title: Insufficient coping behavior under chronic stress and vulnerability to psychiatric disorders.
abstract: BACKGROUND
  Epidemiological data indicate that 75% of subjects with major psychiatric disorders have their onset of illness in the age range of 17-24 years. An estimated 35-50% of college and university students drop out prematurely due to insufficient coping skills under chronic stress, while 85% of students receiving a psychiatric diagnosis withdraw from college/university prior to the completion of their education. In this study, we aimed at developing standardized means of identifying students with insufficient coping skills under chronic stress and at risk for mental health problems.
  
  
  METHODS
  A sample of 1,217 college students from 3 different sites in the USA and Switzerland completed 2 self-report questionnaires: the Coping Strategies Inventory (COPE) and the Zurich Health Questionnaire (ZHQ), which assesses 'regular exercises', 'consumption behavior', 'impaired physical health', 'psychosomatic disturbances' and 'impaired mental health'. The data were subjected to structure analyses by means of a neural network approach. We found 2 highly stable and reproducible COPE scales that explained the observed interindividual variation in coping behavior sufficiently well and in a socioculturally independent way. The scales reflected basic coping behavior in terms of 'activity-passivity' and 'defeatism-resilience', and in the sense of stable, socioculturally independent personality traits.
  
  
  RESULTS
  Correlation analyses carried out for external validation revealed a close relationship between high scores on the defeatism scale and impaired physical and mental health. This underlined the role of insufficient coping behavior as a risk factor for physical and mental health problems.
  
  
  CONCLUSIONS
  The combined COPE and ZHQ instruments appear to constitute powerful screening tools for insufficient coping skills under chronic stress and for risks of mental health problems.
authors.affiliation: Institute of Psychology, University of Lausanne, Lausanne, Switzerland.
authors.forename: Christine
authors.initials: C
authors.lastname: Mohr
authors.forename: Silke
authors.initials: S
authors.lastname: Braun
authors.forename: René
authors.initials: R
authors.lastname: Bridler
authors.forename: Florian
authors.initials: F
authors.lastname: Chmetz
authors.forename: Juan P
authors.initials: JP
authors.lastname: Delfino
authors.forename: Viktoria J
authors.initials: VJ
authors.lastname: Kluckner
authors.forename: Petra
authors.initials: P
authors.lastname: Lott
authors.forename: Yann
authors.initials: Y
authors.lastname: Schrag
authors.forename: Erich
authors.initials: E
authors.lastname: Seifritz
authors.forename: Hans H
authors.initials: HH
authors.lastname: Stassen
mesh_terms: D000223:Adaptation, Psychological; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D008603:Mental Health; D010555:Personality Inventory; D011602:Psychophysiologic Disorders / Q000150:complications; D012015:Reference Standards; D012307:Risk Factors; D013315:Stress, Psychological; D013334:Students / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014495:Universities; D055815:Young Adult