Patterns of Coping Preference Among Persons with Schizophrenia: Associations with Self-Esteem, Hope, Symptoms and Function (Report‪)‬

Data from first person accounts (Frese, 1993) structured interviews (Mueser, et al., 1997) and formal assessments (Ritsner et al., 2006) suggest that many with schizophrenia spectrum disorders experience enduring difficulties coping effectually with daily and unexpected stress. They may struggle to solve problems (e.g. Corrigan and Toomey, 1995; Penn, et al, 1993), and tend, as a matter of style, to ignore stressors or abandon attempts to find alternative solutions to problems when their usual patterns of behavior fail (Farhall & Gehrke, 1997; Lysaker, Wilt, Plascek-Hallberg, Brenner, & Clements, 2003; Wilder-Willis, et al., 2002). In addition to having a tendency to employ specific forms of coping which may repeatedly fail, persons with schizophrenia appear to have a limited range of possible ways to respond when under stress. It is not simply, therefore, that persons with schizophrenia choose the "wrong" behavior when facing a challenge but that they may have a coping style which does not include enough possibilities beyond reacting and avoidance (Roe, Yanos & Lysaker, 2006). Overall, ineffective coping is a matter of broad clinical concern. The inability to manage and respond to stress is believed to be among the primary causes of relapse and reduced quality of life in schizophrenia (Ritsner, et al, 2003; Ventura, et al, 1989). Research has suggested that more impoverished and avoidant styles of coping styles are linked to greater affective distress, greater levels of positive and negative symptoms, lesser hope and more frequent hospitalizations (e.g. Bak et al., 2001; 2003; Lysaker et al., 2005; 2001; Macdonald et al., 1998; Meyer, 2001; Modestin, et al., 2004; Middleboe and Mortensen, 1997; Ritsner & Ratner, 2006; Wiedl, 1992). Simply put, as persons fail to cope they feel increasingly overwhelmed and demoralized, which may lead to exacerbations in symptoms , which may then reinforce maladaptive coping style s in the manner of a vicious cycle.