Positive Coping and Resilience as Mediators Between Negative Symptoms and Disability Among Patients With Schizophrenia

Divergent contribution of environmental factors to soil organic and inorganic carbon in different land use types in a forest-grassland ecotone of Inner Mongolia, China

Understanding the comprehensive impacts of environmental factors on soil organic carbon (SOC) and soil inorganic carbon (SIC) in different land use types is of great significance for sustainable soil management. Least absolute shrinkage and selection operator (LASSO) and structural equation modelling were applied to reveal the driving mechanism of SOC, SIC and the ratio between SOC to SIC (SOC/SIC) in three major land use types (forest, grassland and farmland) in a forest-grassland ecotone (FGE) of Inner Mongolia, Northeast China. Mean annual temperature (MAT), mean annual temperature (MAP) and Enhanced Vegetation Index (EVI) were selected by LASSO as the three most important environmental factors affecting SOC, SIC and SOC/SIC in all land use types. MAT had the strongest direct effects on SOC in forest and grassland among all the environmental factors, suggesting temperature was the most important control factor of SOC in forest and grassland. EVI had relatively strong indirect effects on SOC by influencing total nitrogen and total phosphorus in grassland and farmland, respectively. MAT and MAP had significantly direct effects on SIC in all land use types, demonstrating the balance between precipitation and evapotranspiration affected by temperature were the major control factors of SIC. In addition, MAT had significantly positive direct effects (>42%) on SOC/SIC in all land use types, suggesting climate warming can have positive feedbacks on the proportion of SOC in the soil carbon pool in FGE. This study provides a comprehensive understanding of the driving mechanism of SOC, SIC and SOC/SIC in FGE of Northeast China.

Sleep quality, psychological resilience, family resilience, social support, and mental disability in patients with chronic schizophrenia: A cross-sectional study

After the remission of psychotic symptoms in patients with chronic schizophrenia, a persistently high rate of disability suggests potential influences from socio-ecological factors. This study aimed to explore the complex relationships between socioecological factors, including sleep quality, psychological resilience, family resilience, and social support, and the severity of psychiatric disability in patients with chronic schizophrenia. Employing a cross-sectional design, the study involved 188 individuals with chronic schizophrenia. Disability was measured using the World Health Organization Disability Assessment Schedule 2.0 (WHO-DAS 2.0), while social support, family resilience, psychological resilience, and sleep quality were assessed using the Social Support Rating Scale (SSRS), Family Hardiness Index (FHI), Connor-Davidson Resilience Scale (CD-RISC), and Pittsburgh Sleep Quality Index (PSQI), respectively. LASSO regression and structural equation modeling (SEM) analyses were conducted to identify predictive factors and their interrelationships. The mean WHO-DAS 2.0 score of 72.91 ± 14.04 indicated substantial difficulties in daily activities, necessitating comprehensive support among participants. LASSO regression identified frequent disease relapses, low education levels, and poor sleep quality as risk factors for disability, whereas strong social support, family resilience, and individual resilience emerged as protective factors against disability. SEM demonstrated that the enhancement of family and individual resilience by social support contributes to the mitigation of disability. The study underscores the critical roles of social support, family resilience, and individual psychological resilience in reducing disability in patients with chronic schizophrenia, suggesting that interventions targeting these factors may improve rehabilitation outcomes.

Genetic determinants of coping, resilience and self-esteem in schizophrenia suggest a primary role for social factors and hippocampal neurogenesis

Schizophrenia is a severe psychiatric disorder, associated with a reduction in life expectancy of 15-20 years. Available treatments are at least partially effective in most affected individuals, and personal resources such as resilience (successful adaptation despite adversity) and coping abilities (strategies used to deal with stressful or threatening situations), are important determinants of disease outcomes and long-term sustained recovery. Published findings support the existence of a genetic background underlying resilience and coping, with variable heritability estimates. However, genome-wide analyses concerning the genetic determinants of these personal resources, especially in the context of schizophrenia, are lacking. Here, we performed a genome-wide association study coupled with accessory analyses to investigate potential genetic determinants of resilience, coping and self-esteem in 490 schizophrenia patients. Results revealed a complex genetic background partly overlapping with that of neuroticism, worry and schizophrenia itself and support the importance of social aspects in shapingthese psychological constructs. Hippocampal neurogenesis and lipid metabolism appear to be potentially relevant biological underpinnings, and specific miRNAs such as miR-124 and miR-137 may warrant further studies as potential biomarkers. In conclusion, this study represents an important first step in the identification of genetic and biological correlates shaping resilience, coping resources and self-esteem in schizophrenia.

Clinical and psychological factors associated with resilience in patients with schizophrenia: data from the Italian network for research on psychoses using machine learning

BACKGROUND

Resilience is defined as the ability to modify thoughts to cope with stressful events. Patients with schizophrenia (SCZ) having higher resilience (HR) levels show less severe symptoms and better real-life functioning. However, the clinical factors contributing to determine resilience levels in patients remain unclear. Thus, based on psychological, historical, clinical and environmental variables, we built a supervised machine learning algorithm to classify patients with HR or lower resilience (LR).

