Coping as a mediator of stress and psychotic-like experiences

Abstract

Background There is evidence that individuals along the whole psychosis continuum have increased responsiveness to stress; however, coping responses to stressors have not been extensively explored in subthreshold psychotic symptoms. Methods In 454 undergraduates, psychotic-like experiences (PLEs) were evaluated using the positive items of the Prodromal Questionnaire. Perceived stress and traumatic life events were assessed using the Life Events Checklist and Perceived Stress Scale, and coping was measured using the Brief COPE. We also examined whether different coping styles mediated the relationship between perceived stress and PLEs, as well as whether different coping styles mediated the relationship between traumatic life events and PLEs. Results Both number of traumatic life events and current level of perceived stress were significantly associated with PLEs. These relationships were both mediated by higher levels of maladaptive coping. Conclusions Results have the potential to inform treatment strategies, as well as inform targets for exploration in longitudinal studies of those at risk for psychosis.

Coping Strategies Mediate the Effect of Stressful Life Events on Schizotypal Traits and Psychotic Symptoms in 22q11.2 Deletion Syndrome

“…[25][26][27] Moreover, dysfunctional coping strategies strongly correlated with SIPS positive, negative, disorganized, and generalized subscales in the 22q11DS group. This is in line with a growing body of literature pointing to the importance of coping strategies in the development of psychotic symptoms 27,69,70,81 and psychopathology in general. 68,82…”

“…5 However interestingly, functional coping strategies were not significantly correlated with the SIPS or SPQ subscales in any of the 2 groups. While the protective role of functional coping strategies has been consistently reported particularly in the field of mood disorders, 68 results in the psychosis spectrum are nonconclusive with one study reporting a positive 69 and another negative correlations 70 with the severity of psychotic symptoms.…”

The role of coping in the association between subclinical psychotic experiences and functioning: A within study replication in two independent adolescent samples

“…This, in combination with the current research suggests that coping may be a mediating factor (a factor which explains or accounts for the relationship between two variables) rather than a moderating one (a factor which affects the strength or direction of a relationship between two variables), with coping style playing a potentially causal role in explaining the association between psychosocial functioning and (subthreshold) psychotic experiences. In a sample of undergraduate students, Ered et al (2017) found that coping mediated the relationship between traumatic life events and subclinical psychotic experiences, as well as the relationship between high levels of stress and subclinical psychotic experiences. Taken together with the finding of a bi-directional relationship between coping and subclinical psychotic experiences from Lin and colleagues (2011), this is suggestive that inadequate coping may contribute to perpetuating psychotic experiences.…”

“…Coping tends to occur as a conscious strategy to deal with stress, and can therefore be differentiated from defence mechanisms, which generally occur without conscious awareness (Cramer, 1998). Adolescents and young adults with subclinical psychotic experiences are more likely to use maladaptive coping strategies and less likely to use adaptive ones (Ered, Gibson, Maxwell, Cooper, & Ellman, 2017;Fonseca-Pedrero, Paino, Sierra-Baigrie, Lemos-Giráldez, & Muñiz, 2012;Lin et al, 2011). Maladaptive coping is associated with increased levels of psychotic experiences in both clinical (e.g.…”

“…Maladaptive coping is associated with increased levels of psychotic experiences in both clinical (e.g. Jalbrzikowski et al, 2014;Kommescher et al, 2016;Lee et al, 2011;Phillips, Francey, Edwards, & McMurray, 2009;Ritsner & Ratner, 2006;Roe, Yanos, & Lysaker, 2006) and non-clinical (Ered et al, 2017;Fonseca-Pedrero et al, 2012;Lin et al, 2011) groups, while over time, adaptive coping predicts symptom reduction and psychosocial improvements (Jalbrzikowski et al, 2014).…”