Coping strategies in major depressed, agoraphobic and comorbid in-patients: a longitudinal study.

The first aim of this study was to explore the diagnostic specificity of coping styles by comparing ways of coping in non-anxious major depressed, non-depressed agoraphobic, and both major depressed and agoraphobic (comorbid) in-patients. The second aim was to investigate whether a vulnerability model, a state model, or a combined vulnerability-state model of coping accounted best for the data. On admission and when discharged, 95 patients completed the Way of Coping Checklist and were evaluated on several symptom scales. Self-report symptom scales were completed at one-year follow-up as well. The 'purely' agoraphobic and the comorbid patients showed less seeking of social support and more wishful thinking than the major depressed patients. For the wishful thinking scale, these differences were related to differences in level of global psychopathology. Overall, the results for the seeking social support scale were consistent with a combined vulnerability-state model. The problem-focused coping and wishful thinking scores behaved mostly as state phenomena. The avoidance scores provided ambiguous evidence. In a subsample of 30 agoraphobic patients who received a combination of exposure and psychodynamic treatment, higher pre-treatment levels of seeking social support and lower pre-treatment levels of avoidance as coping both predicted a more favourable course of symptoms pertaining to fear of fear in the one-year follow-up period.