METHODS

SCZ from the Italian Network for Research on Psychoses (N = 598 in the Discovery sample, N = 298 in the Validation sample) underwent historical, clinical, psychological, environmental and resilience assessments. A Support Vector Machine algorithm (based on 85 variables extracted from the above-mentioned assessments) was built in the Discovery sample, and replicated in the Validation sample, to classify between HR and LR patients, within a nested, Leave-Site-Out Cross-Validation framework. We then investigated whether algorithm decision scores were associated with the cognitive and clinical characteristics of patients.

RESULTS

The algorithm classified patients as HR or LR with a Balanced Accuracy of 74.5% (p < 0.0001) in the Discovery sample, and 80.2% in the Validation sample. Higher self-esteem, larger social network and use of adaptive coping strategies were the variables most frequently chosen by the algorithm to generate decisions. Correlations between algorithm decision scores, socio-cognitive abilities, and symptom severity were significant (pFDR < 0.05).

CONCLUSIONS

We identified an accurate, meaningful and generalizable clinical-psychological signature associated with resilience in SCZ. This study delivers relevant information regarding psychological and clinical factors that non-pharmacological interventions could target in schizophrenia.

Sexual Well-Being in Individuals with Schizophrenia: A Pilot Study on the Role of Self-Esteem and Acceptance of Illness

Schizophrenia is one of the most severe chronic mental illnesses. It drastically changes an individual's life and well-being. Sexual well-being in schizophrenia is often sidelined, even though it is one of the main areas for maintaining quality of life. Based on the conservation of resources theory (COR) and empirical data, we assume that self-esteem and acceptance of illness help in coping with schizophrenia and maintaining sexual well-being. This pilot study aimed to determine the relationship between self-esteem, acceptance of illness, and sexual well-being in Polish individuals with schizophrenia. The results of 60 individuals were included in this study. In the present study, the Self-Esteem Scale (SES), Acceptance of Illness Scale (AIS), and Short Sexual Well-Being Scale (SSWBS) were used. The study showed a significant association between self-esteem, acceptance of illness, and sexual well-being. Self-esteem (β = 0.62) and acceptance of illness (β = 0.55) acted as positive and significant predictors of sexual well-being in individuals with schizophrenia. Acceptance of illness was also found to play a mediating role between self-esteem and sexual well-being in people with schizophrenia (indirect effect: β = 0.34; LLCI = 0.063; ULCI = 0.839). The current pilot study demonstrates the relationship between self-esteem, acceptance of illness, and sexual well-being. Our findings highlight the significant role of acceptance of illness in maintaining sexual well-being among individuals with schizophrenia.

Review of Major Social Determinants of Health in Schizophrenia-Spectrum Disorders: II. Assessments

BACKGROUND AND AIMS

Social determinants of health (SDoHs) impact the development and course of schizophrenia-spectrum psychotic disorders (SSPDs). Yet, we found no published scholarly reviews of psychometric properties and pragmatic utility of SDoH assessments among people with SSPDs. We aim to review those aspects of SDoH assessments.

STUDY DESIGN

PsychInfo, PubMed, and Google Scholar databases were examined to obtain data on reliability, validity, administration process, strengths, and limitations of the measures for SDoHs identified in a paired scoping review.

STUDY RESULTS

SDoHs were assessed using different approaches including self-reports, interviews, rating scales, and review of public databases. Of the major SDoHs, early-life adversities, social disconnection, racism, social fragmentation, and food insecurity had measures with satisfactory psychometric properties. Internal consistency reliabilities-evaluated in the general population for 13 measures of early-life adversities, social disconnection, racism, social fragmentation, and food insecurity-ranged from poor to excellent (0.68-0.96). The number of items varied from 1 to more than 100 and administration time ranged from less than 5 minutes to over an hour. Measures of urbanicity, low socioeconomic status, immigration status, homelessness/housing instability, and incarceration were based on public records or targeted sampling.

CONCLUSIONS

Although the reported assessments of SDoHs show promise, there is a need to develop and test brief but validated screening measures suitable for clinical application. Novel assessment tools, including objective assessments at individual and community levels utilizing new technology, and sophisticated psychometric evaluations for reliability, validity, and sensitivity to change with effective interventions are recommended, and suggestions for training curricula are offered.

The relationship between self-esteem and mental disability in patients with schizophrenia: the mediating role of resilience and the moderating role of gender

This study aims to verify the mediating role of resilience between self-esteem and mental disability and to analyze the moderating role of gender in the relationship between resilience and mental disability in patients with schizophrenia. Patients with schizophrenia have been selected from Harbin Psychiatric (Baiyupao) Hospital and Daqing Third Hospital in Heilongjiang Province from January to December 2021. The study recruited a total of 220 patients with schizophrenia, including 120 males and 100 females to measure their self-esteem, resilience and mental disability. The results were as follows: Self-esteem and resilience are important protective factors that have a buffering effect on mental disability. The mediating effect of resilience on self-esteem and mental disability is stronger in males than in females. The results provide new ideas for delaying mental disability and for formulating intervention programs and applying them to clinical practice. The study indicates that psychiatric medical staff should not only treat the patients with schizophrenia psychotic symptoms but also improve their self-esteem and resilience through effective intervention to reduce the occurrence of mental disability.

