Correlates of coping styles in psychotic illness (original) (raw)
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Correlates of coping styles in psychotic illness — An extension study
Psychiatry Research, 2009
Coping/recovery styles of integration and sealing over, reflecting the patient's dealing with his or her psychotic illness, influence the treatment adherence and, perhaps, the therapy outcome. Knowledge of these styles' potential clinical and personality correlates is so far limited. A semi-structured interview and self-rating questionnaires were used to assess 64 inpatients recovering from an acute episode of a schizophrenia spectrum disorder with regard to the prevailing coping/recovery style, depressive and negative syndromes, global functioning, locus of control and personality characteristics of novelty seeking, harm avoidance, and reward dependence. A significant positive correlation was found between coping/recovery style of sealing over and both negative syndrome and external control (by powerful others) orientation; a significant negative correlation was found between sealing over and good global functioning. The final multivariate model comprised negative syndrome, global functioning and a personality characteristic of reward dependence; together these three variables explained 44% of the coping/recovery style variance. Thus, in patients with disorders in the schizophrenia spectrum, the inclination towards sealing over is positively correlated with the higher degree of the overall severity of psychiatric disturbance and it is closely associated with a negative syndrome. In contrast, both the degree of depression and personality characteristics measured do not seem to play an important role with regard to the prevailing coping/recovery style of integration and sealing over.
Coping styles predict responsiveness to cognitive behaviour therapy in psychosis
Psychiatry research, 2011
The study aimed to determine the clinical and neuropsychological predictors of responsiveness to cognitive behavioural therapy for psychosis (CBTp). Sixty patients with schizophrenia or schizoaffective disorder and 25 healthy individuals took part in the study. Thirty patients (25 protocol completers) received CBTp in addition to standard care (SC); 30 patients (18 protocol completers) received SC only. All patients were assessed on symptoms using the Positive and Negative Syndrome Scale (PANSS) and clinical and neuropsychological function before and after CBTp. Symptoms and self-esteem improved to a greater extent in the CBTp+SC than SC control group. Greater pre-therapy coping ability and the self-reflectiveness dimension of cognitive insight at baseline predicted improvement in symptoms in the CBTp+SC group, but not the SC control group, explaining up to 21% of the variance in symptom improvement. Pre-therapy neuropsychological function, duration of illness, clinical insight and ...
Coping and Schizophrenia: A Re-analysis
Archives of Psychiatric Nursing, 2009
Standard notions of coping have not been particularly fruitful in the study of schizophrenia. However, facilitation of adaptive coping with serious mental illnesses such as schizophrenia is an important part of mental health care in general and of psychiatric nursing in particular. This study explored factors of coping and examined their relation with symptom severity and with quality of life of outpatients with schizophrenia. Data were analyzed from a previous cross-sectional study, using theWays of Coping Checklist, the Positive and Negative Syndrome Scale, and the Wisconsin Quality of Life Index. A principal component factor analysis was performed on the Ways of Coping Checklist scores, and the resulting six coping factors were then tested for correlations with Positive and Negative Syndrome Scale and Wisconsin Quality of Life Index scores. Factors conceptually linked with emotion-focused coping were more strongly associated with symptom severity and with quality of life than were factors conceptually linked with problem-focused coping. The emotionfocused versus problem-focused coping framework was only partly explanatory. It may be fruitful to study whether supportive counseling enhances beneficial factors conceptually linked with emotion-focused coping of individuals with schizophrenia.
Psychiatry Research, 2006
This study aimed to identify coping patterns used by schizophrenia inpatients in comparison with those used by healthy individuals, and to explore their association with selected clinical and psychosocial variables. The Coping Inventory for Stressful Situations (CISS) was used to assess coping strategies among 237 inpatients who met DSM-IV criteria for schizophrenia and 175 healthy individuals. Severity of psychopathology and distress, insight into illness, feelings of self-efficacy and self-esteem (self-construct variables), social support, and quality of life were also examined. Factor analysis, analysis of covariance and correlations were used to examine the relationships between the parameters of interest. Using dimensional measures, we found that emotion-oriented coping style and emotional distress were significantly higher in the schizophrenia group, whereas the task-oriented coping style, self-efficacy, perceived social support and satisfaction with quality of life were lower compared with controls. When eight CISS coping patterns were defined, the results revealed that patients used emotion coping patterns 5.5 times more frequently, and task and task-avoidance coping patterns significantly less often than healthy subjects. Coping patterns have different associations with current levels of dysphoric mood and emotional distress, self-construct variables, and satisfaction with quality of life. Thus, the identified coping patterns may be an additional useful presentation of the diversity of coping strategies used by schizophrenia patients. Coping patterns may be considered an important source of knowledge for patients who struggle with the illness and for mental health professionals who work with schizophrenia patients.
The British Journal of Psychiatry, 2004
BackgroundAvoidance coping (e.g. sealing over) is common in people recovering from psychosis, but it is not understood why some individuals ‘seal over’.AimsWe examined the hypothesis that individuals who ‘seal over’ do not have the personal resilience to withstand this major life event.MethodFifty participants were interviewed during an acute episode of psychosis and reassessed at 3-month and 6-month follow-up. Measures included psychotic symptoms, recovery style, service engagement, parental and adult attachment and self-evaluative beliefs.ResultsSealing-over recovery styles are associated with negative early childhood experience, insecure adult attachment, negative self-evaluative beliefs and insecure identity. Insecure adult attachment was associated with less engagement with services.ConclusionsSealing over was associated with multiple signs of low personal resilience in adapting to psychosis.
