had

been sent in full sentences using appropriate

punctuation.

To be an effective virtual leader, man-

agers must recognize that they have choices

in the words and structure of their digital

communications. They also need to develop

the skill of “reading between the lines” in the

messages they receive. It’s important to try

and decipher the emotional content of a

message as well as the written content. Also,

virtual leaders need to think carefully about

what actions they want their digital mes-

sages to initiate. Be clear about what’s

expected and follow up on messages.

For an increasing number of managers,

good interpersonal skills may include the

abilities to communicate support and leader-

ship through digital communication and to

read emotions in others’ messages. In this

“new world” of communication, writing skills

are likely to become an extension of interper-

sonal skills.

empowerment
The act of increasing the decision-making
discretion of workers.

� Korean leaders are expected to be paternalistic toward employees.

� Arab leaders who show kindness or generosity without being asked to do so are seen by other
Arabs as weak.

� Japanese leaders are expected to be humble and speak frequently.

� Scandinavian and Dutch leaders who single out individuals with public praise are likely to
embarrass, not energize, those individuals.

� Effective leaders in Malaysia are expected to show compassion while using more of an autocratic
than a participative style.

� Effective German leaders are characterized by high performance orientation, low compassion,
low self-protection, low team orientation, high autonomy, and high participation.

Sources: Based on J. C. Kennedy, “Leadership in Malaysia: Traditional Values, International Outlook,” Academy
of Management Executive (August 2002), pp. 15–17; F. C. Brodbeck, M. Frese, and M. Javidan, “Leadership
Made in Germany: Low on Compassion, High on Performance,” Academy of Management Executive (February
2002), pp. 16–29; M. F. Peterson and J. G. Hunt, “International Perspectives on International Leadership,”
Leadership Quarterly (Fall 1997), pp. 203–31; R. J. House and R. N. Aditya, “The Social Scientific Study of
Leadership: Quo Vadis?” Journal of Management 23, no. 3 (1997), p. 463; and R. J. House, “Leadership in
the Twenty-First Century,” in A. Howard (ed.), The Changing Nature of Work (San Francisco: Jossey-Bass,
1995), p. 442.

EXHIBIT 11-8 Cross-Cultural Leadership

Because most leadership theories were developed in the United States, they have an
American bias. They emphasize follower responsibilities rather than rights; assume self-
gratification rather than commitment to duty or altruistic motivation; assume centrality
of work and democratic value orientation; and stress rationality rather than spirituality,
religion, or superstition.50 However, the GLOBE research program, which we f irst

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introduced in Chapter 2, is the most extensive and comprehensive cross-cultural study of
leadership ever undertaken. The GLOBE study has found that there are some universal
aspects to leadership. Specifically, a number of elements of transformational leadership
appear to be associated with effective leadership regardless of what country the leader is in.51

These include vision, foresight, providing encouragement, trustworthiness, dynamism,
positiveness, and proactiveness. The results led two members of the GLOBE team to con-
clude that “effective business leaders in any country are expected by their subordinates to
provide a powerful and proactive vision to guide the company into the future, strong
motivational skills to stimulate all employees to fulfill the vision, and excellent planning
skills to assist in implementing the vision.”52 Some people suggest that the universal
appeal of these transformational leader characteristics is due to the pressures toward
common technologies and management practices, as a result of global competitiveness
and multinational influences.

HOW DOES EMOTIONAL INTELLIGENCE AFFECT LEADERSHIP? We introduced emotional
intelligence (EI) in our discussion of emotions in Chapter 8. We revisit the topic here
because of recent studies indicating that EI—more than IQ, expertise, or any other single
factor—is the best predictor of who will emerge as a leader.53

As we said in our earlier discussion of trait research, leaders need basic intelligence
and job-relevant knowledge. But IQ and technical skills are “threshold capabilities.”
They’re necessary but not sufficient requirements for leadership. It’s the possession of
the five components of emotional intelligence—self-awareness, self-management, self-
motivation, empathy, and social skills—that allows an individual to become a star per-
former. Without EI, a person can have outstanding training, a highly analytical mind, a
long-term vision, and an endless supply of terrific ideas but still not make a great leader,
especially as individuals move up in an organization. The evidence indicates that the higher
the rank of a person considered to be a star performer, the more that EI capabilities surface
as the reason for his or her effectiveness. Specifically, when star performers were compared
with average ones in senior management positions, nearly 90 percent of the difference in
their effectiveness was attributable to EI factors rather than basic intelligence.

Interestingly, it’s been pointed out that the maturing of Rudolph Giuliani’s leadership
effectiveness closely followed the development of his emotional intelligence. For the better
part of the eight years he was mayor of New York, Giuliani ruled with an iron fist. He talked
tough, picked fights, and demanded results. The result was a city that was cleaner, safer, and
better governed—but also more polarized. Critics called Giuliani a tin-eared tyrant. In the
eyes of many, something important was missing from his leadership. That something, his
critics acknowledged, emerged as the World Trade Center collapsed. It was a newfound

Ken Chenault, CEO of American Express,
is a leader with high emotional
intelligence. Since joining the company
in 1981, he has emerged as a star
performer in a job that demands
interacting with employees, customers,
and political leaders throughout the
world. Chenault is described as
achievement oriented, open to
discussion, respectful, ethical, and
trustworthy. Mentally tough, he
welcomes constructive confrontation but
is humble and conducts himself in a
respectful and quietly assured manner. In
this photo Chenault visits with Ruth
Simmons, president of Brown University,
during an event that honored both of
them as two of America’s best leaders.

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MANAGING DIVERSITY | Do Men and Women Lead Differently?

Are there gender differences in leadership styles? Are men
more effective leaders, or does that honor belong to
women? Even asking those questions is certain to evoke
reactions on both sides of the debate.54

The evidence indicates that the two sexes are more
alike than different in the ways they lead. Much of this
similarity is based on the fact that leaders, regardless of
gender, perform similar activities in influencing others.
That’s their job, and the two sexes do it equally well. The
same holds true in other professions. For instance,
although the stereotypical nurse is a woman, men are
equally effective and successful in this career.

Saying the sexes are more alike than different still means
the two are not exactly the same. The most common differ-
ence lies in leadership styles. Women tend to use a more
democratic style. They encourage participation of their
followers and are willing to share their positional power with
others. In addition, women tend to influence others best
through their ability to be charmingly influential. Men, on the
other hand, tend to typically use a task-centered leadership

style. This approach includes directing activities of others
and relying on their positional power to control the
organization’s activities. But surprisingly, even this difference
is blurred. All things considered, when a woman is a leader
in a traditionally male-dominated job (such as that of a
police officer), she tends to lead in a manner that is more
task centered.

Further compounding this issue are the changing roles
of leaders in today’s organizations. With an increased
emphasis on teams, employee involvement, and interper-
sonal skills, democratic leadership styles are more in
demand. Leaders need to be more sensitive to their followers’
needs and more open in their communications; they
need to build more trusting relationships. And many of
these factors are behaviors that women have typically
grown up developing.

So what do you think? Is there a difference between
the sexes in terms of leadership styles? Do men or women
make better leaders? Would you prefer to work for a man
or a woman? What’s your opinion?

Discuss
trust as the
essence
of
leadership.

11.5

compassion to complement his command: a mix of resolve, empathy, and inspiration that
brought comfort to millions.55 It’s likely that Giuliani’s emotional capacities and compassion
for others were stimulated by a series of personal hardships—including prostate cancer and
the highly visible breakup of his marriage—both of which had taken place less than a year
before the terrorist attacks on the World Trade Center.56

EI has been shown to be positively related to job performance at all levels. But it appears
to be especially relevant in jobs that demand a high degree of social interaction. And of
course, that’s what leadership is all about. Great leaders demonstrate their EI by exhibiting
all five of its key components—self-awareness, self-management, self-motivation, empathy,
and social skills (see p. 222).

The recent evidence makes a strong case for concluding that EI is an essential element
in leadership effectiveness.57 As such, it could be added to the list of traits associated with
leadership that we described earlier in the chapter. EI may be something that comes easier
for women leaders particularly. The “Managing Diversity” box looks more closely at the
role of gender and leadership.

Why Is Trust the Essence of Leadership?
Trust, or lack of trust, is an increasingly important issue in today’s organi-
zations.58 In today’s uncertain environment, leaders need to build, or even
rebuild, trust and credibility. Before we can discuss ways leaders can do that,
we have to know what trust and credibility are and why they’re so important.

The main component of credibility is honesty. Surveys show that hon-
esty is consistently singled out as the number one characteristic of admired
leaders. “Honesty is absolutely essential to leadership. If people are going to
follow someone willingly, whether it be into battle or into the boardroom, they
first want to assure themselves that the person is worthy of their trust.”59 In addition
to being honest, credible leaders are competent and inspiring. They are personally able to
effectively communicate their confidence and enthusiasm. Thus, followers judge a leader’s
credibility in terms of his or her honesty, competence, and ability to inspire.

credibility
The degree to which followers perceive someone
as honest, competent, and able to inspire.I

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Trust is closely entwined with the concept of credibility, and, in fact, the terms are
often used interchangeably. Trust is defined as the belief in the integrity, character, and
ability of a leader. Followers who trust a leader are willing to be vulnerable to the leader’s
actions because they are conf ident that their rights and interests will not be abused.60

Research has identified five dimensions that make up the concept of trust:61

� Integrity: honesty and truthfulness
� Competence: technical and interpersonal knowledge and skills
� Consistency: reliability, predictability, and good judgment in handling situations
� Loyalty: willingness to protect a person, physically and emotionally
� Openness: willingness to share ideas and information freely

Of these five dimensions, integrity seems to be the most critical when someone assesses
another’s trustworthiness.62 Both integrity and competence were seen in our earlier discus-
sion of leadership traits found to be consistently associated with leadership.

Workplace changes have reinforced why such leadership qualities are important.
For instance, trends of employee empowerment and self-managed work teams have
reduced many of the traditional control mechanisms used to monitor employees. If a
work team is free to schedule its own work, evaluate its own performance, and even make
its own hiring decisions, trust becomes critical. Employees have to trust managers to
treat them fairly, and managers have to trust employees to conscientiously fulf ill their
responsibilities.

Also, leaders have to increasingly lead others who may not be in their immediate work
group or even may be physically separated—members of cross-functional or virtual teams,
individuals who work for suppliers or customers, and perhaps even people who represent
other organizations through strategic alliances. These situations don’t allow leaders the
luxury of falling back on their formal positions for influence. Many of these relationships,
in fact, are fluid and fleeting. So the ability to quickly develop trust and sustain that trust
is crucial to the success of the relationship.

Why is it important that followers trust their leaders? Research has shown that trust
in leadership is significantly related to positive job outcomes including job performance,
organizational citizenship behavior, job satisfaction, and organizational commitment.63

Given the importance of trust to effective leadership, how can leaders build trust? The
“Developing Your Trust-Building Skill” box looks at ways to develop trust-building skills.

Now, more than ever, managerial and leadership effectiveness depends on the ability to
gain the trust of followers.64 Downsizing, corporate financial misrepresentations, and the
increased use of temporary employees have undermined employees’ trust in their leaders and
shaken the confidence of investors, suppliers, and customers. A survey found that only
39 percent of U.S. employees and 51 percent of Canadian employees trusted their executive

leaders.65 Today’s leaders are faced with the challenge of
rebuilding and restoring trust with employees and with
other important organizational stakeholders.

A Final Thought Regarding
Leadership
Despite the belief that some leadership style will always
be effective regardless of the situation, leadership may
not always be important! Research indicates that, in some
situations, any behaviors a leader exhibits are irrelevant.
In other words, certain individual, job, and organizational
variables can act as “substitutes for leadership,” negating
the influence of the leader.66

For instance, follower characteristics such as experi-
ence, training, professional orientation, or need for inde-
pendence can neutralize the effect of leadership. These
characteristics can replace the employee’s need for a

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As a vital component of effective
leadership, trust includes the five key
dimensions of integrity, competence,
consistency, loyalty, and openness. Indra
Nooyi, CEO and chair of PepsiCo, scores
high on all these dimensions, which have
contributed to her high job performance
and career success. Since joining the
company in 1994 as a senior vice
president of strategy and development,
Nooyi has earned the trust of top
managers as she helped them make
tough decisions that moved the
company away from fast food to
focusing on beverages and packaged
food. Nooyi is shown here leading a
meeting with other top executives at
company headquarters in Purchase,
New York.

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trust
The belief in the integrity, character, and ability
of a leader.

Developing Your Skill
About the Skill
Given the importance trust plays in the leadership equa-
tion, today’s leaders should actively seek to build trust with
their followers. Here are some suggestions for achieving
that goal.67

Steps in Practicing the Skill
1 Practice openness. Mistrust comes as much from

what people don’t know as from what they do know.
Openness leads to confidence and trust. So keep
people informed; make clear the criteria on how
decisions are made; explain the rationale for your
decisions; be candid about problems; and fully
disclose relevant information.

2 Be fair. Before making decisions or taking actions,
consider how others will perceive them in terms of
objectivity and fairness. Give credit where credit is
due; be objective and impartial in performance
appraisals; and pay attention to equity perceptions in
reward distributions.

3 Speak your feelings. Leaders who convey only hard
facts come across as cold and distant. When you
share your feelings, others will see you as real and
human. They will know who you are and their respect
for you will increase.

