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Gotham Map for The authors consider whether this may be due to differences in access to pain management, or whether it reflects other factors not considered in their study, such as socioeconomic or life stress, which may be detrimental to the QoL evaluations these individuals made. These findings highlight that several factors need to be taken into account when attempting to establish what predicts’ QoL the presence or absence of pain; the presence or absence of depressed mood; levels of social support, ethnicity and other background stressors that may be happening independently of the disease process under study. In terms of coping response, Carver et al. point out that avoidant coping is likely to be beneficial to QoL in situations where a person is unable to exert control, and they suggest that approach coping in these situations could lead to frustration when control is not forthcoming. Others suggest that maintaining a good QoL in relatively unalterable situations, such as that faced by individuals with chronic pain, may require individuals to cope by means of acceptance coping or positive reinterpretation McCracken For example, McCracken and Eccleston , in a study of adults with chronic pain, found that coping was weakly related to pain acceptance and unreliably associated with adjustment, but that among those who did show acceptance of their pain, many QoL indicators were higher, including reduced pain symptomatology and disability, less depression and painrelated anxiety, a higher amount of time per day spent up and about, and a greater likelihood to be working. Such findings underscore the fact that, as discussed in Chapter , there is no one coping strategy that is inherently better than another and coping will change over time and place depending on the demands and resources available to the person. In terms of resources upon which individuals may draw when faced with stress or the demands of illness, previous chapters have highlighted the crucial role of social support. Gotham Map 2016.