title: What helps or undermines adolescents' anticipated capacity to cope with mental illness stigma following psychiatric hospitalization.
abstract: BACKGROUND
  Better understanding of the individual and environmental factors that promote adolescents' use of more or less adaptive coping strategies with mental illness stigma would inform interventions designed to bolster youth resilience.
  
  
  OBJECTIVE
  This cross-sectional study draws on data from research on adolescents' well-being after discharge from a first psychiatric hospitalization to explore the relationships between anticipated coping in reaction to a hypothetical social stigma scenario, and various factors conceptualized as 'coping resource' and 'coping vulnerability' factors. Focusing on coping strategies also identified in the companion article, we hypothesize that primary and secondary control engagement coping would relate to more coping resource and less coping vulnerability factors, and the opposite would be true for disengagement, aggression/confrontation and efforts to disconfirm stereotypes.
  
  
  METHODS
  Data were elicited from interviews with 102 adolescents within 7 days of discharge. Hypothesized coping resource factors included social resources, optimistic illness perceptions, better hospital experiences and higher self-esteem. Vulnerability factors included more previous stigma experiences, desire for concealment of treatment, more contingent self-worth, higher symptom levels and higher anticipated stress. Multivariate ordinary least squares (OLS) regression was used to analyze associations between coping strategy endorsement and correlates.
  
  
  RESULTS
  Although some coping correlates 'behaved' contrary to expectations, for the most part, our hypotheses were confirmed. As expected, youth anticipating reacting to the stigmatizing situation with greater disengagement, aggression/confrontation or efforts to disconfirm stenotypes rated significantly lower on 'coping resources' such as self-esteem and higher on vulnerability factors such as symptom severity. The opposite was true for youth who anticipated exercising more primary and secondary control engagement coping.
  
  
  CONCLUSIONS
  This study begins to identify factors that promote more and less adaptive coping strategies among youth at high risk for social stigma. Some factors that can be modified in the shorter term point to useful directions for clinical interventions.
authors: School of Social Work, University of Wisconsin-Madison, Madison, WI, USA moses@wisc.edu.
authors: Tally
authors: T
authors: Moses
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D015999:Multivariate Analysis; D010351:Patient Discharge; D012044:Regression Analysis; D012649:Self Concept; D057545:Social Stigma; D035862:Vulnerable Populations
keywords: Adolescents; coping; correlates; cross-sectional; mental illness; stigma