4 Tell the truth. If honesty is critical to credibility, you
must be perceived as someone who tells the truth. Fol-
lowers are more tolerant of being told something they
“don’t want to hear” than of finding out that their
leader lied to them.

5 Be consistent. People want predictability. Mistrust
comes from not knowing what to expect. Take the time
to think about your values and beliefs. Then let them
consistently guide your decisions. When you know your
central purpose, your actions will follow accordingly,
and you will project a consistency that earns trust.

6 Fulfill your promises. Trust requires that people be-
lieve that you’re dependable. So you need to keep
your word. Promises made must be promises kept.

7 Maintain confidences. You trust those whom you be-
lieve to be discrete and whom you can rely on. If peo-
ple make themselves vulnerable by telling you
something in confidence, they need to feel assured that
you won’t discuss it with others or betray that confi-
dence. If people perceive you as someone who leaks
personal confidences or someone who can’t be de-
pended on, you won’t be perceived as trustworthy.

8 Demonstrate confidence. Develop the admiration
and respect of others by demonstrating technical and
professional ability. Pay particular attention to devel-
oping and displaying your communication, negotiat-
ing, and other interpersonal skills.

Practicing the Skill
You’re a new manager. Your predecessor, who was popular
and who is still with your firm, concealed from your team how
far behind they are on their goals this quarter. As a result,
your team members are looking forward to a promised day
off that they’re not entitled to and will not be getting.

It’s your job to tell them the bad news. How will you do it?

leader’s support or ability to create structure and reduce task ambiguity. Similarly, jobs that
are inherently unambiguous and routine or that are intrinsically satisfying may place fewer
demands on the leadership variable. Finally, such organizational characteristics as explicit
formalized goals, rigid rules and procedures, or cohesive work groups can substitute for
formal leadership.

ApplicationsReview and

Chapter Summary
11.1 Define leader and leadership. A leader is

someone who can influence others and who has
managerial authority. Leadership is a process of lead-
ing a group and influencing that group to achieve its
goals. Managers should be leaders because leading is
one of the four management functions.

11.2 Compare and contrast early leadership theories.
Early attempts to define leader traits were unsuccessful
although later attempts found seven traits associated
with leadership.

The University of Iowa studies explored three
leadership styles. The only conclusion was that group
members were more satisfied under a democratic leader
than under an autocratic one. The Ohio State studies
identified two dimensions of leader behavior—initiating
structure and consideration. A leader high in both those
dimensions at times achieved high group task perform-
ance and high group member satisfaction, but not
always. The University of Michigan studies looked
at employee-oriented leaders and production-oriented
leaders. They concluded that leaders who were em-
ployee oriented could get high group productivity and
high group member satisfaction. The managerial grid
looked at leaders’ concern for production and concern
for people and identified five leader styles. Although it
suggested that a leader who was high in concern for
production and high in concern for people was the best,
there was no substantive evidence for that conclusion.

As the behavioral studies showed, a leader’s
behavior has a dual nature: a focus on the task and
a focus on the people.

11.3 Describe the four major contingency leadership
theories. Fiedler’s model attempted to define the best
style to use in particular situations. He measured
leader style—relationship oriented or task oriented—
using the least-preferred co-worker questionnaire.
Fiedler also assumed a leader’s style was fixed. He
measured three contingency dimensions: leader-
member relations, task structure, and position power.
The model suggests that task-oriented leaders per-
formed best in very favorable and very unfavorable
situations, and relationship-oriented leaders per-
formed best in moderately favorable situations.

Hersey and Blanchard’s situational leadership
theory focused on followers’ readiness. They identi-
fied four leadership styles: telling (high task–low
relationship), selling (high task–high relationship),
participating (low task–high relationship), and
delegating (low task–low relationship). They also
identified four stages of readiness: unable and
unwilling (use telling style); unable but willing

(use selling style); able but unwilling (use participa-
tive style); and able and willing (use delegating style).

The leader-participation model relates leadership
behavior and participation to decision making. It uses
a decision tree format with seven contingencies and
five alternative leadership styles.

The path-goal model developed by Robert
House identified four leadership behaviors: directive,
supportive, participative, and achievement-oriented.
He assumes that a leader can and should be able to
use any of these styles. The two situational contin-
gency variables were found in the environment and
in the follower. Essentially the path-goal model says
that a leader should provide direction and support as
needed; that is, structure the path so the followers
can achieve goals.

11.4 Describe modern views of leadership and the
issues facing today’s leaders. A transactional leader
exchanges rewards for productivity where a transfor-
mational leader stimulates and inspires followers to
achieve goals.

A charismatic leader is an enthusiastic and self-
confident leader whose personality and actions influ-
ence people to behave in certain ways. People can learn
to be charismatic. A visionary leader is able to create
and articulate a realistic, credible, and attractive vision
of the future.

A team leader has two priorities: manage the
team’s external boundary and facilitate the team
process. Four leader roles are involved: liaison with
external constituencies, troubleshooter, conflict
manager, and coach.

The issues facing leaders today include employee
empowerment, national culture, and emotional intelli-
gence. As employees are empowered, the leader’s
role tends to be one of not leading. As leaders adjust
their style to the situation, one of the most important
situational characteristics is national culture. Finally,
EI is proving to be an essential element in leadership
effectiveness.

11.5 Discuss trust as the essence of leadership. The five
dimensions of trust include integrity, competence,
consistency, loyalty, and truthfulness. Integrity refers to
one’s honesty and truthfulness. Competence involves
an individual’s technical and interpersonal knowledge
and skills. Consistency relates to an individual’s relia-
bility, predictability, and good judgment in handling
situations. Loyalty is an individual’s willingness to pro-
tect and save face for another person. Openness means
that you can rely on the individual to give you the
whole truth.

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C H A P T E R 1 1 | L E A D E R S H I P A N D T R U S T 315

To check your understanding of learning outcomes 11.1 – 11.5 , go to

mymanagementlab.com and try the chapter questions.

Understanding the Chapter

1. Discuss the strengths and weaknesses of the trait theory.

2. What would a manager need to know to use Fiedler’s
contingency model? Be specific.

3. Do you think that most managers in real life use a
contingency approach to increase their leadership
effectiveness? Discuss.

4. “All managers should be leaders, but not all leaders
should be managers.” Do you agree or disagree with
this statement? Support your position.

5. Do you think trust evolves out of an individual’s
personal characteristics or out of specific situations?
Explain.

6. Do followers make a difference in whether a leader is
effective? Discuss.

7. Research how organizations can develop effective
leaders and write a short report explaining your
findings.

8. When might leaders be irrelevant?

Understanding Yourself

Do Others See Me as Trustworthy?
Effective leaders have built a trusting relationship between themselves and those
they seek to lead. This instrument provides you with insights into how trustworthy
others are likely to perceive you.

INSTRUMENT For each of the nine statements, respond using one of these answers:

1 = Strongly disagree

2 = Disagree

3 = Slightly disagree

4 = Neither agree nor disagree

5 = Slightly agree

6 = Agree

7 = Strongly agree

I am seen as someone who:

1. Is reliable. 1 2 3 4 5 6 7
2. Is always honest. 1 2 3 4 5 6 7
3. Succeeds by stepping on other people. 1 2 3 4 5 6 7
4. Tries to get the upper hand. 1 2 3 4 5 6 7
5. Takes advantage of others’ problems. 1 2 3 4 5 6 7
6. Keeps my word. 1 2 3 4 5 6 7
7. Doesn’t mislead others. 1 2 3 4 5 6 7
8. Tries to get out of my commitments. 1 2 3 4 5 6 7
9. Takes advantage of people who are vulnerable. 1 2 3 4 5 6 7

SCORING KEY To calculate your trustworthiness score, add up responses to items 1, 2, 6, and 7.
For the other five items, reverse the score (7 becomes 1, 6 becomes 2, etc.). Add up the total.

ANALYSIS AND INTERPRETATION Your total trustworthiness score will range between 9 and
63. The higher your score, the more you’re perceived as a person who can be trusted. Scores of
45 or higher suggest others are likely to perceive you as trustworthy; while scores below 27
suggest that people will not see you as someone who can be trusted.

If you want to build trust with others, look at the behaviors this instrument measures.
Then think about what you can do to improve your score on each. Examples might include
being more open, speaking your feelings, giving generous credit to others, telling the truth,
showing fairness and consistency, following through on promises and commitments, and
maintaining confidences.

Source: Based on P. Bromiley and L. Cummings, “The Organizational Trust Inventory,” in R. M. Kramer and
T. R. Tyler (eds.), Trust in Organizations (Thousand Oaks, CA: Sage, 1996), pp. 328–29.

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FYIA (For Your Immediate Action)

Preferred Bank Card, Inc.

To: Pat Muenks, VP Employee Relations
From: Jan Plemmons, Customer Service Director

Subject: Leadership Training

I agree completely with your recommendation that we need a leadership training

program for our customer service team leaders. These leaders struggle with keeping

our customer service reps focused on our goal of providing timely, accurate, and

friendly service to our bank card holders who call in with questions or complaints.

Can you put together a one-page proposal that describes the leadership topics you

think should be covered? Also, give me some suggestions for how we might present the

information in a way that would be interesting. We need to get started on this immediately,

so please get this report to me by early next week.

This fictionalized company and message were created for educational purposes only. It is not meant to reflect
positively or negatively on management practices by any company that may share this name.

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CASE APPLICATION

317

How important are excellent leaders toorganizations? If you were to ask3M CEO George Buckley, he’d say
extremely important. But he’d also say that
excellent leaders don’t just pop up out of
nowhere. A company has to cultivate leaders
who have the skills and abilities to help it
survive and thrive. And like a successful
baseball team with strong performance
statistics that has a player development plan
in place, 3M has its own farm system. Except its farm system is designed to develop company leaders.

3M’s leadership development program is so effective that in 2009 Chief Executive magazine and Hay Consulting
Group named the company the best at developing future leaders. What is 3M’s leadership program all about? About
eight years ago, the company’s former CEO (Jim McNerney, who is now Boeing’s CEO) and his top team spent
18 months developing a new leadership model for the company. After numerous brainstorming sessions and much
heated debate, the group finally agreed on six “leadership attributes” that they believed were essential for the company
to become skilled at executing strategy and being accountable. Those six attributes included the ability to “chart the
course; energize and inspire others; demonstrate ethics, integrity, and compliance; deliver results; raise the bar; and
innovate resourcefully.” And now under Buckley’s guidance, the company is continuing and reinforcing its pursuit of
leadership excellence with these six attributes.

When asked about his views on leadership, Buckley said that he believes there is a difference between
leaders and managers. “A leader is as much about inspiration as anything else. A manager is more about
process.” He believes that the key to developing leaders is to focus on those things that can be developed—
like strategic thinking. Buckley also believes that leaders should not be promoted up and through the organi-
zation too quickly. They need time to experience failures and what it takes to rebuild.

Finally, when asked about his own leadership style. Buckley responded that, “The absolutely best way for me
to be successful is to have people working for me who are better. Having that kind of emotional self-confidence
is vital to leaders. You build respect in those people because you admire what they do. Having built respect, you
build trust. However hokey it sounds, it works.” And it must be working as the company was named the number
one most admired company in the medical and other precision equipment division of Fortune’s most admired
ranking for 2009.

Discussion Questions

1. What do you think about Buckley’s statement that leaders and managers differ? Do you agree? Why or why not?

2. What leadership models/theories/issues do you see in this case? List and describe.

3. Take each of the six leadership attributes that the company feels is important. Explain what you think each
one involves. Then discuss how those attributes might be developed and measured.

4. What did this case teach you about leadership?

Sources: J. Kerr and R. Albright, “Finding and Cultivating Finishers,” Leadership Excellence (July 2009), p. 20; D. Jones, “3M CEO Emphasizes
Importance of Leaders,” USA Today, May 18, 2009, p. 4B; G. Colvin, “World’s Most Admired Companies 2009,” Fortune, March 16, 2009, pp. 75+;
and M. C. Mankins and R. Steele, “Turning Great Strategy into Great Performance,” Harvard Business Review (July/August 2005), pp. 64–72.

GROWING
LEADERS

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Sixty percent. That’s the percentage of respondents in a
recent employee survey who said that gossip was their
biggest pet peeve about their jobs. Most gossip centers
around the workplace and the personal lives of coworkers.
How often have you gossiped at work . . . either as a sender
or a receiver? Although you may think workplace gossip is
harmless, it can have some pretty serious consequences.
First, spreading rumors can damage morale and increase
anxiety. Secondly, it can hamper productivity and impact
performance. And it can lead to something you might not even have considered, as it did for four former
employees of the town of Hooksett, New Hampshire. Fired by the city council for gossiping about their boss,
they learned the hard way that gossip can cost you your job.1

The longtime employees were fired because one of the women had used derogatory terms to describe the
town administrator and because all of them had discussed a rumor that he was having an affair with a female sub-
ordinate. All four of the women acknowledged feeling resentment toward the woman, who worked in a specially
created position and was paid more than two of the employees, despite having less experience and seniority.

Despite an appeal of their dismissal by the four employees, the Hooksett council didn’t budge and stated,
“These employees do not represent the best interests of the town of Hooksett and the false rumors, gossip and

derogatory statements have contributed to a negative working environment and
malcontent among their fellow employees.” Despite national media attention

and a petition signed by 419 residents asking for the women to be reinstated,
the city council didn’t waver on its decision. An attorney for the four women

said that his clients were, “legitimately questioning the
conduct of their supervisor, and whether the female

subordinate was getting preferential treatment. It
almost cheapens it to call it gossip. It might have
been idle, not particularly thoughtful, talk. But
there was no harm intended.”

