Abstract
The way patients cope with the experience of having an episode and being hospitalized for psychiatric disorder may relate to symptom severity, social functioning, and psychological well-being. Coping was assessed among 70 psychiatric inpatients diagnosed primarily with schizophrenia, major depressive disorder, and schizoaffective disorder. The Brief COPE—a questionnaire developed in health psychology (C. S. Carver, 1997)—was administered in interviewer-assisted format during patients' stay on the ward. Thirty patients were re-interviewed an average of 6 weeks after discharge. Among patients with schizophrenia, schizophrenia symptom severity correlated inversely with adaptive coping (e.g., acceptance, planning, seeking support) but did not correlate with maladaptive coping (e.g., self-blame, denial). Among those with schizophrenia, deficits in adaptive coping also predicted relative increases in schizophrenia symptoms over time, controlling for intake symptom severity. Among patients without schizophrenia, maladaptive coping correlated concurrently with depressive symptoms. Several hypothesized associations between concurrent coping, functioning, and well-being were also documented.
REFERENCES
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182.
Bech, P., Bolwig, T. G., Kramp, P., & Rafaelsen, O. J. (1979). The Bech-Rafaelsen Mania Scale and the Hamilton Depression Scale: Evaluation of homogeneity and inter-observer reliability. Acta Psychiatrica Scandinavica, 130, 330-351.
Bellack, A. S., Mueser, K. T., Wade, J., & Sayers, S. (1992). The ability of schizophrenics to perceive and cope with negative affect. British Journal of Psychiatry, 160, 473-480.
Boschi, S., Adams, R. E., Bromet, E. J., Lavelle, J. E., Everett, E., & Galambos, N. (2000). Coping with psychotic symptoms in the early phases of schizophrenia. American Journal of Orthopsychiatry, 70, 242-252.
Bradshaw, W. H. (1993). Coping-skills training versus a problem-solving approach with schizophrenic patients. Hospital and Community Psychiatry, 44, 1102-1104.
Carr, V. (1988). Patients' techniques for coping with schizophrenia: An exploratory study. British Journal of Medical Psychology, 61, 339-352.
Carter, D. M., Mackinnon, A., & Copolov, D. L. (1996). Patients' strategies for coping with auditory hallucinations. Journal of Nervous and Mental Disease, 184, 159-164.
Carver, C. S. (1997). You want to measure coping but your protocol's too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4, 92-100.
Carver, C. S., Pozo, C, Harris, S. D., Noriega, V., Scheier, M. F., Robinson, D. S., Ketcham, A. S., Moffat, F. L., Jr., & Clark, K. C. (1993). How coping mediates the effect of optimism on distress: A study of women with early stage breast cancer. Journal of Personality and Social Psychology, 65, 375-390.
Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56, 267-283.
Clark, K. K., Bormann, C. A., Cropanzano, R. S., & James, K. (1995). Validation evidence for three coping measures. Journal of Personality Assessment, 65, 434-455.
Coyne, J. C., & Gottlieb, B. H. (1996). The mismeasure of coping by checklist. Journal of Personality, 64, 959-991.
Eisele, R., Gex-Fabry, M., Balant-Gorgia, A. E., Balant, L., & Garrone, G. (1991). Rationale for BPRS use in routine clinical practice: Quantitative assessment of psychopathology, consistent with clinical sense. European Psychiatry, 6, 261-268.
Feldman-Naim, S., Myers, F. S., Clark, C. H., Turner, E. H., & Leibenluft, E. (1997). Agreement between face-to-face and telephone-administered mood ratings in patients with rapid cycling bipolar disorder. Psychiatry Research, 71, 129-132.
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1996). Structured Clinical Interviewfor DSM-IV Axis I Disorders-Patient edition (SCID-I-I/P Version 2.0). (Available from the Biometrics Research Department, New York State Psychiatric Institute, 722 West 168th Street, New York, New York 10032).
Gelkopf, M., & Sigal, M. (1995). It is not enough to have them laugh: Hostility, anger, and humor-coping in schizophrenic patients. Humor: International Journal of Humor Research, 8, 273-284.
Goldstein, M. J. (1978). Further data concerning the relation between premorbid adjustment and paranoid symptomatology. Schizophrenia Bulletin, 4, 236-243.
Greenhouse, W. J., Meyer, B., & Johnson, S. L. (2000). Coping and medication adherence in bipolar disorder. Journal of Affective Disorders, 59, 237-241.
Hatfield, A. B. (1989). Patients' accounts of stress and coping in schizophrenia. Hospital and Community Psychiatry, 40, 1141-1145.
Hatfield, A. B., & Lefley, H. P. (1993). Surviving mental illness: Stress, coping, and adaptation. New York: Guilford Press.
Hodel, B., & Brenner, H. D. (1996). Ein Trainingsprogramm zur Bewältigung von maladaptiven Emotionen bei schizophren Erkrankten. Erste Ergebnisse und Erfahrungen [A training program for managing maladaptive emotions in patients with schizophrenia: First results]. Nervenarzt, 67, 564-571.
Johnson, S. L., Meyer, B., Winett, C. A., & Small, J. (2000). Social support and self-esteem predict changes in bipolar depression but not mania. Journal of Affective Disorders, 58, 79-86.
Johnson, S. L., Winett, C. A., Meyer, B., Greenhouse, W. J., & Miller, I. (1999). Social support and the course of bipolar disorder. Journal of Abnormal Psychology, 108, 558-566.
Joiner, T. E., Jr., Metalsky, G. I., Katz, J., & Beach, S. R. H. (1999). Depression and excessive reassurance-seeking. Psychological Inquiry, 10, 269-278.
