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Coping strategies and social support in old age psychosis

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Abstract

Background

According to vulnerability–stress models of psychosis, cognitive and behavioural coping strategies can help mediate the potentially negative effects of daily stressors. The nature, frequency and effectiveness of coping have been studied in people with psychosis under 65 years of age. However, these findings may not generalise to older people with the diagnosis, as the nature of stressors and coping strategies may change with increasing age. This study therefore aimed to explore coping in older patients with psychosis.

Methods

A total of 48 older patients with psychosis (F20-29, ICD-10) and 25 non-clinical elderly controls were compared using self-report measures of stressors, perceived control over stressors, coping strategies, perceived coping efficacy and social support. A regression analysis was used to explore predictors of dysfunctional coping in the patient group.

Results

Patients used a significantly higher proportion of problem-focused coping strategies, but they were more dysfunctional copers and rated their coping as less effective compared to controls. They also had fewer friends and less emotional support. Severity of symptoms was a significant predictor of dysfunctional coping when depression, cognitive impairment and functional disability were controlled.

Conclusions

Patients with psychosis coped less well with daily stressors than controls and patients with more severe symptoms were more dysfunctional copers. The findings highlight the potential benefit of psychosocial interventions in old age psychosis.

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References

  1. Nuechterlein KH, Dawson ME (1984) A heuristic vulnerability–stress model of schizophrenic episodes. Schizo Bull 10: 300–312

    CAS  Google Scholar 

  2. Van den Bosch RJ, Van Asma MJO, Rombouts R, Louwerens JW (1992) Coping style and cognitive dysfunction in schizophrenic patients. Br J Psychiatry 161(suppl. 18): 123–128

    Google Scholar 

  3. Macdonald EM, Pica S, McDonald S, Hayes RL, Baglioni AJ (1998) Stress and coping in early psychosis. Role of symptoms, self-efficacy, and social support in coping with stress. Br J Psychiatry 172(suppl. 33): 122–127

    CAS  Google Scholar 

  4. Lazarus R, Folkman S (1984) Stress, appraisal and coping, Springer, New York

    Google Scholar 

  5. Lazarus RS, Folkman S (1991) The concept of coping In: Monat A, Lazarus RS (eds) Stress and coping: an anthology, Columbia University Press, New York, pp 189–206

    Google Scholar 

  6. Folkman S, Lazarus RS, Pimley S, Novacek J (1987) Age differences in stress and coping processes. Psychol Aging 2: 171–184

    CAS  PubMed  Google Scholar 

  7. Wrosch C, Heckhausen J, Lachman ME (2000) Primary and secondary control strategies for managing health and financial stress across adulthood. Psychol Aging 15: 387–399

    Article  CAS  PubMed  Google Scholar 

  8. Fuchs T (1994) Uprooting and late-life psychosis. Eur Arch Psychiatry Clin Neurosci 244: 126–130

    Article  CAS  PubMed  Google Scholar 

  9. Fuchs T (1999) Life events and late paraphrenia and depression. Psychopathology 32: 60–69

    CAS  PubMed  Google Scholar 

  10. World Health Organisation (1992) The ICD-10 classification of mental and behavioural disorders, WHO, Geneva

    Google Scholar 

  11. Aldwin CM, Revenson TA (1987) Does coping help? A re-examination of the relationship between coping and mental health. J Pers Soc Psychol 53: 337–348

    CAS  PubMed  Google Scholar 

  12. Stone AA, Greenberg MA, Kennedy-Moore E, Newman MG (1991) Self-report, situation-specific coping questionnaires: What are they measuring? J Pers Soc Psychol 61: 648–658

    CAS  PubMed  Google Scholar 

  13. Pearlin LI, Mullan JT, Semple SJ, Skaff MM. (1990) Care giving and the stress process: An overview of concepts and their measures. Gerontologist 30: 583–594

    CAS  PubMed  Google Scholar 

  14. Kay SR, Fiszbein A, Opler L (1987) The positive and negative syndrome scale (PANSS) for schizophrenia. Schizo Bull 13: 261–276

    CAS  Google Scholar 

  15. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO (1983) Development and validation of a geriatric depression screening scale: A preliminary report. J Psychiatr Res 17: 37–49

    Article  CAS  Google Scholar 

  16. Patterson TL, Shaw W, Semple SJ, Moscona S, Harris MJ, Kaplan RM, Grant I, Jeste DV (1997) Health-related quality of life in older patients with schizophrenia and other psychoses: Relationships among psychosocial and psychiatric factors. Int J Geriatr Psychiatry 12: 452–461