Although the four women represented nearly
50 years of combined service to the city and all
had positive performance reviews, the town coun-

cil believed that the women’s actions were
“insubordinate” and “dishonest.” All four

received a settlement for being fired,
which cost the town a total of $330,000.
The settlement agreement also stipu-
lated, however, that two of the women
can never apply for a job with the
town again.

Gossip Girls

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12.1

Describe
what managers
need to know

about
communicating

effectively.

320

Communication takes place every day in every organization. In all areas. By all organiza-

tional members. Most of that communication tends to be work-related, but as this story

shows, sometimes that communication doesn’t lead to positive outcomes. In this chapter,

we’re going to look at basic concepts of interpersonal communication. We’ll explain the

communication process, methods of communicating, barriers to effective communication,

and ways to overcome those barriers. In addition, we’ll review several communication-based

interpersonal skills including active listening, providing feedback, delegating, managing

conflict, and negotiating. Managers must be proficient at these skills to be able to manage

effectively in today’s organizations.

How Do Managers Communicate
Effectively?
The importance of effective communication for managers cannot be
overemphasized for one specific reason: Everything a manager does
involves communicating. Not some things but everything! A manager can’t
formulate strategy or make a decision without information. That informa-

tion has to be communicated. Once a decision is made, communication must
again take place. Otherwise, no one will know that a decision has been made.

The best idea, the most creative suggestion, or the finest plan cannot take form
without communication. Managers, therefore, need effective communication skills. We’re
not suggesting, of course, that good communication skills alone make a successful manager.
We can say, however, that ineffective communication skills can lead to a continuous stream
of problems for a manager.

How Does the Communication Process Work?
Communication can be thought of as a process or flow. Communication problems occur
when deviations or blockages disrupt that flow. Before communication can take place, a
purpose, expressed as a message to be conveyed, is needed. It passes between a source (the
sender) and a receiver. The message is encoded (converted to symbolic form) and is passed
by way of some medium (channel) to the receiver, who retranslates (decodes) the message
initiated by the sender. The result is communication, which is a transfer of understanding
and meaning from one person to another.2

Exhibit 12-1 depicts the communication process. This model has seven parts: (1) the
communication source or sender, (2) encoding, (3) the message, (4) the channel, (5) decoding,
(6) the receiver, and (7) feedback.

The source initiates a message by encoding a thought. Four conditions affect the
encoded message: skill, attitudes, knowledge, and the social cultural system. Our message
in our communication to you in this book depends on our writing skills; if we don’t have the
requisite writing skills, our message will not reach you in the form desired. Keep in mind
that a person’s total communicative success includes speaking, reading, listening, and
reasoning skills as well. As we discussed in Chapter 8, our attitudes influence our behavior.
We hold predisposed ideas on numerous topics, and our communications are affected by
these attitudes. Furthermore, we’re restricted in our communicative activity by the extent of
our knowledge of the particular topic. We can’t communicate what we don’t know, and
should our knowledge be too extensive, it’s possible that our receiver will not understand our
message. Clearly, the amount of knowledge the source holds about his or her subject will
affect the message he or she seeks to transfer. And, finally, just as attitudes influence our
behavior, so does our position in the social cultural system in which we exist. Your beliefs
and values, all part of your culture, act to influence you as a communicative source.

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Message

Noise

Noi
se Noise

Nois
e

Purpose Message MessageP
Sender

M
Encoding

e M
Channel

Me
Decoding

e
Receiver

Message transferred successfully?
Feedback

EXHIBIT 12-1 The Communication Process

The message is the actual physical product from the source that conveys some
purpose. When we speak, the words spoken are the message. When we write, the writing
is the message. When we paint, the picture is the message. When we gesture, the move-
ments of our arms, the expressions on our faces are the message.3 Our message is affected
by the code or group of symbols we use to transfer meaning, the content of the message
itself, and the decisions that we make in selecting and arranging both codes and content.4

The channel is the medium through which the message travels. It’s selected by the
source, who must determine which channel is formal and which one is informal. Formal
channels are established by the organization and transmit messages that pertain to the job-
related activities of members. They traditionally follow the authority network within the
organization. Other forms of messages, such as personal or social, follow the informal
channels in the organization.

The receiver is the person to whom the message is directed. However, before the
message can be received, the symbols in it must be translated into a form that can be under-
stood by the receiver—the decoding of the message. Just as the encoder was limited by his
or her skills, attitudes, knowledge, and social cultural system, the receiver is equally
restricted. Accordingly, the source must be skillful in writing or speaking; the receiver must
be skillful in reading or listening, and both must be able to reason. A person’s knowledge,
attitudes, and cultural background influence his or her ability to receive, just as they do the
ability to send.

The final link in the communication process is a feedback loop. “If a communication
source decodes the message that he encodes, if the message is put back into his system, we
have feedback.”5 Feedback is the check on how successful we have been in transferring our
messages as originally intended. It determines whether understanding has been achieved.
Given the cultural diversity that exists in our workforce today, the importance of effective
feedback to ensure proper communications cannot be overstated.6

communication process
The seven-step process in which understanding
and meaning is transferred from one person
to another.

communication
A transfer of understanding and meaning from
one person to another. feedback

Checking to see how successfully a message
has been transferred.

decoding
Translating a received message.

channel
The medium by which a message travels.

message
A purpose for communicating that’s to be
conveyed.

encoding
Converting a message into symbolic form.

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Are Written Communications More Effective
Than Verbal Ones?
Written communications include memos, letters, e-mail, organizational periodicals, bulletin
boards, or any other device that transmits written words or symbols. Why would a sender
choose to use written communications? Because they’re tangible, verifiable, and more per-
manent than the oral variety. Typically, both sender and receiver have a record of the commu-
nication. The message can be stored for an indefinite period of time. If questions arise about
the content of the message, it’s physically available for later reference. This feature is partic-
ularly important for complex or lengthy communications. For example, the marketing plan
for a new product is likely to contain a number of tasks spread out over several months. By
putting it in writing, those who have to carry out the plan can readily refer to the document
over the life of the plan. A final benefit of written communication comes from the process
itself. Except in rare instances, such as when presenting a formal speech, more care is taken
with the written word than with the spoken word. Having to put something in writing forces
a person to think more carefully about what he or she wants to convey. Therefore, written
communications are more likely to be well thought out, logical, and clear.

Of course, written messages have their drawbacks. Writing may be more precise, but
it also consumes a great deal of time. You could convey far more information to your
college instructor in a one-hour oral exam than in a one-hour written exam. In fact, you
could probably say in 10 to 15 minutes what it takes you an hour to write. The other major
disadvantage is feedback or, rather, lack of it. Oral communications allow receivers to
respond rapidly to what they think they hear. However, written communications don’t have
a built-in feedback mechanism. Sending a memo is no assurance that it will be received
and, if it is received, no guarantee that the recipient will interpret it as the sender meant.
The latter point is also relevant in oral communication, but it’s easier in such cases merely
to ask the receiver to summarize what you have said. An accurate summary presents feed-
back evidence that the message has been received and understood.

Is the Grapevine an Effective Way to Communicate?
The grapevine is the unofficial way that communications take place in an organization. It’s
neither authorized nor supported by the organization. Rather, information is spread by word
of mouth—and even through electronic means. Ironically, good information passes among
us rapidly, but bad information travels even faster.7 The grapevine gets information out to
organizational members as quickly as possible.

Kicking off the grand opening celebration
of a new Cabela’s outdoor-supply store,
the company’s sales manager and store
manager high-five each other before
delivering an employee pep talk. For this
type of message, oral communication is
much more effective than written
communication because it gives the
senders and the receivers of the message
the opportunity to respond rapidly to
what they hear. Before opening the doors
of the store to customers, the managers
take this opportunity to give employees
last-minute details about their work and
to motivate them in giving customers a
special welcome to the store.

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From the Past to the Present•

•

One of the most famous studies of the grapevine was
conducted by management researcher Keith Davis who
investigated the communication patterns among 67 manage-
rial personnel.8 The approach he used was to learn from each
communication recipient how he or she first received a given
piece of information and then trace it back to its source. It was
found that, while the grapevine was an important source of
information, only 10 percent of the executives acted as liaison
individuals (that is, passed the information on to more than one
other person). For example, when one executive decided to
resign to enter the insurance business, 81 percent of the execu-
tives knew about it, but only 11 percent transmitted this informa-
tion to others. At the time, this study was interesting both
because of what it found, but more importantly because of
what it showed about how the communication network worked.

Recent research by IBM and Massachusetts Institute of
Technology using a similar type of analysis focused more
on people’s social networks of contacts at work rather
than on how information flowed through the organiza-
tional grapevine. However, what was noticeably interest-
ing about this study was that it found that employees who
have strong communication ties with their managers tend
to bring in more money than those who steer clear of
the boss.

What managers can learn from both these studies is that
it’s important to understand the social and communication
networks that employees use as they do their work. Know who
the key contact points are so that if you ever need to find out
or relay information, you know who to go to.

The biggest question raised about grapevines, however, focuses on the accuracy of the
rumors. Research on this topic has found somewhat mixed results. In an organization charac-
terized by openness, the grapevine may be extremely accurate. In an authoritative culture, the
rumor mill may not be accurate. But even then, although the information flowing is inaccu-
rate, it still contains some element of truth. Rumors about major layoffs, plant closings, and
the like may be filled with inaccurate information regarding who will be affected or when it
may occur. Nonetheless, the reports that something is about to happen are probably on target.

How Do Nonverbal Cues Affect Communication?
Some of the most meaningful communications are neither spoken nor written. These are
nonverbal communications. A loud siren or a red light at an intersection tells you some-
thing without words. A college instructor doesn’t need words to know that students are
bored; their eyes get glassy or they begin to read the school newspaper during class.
Similarly, when papers start to rustle and notebooks begin to close, the message is clear:
Class time is about over. The size of a person’s office and desk or the clothes he or she wears
also convey messages to others. However, the best-known areas of nonverbal communica-
tion are body language and verbal intonation.

Body language refers to gestures, facial expressions, and other body movements.9

A snarl, for example, says something different from a smile. Hand motions, facial
expressions, and other gestures can communicate emotions or temperaments such as
aggression, fear, shyness, arrogance, joy, and anger.10

Verbal intonation refers to the emphasis someone gives to words or phrases. To illustrate
how intonations can change the meaning of a message, consider the student who asks the
instructor a question. The instructor replies, “What do you mean by that?” The student’s
reaction will vary, depending on the tone of the instructor’s response. A soft, smooth tone
creates a different meaning from one that is abrasive with a strong emphasis on the last word.
Most of us would view the first intonation as coming from someone who sincerely sought
clarification, whereas the second suggests that the person is aggressive or defensive. The
adage, “It’s not what you say but how you say it,” is something managers should remember
as they communicate.

verbal intonation
An emphasis given to words or phrases that
conveys meaning.

body language
Nonverbal communication cues such as facial
expressions, gestures, and other body
movements.

grapevine
An unofficial channel of

communication.

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BARRIER DESCRIPTION

Filtering The deliberate manipulation of information to make it appear
more favorable to the receiver.

Selective Perception Receiving communications on the basis of what one selectively
sees and hears depending on his or her needs, motivation,
experience, background, and other personal characteristics.

Information Overload When the amount of information one has to work with exceeds
one’s processing capacity.

Emotions How the receiver feels when a message is received.

Language Words have different meanings to different people. Receivers
will use their definition of words being communicated.

Gender How males and females react to communication may be
different, and they each have a different communication style.

National Culture Communication differences arising from the different languages
that individuals use to communicate and the national culture of
which they are a part.

EXHIBIT 12-2 Barriers to Effective Communication

The fact that every oral communication also has a nonverbal message cannot be
overemphasized.11 Why? Because the nonverbal component is likely to carry the greatest
impact. Research indicates that from 65 to 90 percent of the message of every face-to-face
conversation is interpreted through body language. Without complete agreement between
the spoken words and the body language that accompanies it, receivers are more likely to
react to body language as the “true meaning.”12

What Barriers Keep Communication from Being
Effective?
A number of interpersonal and intrapersonal barriers help to explain why the message
decoded by a receiver is often different from that which the sender intended. We summarize
the more prominent barriers to effective communication in Exhibit 12-2 and briefly
describe them here.

HOW DOES FILTERING AFFECT COMMUNICATION? Filtering refers to the way that a
sender manipulates information so that it will be seen more favorably by the receiver.
For example, when a manager tells his boss what he feels that boss wants to hear, he is
f iltering information. Does f iltering happen much in organizations? Sure it does. As
information is passed up to senior executives, it has to be condensed and synthesized by
subordinates so upper management doesn’t become overloaded with information.
Those doing the condensing filter communications through their own personal interests
and perceptions of what’s important.

The extent of f iltering tends to be the function of the organization’s culture and
number of vertical levels in the organization. More vertical levels in an organization
mean more opportunities for filtering. As organizations become less dependent on strict
hierarchical arrangements and instead use more collaborative, cooperative work
arrangements, information f iltering may become less of a problem. In addition, the
ever-increasing use of e-mail to communicate in organizations reduces filtering because
communication is more direct as intermediaries are bypassed. Finally, the organiza-
tional culture encourages or discourages f iltering by the type of behavior it rewards.
The more that organizational rewards emphasize style and appearance, the more
managers will be motivated to f ilter communications in their favor.