Structural model of resilience based on parental support: the mediating role of hope and active coping

Resilience is an essential trait in the academic and non-academic lives of students that has been associated with positive psychological and non-psychological outcomes. Given the importance and role of resilience, the main goal of this study was to create a structural model of resilience based on parental support and emphasizing the mediating role of hope and coping. The research design was correlational in nature and used structural equation modeling (SEM). The population of this study included high school students in Tehran city in 2019-2020 school year, and the sample consisted of 560 students selected by cluster sampling method. By applying Spearman correlation analysis and structural equation modeling, a significant relationship between hope, coping, resilience, and parental support was found. Both the SEM measurement and structural models provided a good fit. The significant findings of the present study include the direct and significant effect of parental support on resilience. The indirect and significant effect of parental support on resilience through the mediating role of hope and coping was also confirmed. Overall, the results of this study show that the effect of parental support on resilience can be improved by promoting hope and coping styles.

Contribution of coping style to the association between illness uncertainty and demoralisation in patients with breast cancer: a cross-sectional mediation analysis

OBJECTIVE

Demoralisation is a common psychological issue in patients with cancer and aggravates depression, reduces the quality of life and even causes suicidal ideation. There is a lack of knowledge about illness uncertainty, coping style and demoralisation in patients with breast cancer. The current study explored the relationship between illness uncertainty and demoralisation among those patients, as well as the potential mediating role of coping style.

DESIGN

A cross-sectional study.

SETTING

Participants were recruited from the Breast Tumor Center in a tertiary hospital in Shijiazhuang, Hebei province.

PARTICIPANTS

A total of 211 patients with breast cancer completed the survey.

OUTCOME MEASURES

A total of 211 patients with breast cancer completed the Mishel's Uncertainty in Illness Scale, Trait Coping Style Questionnaire and the Mandarin version of Demoralization Scale (DS-MV).

RESULTS

Of the patients, 47.40% exhibited symptoms of demoralisation (DS-MV>30), and the mean of demoralisation score was (29.55±13.21). The results demonstrated that illness uncertainty and negative coping styles were positively related to demoralisation (p<0.001), while active coping styles were negatively related to demoralisation (p<0.001). Importantly, coping styles could partially mediate the relationship between illness uncertainty and demoralisation (p<0.01).

CONCLUSION

Our study illustrated that illness uncertainty was associated with demoralisation in patients with breast cancer, and coping style acted as a mediator in this relationship. The findings highlighted the critical role of reducing negative coping styles to the early prevention and efficient treatment of demoralisation among those patients.

Resilience and its relationship with disability in persons with bipolar disorder and schizophrenia: A comparative study

Background

Resilience is the capacity to bounce back from adversity. Severe mental illnesses are associated with poor and heterogeneous functional outcomes. Symptom remission is inadequate to achieve patient-oriented outcome, and positive psychopathology constructs like resilience have emerged as possible mediators. An exploration of resilience and its association with functional outcomes can drive therapeutic endeavors.

Aim

To assess and compare the influence of resilience on disability among patients diagnosed and treated for bipolar disorder and schizophrenia in a tertiary care facility.

Methods

Study design - Hospital-based, cross-sectional, comparative design; study population - patients of bipolar disorder and schizophrenia with 2-5 years illness and Clinical Global Impression - Severity (CGI-S) <4; sampling procedure - consecutive sampling; sample size - 30 patients each; scales used - Connor-Davidson Resilience Scale (CD-RISC), Indian Disability Evaluation and Assessment Scale (IDEAS), and CGI-S; patients were evaluated with IDEAS, and 15 persons with and without a significant disability were recruited in each group of schizophrenia and bipolar disorder.

Results

The mean CD-RISC 25 score for persons with schizophrenia was 73.60 ± 13.87, whereas that for persons with bipolar disorder was 78.10 ± 15.26. For schizophrenia, only CDRISC-25 scores are statistically significant (t = -2.582, P = 0.018) for predicting IDEAS global disability. For bipolar disorder, CDRISC-25 scores (t = -2.977, P = 0.008) and CGI-severity scores (t = 3.135, P = 0.005) are statistically significant for predicting IDEAS global disability.

Conclusion

When disability is factored in, resilience is comparable in persons with schizophrenia and bipolar disorder. Resilience independently predicts disability in both groups. However, the type of disorder does not significantly affect the relationship between resilience and disability. Irrespective of diagnosis, higher resilience is associated with lower disability.

The influence of resilience on stress reaction of college students during COVID-19: the mediating role of coping style and positive adaptive response

The COVID-19 pandemic was a stressful event for all. It threatened people's physical and mental health. Previous studies have found that resilience can help people deal with stress and difficulties more effectively and prevent them from mental health problems. Coping style mediates the relationship between resilience and psychological well-being. Given the novelty and recency of the COVID-19, it is unknown whether resilience can also protect individuals in new difficulties, and whether the previous effective coping styles can be applied to new situations. The current study aimed to explore the influence mechanism of college students' resilience on negative stress response during the pandemic, and the chain mediation of coping style and positive adaptive response. A questionnaire survey was conducted among 910 college students (Mage = 20.58 years; 41.1% men, 58.9% women) studying in Shanghai by stratified random cluster sampling. At that time, they were in 27 different provinces and cities because of the COVID-19 pandemic lockdown. The research tools included Connor-Davidson Resilience Scale (CD-RISC), Simplified Coping Style Questionnaire (SCSQ), Positive Adaptive Response Questionnaire (PARQ), and Negative Stress Reaction Questionnaire (NSRQ). The results showed that: (1) College students' resilience, coping style, positive adaptive response and negative stress reaction were significantly correlated with each other; (2) Resilience could not directly affect negative stress reaction, but it could affect negative stress reaction through the chain mediation of coping style and positive adaptive response. These findings suggest that resilience enhancement intervention programs need to focus on the cultivation of individual positive coping style; In response to major emergencies such as the COVID-19 pandemic, officials can help people reduce negative stress reaction by disseminating positive coping strategies through the media.

