Ventura Joseph, Nuechterlein Keith H, Subotnik Kenneth L, Green Michael F, Gitlin Michael J
UCLA, Department of Psychiatry and Biobehavioral Sciences, 300 Medical Plaza, Room 2243, Los Angeles, CA 90095-6968, USA.
Schizophr Res. 2004 Aug 1;69(2-3):343-52. doi: 10.1016/j.schres.2003.09.002.
Although stressful life events can trigger psychotic and depressive symptom exacerbation in schizophrenia, many patients who experience stressful events do not subsequently relapse. Models of vulnerability, stress, and protective factors in schizophrenia suggest that effective coping responses may serve as protective factors. Coping behavior, in turn, may be influenced by a schizophrenia patient's level of self-efficacy and neurocognitive functioning. Using the Coping Responses Inventory, we examined how 29 recent-onset schizophrenia outpatients and 24 demographically matched normal comparison subjects responded to a negative interpersonal life event. Approach oriented coping responses, such as "Think of different ways to deal with the problem" and "Make a plan of action and follow it," were used significantly more often by normal subjects (M=2.27) than by schizophrenia patients (M=1.89; p < 0.02). Among schizophrenia patients, greater use of approach, problem-focused coping strategies was associated with high self-efficacy (r=0.55, p < 0.01) and better performance on a measure of sustained attention emphasizing perceptual processing (r=0.42, p < 0.05). Multiple regression indicated that self-efficacy and sustained attention accounted for 56% of the variance in the use of problem-focused coping, strategies by schizophrenia patients.
尽管生活中的压力事件会引发精神分裂症患者的精神病性症状和抑郁症状加重,但许多经历压力事件的患者随后并未复发。精神分裂症的易感性、压力和保护因素模型表明,有效的应对反应可能起到保护作用。反过来,应对行为可能会受到精神分裂症患者自我效能感水平和神经认知功能的影响。我们使用应对反应量表,研究了29名近期发病的精神分裂症门诊患者和24名人口统计学特征匹配的正常对照受试者对负面人际生活事件的反应。正常受试者(M = 2.27)比精神分裂症患者(M = 1.89;p < 0.02)更频繁地使用以解决问题为导向的应对反应,如“想出不同的方法来处理问题”和“制定行动计划并遵循它”。在精神分裂症患者中,更多地使用以解决问题为导向的应对策略与高自我效能感(r = 0.55,p < 0.01)以及在一项强调感知处理的持续性注意力测量中的更好表现相关(r = 0.42,p < 0.05)。多元回归分析表明,自我效能感和持续性注意力解释了精神分裂症患者使用以解决问题为导向的应对策略差异的56%。