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This research paper synthesizes findings from five different contemporary studies related to the impact of stress and the personal and professional coping mechanisms that are used by superintendents in this era of dynamic change and intense accountability. The studies were conducted with practicing superintendents during an eight-year time period (2006-2013) by researchers with several decades of practical experiences as school district leaders. The studies were conducted in the following 7 states: Delaware, Georgia, Maryland, New York, Pennsylvania, New Jersey, and Virginia. This paper is based on related quantitative data collected over this eight-year period from almost 1000 practicing school administrators (N = 980) with over 6% of them (63) participating in structured qualitative interviews.