HOW DOES SELECTIVE PERCEPTION AFFECT COMMUNICATION? The second barrier is
selective perception. We’ve mentioned selective perception before in this book. We
discuss it again here because the receivers in the communication process selectively see

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and hear based on their needs, motivations, experience,
background, and other personal characteristics. Receivers
also project their interests and expectations into com-
munications as they decode them. The employment
interviewer who expects a female job applicant to put
her family ahead of her career is likely to see that
tendency in female applicants, regardless of whether the
applicants would do so or not. As we said in Chapter 8,
we don’t see reality; rather, we interpret what we see
and call it reality.

HOW DOES INFORMATION OVERLOAD AFFECT
COMMUNICATION? Individuals have a finite capaci-
ty for processing data. For instance, consider the inter-
national sales representative who returns home to find
that she has more than 600 e-mails waiting for her. It’s
not possible to fully read and respond to each one of
those messages without facing information overload.
Today’s typical executive frequently complains of information overload.13 The demands
of keeping up with e-mail, phone calls, faxes, meetings, and professional reading create
an onslaught of data that is nearly impossible to process and assimilate. What happens
when you have more information than you can sort out and use? You’re likely to select
out, ignore, pass over, or forget information. Or you may put off further processing until
the overload situation is over. In any case, the result is lost information and less effective
communication.

HOW DO EMOTIONS AFFECT COMMUNICATION? How a receiver feels when a message
is received influences how he or she interprets it. You’ll often interpret the same message
differently, depending on whether you’re happy or distressed. Extreme emotions are most
likely to hinder effective communications. In such instances, we often disregard our rational
and objective thinking processes and substitute emotional judgments. It’s best to avoid
reacting to a message when you’re upset because you’re not likely to be thinking clearly.

HOW DOES LANGUAGE AFFECT COMMUNICATION? Words mean different things to
different people. “The meanings of words are not in the words; they are in us.”14 Age,
education, and cultural background are three of the more obvious variables that influ-
ence the language a person uses and the def initions he or she applies to words.
Columnist George F. Will and rap artist Nelly both speak English. But the language one
uses is vastly different from how the other speaks.

In an organization, employees usually come from diverse backgrounds and, therefore,
have different patterns of speech. Additionally, the grouping of employees into departments
creates specialists who develop their own jargon or technical language.15 In large organiza-
tions, members are also frequently widely dispersed geographically—even operating in
different countries—and individuals in each locale will use terms and phrases that are unique
to their area.16 And the existence of vertical levels can also cause language problems. The
language of senior executives, for instance, can be mystifying to regular employees not
familiar with management jargon. Keep in mind that while we may speak the same lan-
guage, our use of that language is far from uniform. Senders tend to assume that the words
and phrases they use mean the same to the receiver as they do to them. This assumption, of

selective perception
Selectively perceiving or hearing a
communication based on your own needs,
motivations, experiences, or other personal
characteristics.

filtering
Deliberately manipulating information to make
it appear more favorable to the receiver.

jargon
Technical language.

information overload
What results when information exceeds
processing capacity.

One of the barriers to effective
communication is information overload.
Because people have a limit to how
much information they can process,
too much information can affect the
communication process. When it
becomes almost impossible to process
and assimilate too much data, people
are prone to ignore, pass over, or forget
information. This often results in lost
information or less effective
communication. Efforts to remove the
barrier of information overload include
an experiment by Intel Corporation’s
chip design group. They tried establishing
periods of quiet time for employees and
limiting e-mail messages, but employees
said they found the experiment too
restrictive. The end-of-chapter Case
Application describes another
organization that tried something
similar . . . with similar results.

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MANAGING DIVERSITY | The Communication Styles of Men and Women

“You don’t understand what I’m saying, and you never
listen!” “You’re making a big deal out of nothing.” Have
you said statements like these to friends of the opposite
sex? Most of us probably have! Research shows, as does
personal experience, that men and women communicate
differently.19

Deborah Tannen has studied the ways that men and
women communicate and reports some interesting differ-
ences. The essence of her research is that men use talk to
emphasize status, while women use it to create connection.
She states that communication between the sexes can be
a continual balancing act of juggling our conflicting needs
for intimacy, which suggests closeness and commonality,
and independence, which emphasizes separateness and
differences. It’s no wonder, then, that communication
problems arise! Women speak and hear a language of
connection and intimacy. Men hear and speak a language
of status and independence. For many men, conversations
are merely a way to preserve independence and maintain
status in a hierarchical social order. Yet for many women,
conversations are negotiations for closeness and seeking
out support and confirmation. Let’s look at a few examples
of what Tannen has described.

Men frequently complain that women talk on and on
about their problems. Women, however, criticize men for
not listening. What’s happening is that when a man hears
a woman talking about a problem, he frequently asserts
his desire for independence and control by offering solu-
tions. Many women, in contrast, view conversing about a

problem as a way to promote closeness. The woman talks
about a problem to gain support and connection, not to
get the male’s advice.

Here’s another example: Men are often more direct than
women in conversation. A man might say, “I think you’re
wrong on that point.” A woman might say, “Have you
looked at the marketing department’s research report on
that issue?” The implication in the woman’s comment is that
the report will point out the error. Men frequently misread
women’s indirectness as “covert” or “sneaky,” but women
aren’t as concerned as men with the status and one-
upmanship that directness often creates.

Finally, men often criticize women for seeming to
apologize all the time. Men tend to see the phrase “I’m
sorry” as a sign of weakness because they interpret the
phrase to mean the woman is accepting blame, when he
may know she’s not to blame. The woman also knows
she’s not at fault. Yet she’s typically using “I’m sorry” to
express regret: “I know you must feel bad about this and
I do, too.”

How can these differences in communication styles be
managed? Keeping gender differences from becoming
persistent barriers to effective communication requires
acceptance, understanding, and a commitment to
communicate adaptively with each other. Both men
and women need to acknowledge that there are differ-
ences in communication styles, that one style isn’t better
than the other, and that it takes real effort to “talk” with
each other successfully.

course, is incorrect and creates communication barriers. Knowing how each of us modifies
the language would help minimize those barriers.

HOW DOES GENDER AFFECT COMMUNICATION? Effective communication between the
sexes is important in all organizations if they are to meet organizational goals. But how can
we manage the various differences in communication styles? To keep gender differences
from becoming persistent barriers to effective communication requires acceptance, under-
standing, and a commitment to communicate adaptively with each other. Both men and
women need to acknowledge that there are differences in communication styles, that one
style isn’t better than the other, and that it takes real effort to talk with each other success-
fully. See the “Managing Diversity” box for more information on how men and women
communicate.

HOW DOES NATIONAL CULTURE AFFECT COMMUNICATION? Finally, communication
differences can also arise from the different languages that individuals use to communicate
and the national culture of which they’re a part.17 For example, let’s compare countries that
place a high value on individualism (such as the United States) with countries where the
emphasis is on collectivism (such as Japan).18

In the United States, communication patterns tend to be oriented to the individual and
clearly spelled out. Managers in the United States rely heavily on memoranda, announce-
ments, position papers, and other formal forms of communication to state their positions on
issues. Supervisors here may hoard information in an attempt to make themselves look good
(filtering) and as a way of persuading their employees to accept decisions and plans. And
for their own protection, lower-level employees also engage in this practice.

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In collectivist countries, such as Japan, there’s more interaction for its own sake and a
more informal manner of interpersonal contact. The Japanese manager, in contrast to the
U.S. manager, engages in extensive verbal consultation with employees over an issue first and
draws up a formal document later to outline the agreement that was made. The Japanese
value decisions by consensus, and open communication is an inherent part of the work
setting. Also, face-to-face communication is encouraged.20

Cultural differences can affect the way a manager chooses to communicate.21 And these
differences undoubtedly can be a barrier to effective communication if not recognized and
taken into consideration.

How Can Managers Overcome Communication
Barriers?
Given these barriers to communication, what can managers do to overcome them? The following
suggestions should help make communication more effective (see also Exhibit 12-3).

WHY USE FEEDBACK? Many communication problems are directly attributed to misun-
derstanding and inaccuracies. These problems are less likely to occur if the manager gets
feedback, both verbal and nonverbal.

A manager can ask questions about a message to determine whether it was received and
understood as intended. Or the manager can ask the receiver to restate the message in his
or her own words. If the manager hears what was intended, understanding and accuracy
should improve. Feedback can also be more subtle as general comments can give a manager
a sense of the receiver’s reaction to a message.

Feedback doesn’t have to be verbal. If a sales manager e-mails information about a new
monthly sales report that all sales representatives will need to complete and some of them
don’t turn it in, the sales manager has received feedback. This feedback suggests that the
sales manager needs to clarify the initial communication. Similarly, managers can look for
nonverbal cues to tell whether someone’s getting the message.

WHY SHOULD SIMPLIFIED LANGUAGE BE USED? Because language can be a barrier,
managers should consider the audience to whom the message is directed and tailor the
language to them. Remember, effective communication is achieved when a message is
both received and understood. This means, for example, that a hospital administrator
should always try to communicate in clear, easily understood terms and to use language
tailored to different employee groups. Messages to the surgical staff should be purpose-
fully different from that used with office employees. Jargon can facilitate understand-
ing if it’s used within a group that knows what it means, but can cause problems when
used outside that group.

Use Feedback Check the accuracy of what has been communicated—or what
you think you heard.

Simplify Language Use words that the intended audience understands.

Listen Actively Listen for the full meaning of the message without making
premature judgment or interpretation—or thinking about what
you are going to say in response.

Constrain Emotions Recognize when your emotions are running high. When they
are, don’t communicate until you have calmed down.

Watch Nonverbal Cues Be aware that your actions speak louder than your words.
Keep the two consistent.

EXHIBIT 12-3 Overcoming Barriers to Effective Communication

328 PA R T F O U R | L E A D I N G

Developing Your Skill
About the Skill
Active listening requires you to concentrate on what is
being said. It’s more than just hearing the words. It involves
a concerted effort to understand and interpret the
speaker’s message.

Steps in Practicing the Skill
1 Make eye contact. How do you feel when somebody

doesn’t look at you when you’re speaking? If you’re
like most people, you’re likely to interpret this behavior
as aloofness or disinterest. Making eye contact with
the speaker focuses your attention, reduces the likeli-
hood that you will become distracted, and encour-
ages the speaker.

2 Exhibit affirmative nods and appropriate facial
expressions. The effective listener shows interest in
what is being said through nonverbal signals. Affirma-
tive nods and appropriate facial expressions, when
added to good eye contact, convey to the speaker
that you’re listening.

3 Avoid distracting actions or gestures that suggest
boredom. In addition to showing interest, you must
avoid actions that suggest that your mind is some-
where else. When listening, don’t look at your watch,
shuffle papers, play with your pencil, or engage in
similar distractions. They make the speaker feel that
you’re bored or disinterested, or indicate that you
aren’t fully attentive.

4 Ask questions. The critical listener analyzes what he
or she hears and asks questions. This behavior provides
clarification, ensures understanding, and assures the
speaker that you’re listening.

5 Paraphrase using your own words. The effective
listener uses phrases such as “What I hear you saying
is . . .” or “Do you mean . . .?” Paraphrasing is an
excellent control device to check on whether you’re
listening carefully and to verify that what you heard
is accurate.

6 Avoid interrupting the speaker. Let the speaker com-
plete his or her thought before you try to respond. Don’t
try to second-guess where the speaker’s thoughts are
going. When the speaker is finished, you’ll know it.

7 Don’t overtalk. Most of us would rather express our
own ideas than listen to what someone else says.
Talking might be more fun and silence might be
uncomfortable, but you can’t talk and listen at the
same time. The good listener recognizes this fact and
doesn’t overtalk.

8 Make smooth transitions between the roles of
speaker and listener. The effective listener makes
transitions smoothly from speaker to listener and back
to speaker. From a listening perspective, this means
concentrating on what a speaker has to say and
practicing not thinking about what you’re going to say
as soon as you get your chance.

Practicing the Skill
Ask a friend to tell you about his or her day and listen with-
out interrupting. When your friend has finished speaking, ask
two or three questions, if needed, to obtain more clarity and
detail. Listen carefully to the answers. Now summarize your
friend’s day in no more than five sentences.

How well did you do? Let your friend rate the accuracy
of your paraphrase (and try not to interrupt).

WHY MUST WE LISTEN ACTIVELY? When someone talks, we hear. But too often we don’t
listen. Listening is an active search for meaning, whereas hearing is passive. In listening,
the receiver is also putting effort into the communication.

Many of us are poor listeners. Why? Because it’s difficult, and most of us would rather do
the talking. Listening, in fact, is often more tiring than talking. Unlike hearing, active listening,
which is listening for full meaning without making premature judgments or interpretations,
demands total concentration. The average person normally speaks at a rate of about 125 to 200
words per minute. However, the average listener can comprehend up to 400 words per minute.22

The difference leaves lots of idle brain time and opportunities for the mind to wander.
Active listening is enhanced by developing empathy with the sender—that is, by

putting yourself in the sender’s position. Because senders differ in attitudes, interests, needs, and
expectations, empathy makes it easier to understand the actual content of a message. An
empathetic listener reserves judgment on the message’s content and carefully listens to what is
being said. The goal is to improve one’s ability to get the full meaning of a communication
without distorting it by premature judgments or interpretations. Other specific behaviors that
active listeners demonstrate are discussed in the “Developing Your Active-Listening Skill” box.