Resilience and Coping Strategies in Adults with Autism Spectrum Disorder

Individuals with Autism spectrum disorder (ASD) are prone to stress and anxiety affecting their mental health. Although developing coping and resilience are key to cope with stressors of life, limited research exists. We aimed to explore stakeholders' experiences related to the coping and resilience of adults with ASD. We interviewed 22 participants, including 13 adults with ASD, five parents, and four service provides of adults with ASD from various Canadian provinces. Using thematic analysis, three themes emerged including: (a) societal expectations and conformity, (b) adjusting daily routines, and (c) learning overtime. This study highlights the importance of coping and informs the development of services to help enhance resilience among adults with ASD.

Internalised stigma, social support, coping and care-giving burden among Chinese family caregivers of adults diagnosed with schizophrenia: A parallel mediation analysis

Care-giving burden and internalised stigma are prevalent among family caregivers of people diagnosed with schizophrenia. Internalised stigma has been regarded as a source of care-giving burden. But it remains unclear if high levels of internalised stigma directly contribute to an increased risk of care-giving burden or if the effects could be buffered by psychological factors. This cross-sectional study was to investigate the relationship between internalised stigma and care-giving burden, and to determine the mediating effects of coping styles and social support. Data were collected from 344 Chinese family caregivers of adults diagnosed with schizophrenia in a psychiatric outpatient department of a tertiary hospital in Changsha, Hunan between April and August 2018. A self-reported questionnaire was used to collect data anonymously. Instruments included the Simplified Coping Style Questionnaire, the Multidimensional Scale of Perceived Social Support, the Internalized Stigma of Mental Illness Scale and the Caregiver Burden Inventory. Data analysis was conducted using descriptive statistics, the Spearman correlation and regression analysis to estimate direct and indirect effects using bootstrap analysis. Results showed that internalised stigma, social support and passive coping were significant correlates of care-giving burden; social support partially mediated the relationship between internalised stigma and care-giving burden; active coping did not show impacts on internalised stigma and care-giving burden. This study provided social workers and healthcare providers with a better understanding of the development of care-giving burden. Comprehensive interventions should be designed to provide supportive resources and reduce the possibilities of internalisation of stigma and passive coping, to alleviate care-giving burden.

Identifying clinical and psychological correlates of persistent negative symptoms in early-onset psychotic disorders

Persistent negative symptoms (PNS) contribute to impairment in psychosis. The characteristics of PNS seen in youth remained under-investigated. We aimed to demonstrate clinical, treatment-related, and psychosocial characteristics of PNS in early-onset schizophrenia-spectrum disorders (EOSD). 132 patients with EOSD were assessed with Positive and Negative Symptom Scale, Brief Negative Symptom Scale, Calgary Depression Scale for Schizophrenia, and Simpson-Angus Scale. Parenting skills and resilience were evaluated using Parental Attitude Research Instrument and Child and Youth Resilience Measure-12. Longer duration of untreated psychosis (DUP) and prodromal phase were found in primary and secondary PNS groups, compared to the non-PNS group. The primary PNS group was characterized by earlier age-onset, lower smoking rates, and more common clozapine use. Resilience and egalitarian/democratic parenting were negatively correlated with symptoms related to motivation/pleasure and blunted expression. More blunted expression-related symptoms and longer DUP in the first episode significantly predicted primary/secondary PNS at follow-up. Using the data from total negative symptom scores and DUP, Receiver Operating Characteristic analyses significantly differentiated primary/secondary PNS groups from the non-PNS counterparts. PNS associated with blunted expression and low motivation/pleasure in the first episode could persist into clinical follow-up. Effective pharmacological treatment and psychosocial interventions are needed in youth.

Predictors of Psychosocial Adaptation and Mental Well-Being Among People With Chronic Illnesses and Disabilities in Hong Kong

Psychosocial adaptation to chronic illness and disability (CID) involves a complex interplay of the client’s background factors with resilience and coping. To date, there have been few studies on psychosocial adaptation to CID in the Chinese context. To examine the predictors of psychosocial adaptation, we surveyed people with CID from community-rehabilitation settings and self-help groups ( N = 224). The research questionnaire collected information on demographics, health-related factors, social support, resilience, coping strategies, psychosocial adaptation, and mental well-being. Resilience, coping strategies, health-related factors, and sex were found to be important predictors of psychosocial adaptation. Using structural equation modeling (SEM), we tested a conceptual model on how social support and health-related factors predict adjustment variables (resilience and coping strategies), which further affect psychosocial adaptation and mental well-being. All the variables are closely linked and the path coefficients are all significant. An overall fair model fit (comparative fit index [CFI] = 0.89; root mean square error of approximation [RMSEA] = 0.089) was obtained. The results provide support for the conceptual model we proposed based on health-related coping and the phase model of psychosocial adaptation. The key predictors of psychosocial adaptation and mental well-being in Chinese people with CID in Hong Kong are similar to those identified in non-Chinese studies.

