Coping styles predict responsiveness to cognitive behaviour therapy in psychosis.
The study aimed to determine the clinical and neuropsychological predictors of responsiveness to cognitive behavioural therapy for psychosis (CBTp). Sixty patients with schizophrenia or schizoaffective disorder and 25 healthy individuals took part in the study. Thirty patients (25 protocol completers) received CBTp in addition to standard care (SC); 30 patients (18 protocol completers) received SC only. All patients were assessed on symptoms using the Positive and Negative Syndrome Scale (PANSS) and clinical and neuropsychological function before and after CBTp. Symptoms and self-esteem improved to a greater extent in the CBTp+SC than SC control group. Greater pre-therapy coping ability and the self-reflectiveness dimension of cognitive insight at baseline predicted improvement in symptoms in the CBTp+SC group, but not the SC control group, explaining up to 21% of the variance in symptom improvement. Pre-therapy neuropsychological function, duration of illness, clinical insight and gender did not predict CBTp responsiveness. Being able to have a range of coping strategies and reflect on one's experiences while refraining from overconfidence in one's interpretations before therapy is conducive to better CBTp responsiveness.
Department of Psychology, Institute of Psychiatry, King's College London, London, UK. preethi.premkumar@iop.kcl.ac.uk
Preethi
P
Premkumar
Emmanuelle R
ER
Peters
Dominic
D
Fannon
Anantha P
AP
Anilkumar
Elizabeth
E
Kuipers
Veena
V
Kumari
D000223:Adaptation, Psychological; D000328:Adult; D001288:Attention / Q000502:physiology; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D056344:Executive Function / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000628:therapy*; D012559:Schizophrenia / Q000628:therapy*; D016896:Treatment Outcome; D014706:Verbal Learning / Q000502:physiology
Am J Psychiatry. 2008 Feb;165(2):214-20
18172018
Clin Neuropsychol. 1999 Aug;13(3):348-58
10726605
Biol Psychiatry. 2009 Sep 15;66(6):594-602
19560121
Schizophr Res. 2007 Nov;96(1-3):62-71
17604968
Schizophr Res. 2007 Feb;90(1-3):325-33
17092694
Acta Psychiatr Scand. 2010 Oct;122(4):302-18
20491720
Schizophr Res. 2009 Dec;115(2-3):146-55
19734016
Acta Psychiatr Scand. 1994 Jan;89(1):62-7
7908156
Br J Clin Psychol. 1999 Jun;38(2):113-54
10389596
Schizophr Res. 2002 Jan 1;53(1-2):167-9
11728848
Psychiatry Res. 1988 Nov;26(2):223-38
3237915
Psychiatry Res. 2005 Sep 15;136(2-3):251-5
16122813
Front Behav Neurosci. 2010 Feb 12;4:4
20179788
Eur Psychiatry. 2003 Jun;18(4):149-54
12814846
Schizophr Res. 2007 Aug;94(1-3):12-22
17561377
Anxiety Stress Coping. 2009 Jul;22(4):371-410
19333796
Schizophr Res. 2008 Mar;100(1-3):133-43
18222648
Schizophr Bull. 2009 Sep;35(5):859-64
19571248
Alcohol Clin Exp Res. 1986 Mar-Apr;10(2):145-9
3521371
J Pers Soc Psychol. 1989 Feb;56(2):267-83
2926629
Schizophr Res. 2010 Sep;122(1-3):124-30
19457645
Schizophr Res. 2005 Dec 15;80(2-3):163-71
16125370
BMJ. 1998 Aug 1;317(7154):303-7
9685273
J Consult Clin Psychol. 1988 Dec;56(6):893-7
3204199
Psychiatry Clin Neurosci. 2007 Dec;61(6):634-9
18081624
Schizophr Bull. 1987;13(2):261-76
3616518
Am J Psychiatry. 2006 Apr;163(4):735-8
16585452
Cognition. 1994 Apr-Jun;50(1-3):7-15
8039375
Schizophr Res. 2004 Jun 1;68(2-3):319-29
15099613
Br J Psychiatry. 2004 Oct;185:291-7
15458988
Psychiatry Res. 2007 May 15;155(1):21-8
17395435
J Rehabil Res Dev. 2009;46(8):1053-8
20157862
Br J Clin Psychol. 2006 Jun;45(Pt 2):247-60
16719982
Arch Gen Psychiatry. 1997 Feb;54(2):159-65
9040284
Alcohol Clin Exp Res. 1989 Dec;13(6):799-803
2690666
Schizophr Res. 2004 Oct 1;70(2-3):117-45
15329292
Br J Psychiatry. 2008 Jun;192(6):412-23
18515890
Br J Psychiatry. 1997 Nov;171:420-6
9463599
Br J Psychiatry. 1993 Apr;162:524-32
8481745
Schizophr Res. 2006 Jun;84(2-3):297-304
16545944
Psychother Psychosom. 2010;79(2):129-30
20090401