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Explain
how technology

affects
managerial

communication.

12.2

WHY MUST WE CONSTRAIN EMOTIONS? It would be
naïve to assume that managers always communicate in
a rational manner. We know that emotions can cloud
and distort communication. A manager who’s upset
over an issue is more likely to misconstrue incoming
messages and fail to communicate his or her outgoing
messages clearly and accurately. What to do? The sim-
plest answer is to calm down and get emotions under
control before communicating. The following is a good
example of why it’s important to be aware of your emo-
tions before communicating.

Neal L. Patterson, CEO of Cerner Corporation, a
health care software development company based in
Kansas City, was upset with the fact that employees didn’t
seem to be putting in enough hours. So he sent an angry
and emotional e-mail to about 400 company managers that
said, in part:

We are getting less than 40 hours of work from a large number of our K.C.-based
EMPLOYEES. The parking lot is sparsely used at 8 a.m.; likewise at 5 p.m. As managers,
you either do not know what your EMPLOYEES are doing, or you do not CARE. You
have created expectations on the work effort which allowed this to happen inside Cerner,
creating a very unhealthy environment. In either case, you have a problem and you will
fix it or I will replace you . . . I will hold you accountable. You have allowed things to
get to this state. You have two weeks. Tick, tock.”23

Although the e-mail was meant only for the company’s managers, it was leaked and posted on
an Internet discussion site. The tone of the e-mail surprised industry analysts, investors, and
of course, Cerner’s managers and employees. The company’s stock price dropped 22 percent
over the next three days. Patterson apologized to his employees and acknowledged, “I lit a
match and started a firestorm.”

WHY THE EMPHASIS ON NONVERBAL CUES? If actions speak louder than words, then it’s
important to make sure your actions align with and reinforce the words that go along with
them. An effective communicator watches his or her nonverbal cues to ensure that they
convey the desired message.

How Is Technology Affecting Managerial
Communication?
Information technology has radically changed the way organizational
members communicate. For example, it has significantly improved a manager’s
ability to monitor individual and team performance, it has allowed employees
to have more complete information to make faster decisions, and it has
provided employees more opportunities to collaborate and share information. In
addition, information technology has made it possible for people in organizations
to be fully accessible 24 hours a day, 7 days a week, regardless of where they are.
Employees don’t have to be at their desks with their computers turned on in order to commu-
nicate with others in the organization. Three developments in information technology appear
to have had a significant effect on current managerial communication: networked computer
systems, wireless capabilities, and knowledge management systems.

C H A P T E R 1 2 | C O M M U N I C AT I O N A N D I N T E R P E R S O N A L S K I L L S 329

active listening
Listening for full meaning without making
premature judgments or interpretations.

Roman Garza, manager of a Target
store, concentrates intensely while
listening to an employee who
approached him about a work
scheduling concern. Garza’s active
listening skill requires intense
concentration so he can focus on the
speaker and tune out the many
customary noises and distractions in a
retail store environment. Effective
listening also requires that Garza
empathizes with the employee by trying
to understand what she is saying, by
listening objectively without judging the
content of what she is saying, and by
taking responsibility for doing whatever is
needed to get the full meaning of what
she intends to communicate.

330 PA R T F O U R | L E A D I N G

What Are Networked Communication Capabilities?
In a networked computer system, an organization links its computers together through
compatible hardware and software, creating an integrated organizational network. Organi-
zation members can then communicate with each other and tap into information whether
they’re down the hall, across town, or anywhere on the globe. Although the mechanics of
how network systems work are beyond the scope of this book, we’ll address some of the
communication applications.

E-mail is the instantaneous transmission of messages on computers that are linked together.
Messages wait at a receiver’s computer and are read at the receiver’s convenience. E-mail is
fast and cheap and can be used to send the same message to many people at the same time. It’s
a quick and convenient way for organization members to share information and communicate.
Files can also be attached to e-mail messages, which enables the receiver to have a hard copy
of a document.

Some organization members who find e-mail slow and cumbersome are using instant
messaging (IM). This interactive, real-time communication takes place among computer
users who are logged on to the computer network at the same time. Instant messaging was
first popular among teens and preteens who wanted to communicate with their friends
online. Now it’s moved to the workplace. With IM, information that needs to be commu-
nicated can be done so instantaneously without waiting for colleagues to read e-mail
messages. However, instant messaging is not without its drawbacks. It requires users to be
logged on to the organization’s computer network at the same time, which potentially leaves
the network open to security breaches.

A voice mail system digitizes a spoken message, transmits it over the network, and
stores the message on a disk for the receiver to retrieve later.25 This capability allows infor-
mation to be transmitted even though a receiver may not be physically present to take the
information. Receivers can choose to save the message for future use, delete it, or route it
to other parties.

Fax machines can transmit documents containing both text and graphics over ordinary
telephone lines. A sending fax machine scans and digitizes the document, and a receiving
fax machine reads the scanned information and reproduces it in hard-copy form. Informa-
tion that’s best viewed in printed form can be easily and quickly shared by organization
members.

Electronic data interchange (EDI) is a way for organizations to exchange business trans-
action documents such as invoices or purchase orders, using direct, computer-to-computer
networks. Organizations often use EDI with vendors, suppliers, and customers because it saves
time and money. How? Information on transactions is transmitted from one organization’s
computer system to another through an interorganizational telecommunications network. The
printing and handling of paper documents at one organization are eliminated as is the inputting
of data at the other organization.

Meetings—one-on-one, team, divisional, or organization-wide—have always been one
way to share information. The limitations of technology used to dictate that meetings take
place among people in the same physical location. But that’s no longer the case. Teleconfer-
encing allows a group of people to confer simultaneously using telephone or e-mail group
communications software. If meeting participants can see each other over video screens, the
simultaneous conference is called videoconferencing. Work groups, large and small, which
might be in different locations, can use these communication network tools to collaborate and
share information. Doing so is often much less expensive than incurring travel costs for bring-
ing members together from several locations.

Networked computer systems allow for organizational intranets and extranets. An
intranet is an organizational communication network that uses Internet technology but is
accessible only to organizational employees. Many organizations are using intranets as ways
for employees to share information and collaborate on documents and projects—as well as
access company policy manuals and employee-specific materials, such as employee
benefits—from different locations.26 An extranet is an organizational communication
network that uses Internet technology and allows authorized users inside the organization

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Published by Prentice Hall. Copyright © 2011 by Pearson Education, Inc.

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to communicate with certain outsiders such as customers or vendors. Most of the large auto
manufacturers, for example, have extranets that allow faster and more convenient commu-
nication with dealers.

Finally, organizations are using Internet-based voice communication. Popular Web sites
such as Skype, Vonage, and Yahoo!, among others, let users chat with each other. And a
number of companies are using these services for employees to use in conference calls or
for instant messaging.

How Have Wireless Capabilities Affected
Communication?
At Seattle-based Starbucks Corporation, district managers use mobile technology, giving
them more time to spend in the company’s stores. A company executive says, “These are the
most important people in the company. Each has between 8 to 10 stores that he or she
services. And while their primary job is outside of the office—and in those stores—they still
need to be connected.”28 As this example shows, wireless communication technology has the
ability to improve work for managers and employees.

While networked computer systems require organizations and organizational members to
be connected by wires, wireless communication doesn’t. Smartphones, netbook computers,
notebook computers, and other pocket communication devices have spawned a whole new
way for managers to “keep in touch.” Globally, millions of users use wireless technology to
send and receive information from anywhere. One result: Employees no longer have to be at
their desks with their computers plugged in and turned on in order to communicate with
others in the organization. As technology continues to advance in this area, we’ll see more
and more organization members using wireless communication as a way to collaborate and
share information.29

How Does Knowledge Management Affect
Communication?
Part of a manager’s responsibility in fostering an environment conducive to learning and
effective communications is to create learning capabilities throughout the organization.
These opportunities should extend from the lowest to the highest levels in all areas. How

FYEO—DECODING COMMUNICATION JARGON

O
kay . . . how well do you know the

net lingo?27 If you received an e-mail

or text message with GFTD written in

it, would you know what that meant? What

about NSFW or BIL? When an employee

received an e-mail at work from a friend with

an attached slideshow entitled “Awkward

Family Photos,” she clicked through it and

saw some pretty unusual—yes, awkward—

photos. Looking back at the e-mail, that’s

when she also saw the abbreviation “NSFW”

written at the bottom. Not knowing what that

was, she looked the abbreviation up on

netlingo.com (one of several Web sites that

translate Internet and texting abbreviations).

Come to find out, she should have paid more

attention to the abbreviation since NSFW

stands for “not safe for work.”

“As text-messaging shorthand becomes

increasingly widespread in e-mails, text mes-

sages, and Tweets,” people need to be aware

of what it means. At many workplaces, a

working knowledge of Net lingo is becoming

necessary. As employees use social media

sites like Twitter and Facebook and even text

messaging to communicate with colleagues

and customers, the shorthand abbreviations

are often necessary to stay within message

length limits. However, as the NSFW example

showed, not knowing or even misunderstand-

ing the lingo can lead to surprises, inappro-

priate responses, or miscommunications.

(BTW—which is net lingo for “by the

way”—FYEO means “for your eyes only,”

GFTD stands for “gone for the day,” and BIL is

“boss is listening.”)

12.3

Discuss
the

interpersonal
skills that

every manager
needs.

332 PA R T F O U R | L E A D I N G

can managers create such an environment? An important step
is recognizing the value of knowledge as a major resource, just
like cash, raw materials, or office equipment. To illustrate the
value of knowledge, think about how you register for your
college classes. Do you talk to others who have had a certain
professor? Do you listen to their experiences with this
individual and make your decision based on what they have to
say (their knowledge about the situation)? If you do, you’re tap-
ping into the value of knowledge. But in an organization, just
recognizing the value of accumulated knowledge or wisdom
isn’t enough. Managers must deliberately manage that base of
knowledge. Knowledge management involves cultivating a
learning culture in which organizational members systemati-
cally gather knowledge and share it with others in the organiza-
tion so as to achieve better performance.30 For instance,
accountants and consultants at Ernst and Young document best
practices that they’ve developed, unusual problems they’ve dealt
with, and other work information. This “knowledge” is then
shared with all employees through computer-based applications
and through community of interest teams that meet regularly
throughout the company. Many other organizations—General
Electric, Toyota, Hewlett-Packard—have recognized the impor-
tance of knowledge management within a learning organization
(see Chapter 5). Today’s technologies are helping improve
knowledge management and facilitating organizational com-
munications and decision making.

What Interpersonal Skills Do Managers
Need?
Would it surprise you to know that more managers are probably fired
because of poor interpersonal skills than for a lack of technical ability?31

Moreover, a survey of top executives at Fortune 500 companies found that
interpersonal skills were the most important consideration in hiring senior-

level employees.32 Because managers ultimately get things done through
others, competencies in leadership, communication, and other interpersonal

skills are prerequisites to managerial effectiveness.33 Therefore, the rest of this
chapter focuses on key interpersonal skills that every manager needs.34

Why Are Active Listening Skills Important?
Previously, we discussed the importance of active listening. It’s one of the most important
interpersonal skills that managers can develop. But active listening is hard work. You have
to concentrate, and you have to want to fully understand what a speaker is saying. Students
who use active listening techniques for an entire 75-minute lecture are as tired as their
instructor when the lecture is over because they’ve put as much energy into listening as the
instructor put into speaking.

Active listening requires four essential elements: (1) intensity, (2) empathy, (3) acceptance,
and (4) a willingness to take responsibility for completeness.35 As noted, the human brain is
capable of handling a speaking rate that’s faster than that of the average speaker, leaving a lot
of time for daydreaming. The active listener concentrates intensely on what the speaker is
saying and tunes out the thousands of miscellaneous thoughts (about money, sex, vacation,
parties, exams, and so on) that create distractions. What do active listeners do with their idle
brain time? They summarize and integrate what has been said. They put each new bit of
information into the context of what preceded it.

Right orWrong?

How honest should managers be with employees about a company’s wors-
ening financial condition?24 When one business owner who owns a legal
services firm mentioned to his employees that the business was not doing
well, it ended up scaring them.“People started crying. One person gave
notice and left for a job at another company.”What do you think? What would
be achieved by telling them? Is not telling them unethical? Why or why not?

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Published by Prentice Hall. Copyright © 2011 by Pearson Education, Inc.

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Empathy requires you to put yourself into the speaker’s shoes. You try to understand what
the speaker wants to communicate rather than what you want to hear. Notice that empathy
demands both knowledge of the speaker and flexibility on your part. You need to suspend your
own thoughts and feelings and adjust what you see and feel to your speaker’s world. In that way,
you increase the likelihood that you’ll interpret the message in the way the speaker intended.

An active listener demonstrates acceptance. He or she listens objectively without judg-
ing content, which is not an easy task. It’s natural to be distracted by what a speaker says,
especially when we disagree with it. When we hear something we disagree with, we have a
tendency to begin formulating our mental arguments to counter what is being said. Of course,
in doing so, we miss the rest of the message. The challenge for the active listener is to absorb
what’s being said and withhold judgment on content until the speaker is finished.