Factors influencing the duration of hospitalization of patients with schizophrenia

Introduction

Severe mental disorders represent an important and large proportion of healthcare resource utilization and are associated with increased hospitalization rates and costs. Given the high percentage of total hospital days and costs associated with caring for people with psychotic disorders, a better understanding of the factors that determine the duration of hospitalization of patients with such disorders is imperative.

Purpose

The aim of the present study was to investigate socio-demographic, clinical and psychosocial characteristics of patients with schizophrenia, admitted to a Greek public psychiatric hospital, and the relationship between these characteristics and duration of hospitalization among these patients.

Methods

This is a cross-sectional study. The study sample consisted of 103 patients diagnosed with schizophrenia (F-20). The collection of data was performed by using the NEO-Five Factor Inventory, the Connor-Davidson Resilience Scale (CD-RISC25), Multidimensional Scale of Perceived Social Support, (MSPSS), Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning scale (GAF) for assessing key personality factors, psychological resilience, social support, symptom severity and the severity of the disease, respectively. Descriptive analyses and inferential statistic methods were applied. Correlation between socio-demographic, psychosocial or clinical characteristics with the length of stay were explored. In addition, linear regression analysis was performed in order to examine predicting factors for the duration of hospitalization. All statistical analysis was performed using SPSS v.25.

Results

The mean age of the sample was 43.9 (SD = ±11.4) years, 67% of patients were men, and the mean length of hospitalization was 40.7 days. Factors found to be significantly associated with length of stay in the overall sample include the previous admissions (p=0.010), the type of admission (compulsory or voluntary) (p=0.017), bed rest (p=0.043) and duration of bed rest (p=0.002), and the existence of social support networks especially from friends (p=0.018).

Conclusions

Our findings indicate that basic psychosocial and clinical factors were associated with the duration of hospital stay. Duration of hospitalization results from a complex interface between characteristics and activities of the health system, patient, and clinician's influence on discharge timing, which requires additional study. Our findings further warrant the need for policymakers to consider socio-demographic status, psychosocial and clinical factors when allocating resources to hospitals caring for patients with severe mental disorders.

Resilience and its inter-relationship with symptomatology, illness course, psychosocial functioning, and mediational roles in schizophrenia: A systematic review

BACKGROUND

Schizophrenia is a major psychiatric disorder which poses substantial illness burden on affected individuals. In view of the need to better understand the growing literature on resilience (adaptation in the face of adversity) and its clinical correlates to inform and optimize clinical management in schizophrenia, we sought to summarize the extant literature which examined the inter-relationships between resilience and demographic features, phenomenology, illness course, psychosocial functioning, and its mediational role among relevant factors.

METHODS

A systematic review was conducted on published empirical studies examining the topic of resilience and clinical correlates within schizophrenia spectrum conditions up until December 2020.

RESULTS

Higher level of resilience was associated with lower severity of specific symptomatology including positive, negative, depressive symptoms, suicidal ideation, cognitive deficits, and better insight. Moreover, higher resilience was significantly associated with different aspects of illness course (such as shorter duration of untreated psychosis, longer duration of illness, improved symptom remission and recovery), internal factors (such as lower stigma, better self-esteem), and psychosocial functioning (better overall, real-life, social and interpersonal functioning, better quality of life). Resilience also acts as a mediator in pathways leading to depression, functioning, and quality of life within schizophrenia spectrum conditions.

DISCUSSION

Viewed within the context of various resiliency models (compensatory, challenge, protective factor models), suggestions were made to enhance resilience and balance risk versus protective factors in order to improve disease management. Future research should seek to better elucidate associated biomarkers, inter-relationships with carer resilience, and evaluate the efficacy of suitable resilience-targeted interventions in schizophrenia.

Potentially traumatic events and post-traumatic growth among Chinese peacekeepers: A moderated mediation model

Peacekeepers are inherently exposed to potentially traumatic events (PTEs) in the line of duty. However, little is known about whether PTEs during peacekeeping missions may foster post-traumatic growth (PTG) among peacekeepers and its mechanisms. This study aimed to investigate the association between PTEs and PTG among Chinese peacekeepers, as well as the mediating role of coping style and the moderating role of resilience. Five hundred ninety-five Chinese peacekeepers completing the United Nations (UN) peacekeeping mission in South Sudan and returning to China were recruited to complete Peacekeeping Traumatic Stress Exposure Scale, Posttraumatic Growth Inventory, Simplified Coping Style Questionnaire and the Chinese version of Connor and Davidson's Resilience Scale. PTEs were positively associated with PTG among Chinese peacekeepers. Coping style partially mediated the association between PTEs and PTG. Resilience moderated the association between coping style and PTG. Specifically, at a lower level of resilience, positive coping style was more effective in predicting PTG. This study contributes to understanding the complex association between PTEs in peacekeeping missions, coping style, resilience and PTG by focusing on the experiences of Chinese peacekeepers and adds value to the current literature on psychological health in peacekeepers.

