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

Abstract

An inverse association between psychosocial functioning and psychotic experiences is now established in both clinical and non-clinical populations, however the mechanisms which drive this are unclear. Adolescents with subclinical psychotic experiences (SPE) are more likely to use maladaptive coping strategies and less likely to use adaptive ones, and maladaptive coping has also been associated with poor functioning. A within study replication in two adolescent samples from the general populations of Melbourne, Australia (n = 723) and Birmingham, United Kingdom (n = 239), was conducted to determine whether the association between SPE and psychosocial functioning is mediated by coping style. SPE were associated with reduced general and family functioning and to a lesser extent with reduced peer functioning. Task-oriented (focusing on solving the problem) and emotion-oriented (negative emotional responses) coping were found to mediate the relationship between SPE and three types of functioning in both the Melbourne and the Birmingham samples. The within study replication consistently found that coping style mediates SPE and psychosocial functioning, despite significant differences in age, gender, functioning, use of coping styles, and level of SPE between the two samples. Longitudinal research is needed to fully understand any causal role coping may play in the relationship between SPE and poor functioning. The results have important public health and clinical implications, and suggest that techniques which increase levels of adaptive coping and reduce levels of maladaptive coping (in particular emotion-oriented styles) may help to break the cycle between SPE, functional decline, and eventual need for care.

The Mediating Role of Stress in the Relationship Between Attention to Threat Bias and Psychotic-Like Experiences Depends on Coping Strategies

“…Our findings indicate, that only the level of distraction seeking modifies the stress-PLEs relationship. What is more, in the Chisholm et al (35) study the role of attention to threat bias was not considered. It is plausible, that distraction seeking increases the PLEs only among distressed individuals with heightened threat sensitivity.…”

“…It should be noted, that the previous study of Chisholm et al (35) did not find avoidant coping to be maladaptive in a group of non-clinical adolescents. However, Chisholm et al (35) considered jointly the two types of avoidant styles, i.e. distraction seeking and social diversion, therefore, they were unable to capture the role of each of these styles in the relationship between stress and PLEs.…”

“…It is plausible, that distraction seeking increases the PLEs only among distressed individuals with heightened threat sensitivity. For these participants, engaging in distraction-biased activities may provide additional stress due to their tendency to examine the phenomena they encounter in terms of threat, whereas in adolescents without ATB undertaking additional activities may be even adaptive since in adolescents avoidance-oriented coping was found to be positively associated with social relationships (35).…”

Validation of the Dutch version of the Multidimensional Adolescent Functioning Scale (MAFS)

“…Although the MAFS has been used as an outcome measure in several studies (e.g., [ 14 , 15 ]), only the English version of the MAFS has been validated at present. This version was found to have good psychometric properties in adolescents [ 2 ].…”

Personal and Contextual components of Resilience mediate Risky Family Environment's effect on Psychotic-Like Experiences.

“…The presence of good social resources, in fact, could be spared from the destructive effects of a stressful familial environment. Nevertheless, in order to access environmental social resources, one needs to be socially competent in the first place, a functional domain that has been confirmed to be impaired in individuals with PLE (Chisholm et al, 2018). Social competence is a particular factor in resilience as assessed by RSA.…”