Kanas, N., Stewart, P., & Haney, K. (1988). Content and outcome in a short-term therapy group for schizophrenic outpatients. Hospital and Community Psychiatry, 39, 437-439.
Kennedy, P., Lowe, R., Grey, N., & Short, E. (1995). Traumatic spinal cord injury and psychological impact: A cross-sectional analysis of coping strategies. British Journal of Clinical Psychology, 34, 627-639.
Kingdon, D. G., & Turkington, D. (1994). Cognitive-behavioral therapy of schizophrenia. New York: Guilford.
Kirov, G., Kemp, R., Kirov, K., & David, A. (1998). Religious faith after psychotic illness. Psychopathology, 31, 234-245.
Knudson, B., & Coyle, A. (1999). Coping strategies for auditory hallucinations: A review. Counseling Psychology Quarterly, 12, 25-38.
Lee, P. W., Lieh-Mak, F., Yu, K. K., & Spinks, J. A. (1993). Coping strategies of schizophrenic patients and their relationship to outcome. British Journal of Psychiatry, 163, 177-182.
Lowe, R., Norman, P., & Bennett, P. (2000). Coping, emotion and perceived health following myocardial infarction: Concurrent and predictive associations. British Journal of Health Psychology, 5, 337-350.
Lukoff, D., Snyder, K., Ventura, J., & Nuechterlein, K. H. (1984). Life events, familial stress, and coping in the developmental course of schizophrenia. Schizophrenia Bulletin, 10, 258-292.
Miklowitz, D. J. (1987). Interviewing and coding manual for the UCLA Social Attainment Survey. Unpublished Manuscript.
Miklowitz, D. J., Goldstein, M. J., & Falloon, I. R. (1983). Premorbid and symptomatic characteristics of schizophrenics from families with high and low levels of expressed emotion. Journal of Abnormal Psychology, 92, 359-367.
Miller, I. W., Bishop, S., Norman, W. H., & Maddever, H. (1985). The modified Hamilton Rating Scale for depression: Reliability and validity. Psychiatry Research, 14, 131-142.
Murphy, M. A. (2000). Coping with the spiritual meaning of psychosis. Psychiatric Rehabilitation Journal, 24, 179-183.
Nunnally, J. C. (1978). Psychometric Theory (2nd ed.). New York: McGraw-Hill.
Pallanti, S., Quercioli, L., & Pazzagli, A. (1997). Relapse in young paranoid schizophrenic patients: A prospective study of stressful life events, P300 measures, and coping. American Journal of Psychiatry, 154, 792-798.
Perlman, L. M., & Hubbard, B. A. (2000). A self-control skills group for persistent auditory hallucinations. Cognitive and Behavioral Practice, 7, 17-21.
Potts, M. K., Daniels, M., Burnam, M. A., & Wells, K. B. (1990).A structured interview version of the Hamilton Depression Rating Scale: Evidence of reliability and versatility of administration. Journal of Psychiatric Research, 24, 335-350.
Rim, Y. (1993). Coping styles, schizotypy and the opposite directions effect. Personality and Individual Differences, 14, 741-745.
Rosenfarb, I. S., Ventura, J., Nuechterlein, K. H., Goldstein, M. J., Snyder, K. S., & Hwang, S. (1999). Expressed emotion, appraisal, and coping by patients with recent onset schizophrenia. Scandinavian Journal of Behaviour Therapy, 28, 3-8.
Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology, 57, 1069-1081.
Ryff, C. D., & Keyes, C. L. M. (1995). The structure of psychological well-being revisited. Journal of Personality and Social Psychology, 69, 719-727.
Smith, T. E., Bellack, A. S., & Liberman, R. P. (1996). Social skills training for schizophrenia: Review and future directions. Clinical Psychology Review, 16, 599-617.
Stein, L. I., & Santos, A. B. (1998). Assertive community treatment of persons with severe mental illness. New York: Norton.
Turkington, D., & Siddle, R. (2000). Improving understanding in people with schizophrenia by changing attitudes. Psychiatric Rehabilitation Skills, 4, 300-320.
Van den Bosch, R. J., & Rombouts, R. P. (1997). Coping and cognition in schizophrenia and depression. Comprehensive Psychiatry, 38, 341-344.
Wahass, S., & Kent, G. (1997). Coping with auditory hallucinations: A cross-cultural comparison between Western (British) and non-Western (Saudi Arabian) patients. Journal of Nervous and Mental Disease, 185, 664-668.
Wiedl, K. H. (1992). Assessment of coping with schizophrenia: Stressors, appraisals, and coping behaviour. British Journal of Psychiatry, 161, 114-122.
Wiedl, K. H., & Schöttner, B. (1991). Coping with symptoms related to schizophrenia. Schizophrenia Bulletin, 17, 525-538.
Witztum, E., Briskin, S., & Lerner, V. (1999). The use of humor with chronic schizophrenic patients. Journal of Contemporary Psychotherapy, 29, 223-234.
Yagi, G., Kinoshita, F., & Kanba, S. (1991). Coping style of schizophrenic patients in the recovery from acute psychotic state. Schizophrenia Research, 6, 87-88.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Meyer, B. Coping with Severe Mental Illness: Relations of the Brief COPE with Symptoms, Functioning, and Well-Being. Journal of Psychopathology and Behavioral Assessment 23, 265–277 (2001). https://doi.org/10.1023/A:1012731520781
Issue Date:
DOI: https://doi.org/10.1023/A:1012731520781