Mindfulness on Daily Life Coping in People Experiencing Psychosis: A Randomized Controlled Trial

Background/Objective

Cognitive Behavior Therapy for psychosis (CBTp) is a recommended treatment for psychoses whose effect is mediated by coping. Mindfulness (MBI) have shown positive effects in psychosis. This study examines the hypothesis that combining CBTp+MBI could improve coping with day-to-day life in psychosis better than CBTp alone in people attending a public community rehabilitation center.

Method

Fifty-six outpatients were recruited and randomly allocated either to CBTp or CBTp+MBI. Measures comprised PANSS interview and COPE Inventory. Data were analyzed using a repeated measures ANOVA and RCI calculation.

Results

There were no statistical differences between groups at pre-treatment. Significant statistical differences were found for the interaction Treatment x Time in Mental disengagement (F = 5.65, p = .021, η2 = .102), Acceptance (F = 7.69, p = .008, η2 = .133), and Suppressing competing activities (F = 4.62, p = .037, η2 = .085).

Conclusions

MBI promotes specific coping styles in people who experience psychosis that otherwise are not improved with CBTp. Only the MBI group improved acceptance of the presence of the stressor and reduced mental disengagement from the context. The intervention is feasible and effective for public healthcare settings.

Post-traumatic Growth and Psychological Resilience During the COVID-19 Pandemic: A Serial Mediation Model

Although the World Health Organization (WHO) has issued guidelines for managing to contain, mitigate, and limit of the COVID-19. However, it is more essential to highlight the urgency and importance of evaluating social functioning and mental health status during the pandemic. College students have experienced serious problems and have had to overcome many negative situations brought about by the pandemic. Accordingly, the present study intended to use Chinese college students as sample to examine the positive adoption and changes during the ongoing COVID-19. Guided by literatures in this filed, we explored the internal mechanism of post-traumatic growth affecting psychological resilience, and considered about mediation roles of positive coping styles and cognitive reappraisal. A total of 463 college students from universities in China effectively completed online questionnaires. The result indicated that these four variables were positively correlated with each other (ps < 0.001). More importantly, our findings proved a direct and positive effect on psychological resilience. Positive coping styles and cognitive reappraisal, respectively, mediated the relationship between post-traumatic growth and psychological resilience. Over all, the hypothesized serial model conclusively fits the data: students with high-level post-traumatic growth tended to report increased use of positive coping strategies, which further facilitated their cognitive reappraisal, and subsequently, promoted their psychological resilience. The findings obtained in this study will provide a theoretical basis and possible viable strategies for both targeted crisis intervention and psychological trauma recovery plans.

Resilience and mental health: A longitudinal cohort study of Chinese adolescents before and during COVID-19

BACKGROUND

The COVID-19 outbreak has resulted in mental health issues, mainly depression and anxiety, prompted by stressors such as the need to maintain social distance, adapting to quarantine, and lockdown policies. Resilience may be vital in protecting individuals from mental disorders. However, few studies have examined the longitudinal relationships between resilience and mental disorders (i.e., depression and anxiety) among adolescents before and during the COVID-19 pandemic.

OBJECTIVE

This study aimed to examine the association between resilience, depression, and anxiety among Chinese adolescents before and during COVID-19 using a longitudinal cross-lagged model.

METHODS

A total of 7,958 Chinese adolescents completed a baseline survey in the month before COVID-19 and were followed up after the COVID-19 lockdown. Structural equation modeling analyses were applied to evaluate the associations between resilience, depression, and anxiety after controlling for three covariates (i.e., gender, age, and COVID-19 effect).

RESULTS

A higher level of resilience before COVID-19 significantly predicted decreased severity of depression and anxiety after the lockdown. Moreover, the mean level of resilience and prevalence of mental disorders (i.e., depression and anxiety) among Chinese adolescents decreased after the lockdown. These findings suggest resilience is a vital protective factor against depression and anxiety among adolescents. Furthermore, younger participants and those less affected by the pandemic could be more resilient. No significant link was found between gender and resilience in the second wave.

CONCLUSIONS

Resilience is an essential protective factor for reducing mental disorders among Chinese adolescents exposed to COVID-19. Resilience-related interventions should be developed to efficiently promote mental health recovery among youth during pandemics.

Psychiatric hospitalization during the two SARS-CoV-2 pandemic waves: New warnings for acute psychotic episodes and suicidal behaviors

BACKGROUND

The subsequent waves of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic have represented a dramatic health emergency characterized by significant consequences on mental health. Diachronic variations in the incidence rates of acute relapse of psychiatric disorders may represent significant "sentinel events" for assessing the mental health response to an unprecedented stressful event.

AIM

To investigate the variation in psychiatric hospitalization rates and differences in sociodemographic and clinical-psychopathological peculiarities at Bologna "Maggiore" General Hospital Psychiatric Ward (GHPW) between the first two waves SARS-CoV-2 pandemic and the same periods of the previous 3 years. The secondary purpose of the study was to suggest a diachronic response pathway to stress by reporting additional literature data on coping strategies.