The final ingredient of active listening is taking responsibility for completeness. That is,
the listener does whatever is necessary to get the full intended meaning from the speaker’s
communication. Two widely used active listening techniques are listening for feeling as well
as for content and asking questions to ensure understanding. (Look back at the “Developing
Your Active-Listening Skill” box on p. 328 for additional information.)

Why Are Feedback Skills Important?
Ask a manager about the performance feedback he or she gives employees, and you’re likely
to get a qualified answer. If the feedback is positive, it’s likely to be given promptly and
enthusiastically. Negative feedback is often treated differently.37 Like most of us, managers
don’t particularly enjoy communicating bad news. They fear offending the receiver or
having to deal with his or her emotions. The result is that negative feedback is often avoided,
delayed, or substantially distorted. In this section, we want to show you the importance of
providing both positive and negative feedback and to identify specific techniques to help
make your feedback more effective.

HOW ARE POSITIVE AND NEGATIVE FEEDBACK DIFFERENT? We know that managers
treat positive and negative feedback differently. So do receivers. You need to understand
this fact and adjust your feedback style accordingly.

Positive feedback is more readily and accurately perceived than negative feedback.
Furthermore, whereas positive feedback is almost always accepted, negative feedback often
meets resistance.38 Why? The logical answer appears to be that people want to hear good
news and block out the rest. Positive feedback fits what most people wish to hear and
already believe about themselves. Does this mean, then, that you should avoid giving nega-
tive feedback? No! What it means is that you need to be aware of potential resistance and learn
to use negative feedback in situations in which it’s most likely to be accepted.39 What are
those situations? Research indicates that negative feedback is most likely to be accepted when
it comes from a credible source or if it’s objective. Subjective impressions carry weight only
when they come from a person with high status and credibility.40 In other words, negative
feedback that’s supported by hard data—numbers, specific examples, and the like—is
more likely to be accepted. Negative feedback that’s subjective can be a meaningful tool for
experienced managers, particularly those in upper levels of the organization who have built
the trust and earned the respect of their employees. From less experienced managers, those
in the lower ranks of the organization, and those whose reputations have not yet been
established, negative feedback that’s subjective in nature is not likely to be well received.

HOW DO YOU GIVE EFFECTIVE FEEDBACK? Six specif ic suggestions can help you
become more effective in providing feedback.41 These are as follows:

� Focus on specific behaviors. Feedback should be specific rather than general. Avoid
statements such as “You have a bad attitude” or “I’m really impressed with the good job

knowledge management
Cultivating a learning culture in which
organizational members systematically gather
knowledge and share it with others.

percent of men said they
have heard a sexually inap-
propriate comment at work.

percent of women said the
same.

seconds is how long it
takes to retrieve your train
of thought after an e-mail

interruption.

percent of workers think it’s
very common for employees
to engage in office gossip.

percent of those workers
think gossip has a negative
effect on the workplace.

thousand is the average
number of words spoken in
a day by women and men.

percent of a day is how
much the average U.S.
worker loses to interruptions.

44
22
64

84
63
16
28

percent of large organiza-
tions have a formal pro-
cess in place to capture

knowledge.

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you did.” They are vague, and, although they provide information, they don’t tell the
receiver enough so that he or she can correct the “bad attitude,” or on what basis you
concluded that a good job has been done so the person knows what behaviors to repeat.

� Keep feedback impersonal. Feedback, particularly the negative kind, should be descriptive
rather than judgmental or evaluative. No matter how upset you are, keep the feedback
focused on job-related behaviors and never criticize someone personally because of an
inappropriate action. Telling people they’re incompetent, lazy, or the like is almost always
counterproductive. It provokes such an emotional reaction that the performance deviation
itself is apt to be overlooked. When you’re criticizing, remember that you’re censuring job-
related behavior, not the person. You might be tempted to tell someone he or she is rude
and insensitive (which just might be true); however, that’s hardly impersonal. It’s better to
say something more specific, such as “You’ve interrupted me three times with questions
that weren’t urgent when you knew I was talking long distance to a customer in Brazil.”

� Keep feedback goal oriented. Feedback should not be given primarily to “dump” or
“unload” on another person. If you have to say something negative, make sure it’s
directed toward the receiver’s goals. Ask yourself whom the feedback is supposed to
help. If the answer is essentially you (“I’ve got something I just want to get off my
chest”), bite your tongue and hold the comment. Such feedback undermines your credi-
bility and lessens the meaning and influence of future feedback sessions.

� Make feedback well timed. Feedback is most meaningful to a receiver when only a short
interval elapses between his or her behavior and the receipt of feedback about that behav-
ior. For example, a new employee who makes a mistake is more likely to respond to his or
her manager’s suggestions for improving right after the mistake or at the end of the work-
day rather than during a performance review session six months from now. If you have to
spend time recreating a situation and refreshing someone’s memory of it, the feedback you
are providing is likely to be ineffective. Moreover, if you’re particularly concerned with
changing behavior, delays in providing timely feedback on the undesirable actions lessen
the likelihood that the feedback will bring about the desired change. Of course, making
feedback prompt merely for promptness sake can backfire if you have insufficient infor-
mation or if you’re upset. In such instances, well timed could mean somewhat delayed.

� Ensure understanding. Is your feedback concise and complete enough that the receiver
clearly and fully understands your communication? Remember that every successful
communication requires both transference and understanding of meaning. If feedback
is to be effective, you need to ensure that the receiver understands it. As suggested in
our discussion of listening techniques, ask the receiver to rephrase the message to find
out whether he or she fully captured the meaning you intended.

� Direct negative feedback toward behavior that the receiver can control. Little value comes
from reminding a person of some shortcoming over which he or she has no control. Nega-
tive feedback should be directed toward behavior that the receiver can do something about.

For instance, criticizing an employee who’s late for work
because she forgot to set her alarm clock is valid. Criticiz-
ing her for being late for work when the subway she takes
to work every day had a power failure, stranding her for
90 minutes, is pointless. She was powerless to do anything
to correct what happened—short of finding a different
means of traveling to work, which may be unrealistic. In
addition, when negative feedback is given concerning
something that the receiver can control, it might be a good
idea to indicate specifically what can be done to improve
the situation. Such suggestions take some of the sting out of
the criticism and offer guidance to receivers who under-
stand the problem but don’t know how to resolve it.

What Are Empowerment Skills?
As we’ve described in various places throughout this
text, more and more managers are leading by empower-
ing their employees. Millions of employees and teams

Guest services employees at Winchester
Hospital meet every morning and later
in the day to share news and receive
up-to-date information that helps them
make informed decisions about their
work. Winchester empowers its staff to
provide service excellence, from guest
services employees shown here to
medical professionals. Chefs, for
example, are encouraged to create
their own special dish for patients once
a week, and medical staff is empowered
to develop new patient programs. One
group of nurses worked with the
hospital’s child life specialist to devise
a program of bringing dogs to the
hospital to visit patients. Empowerment
contributes to the hospital’s reputation
as an employer that cares as deeply for
its employees as for its patients.

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Fundamentals of Management: Essential Concepts and Applications, Seventh Edition, by Stephen P. Robbins, David A. DeCenzo, and Mary Coulter.
Published by Prentice Hall. Copyright © 2011 by Pearson Education, Inc.

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of employees are making key operating decisions that directly affect their work. They’re
developing budgets, scheduling workloads, controlling inventories, solving quality prob-
lems, and engaging in activities that until recently were viewed exclusively as part of the
manager’s job.42

The increased use of empowerment is being driven by two forces. First is the need for
quick decisions by those who are most knowledgeable about the issue, which requires mov-
ing decisions to lower levels. If organizations are to successfully compete in a dynamic global
economy, they have to be able to make decisions and implement changes quickly. Second is
the reality that the downsizing of organizations during the past two decades has left many
managers with considerably larger spans of control than they had previously. In order to cope
with the demands of an increased load, managers had to empower their employees. Two aspects
of empowerment are understanding the value of delegating and knowing how to do it.

Delegation is the assignment of authority to another person to carry out specific
activities. It allows an employee to make decisions—that is, it is a shift of decision-making
authority from one organizational level to another lower one (see Exhibit 12-4). Delegation,
however, should not be confused with participation. In participative decision making,
authority is shared. With delegation, employees make decisions on their own. That’s why
delegation is such a vital component of worker empowerment!

DON’T MANAGERS ABDICATE THEIR RESPONSIBILITY WHEN THEY DELEGATE? When
done properly, delegation is not abdication. The key word here is properly. If you, as a manager,
dump tasks on an employee without clarifying the exact job to be done, the range of the
employee’s discretion, the expected level of performance, the time frame in which the tasks are
to be completed, and similar concerns, you are abdicating responsibility and inviting trouble.43

Don’t fall into the trap, however, of assuming that, to avoid the appearance of abdicating, you
should minimize delegation. Unfortunately, that’s how many new and inexperienced

delegation
Assigning authority to another person to carry
out specific activities.

Effective delegation pushes authority down
vertically through the ranks of an organization.

Authority

Top
managers

Non-managerial
employees

First-line
managers

Middle
managers

EXHIBIT 12-4 Effective Delegation

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managers interpret the situation. Lacking confidence in their employees or fearful that they’ll
be criticized for their employees’ mistakes, these managers try to do everything themselves.

It might be true that you’re capable of doing tasks better, faster, or with fewer mistakes.
The catch is that your time and energy are scarce resources. It’s not possible for you to do
everything yourself. As a manager, you’ll need to delegate to be effective in your job. This
fact suggests two important points. First, you should expect and accept some mistakes by your
employees. Mistakes are part of delegation. They’re often good learning experiences for
employees as long as their costs are not excessive. Second, to ensure that the costs of mistakes
don’t exceed the value of the learning, you need to put adequate controls in place. As we’ll
discuss shortly, delegation without feedback controls that let you know about potentially
serious problems is a form of abdication.

How much authority should a manager delegate? Should he or she keep authority
centralized, delegating only the minimal amount to complete the delegated duties? What
contingency factors should be considered in determining the degree to which authority is
delegated? Exhibit 12-5 presents the most widely cited contingency factors to provide
some guidance in making those determinations.

HOW DO YOU DELEGATE EFFECTIVELY? Assuming that delegation is in order, how do
you delegate? A number of methods have been suggested for differentiating the effective
delegator from the ineffective one.44

� Clarify the assignment. First determine what is to be delegated and to whom. Identify
the person who’s most capable of doing the task and then determine whether he or she
has the time and motivation to do the job. Assuming that you have a willing employee,
it’s your responsibility to provide clear information on what’s being delegated, the results
you expect, and any time or performance expectations you hold. Unless the project
entails an overriding need to adhere to specific methods, you should ask an employee
only to provide the desired results. That is, get agreement on what is to be done and
the results expected, but let the employee decide by which means the work is to be
completed. By focusing on goals and allowing the employee the freedom to use his or
her own judgment as to how those goals are to be achieved, you increase trust between
you and the employee, improve the employee’s motivation, and enhance accountability
for results.

• The size of the organization. The larger the organization, the greater the number of
decisions that have to be made. Because top managers in an organization have only so
much time and can obtain only so much information, in larger organizations they become
increasingly dependent on the decision making of lower-level managers. Therefore,
managers in large organizations resort to increased delegation.

• The importance of the duty or decision. The more important a duty or decision (as
expressed in terms of cost and impact on the future of an organization), the less likely it
is to be delegated. For instance, a department head may be delegated authority to make
expenditures up to $7,500, and division heads and vice presidents up to $50,000 and
$125,000, respectively.

• Task complexity. The more complex the task, the more difficult it is for top management
to possess current and sufficient technical information to make effective decisions. Complex
tasks require greater expertise, and decisions about them should be delegated to the people
who have the necessary technical knowledge.

• Organizational culture. If management has confidence and trust in employees, the culture
will support a greater degree of delegation. However, if top management does not have
confidence in the abilities of lower-level managers, it will delegate authority only when
absolutely necessary. In such instances, as little authority as possible is delegated.

• Qualities of employees. A final contingency consideration is the qualities of employees.
Delegation requires employees with the skills, abilities, and motivation to accept authority
and act on it. If these are lacking, top management will be reluctant to relinquish authority.

EXHIBIT 12-5 Contingency Factors in Delegation

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� Specify employees’ range of discretion. Every act of delegation comes with constraints.
You’re delegating authority to act but not unlimited authority. You’re delegating the
authority to act on certain issues within certain parameters. You need to specify what
those parameters are so that employees know, in no uncertain terms, the range of their
discretion. When those parameters have been successfully communicated, both you and
employees will have the same idea of the limits to the authority and how far they can
go without further approval.

� Allow employees to participate. One of the best ways to decide how much authority will be
necessary is to allow employees who will be held accountable for the tasks to participate in
that decision. Be aware, however, that participation can present its own set of potential prob-
lems as a result of employees’ self-interest and biases in evaluating their own abilities. Some
employees might be personally motivated to expand their authority beyond what they need
and beyond what they are capable of handling. Allowing such people too much participa-
tion in deciding what tasks they should take on and how much authority they must have to
complete those tasks can undermine the effectiveness of the delegation process.

� Inform others that delegation has occurred. Delegation should not take place in a
vacuum. Not only do you and your employees need to know specifically what has been
delegated and how much authority has been granted; anyone else who’s likely to be
affected by the delegation act needs to be informed, including people outside the organi-
zation as well as inside it. Essentially, you need to convey what has been delegated (the
task and amount of authority) and to whom. Failure to inform others makes conflict
likely and decreases the chances that your employees will be able to accomplish the
delegated act efficiently.