International Journal of Behavioral Consultation and Therapy, 2009
Maladaptive styles of coping are believed to be a barrier to recovery from schizophrenia. In this study we obtained measures of coping for 133 persons with schizophrenia or schizoaffective disorder. A cluster analysis was then performed based on those scores and produced five distinctive coping profiles. These five groups were then compared on concurrent assessments of hope, self-esteem, symptoms and social function. Multivariate and univariate ANOVA revealed that the group with a coping profile that involved a preference for both considering and acting had significantly greater levels of hope and selfesteem than groups with the other four coping profiles (p<.05). The group with a preference for resigning had lesser hope, self-esteem and more depressive symptoms than another other group (p<.05).
Changes in Patient Coping Style Following Individual and Family Treatment for Schizophrenia
British Journal of Psychiatry, 1991
Changes in relatives' affective attitudes are important contributors to the impact of family psychoeducational programmes on the course of schizophrenia. It remains unclear whether similar changes occur in the interactional style of schizophrenic patients participating in psychoeducational treatment. This study examined changes in the interactional style (coping style) of 33 schizophrenic patients in individual or family treatment. Significant changes were seen in the interactional style of the patients participating in the individual treatment. Similar changes were evident, but not significant, in the family treatment group. The quality of patient interactional style before or after treatment did not predict relapse in either group. Changes in relatives' interactional style early in family treatment are necessary to affect the short-term course of schizophrenia. Modification in patient behaviour during the early phase does not have similar predictive value.
Longitudinal assessment of coping abilities at exacerbation and stabilization in schizophrenia
Comprehensive Psychiatry, 2005
Coping strategies play an important role in one's ability to adapt to stressful life conditions such as schizophrenia. To better understand the nature of various coping mechanisms at various stages in schizophrenia, this study examined task-, emotion-, and avoidance-oriented coping strategies and explored associated clinical factors at exacerbation and stabilization phases of the illness.Patients with schizophrenia were examined twice (at exacerbation phase, N = 237 and at stabilization phase, N = 148) with the Coping Inventory for Stressful Situations, and standardized measures of psychopathology and emotional distress severity, side effects, insight, self-constructs, social support, and quality of life. Multiple regression analysis was performed with coping strategies as dependent variables at exacerbation and stabilization including analysis of any change during the 16-month follow-up period.Analysis indicated that emotion coping strategies were used more at exacerbation than at stabilization phase. Regression analysis demonstrated emotional distress to be a strong predictor of emotion-oriented coping, with self-efficacy and social support being the best predictors of task and avoidance coping strategies, respectively. Individual changes in these variables also appear to be important predictors for fluctuations of these coping strategies over time. Severity of symptoms accounted for 3.5% and 5.5% to 9% of the total variance of emotion- and task-oriented coping strategies, respectively.Emotion, task, and avoidance coping strategies and their predictors are influenced and may vary over the course of schizophrenia illness. Experienced emotional distress, self-efficacy, and social support are the best predictors of coping strategies both at exacerbation and stabilization phases of illness.
Journal of Psychiatric and Mental Health Nursing, 2010
• This paper considers the potential impact of identifying individual coping style on the concept of schizophrenia within the framework of the stress vulnerability model. There is discussion of the role of psychological theories in our understanding of schizophrenia and the experience of those who live with this condition. • The concept of individual coping style, with particular attention to repressive coping style, is considered and the research on the impact of coping style on the person's mental and physical well-being is discussed. Whether this way of thinking about and understanding repression is helpful in how we understand schizophrenia is then considered. • Possible implications of identifying repression in people with schizophrenia by using the idea of coping style as a measure of this concept are considered, gaining and understanding of what role this identification may have on our understanding of how people experience this condition and express this experience to those who work with them. • The potential for study in this area may allow a greater understanding of the way in which our protective psychological functions interact with experience of the distressing and challenging symptoms, often associated with schizophrenia, and influence future understanding of the process and progress of this condition.
The Journal of Nervous and Mental Disease, 2011
Although people with schizophrenia use various coping strategies, it is largely unknown how their coping style contributes to remission of the illness. The concept of recovery styleVeither by sealing over or integratingV reflects an important distinction. We wanted to examine whether recovery style predicts remission at a 1-year follow-up. We examined the recovery style, insight, therapeutic alliance, and symptoms in 103 patients with psychotic disorders. To assess the remission status, the symptoms were measured at 6 and 12 months. Logistic regression analyses were used. Results showed that scoring an extra category toward integration (six categories exist) increased the odds of remission 1.84-fold (95% confidence interval, 1.11 to 3.03). Insight and therapeutic alliance were not predictive. Although remission was also predicted by positive symptom levels at baseline, this did not influence the effect of recovery style. In conclusion, independently of symptom levels, insight, or therapeutic alliance, an integrating recovery style increases the odds of remission at a 1-year follow-up.