METHODS

This observational and retrospective study collected information on admission to the GHPW at the "Maggiore" Hospital in Bologna in the index periods defined as follows: the first period between February 24, 2020 and April 30, 2020 (first epidemic wave) and the second period between October 8, 2020, and January 7, 2021 (second pandemic wave). Absolute numbers and proportion of admitted patients, their sociodemographic and clinical-psychopathological characteristics were compared with the same parameters recorded in the two same periods of the previous 3 years. No strict inclusion or exclusion criteria were provided in the data collection to collect information on all patients requiring acute psychiatric hospitalization.

RESULTS

During the first wave, there was a significant reduction in hospitalization rates, although there was a simultaneous increase in compulsory hospitalizations and the acute relapse of schizophrenia spectrum and other psychotic disorders. During the second wave, hospitalization rates reached those recorded during the same period of the previous 3 years, mainly due to the rise of bipolar and related disorders, depressive disorders, anxiety disorders, trauma- and stressor-related disorders and suicidal behaviors.

CONCLUSION

The coping strategies adopted during the first wave of the SARS-CoV-2 pandemic protected the vulnerable population from the general risk of clinical-psychopathological acute relapse, even if they increased the susceptibility to run into schizophrenia spectrum and other psychotic disorder relapses. In the medium-long term (as in the second pandemic wave), the same strategies do not play protective roles against the stress associated with the pandemic and social restriction measures. Indeed, during the second wave of the SARS-CoV-2 pandemic, an increase in total hospitalization rate, suicidal behaviors and the incidence rate of bipolar and related disorders, depressive disorders, anxiety disorders, trauma- and stressor-related disorders was observed.

Attachment anxiety and resilience: The mediating role of coping

In recent research, attachment has been addressed as a core factor that potentially contributes to resilience. However, there is still much to investigate regarding the mechanisms of this relationship. Emotion-focused coping and problem-focused coping strategies may be promising pathways via which attachment associates with resilience. The present study evaluated the role of attachment insecurity (i.e., attachment anxiety and avoidance) in resilience among a Turkish sample during the COVID-19 pandemic. We hypothesized that individuals with high levels of attachment anxiety would experience lower resilience via emotion-focused coping strategies. On the other hand, we did not have a specific hypothesis for attachment avoidance due to contrasting research findings of previous studies. Participants reported their attachment orientation, resilience, and coping strategies. Attachment anxiety was directly and, through both coping strategies, indirectly linked to resilience however attachment avoidance was only indirectly related to resilience through problem-focused coping. The findings indicate that low levels of attachment anxiety and the ability to use problem-focused coping strategies may be associated with greater resilience. The fostering of attachment security may thus reduce the use of emotion-focused strategies and may promote resilience among individuals with high levels of attachment anxiety. Moreover, our study is one of the first to investigate attachment orientations in relevance with coping and resilience during the ongoing pandemic This research has implications regarding the potentials of introducing psycho-educational trainings for better coping strategies in crisis like COVID-19 pandemic.

Relationship between stressful life events, coping styles, and schizophrenia relapse

This study aimed to explore the relationship between stressful life events, coping styles, and schizophrenia relapse. The sample for this study included 248 patients with schizophrenia from a psychiatric outpatient clinic in Hunan Province, China. Stressful life events, occurrence of schizophrenia relapse, and coping style were assessed by the Scale for the Social Readjustment Rating, Brief Psychiatric Rating Scale, and Simplified Coping Style Questionnaire, respectively. Spearman correlation analysis and binary logistic regression analysis were adopted to explore the relationships among coping styles, schizophrenia relapse, and stressful life events. Stressful life events and negative coping exhibited significant positive association with schizophrenia relapse, while positive coping exhibited a significant negative association with schizophrenia relapse. Stressful life events and positive coping exerted significant effects on schizophrenia relapse, while negative coping did not. We also found that both positive coping and negative coping have moderating effects on the relationship between stressful life events and schizophrenia relapse, but the relationship is weak. The study highlighted the importance of interventions designed to reduce stressful life events, promote positive coping, and address negative coping in patients with schizophrenia.

Relationships of coping styles and psychological distress among patients with insomnia disorder

BACKGROUND

Insomnia appears to be one of the most frequent sleep complaints in the general population. It has significant negative impact on daily functioning. However, there has been little research that described the effect of coping style in insomnia disorder.

METHODS

The Simplified Coping Style Questionnaire (SCSQ) was used to evaluate 79 adult patients with insomnia disorder alongside 80 healthy controls. Additionally, sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), and Symptom Checklist-90-Revised (SCL-90R) was utilized to determine the status of depression, anxiety and other psychological symptoms.

RESULTS

Positive coping style score was significantly lower, whereas negative coping style score and nine symptomatic dimensions of SCL-90R were significantly higher in insomnia patients than in controls. Positive coping style score was adversely related to PSQI score, obsessive-compulsive, depression, anxiety and phobic anxiety, whereas negative coping style score was positively related to PSQI score, somatization and interpersonal sensitivity. Further multiple stepwise regression analysis showed that PSQI total score was independently and positively correlated with negative coping style score.

CONCLUSIONS

Insomniacs use more negative coping styles and less positive ones. Positive coping is adversely associated with insomnia symptoms and psychological distress, whereas negative coping is positively related to those symptoms. And negative coping has a negative effect on sleep quality. we should attach importance to coping styles of insomniacs in clinical practice, which may help to develop more targeted prevention and intervention strategies.