� Establish feedback controls. To delegate without instituting feedback controls is inviting
problems. It is always possible that employees will misuse the discretion they have been
given. Controls to monitor employees’ progress increase the likelihood that important
problems will be identified early and that the task will be completed on time and to the
desired specification. Ideally, these controls should be determined at the time of initial
assignment. Agree on a specific time for completion of the task, and then set progress
dates by which the employees will report on how well they are doing and on any major
problems that have surfaced. These controls can be supplemented with periodic spot checks
to ensure that authority guidelines are not being abused, organization policies are being
followed, proper procedures are being met, and the like. Too much of a good thing can be
dysfunctional. If the controls are too constraining, employees will be deprived of the
opportunity to build self-confidence. As a result, much of the motivational aspect of
delegation may be lost. A well-designed control system, which we will elaborate on in
more detail in the next chapter, permits your employees to make small mistakes but quickly
alerts you when big mistakes are imminent.

How Do You Manage Conflict?
The ability to manage conflict is undoubtedly one of the most important skills a manager
needs to possess.45 A study of middle- and top-level executives by the American Management
Association revealed that the average manager spends approximately 20 percent of his or her
time dealing with conflict.46 The importance of conflict management is reinforced by a
survey of the topics managers consider most important in management development
programs; conflict management was rated as more important than decision making, leadership,
or communication skills.47

WHAT IS CONFLICT MANAGEMENT? Conflict is perceived incompatible differences
resulting in some form of interference or opposition. Whether the differences are real is
irrelevant. If people perceive that differences exist, then there is conflict.

conflict
Perceived differences resulting in interference
or opposition.I

338 PA R T F O U R | L E A D I N G

Three different views have evolved regarding conflict.48 The traditional view of con-
flict argues that conflict must be avoided—that it indicates a problem within the group.
Another view, the human relations view of conflict, argues that conflict is a natural and
inevitable outcome in any group and need not be negative, but has potential to be a posi-
tive force in contributing to a group’s performance. The third and most recent view, the
interactionist view of conflict, proposes that not only can conflict be a positive force in a
group but that some conflict is absolutely necessary for a group to perform effectively.

The interactionist view doesn’t suggest that all conflicts are good. Some conflicts—
functional conflicts—are constructive and support an organization’s goals and improve per-
formance. Other conflicts—dysfunctional conflicts—are destructive and prevent
organizations from achieving goals. Exhibit 12-6 illustrates the challenge facing managers.

When is conflict functional and when is it dysfunctional? Research indicates that you
need to look at the type of conflict.49 Task conflict relates to the content and goals of the
work. Relationship conflict focuses on interpersonal relationships. Process conflict refers to
how the work gets done. Research shows that relationship conflicts are almost always
dysfunctional because the interpersonal hostilities increase personality clashes and decrease
mutual understanding and the tasks don’t get done. On the other hand, low levels of process
conflict and low-to-moderate levels of task conflict are functional. For process conflict to be
productive, it must be minimal. Otherwise, intense arguments over who should do what may
become dysfunctional since they can lead to uncertainty about task assignments, increase
the time to complete tasks, and lead to members working at cross-purposes. However, a low-
to-moderate level of task conflict consistently has a positive effect on group performance
because it stimulates discussion of ideas that help groups be more innovative.50 Because we

Situation Level of
Conflict

Type of
Conflict

Organization’s
Internal

Characteristics

Level of
Organizational
Performance

Low

or
none

Optimal

High

Dysfunctional

Functional

Dysfunctional

Apathetic
Stagnant
Unresponsive to change
Lack of new ideas

Viable
Self-critical
Innovative
Disruptive
Chaotic
Uncooperative

Low
High
Low
A

B
C

Low
Low

High
High

Level of Conflict

•

L
e

ve
l o

f
O

rg
a

n
iz

a
ti

o
n

a
l P

e
rf

o
rm

a
n

c
e

EXHIBIT 12-6 Conflict and Organizational Performance

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don’t yet have a sophisticated measuring instrument for assessing whether conflict levels are
optimal, too high, or too low, the manager must try to judge that intelligently.

WHICH CONFLICTS DO YOU HANDLE? When group conflict levels are too high, managers
can select from five conflict management options: avoidance, accommodation, forcing,
compromise, and collaboration.51 (See Exhibit 12-7 for a description of these techniques.)
Keep in mind that no one option is ideal for every situation. Which approach to use depends
on the circumstances.

Regardless of our desires, reality tells us that some conflicts are unmanageable.52 When
antagonisms are deeply rooted, when one or both parties wish to prolong a conflict, or when
emotions run so high that constructive interaction is impossible, your efforts to manage the
conflict are unlikely to meet with much success. Don’t be lured into the naïve belief that a good
manager can resolve every conflict effectively. Some aren’t worth the effort; some are outside
your realm of influence. Still others may be functional and, as such, are best left alone.

HOW DOES A MANAGER STIMULATE CONFLICT? What about the other side of conflict
management—situations that require managers to stimulate conflict? The notion of stimu-
lating conflict is often difficult to accept. For almost all of us the term conflict has a nega-
tive connotation, and the idea of purposely creating conflict seems to be the antithesis of
good management. Few of us enjoy being in conflict situations, yet evidence demonstrates
that in some situations an increase in conflict is constructive.53 Although no clear demarca-
tion separates functional from dysfunctional conflict, and no definitive method is available
for assessing the need for more conflict, an aff irmative answer to one or more of the
following questions may suggest a need for conflict stimulation.54

� Are you surrounded by “yes” people?
� Are employees afraid to admit ignorance and uncertainties to you?

STRATEGY BEST USED WHEN

Avoidance Conflict is trivial, when emotions are running high and time is
needed to cool them down, or when the potential disruption
from an assertive action outweighs the benefits of resolution

Accommodation The issue under dispute isn’t that important to you or when
you want to build up credits for later issues

Forcing You need a quick resolution on important issues that require
unpopular actions to be taken and when commitment by
others to your solution is not critical

Compromise Conflicting parties are about equal in power, when it is
desirable to achieve a temporary solution to a complex issue, or
when time pressures demand an expedient solution

Collaboration Time pressures are minimal, when all parties seriously want a
win-win solution, and when the issue is too important to be
compromised

EXHIBIT 12-7 Conflict Management: What Works Best and When

functional conflicts
Conflict that’s constructive and supports an
organization’s goals.

interactionist view of conflict
The view that some conflict is necessary for an
organization to perform effectively.

human relations view of conflict
The view that conflict is natural and inevitable
and has the potential to be a positive force.

traditional view of conflict
The view that all conflict is bad and must be
avoided.

task conflict
Conflict that relates to the content and goals of
work.

process conflict
Conflict that refers to how the work gets done.

relationship conflict
Conflict that focuses on interpersonal
relationships.

dysfunctional conflicts
Conflict that’s destructive and prevents an
organization from achieving its goals.

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As a necessary part of the creative
process, functional conflict has a
legitimate place in innovative
organizations. John Chambers, CEO of
Cisco Systems, is respected worldwide
as a leader of innovation who has the
ability to drive an entrepreneurial
culture. At Cisco, he has created a
culture of trust, open communication,
teamwork, and collaboration that
generates a steady flow of new ideas.
He has formed cross-functional teams
that work through problems by exploring
alternative viewpoints of employees
from different disciplines. Functional
conflict helps Cisco adapt to new and
shifting technologies and rapidly
changing business environments.
Chambers is shown here communicating
with students of the Mediterranean
Youth Technology Club in Israel.

� Are decision makers so focused on reaching a compromise that they lose sight of
values, long-term objectives, or the organization’s welfare?

� Do managers believe that it’s in their best interest to maintain the impression of peace
and cooperation in their unit, regardless of the price?

� Are decision makers excessively concerned about hurting the feelings of others?
� Do managers believe that popularity is more important for obtaining organizational

rewards than competence and high performance?
� Do managers put undue emphasis on obtaining consensus for their decisions?
� Do employees show unusually high resistance to change?
� Is there a lack of new ideas?

We know a lot more about resolving conflict than about stimulating it. That’s only
natural, because human beings have been concerned with the subject of conflict reduction
for hundreds, maybe thousands, of years. The dearth of ideas on conflict stimulation
techniques reflects the recent interest in the subject. The following are some preliminary
suggestions that managers might want to use.55

The initial step in stimulating functional conflict is for managers to convey to employees
the message, supported by actions, that conflict has its legitimate place. This step may
require changing the culture of the organization. Individuals who challenge the status quo,
suggest innovative ideas, offer divergent opinions, and demonstrate original thinking need
to be rewarded visibly with promotions, salary, and other positive reinforcers.

As far back as Franklin D. Roosevelt’s administration, and probably before, the White
House consistently has used communication to stimulate conflict. Senior officials plant
possible decisions with the media through the infamous “reliable source” route. For example,
the name of a prominent judge is leaked as a possible Supreme Court appointment. If the
candidate survives the public scrutiny, his or her appointment will be announced by the
president. However, if the candidate is found lacking by the media and the public, the pres-
ident’s press secretary or other high-level official may make a formal statement such as,
“At no time was this candidate under consideration.” Regardless of party affiliation,
occupants of the White House have regularly used the reliable source method as a conflict
stimulation technique. It is all the more popular because of its handy escape mechanism. If
the conflict level gets too high, the source can be denied and eliminated.

Ambiguous or threatening messages also encourage conflict. Information that a plant
might close, that a department is likely to be eliminated, or that a layoff is imminent can
reduce apathy, stimulate new ideas, and force reevaluation—all positive outcomes of increased
conflict. Another widely used method for shaking up a stagnant unit or organization is to bring
in outsiders either from outside or by internal transfer with backgrounds, values, attitudes, or
managerial styles that differ from those of present members. Many large corporations have

used this technique during the past decade to fill vacan-
cies on their boards of directors. Women, minority group

members, consumer activists, and others whose
backgrounds and interests differ significantly from
those of the rest of the board have been selected to add

a fresh perspective.
We also know that structural vari-

ables are a source of conflict. It is,
therefore, only logical that managers
look to structure as a conflict stimu-
lation device. Centralizing decisions,
realigning work groups, increasing
formalization, and increasing inter-
dependencies between units are all
structural devices that disrupt the sta-
tus quo and increase conflict levels.

Finally, one can appoint a
devil’s advocate, a person who pur-
posely presents arguments that run

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negotiation
A process in which two or more parties who
have different preferences must make a joint
decision and come to an agreement.

devil’s advocate
A person who purposely presents arguments
that run counter to those proposed by the
majority or against current practices.

counter to those proposed by the majority or against current practices. He or she plays the role
of the critic, even to the point of arguing against positions with which he or she actually agrees.
A devil’s advocate acts as a check against groupthink and practices that have no better justifi-
cation than “that’s the way we’ve always done it around here.” When thoughtfully listened to,
the advocate can improve the quality of group decision making. On the other hand, others in the
group often view advocates as time wasters, and their appointment is almost certain to delay any
decision process.

What Are Negotiation Skills?
We know that lawyers and auto salespeople spend a significant amount of time on their jobs
negotiating. But so, too, do managers. They have to negotiate salaries for incoming employ-
ees, cut deals with their bosses, work out differences with their peers, and resolve conflicts
with employees. Others have to negotiate labor contracts and other agreements with people
outside their organizations. For our purposes, we will define negotiation as a process in
which two or more parties who have different preferences must make a joint decision and
come to an agreement. To achieve this goal, both parties typically use a bargaining strategy.

HOW DO BARGAINING STRATEGIES DIFFER? Two general approaches to negotiation are
distributive bargaining and integrative bargaining.56 Let’s see what’s involved in each.

You see a used car advertised for sale in the newspaper. It appears to be just what you’ve
been looking for. You go out to see the car. It’s great, and you want it. The owner tells you
the asking price. You don’t want to pay that much. The two of you then negotiate over the
price. The negotiating process you are engaging in is called distributive bargaining. Its most
identifying feature is that it operates under zero-sum conditions.57 That is, any gain you
make is at the expense of the other person, and vice versa. Every dollar you can get the
seller to cut from the price of the used car is a dollar you save. Conversely, every dollar
more he or she can get from you comes at your expense. Thus, the essence of distributive
bargaining is negotiating over who gets what share of a fixed pie. Probably the most widely
cited examples of distributive bargaining are traditional labor-management negotiations
over wages and benefits. Typically, labor’s representatives come to the bargaining table
determined to get as much as they can from management. Because every cent more that
labor negotiates increases management’s costs, each party bargains aggressively and often
treats the other as an opponent who must be defeated. In distributive bargaining, each party
has a target point that defines what he or she would like to achieve. Each also has a resist-
ance point that marks the lowest acceptable outcome (see Exhibit 12-8). The area between

distributive bargaining
Negotiation under zero-sum conditions, in which
any gain by one party involves a loss to the
other party.

Party A’s aspiration range

Party B’s aspiration range

Settlement
range

Party A’s
target

point

Party B’s
resistance

point

Party A’s
resistance

point

Party B’s
target
point

EXHIBIT 12-8 Determining the Bargaining Zone

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their resistance points is the settlement range. As long as these ranges of aspiration overlap
each other to some extent, there exists a settlement area in which each one’s aspirations
can be met.

