title: Insight, distress and coping styles in schizophrenia.
abstract: BACKGROUND
  The stigma and negative societal views attached to schizophrenia can make the diagnosis distressing. There is evidence that poor insight into symptoms of the disorder and need for treatment may reflect the use of denial as a coping style. However, the relationships between insight and other coping styles have seldom been investigated.
  
  
  METHODS
  We examined the associations between insight, distress and a number of coping styles in 65 outpatients with schizophrenia (final n=57) in a cross-sectional study.
  
  
  RESULTS
  We found that (i) awareness of symptoms and problems correlated with greater distress, (ii) 'preference for positive reinterpretation and growth' coping style correlated with lower distress and with lower symptom awareness (re-labelling), (iii) 'preference for mental disengagement' coping style correlated with greater distress and lower awareness of problems, and (iv) 'social support-seeking' coping style correlated with greater awareness of illness, but not distress. No relationship occurred between the use of 'denial' as a coping style and insight or distress.
  
  
  CONCLUSIONS
  Our findings demonstrate that awareness of illness and related problems is associated with greater distress in schizophrenia. However, this investigation has not supported a simple psychological denial explanation for this relationship, as complex relationships emerged between different dimensions of insight and coping styles. The negative association between 'positive reinterpretation and growth' and distress suggests that adopting this style may lead to re-labelling symptoms in a less distressing way. Avoidant and isolating styles of coping both appear unhelpful. Psychological interventions should aim to promote more active coping such as discussing a mental health problem with others.
authors.affiliation: Department of Psychology, Institute of Psychiatry, King's College London, London, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Cooke
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Peters
authors.forename: Dominic
authors.initials: D
authors.lastname: Fannon
authors.forename: Anantha P P
authors.initials: AP
authors.lastname: Anilkumar
authors.forename: Ingrid
authors.initials: I
authors.lastname: Aasen
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kuipers
authors.forename: Veena
authors.initials: V
authors.lastname: Kumari
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015995:Prevalence; D012559:Schizophrenia / Q000453:epidemiology* / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D011795:Surveys and Questionnaires