Ritsner M, Ben-Avi I, Ponizovsky A, Timinsky I, Bistrov E, Modai I
Sha'ar Menashe Mental Health Center, Institute for Psychiatric Studies, Hadera, Israel.
Qual Life Res. 2003 Feb;12(1):1-9. doi: 10.1023/a:1022049111822.
The question addressed in this paper is whether different coping styles mediate the relationship between psychopathology and related distress and the quality of life (QOL) among patients with schizophrenia. In a cross-sectional design, 161 schizophrenia inpatients were comprehensively evaluated with standardized measures of QOL, psychopathology, psychological distress and coping styles. Correlations and regression analyses were performed to examine the relationship among parameters and to estimate the mediating effect of coping styles on QOL in the framework of a distress/protection model. Life quality correlated positively with task- and avoidance-oriented coping styles and slightly negatively with emotion-oriented coping. Emotion-oriented coping mediated the relationship between the severity of activation, anxiety/depression symptoms, and QOL, while avoidance-oriented (distraction) coping was mediated between QOL and paranoid symptoms. Coping styles accounted for 25% of the variance in subjective QOL scores compared with 15% for psychological distress, and only 3% for clinical variables. The ability to cope with symptoms and associated distress substantially contributes to QOL appraisal in schizophrenia. Thus, different coping strategies may reduce the negative influence of specific symptoms and related distress on the subjective QOL of schizophrenia patients.
本文探讨的问题是,不同的应对方式是否在精神分裂症患者的精神病理学与相关痛苦及生活质量(QOL)之间起中介作用。在一项横断面设计中,采用生活质量、精神病理学、心理痛苦和应对方式的标准化测量方法,对161名精神分裂症住院患者进行了全面评估。进行相关性和回归分析,以检验各参数之间的关系,并在痛苦/保护模型的框架内估计应对方式对生活质量的中介作用。生活质量与任务导向型和回避导向型应对方式呈正相关,与情绪导向型应对呈轻微负相关。情绪导向型应对在激活严重程度、焦虑/抑郁症状和生活质量之间起中介作用,而回避导向型(分心)应对在生活质量和偏执症状之间起中介作用。与心理痛苦占主观生活质量得分方差的15%、临床变量仅占3%相比,应对方式占主观生活质量得分方差的25%。应对症状及相关痛苦的能力对精神分裂症患者的生活质量评估有很大贡献。因此,不同的应对策略可能会减少特定症状及相关痛苦对精神分裂症患者主观生活质量的负面影响。