Could repressive coping be a mediating factor in the symptom profile of individuals diagnosed with schizophrenia? (original) (raw)
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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.
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.
International Journal of Environmental Research and Public Health
Background: Schizophrenia is considered a chronic and disabling mental disorder that affects approximately one percent of the world’s population. It is characterized by a variable course and its various symptoms may predominate depending on the characteristics of the person. Aim: Recognition of the personality traits and styles of stress-coping applied by healthy people and people diagnosed with schizophrenia. Methods: The study examined 60 people in total: 30 healthy people between 19 and 58 years old and29 people diagnosed with schizophrenia and 1 person with schizophrenia spectrum disorder between 25 and 72 years old. In the present study we used Personality inventory NEO-FFI by Paul Costa and Robert McCreae, designed to diagnose personality traits described in the five-factor model called “The Big Five” and CISS: Coping Inventory for Stressful Situations by N. S. Endler, J. D. A. Parker, designed to diagnose stress-coping styles.
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.
From Vulnerability to Resilience: A Coping Related Approach to Psychosis
Psychosis - Biopsychosocial and Relational Perspectives, 2018
Many of us may have to face stressful events during life. How we are affected by these events depends on our vulnerability limit and our coping mechanisms. Both vulnerability-stress models and cognitive-behavioral theories of psychosis consider biological, psychological, and social factors together as determinants of our vulnerability limit. This point of view enables us to handle the psychotic disorders as a continuity of normality. In addition, coping mechanisms have an important role in the maintenance and/or recovery of psychotic symptoms. Therefore, the objective of this chapter is to summarize copingrelated explanations that facilitate understanding the symptomatology of psychosis and defining the adaptive ways to challenge it.
Correlates of coping styles in psychotic illness
2004
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 With Symptoms Related to Schizophrenia
Schizophrenia Bulletin, 1991
This article describes a method developed to assess coping with schizophrenia by inpatients and outpatients. The approach is based on a transactional theory of coping. Symptoms related to the disease, subjective appraisals given by the 40 patients, and coping behavior are assessed using a list of disease-related strains, rating scales, and a semistructured interview. Results of this study indicate that the patients' appraisals of the effects of their efforts to cope may not be realistic, leading to a low degree of satisfaction. Coping, described as "problem-centered" versus "nonproblem-centered" and as behavioral, cognitive, or emotional, seemed to be related to the patients' clinical status. Nonproblem-centered strategies predominated in the highly strained groups, along with a tendency to more emotional and less cognitive coping.
Quality of life and coping with schizophrenia symptoms
Quality of Life Research, 2003
The question addressed in this paper is whether different coping styles mediate the relationship between psychopathology and related distress and the quality of life (QOL) among patients with schizophrenia. In a cross-sectional design, 161 schizophrenia inpatients were comprehensively evaluated with standardized measures of QOL, psychopathology, psychological distress and coping styles. Correlations and regression analyses were performed to examine the relationship among parameters and to estimate the mediating effect of coping styles on QOL in the framework of a distress/protection model. Life quality correlated positively with task- and avoidance-oriented coping styles and slightly negatively with emotion-oriented coping. Emotion-oriented coping mediated the relationship between the severity of activation, anxiety/depression symptoms, and QOL, while avoidance-oriented (distraction) coping was mediated between QOL and paranoid symptoms. Coping styles accounted for 25% of the variance in subjective QOL scores compared with 15% for psychological distress, and only 3% for clinical variables. The ability to cope with symptoms and associated distress substantially contributes to QOL appraisal in schizophrenia. Thus, different coping strategies may reduce the negative influence of specific symptoms and related distress on the subjective QOL of schizophrenia patients.