Zhu Xiaodan, Xu Xuebing, Xu Chao, Zhang Jingyi, Zhang Xiaofeng, Ma Li, Liu Juan, Wang Kefang
Division of Nursing Fundamentals, School of Nursing, Shandong University, Jinan, Shandong, China,
Inpatient Department, Ningxia Mental Health Center, Ningxia Ning-An Hospital, Yinchuan, Ningxia, China.
Neuropsychiatr Dis Treat. 2019 Feb 21;15:523-530. doi: 10.2147/NDT.S181471. eCollection 2019.
Previous studies have not determined the interactive effects of stress and coping style on cognitive function in patients with schizophrenia, and the current studies have been restricted to the relationship between stress and stress response, which may be associated with cognitive impairment in individuals with schizophrenia. The present research was aimed to determine whether stress is related to cognitive function in patients with schizophrenia. In addition, this research further investigates the moderating effects of coping style on the relationship between stress and cognitive function in patients with schizophrenia on the basis of stress and coping theory.
Our sample consisted of 274 patients with a confirmed diagnosis of schizophrenia, and all of them completed the Simple Cope Style Questionnaire, Social Readjustment Rating Scale, and cognitive function assessment. A multivariate regression analysis was performed to investigate the possible correlations between cognitive function and stress, and the moderating effects of coping style on the relationship between stress and cognitive function were tested using the PROCESS macro for SPSS.
Stress was negatively correlated with working memory. Negative coping but not positive coping moderated the relationship between stress and working memory in patients with schizophrenia, and the Johnson-Neyman technique showed that the moderating effect was significant only above this cutoff (38.32% of all negative coping scores). This means that when exposed to similar stress, patients adopting high negative coping had worse working memory than those who did not.
These findings suggested that the assessment of stress and coping style may help estimate working memory impairment risk in patients with schizophrenia, and reducing negative coping may be a crucial intervention target to prevent further impairment of working memory in patients with schizophrenia suffering from great stress.
以往研究尚未确定应激与应对方式对精神分裂症患者认知功能的交互作用,且目前研究局限于应激与应激反应之间的关系,这可能与精神分裂症患者的认知损害有关。本研究旨在确定应激是否与精神分裂症患者的认知功能相关。此外,本研究基于应激与应对理论,进一步探讨应对方式对精神分裂症患者应激与认知功能关系的调节作用。
我们的样本包括274例确诊为精神分裂症的患者,他们均完成了简易应对方式问卷、社会再适应评定量表和认知功能评估。进行多元回归分析以研究认知功能与应激之间的可能相关性,并使用SPSS的PROCESS宏检验应对方式对应激与认知功能关系的调节作用。
应激与工作记忆呈负相关。消极应对而非积极应对调节了精神分裂症患者应激与工作记忆之间的关系,约翰逊-内曼技术表明,仅在该临界值(所有消极应对得分的38.32%)以上,调节作用才显著。这意味着在面临相似应激时,采用高度消极应对方式的患者比未采用的患者工作记忆更差。
这些发现表明,评估应激和应对方式可能有助于估计精神分裂症患者工作记忆损害风险,减少消极应对可能是预防遭受巨大应激的精神分裂症患者工作记忆进一步损害的关键干预靶点。