title: Dysfunctional coping with stress in psychosis. An investigation with the Maladaptive and Adaptive Coping Styles (MAX) questionnaire.
abstract: Psychotic episodes have long been conceptualized as inevitable incidents triggered by endogenous biological impairments. It is now well-accepted that the ability of an individual to deal with social and environmental challenges plays an important role in regard to whether or not a vulnerability to psychosis translates into symptoms. For the present study, we examined symptomatic correlates of dysfunctional coping in psychosis and aimed to elucidate a profile of coping strategies that distinguishes patients with schizophrenia from those with depression.
  
  
  
  The newly devised Maladaptive and Adaptive Coping Styles Scale (MAX) was administered to 75 individuals with psychosis, 100 individuals with depression and 1100 nonclinical controls.
  
  
  
  Schizophrenia patients showed compromised coping abilities relative to nonclinical controls, particularly a lack of engaging in adaptive coping. Depression was more closely tied to dysfunctional coping than were positive symptoms as indicated by group comparisons and correlational analyses. Correlations between positive symptoms, particularly paranoid symptoms, and avoidance and suppression remained significant when depression was controlled for.
  
  
  
  Although maladaptive and adaptive coping are unlikely to represent proximal mechanisms for the pathogenesis of positive symptoms, fostering coping skills may reduce positive symptoms via the improvement of depressive symptoms, which are increasingly regarded as risk factors for core psychotic symptoms. Furthermore, the reduction of avoidance and suppression may directly improve positive symptoms.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Moritz
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Thies
authors.initials: T
authors.lastname: Lüdtke
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Bern, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Westermann
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Joy
authors.initials: J
authors.lastname: Hermeneit
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Jessica
authors.initials: J
authors.lastname: Watroba
authors.affiliation: Department of Psychology, University of Hamburg, Germany.
authors.forename: Tania M
authors.initials: TM
authors.lastname: Lincoln
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology*; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D013315:Stress, Psychological; D011795:Surveys and Questionnaires
keywords: Coping; Depression; Emotion regulation; Positive symptoms; Schizophrenia