When engaged in distributive bargaining, you should try to get your opponent to
agree to your specific target point or to get as close to it as possible. Examples of such
tactics are persuading your opponent of the impossibility of getting to his or her target point
and the advisability of accepting a settlement near yours; arguing that your target is fair, but
your opponent’s isn’t; and attempting to get your opponent to feel emotionally generous
toward you and thus accept an outcome close to your target point.

A sales representative for a women’s sportswear manufacturer has just closed a $25,000
order from an independent clothing retailer. The sales rep calls in the order to her firm’s
credit department. She is told that the firm can’t approve credit to this customer because of
a past slow pay record. The next day, the sales rep and the firm’s credit manager meet to dis-
cuss the problem. The sales rep doesn’t want to lose the business. Neither does the credit
manager, but he also doesn’t want to get stuck with an uncollectible debt. The two openly
review their options. After considerable discussion, they agree on a solution that meets both
their needs. The credit manager will approve the sale, but the clothing store’s owner will pro-
vide a bank guarantee that will assure payment if the bill isn’t paid within 60 days.

The sales-credit negotiation is an example of integrative bargaining. In contrast to
distributive bargaining, integrative problem solving operates under the assumption that at
least one settlement can create a win-win solution. In general, integrative bargaining is
preferable to distributive bargaining. Why? Because the former builds long-term relation-
ships and facilitates working together in the future. It bonds negotiators and allows each to
leave the bargaining table feeling that he or she has achieved a victory. Distributive
bargaining, on the other hand, leaves one party a loser. It tends to build animosities and
deepen divisions between people who have to work together on an ongoing basis.

Why, then, don’t we see more integrative bargaining in organizations? The answer lies
in the conditions necessary for this type of negotiation to succeed. These conditions include
openness with information and frankness between parties, a sensitivity by each party to the
other’s needs, the ability to trust one another, and a willingness by both parties to maintain
flexibility.58 Because many organizational cultures and intraorganizational relationships are
not characterized by openness, trust, and flexibility, it isn’t surprising that negotiations often
take on a win-at-any-cost dynamic. With that in mind, let’s look at some suggestions for
negotiating successfully.

HOW DO YOU DEVELOP EFFECTIVE NEGOTIATION SKILLS? The essence of effective
negotiation can be summarized in the following seven recommendations.59

� Research the individual with whom you’ll be negotiating. Acquire as much infor-
mation as you can about the person with whom you’ll be negotiating. What are that
individual’s interests and goals? What people must he or she appease? What is his or
her strategy? This information will help you to better understand his or her behavior,
to predict his or her responses to your offers, and to frame solutions in terms of his
or her interests.

� Begin with a positive overture. Research shows that concessions tend to be recipro-
cated and lead to agreements. As a result, begin bargaining with a positive overture—
perhaps a small concession—and then reciprocate the other party’s concessions.

� Address problems, not personalities. Concentrate on the negotiation issues, not on the
personal characteristics of the individual with whom you’re negotiating. When negoti-
ations get tough, avoid the tendency to attack the other party. Remember it’s that
person’s ideas or position that you disagree with, not with him or her personally.

integrative bargaining
Negotiation in which there is at least one
settlement that involves no loss to either party.

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� Pay little attention to initial offers. Treat an initial offer as merely a point of departure.
Everyone has to have an initial position, and initial positions tend to be extreme and
idealistic. Treat them as such.

� Emphasize win-win solutions. If conditions are supportive, look for an integrative
solution. Frame options in terms of the other party’s interests and look for solutions
that can allow this individual, as well as yourself, to declare a victory.

� Create an open and trusting climate. Skilled negotiators are better listeners, ask more
questions, focus on their arguments more directly, are less defensive, and have learned
to avoid words or phrases that can irritate the person with whom they’re negotiating
(such as a “generous offer,” “fair price,” or “reasonable arrangement”). In other words,
they’re better at creating an open and trusting climate that is necessary for reaching a
win-win settlement.

� If needed, be open to accepting third-party assistance. When stalemates are reached,
consider the use of a neutral third party—a mediator, an arbitrator, or a conciliator.
Mediators can help parties come to an agreement, but they don’t impose a settlement.
Arbitrators hear both sides of the dispute, then impose a solution. Conciliators are more
informal and act as a communication conduit, passing information between the parties,
interpreting messages, and clarifying misunderstandings.

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To check your understanding of learning outcomes 12.1 – 12.3 , go to

mymanagementlab.com and try the chapter questions.

ApplicationsReview and

Chapter Summary
12.1 Describe what managers need to know about

communicating effectively. Communication is the
transfer and understanding of meaning. There are
seven elements in the communication process.
First there is a sender or source who has a message.
A message is a purpose to be conveyed. Encoding is
converting a message into symbols. A channel is the
medium a message travels along. Decoding is when
the receiver retranslates a sender’s message. Finally,
there is feedback. The barriers to effective communica-
tion include filtering, emotions, information overload,
defensiveness, language, and national culture. Managers
can overcome these barriers by using feedback, simpli-
fying language, listening actively, constraining
emotions, and watching for nonverbal clues.

12.2 Explain how technology affects managerial
communication. Technology has radically changed
the way organizational members communicate. It
improves a manager’s ability to monitor performance;
it gives employees more complete information to
make faster decisions; it has provided employees
more opportunities to collaborate and share informa-
tion; and it has made it possible for people to be fully
accessible, anytime anywhere. IT has affected
managerial communication through the use of
networked computer systems, wireless capabilities,
and knowledge management systems.

12.3 Discuss the interpersonal skills that every
manager needs. Behaviors related to effective active
listening are making eye contact, exhibiting affirma-
tive nods and appropriate facial expressions, avoiding
distracting actions or gestures, asking questions,
paraphrasing, avoiding interruption of the speaker,
not overtalking, and making smooth transitions
between the roles of speaker and listener. In order to

provide effective feedback, you must focus on
specific behaviors; keep feedback impersonal, goal
oriented, and well timed; ensure understanding; and
direct negative feedback toward behavior that the
recipient can control. Contingency factors guide
managers in determining the degree to which author-
ity should be delegated. These factors include the size
of the organization (larger organizations are associ-
ated with increased delegation); the importance of
the duty or decision (the more important a duty or
decision is, the less likely it is to be delegated); task
complexity (the more complex the task is, the more
likely it is that decisions about the task will be dele-
gated); organizational culture (confidence and trust in
subordinates are associated with delegation); and
qualities of subordinates (delegation requires subordi-
nates with the skills, abilities, and motivation to
accept authority and act on it). Behaviors related to
effective delegating are clarifying the assignment,
specifying the employee’s range of discretion, allow-
ing the employee to participate, informing others that
delegation has occurred, and establishing feedback
controls. The steps to be followed in analyzing and
resolving conflict situations begin by identifying your
underlying conflict-handling style. Second, select
only conflicts that are worth the effort and that can be
managed. Third, evaluate the conflict players. Fourth,
assess the source of the conflict. Finally, choose the
conflict resolution option that best reflects your style
and the situation. Effective negotiation skills require
researching the individual with whom you’ll be nego-
tiating; beginning with a positive overture; addressing
problems, not personalities; paying little attention to
the first offer; emphasizing win-win solutions; creat-
ing an open and trusting climate; and being open to
third-party assistance, if needed.

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Fundamentals of Management: Essential Concepts and Applications, Seventh Edition, by Stephen P. Robbins, David A. DeCenzo, and Mary Coulter.
Published by Prentice Hall. Copyright © 2011 by Pearson Education, Inc.

C H A P T E R 1 2 | C O M M U N I C AT I O N A N D I N T E R P E R S O N A L S K I L L S 345

Understanding the Chapter

1. Which type of communication do you think is most
effective in a work setting? Why?

2. Why isn’t effective communication synonymous with
agreement?

3. Which do you think is more important for a manager:
speaking accurately or listening actively? Why?

4. “Ineffective communication is the fault of the
sender.” Do you agree or disagree with this
statement? Discuss.

5. Is information technology helping managers be more
efficient and effective? Explain your answer.

6. Why are effective interpersonal skills so important to
a manager’s success?

7. How might a manager use the grapevine to his or her
advantage? Support your response.

8. Research the characteristics of a good communicator.
Write up your findings in a bulleted list report. Be
sure to cite your sources.

Understanding Yourself

How Good Are My Listening Skills?
Effective communicators have developed good listening skills. This instrument is
designed to provide you with some insights into your listening skills.

INSTRUMENT Respond to each of the 15 statements using the following scale:

1 = Strongly agree

2 = Agree

3 = Neither agree or disagree

4 = Disagree

5 = Strongly disagree

1. I frequently attempt to listen to several conversations at the same time. 1 2 3 4 5

2. I like people to give me only the facts and then let me make my own interpretation. 1 2 3 4 5

3. I sometimes pretend to pay attention to people. 1 2 3 4 5

4. I consider myself a good judge of nonverbal communications. 1 2 3 4 5

5. I usually know what another person is going to say before he or she says it. 1 2 3 4 5

6. I usually end conversations that don’t interest me by diverting
my attention from the speaker. 1 2 3 4 5

7. I frequently nod, frown, or provide other nonverbal cues to let the
speaker know how I feel about what he or she is saying. 1 2 3 4 5

8. I usually respond immediately when someone has finished talking. 1 2 3 4 5

9. I evaluate what is being said while it is being said. 1 2 3 4 5

10. I usually formulate a response while the other person is still talking. 1 2 3 4 5

11. The speaker’s “delivery” style frequently keeps me from listening to content. 1 2 3 4 5

12. I usually ask people to clarify what they have said rather than guess at the meaning. 1 2 3 4 5

13. I make a concerted effort to understand other people’s points of view. 1 2 3 4 5

14. I frequently hear what I expect to hear rather than what is said. 1 2 3 4 5

15. Most people feel that I have understood their point of view when we disagree. 1 2 3 4 5

Source: Adapted from E. C. Glenn and E. A. Pood, “Listening Self-Inventory,” Supervisory Management (January
1989), pp. 12–15. Used with permission of publisher; © 1989 American Management Association, New York.

SCORING KEY You score this instrument by adding up your responses for all items;
however, you need to reverse your scores (5 becomes 1, 4 becomes 2, etc.) for statements
4, 12, 13, and 15.

ANALYSIS AND INTERPRETATION Scores range from 15 to 75. The higher your score,
the better listener you are. While any cutoffs are essentially arbitrary, if you score 60 or
above, your listening skills are fairly good. Scores of 40 or less indicate you need to make
a serious effort at improving your listening skills. You might want to start by looking at
the “Developing Your Active-Listening Skill” box included in this chapter.

346 PA R T F O U R | L E A D I N G

FYIA (For Your Immediate Action)

Stone, Hartwick, and Mueller Talent Management Associates

To: Chris Richards
From: Dana Gibson

Subject: Office Gossip

I need some advice, Chris. As you know, my department and all its employees are

being transferred from Los Angeles to Dallas. We’ve had to keep the information

“under wraps” for competitive reasons. However, one of my employees asked me

point blank yesterday about a rumor she’s heard that this move is in the works. I didn’t

answer her question directly. But I’m afraid that the office grapevine is going to start

spreading inaccurate information and then affect morale and productivity. What should

I do now? Send me your written response soon (confidential, please!) about what you

would do.

This fictionalized company and message were created for educational purposes only. It is not meant to reflect
positively or negatively on management practices by any company that may share this name.

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Fundamentals of Management: Essential Concepts and Applications, Seventh Edition, by Stephen P. Robbins, David A. DeCenzo, and Mary Coulter.
Published by Prentice Hall. Copyright © 2011 by Pearson Education, Inc.

CASE APPLICATION

It’s estimated that during 2008, each corporate user of e-mail sent orreceived over 150 messages per day. By 2011, that number isestimated to be well over 225. Another study found that one-third
of e-mail users feel stressed by heavy e-mail volume. Once imagined
to be a time-saver, has the inbox become a burden?

U.S. Cellular’s Chief Operating Off icer Jay Ellison thought so
and did something about it. He imposed a “no e-mail Friday” rule, a
move that a growing number of companies are taking. Although most
bans typically allow e-mailing clients and customers or responding
to urgent matters, the intent is to slow down the routine internal
e-mails that take up time and clog the organization’s computer network.
The limits also aim at encouraging more face-to-face and phone con-
tact with coworkers and customers. Ellison also hoped that it would
give his employees a small respite from the e-mail onslaught. What he
got, however, was a rebellion. One employee confronted him saying
that Ellison didn’t understand how much work had to get done and
how much easier it was when using e-mail.

Discussion Questions

1. What advantages and disadvantages are there to e-mail as a form of communication? In addition to your
own personal experience with e-mail, do some research before answering this question.

2. Why do you think the employees rebelled?

3. What’s your opinion about Ellison’s actions? Was he right or wrong? Be sure to look at this from the
perspective of both the organization and the employees.

4. What other approaches might Ellison have taken to address this issue of out-of-control e-mail?

Sources: S. Shellenbarger, “A Day Without Email Is Like . . .”Wall Street Journal, October 11, 2007, pp. D1+; M. Kessler, “Fridays Go from Casual
to E-Mail-Free,” USA Today, October 5, 2007, p. 1A; D. Beizer, “Email Is Dead,” Fast Company, July/August 2007, p. 46; O. Malik, “Why Email Is
Bankrupt,” Business 2.0, July 2007, p. 46; and D. Brady, “*!#?@ the E-Mail. Can We Talk?” BusinessWeek, December 4, 2006, p. 109.

347

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