    Article  CAS  PubMed  Google Scholar 

  17. Nelson HE (1982) The national adult reading test (NART), Nelson, Windsor

    Google Scholar 

  18. Mahoney FI, Barthel DW (1965) Functional evaluation: The Barthel Index. Rehabilitation 14: 61–65

    CAS  Google Scholar 

  19. Rait G, Fletcher A, Smeeth L, Brayne C, Stirling S, Nunes M, Breeze E, Siu-Woon Ng E, Bulpitt CJ, Jones D, Tulloch AJ (2005) Prevalence of cognitive impairment: results from the MRC trial of assessment and management of older people in the community. Age Ageing 34: 242–248

    Article  PubMed  Google Scholar 

  20. Wilder-Willis KE, Shear PK, Steffen JJ, Borkin J (2002) Relationship between cognitive dysfunction and coping abilities in schizophrenia. Schizophr Res 55: 259–267

    Article  PubMed  Google Scholar 

  21. Brenner HD, Boker W, Muller J, Spichtig L, Wurgler S (1987) On autoprotective efforts of schizophrenics, neurotics and controls. Acta Psychiatric Scan 75: 405–414

    CAS  Google Scholar 

  22. Parkes KR (1984) Locus of control, cognitive appraisal and coping in stressful episodes. J Pers Soc Psychol 46: 655–668

    CAS  PubMed  Google Scholar 

  23. Tarrier N (2000) The use of coping strategies in self-regulation in the treatment of psychosis. In: Morrison AP (eds) A casebook for cognitive therapy, Routledge, Hove, pp 79–104

    Google Scholar 

  24. Semple SJ, Patterson TL, Shaw WS, Grant I, Moscona S, Koch W, Jeste D, Clinical Research Center on Late Life Psychosis Research Group (1997) Study on psychosocial issues. The social networks of older schizophrenia patients. Int Psychogeriatry 9: 81–94

    CAS  Google Scholar 

  25. Patterson TL, Semple SJ, Shaw WS, Halpain M, Moscona S, Grant I, Jeste DV (1997) Self-reported social functioning among older patients with schizophrenia. Schizophr Res 27: 199–210

    Article  CAS  PubMed  Google Scholar 

  26. Wiedl KH (1992) Assessment of coping with schizophrenia. Stressors, appraisals, and coping behaviour. Br J Psychiatry 161(suppl. 18): 114–122

    Google Scholar 

  27. Pilling S, Bebbington P, Kuipers E, Garety P, Geddes J, Orbach G, Morgan C (2002) Psychological treatment in schizophrenia: 1. Meta-analysis of family intervention and cognitive-behavioural therapy. Psychol Med 32: 763–782

    CAS  PubMed  Google Scholar 

  28. Barrowclough C, King P, Colville J, Russell E, Burns A, Tarrier N (2001) A randomised trial of the effectiveness of cognitive-behavioral therapy and supportive counseling for anxiety symptoms in older adults. J Consult Clin Psicol 69: 756–762

    CAS  Google Scholar 

  29. Cohen CI, Cohen GD, Blank K, Gaitz C, Katz IR, Leuchter A, Maletta G, Meyers B, Sakauye K, Shamoian C (2000) Schizophrenia and older adults. An overview: Directions for research and policy. Am J Geriatr Psychiatry 8: 19–28

    CAS  PubMed  Google Scholar 

  30. Folstein M, Folstein SE, McHugh PR (1975) Mini-mental state: a practical method of grading the cognitive status of patients for the clinician. J Psychiatri Res 12: 189–198

    CAS  Google Scholar 

  31. Kodar D, Brodaty H, Anstey K (1996) Cognitive therapy for depression in the elderly. Int J Geriatr Psychiatry 11: 97–107

    Google Scholar 

  32. Cresswell CM, Kuipers L, Power MJ (1992) Social networks and support in long-term psychiatric patients. Psychological Medicine 22: 1019–1026

    CAS  PubMed  Google Scholar 

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Acknowledgements

We thank study participants, Julie Morris for her statistical advice, Katherine Eastham and Virginia Bell for their assistance in the reliability analyses and Catherine Stewart and Lisa Marie Aitken for their assistance in patient recruitment.

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Authors and Affiliations

  1. School of Psychological Sciences, University of Manchester, Unit 4, Ground Floor, Rutherford Building, Manchester Science Park, Lloyd Street North, Manchester, M15 6SZ, UK

    Katherine Berry, Christine Barrowclough, Jane Byrne & Nitin Purandare

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  1. Katherine Berry
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  2. Christine Barrowclough
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  3. Jane Byrne
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  4. Nitin Purandare
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Correspondence to Katherine Berry.

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Berry, K., Barrowclough, C., Byrne, J. et al. Coping strategies and social support in old age psychosis. Soc Psychiat Epidemiol 41, 280–284 (2006). https://doi.org/10.1007/s00127-005-0023-1

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