title: Coping as a predictor of treatment outcome in people at clinical high risk of psychosis.
abstract: OBJECTIVE
  The concept of coping is relevant to recent models of psychosis, and people with established psychotic disorders have been found to predominately use maladaptive coping strategies. This study aimed to examine the general coping patterns of people at clinical high risk of psychosis (CHR) and to investigate whether pre-therapy coping behaviour plays a role in predicting responsiveness to early interventions.
  
  
  METHODS
  One hundred twenty-eight help-seeking CHR outpatients were randomized into two treatment groups: either receiving integrated psychological intervention (IPI), including cognitive behaviour therapy, or supportive counselling (SC) for 12 months. Of those, 91 persons completed a Stress Coping Questionnaire (SCQ) at intake: 45 in the IPI group and 46 in the SC group. General coping behaviour in this sample was analysed and several regressions were conducted separately for each treatment group to examine coping as a predictor of outcome after 12 months of different forms of treatment.
  
  
  RESULTS
  Participants relied significantly more on negative than on positive coping strategies, t(90) = -7.185, P < 0.001, and within the positive strategies, stress control was the most preferred one, t(90) = 10.979, P < 0.001. Several pre-therapy coping strategies significantly predicted improvement in symptomatic outcome in both treatment groups, explaining between 16% and 25% of variance. The predictive value of coping was higher in the SC group.
  
  
  CONCLUSIONS
  Maladaptive coping behaviours were found to emerge in the early stages of psychosis and coping behaviour contributed significantly to the prediction of post-treatment symptom improvement. These findings indicate a need for psychosocial support and coping strategy enhancement in people at risk of psychosis.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
authors.forename: Mareike
authors.initials: M
authors.lastname: Kommescher
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Wagner
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
authors.forename: Verena
authors.initials: V
authors.lastname: Pützfeld
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Berning
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Janssen
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Munich, Munich, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Decker
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Munich, Munich, Germany.
authors.forename: Ronald
authors.initials: R
authors.lastname: Bottlender
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Munich, Munich, Germany.
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Möller
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Gaebel
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Klosterkötter
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Bechdolf
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D015928:Cognitive Behavioral Therapy; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: cognitive behaviour therapy; coping; early intervention; predictor; psychosis prodrome