Autism spectrum in patients with schizophrenia: correlations with real-life functioning, resilience, and coping styles

BACKGROUND

Previous researches highlighted among patients with schizophrenia spectrum disorders (SSD) a significant presence of autistic traits, which seem to influence clinical and functional outcomes. The aim of this study was to further deepen the investigation, evaluating how patients with SSD with or without autistic traits may differ with respect to levels of functioning, self-esteem, resilience, and coping profiles.

METHODS

As part of the add-on autism spectrum study of the Italian Network for Research on Psychoses, 164 outpatients with schizophrenia (SCZ) were recruited at eight Italian University psychiatric clinics. Subjects were grouped depending on the presence of significant autistic traits according to the Adult Autism Subthreshold Spectrum (AdAS Spectrum) instrument ("AT group" vs "No AT group"). Other instruments employed were: Autism Spectrum Quotient (AQ), Specific Levels of Functioning (SLOF), Self-Esteem Rating scale (SERS), Resilience Scale for Adults (RSA), and brief-COPE.

RESULTS

The "AT group" reported significantly higher scores than the "No AT group" on SLOF activities of community living but significantly lower scores on work skills subscale. The same group scored significantly lower also on SERS total score and RSA perception of the self subscale. Higher scores were reported on COPE self-blame, use of emotional support and humor domains in the AT group. Several correlations were found between specific dimensions of the instruments.

CONCLUSION

Our findings suggest the presence of specific patterns of functioning, resilience, and coping abilities among SSD patients with autistic traits.

The clinical characterization of the patient with primary psychosis aimed at personalization of management

The current management of patients with primary psychosis worldwide is often remarkably stereotyped. In almost all cases an antipsychotic medica-tion is prescribed, with second-generation antipsychotics usually preferred to first-generation ones. Cognitive behavioral therapy is rarely used in the vast majority of countries, although there is evidence to support its efficacy. Psychosocial interventions are often provided, especially in chronic cases, but those applied are frequently not validated by research. Evidence-based family interventions and supported employment programs are seldom implemented in ordinary practice. Although the notion that patients with primary psychosis are at increased risk for cardiovascular diseases and diabetes mellitus is widely shared, it is not frequent that appropriate measures be implemented to address this problem. The view that the management of the patient with primary psychosis should be personalized is endorsed by the vast majority of clinicians, but this personalization is lacking or inadequate in most clinical contexts. Although many mental health services would declare themselves "recovery-oriented", it is not common that a focus on empowerment, identity, meaning and resilience is ensured in ordinary practice. The present paper aims to address this situation. It describes systematically the salient domains that should be considered in the characterization of the individual patient with primary psychosis aimed at personalization of management. These include positive and negative symptom dimensions, other psychopathological components, onset and course, neurocognition and social cognition, neurodevelopmental indicators; social functioning, quality of life and unmet needs; clinical staging, antecedent and concomitant psychiatric conditions, physical comorbidities, family history, history of obstetric complications, early and recent environmental exposures, protective factors and resilience, and internalized stigma. For each domain, simple assessment instruments are identified that could be considered for use in clinical practice and included in standardized decision tools. A management of primary psychosis is encouraged which takes into account all the available treatment modalities whose efficacy is supported by research evidence, selects and modulates them in the individual patient on the basis of the clinical characterization, addresses the patient's needs in terms of employment, housing, self-care, social relationships and education, and offers a focus on identity, meaning and resilience.

Psychological resilience and positive coping styles among Chinese undergraduate students: a cross-sectional study

Background

Psychological resilience and coping strategies have been found to be related to various psychological and mental health problems. Evaluations of the relationship between resilience and coping style among university students are important for developing effective health promotion strategies focused on resilience intervention to benefit students’ health and well-being. The relationship between psychological resilience and coping styles has usually been examined among adults and patients. Very few studies have investigated the relationship between resilience and coping style in university students. The present study aimed to investigate the associations between psychological resilience, students’ characteristics (gender, major and grade) and coping styles among undergraduate students.

Methods

A cross-sectional survey was conducted among undergraduate students in Shandong Province, China. Undergraduate students were randomly selected from 6 universities in 3 cities of the province using a stratified random sampling method. The questionnaire included questions on the participants’ demographic information, including gender, grade and major, measures of psychological resilience and coping style. Coping style was measured by the Simplified Coping Style Questionnaire (SCSQ). The Asian Resilience Scale (ARS) was applied to evaluate undergraduates’ psychological resilience. Multivariable regression analysis was used to examine the relationships between resilience, students’ characteristics and positive coping styles.

Results

A sample of 1743 undergraduates was analysed. The mean psychological resilience score was 70.41. The mean score for positive coping style was 24.72. Multiple regression analysis showed that three factors of psychological resilience, mood control, self-plasticity and coping flexibility, were all significant factors for positive coping styles (regression coefficient = 0.34, 0.35, 0.14, p < 0.01 for the three factors, respectively). Medical students and females had higher scores for positive coping styles than non-medical students and males (p < 0.01).

Conclusions

The research revealed that females and medical students are more likely than males and non-medical students to adopt positive coping styles. Higher psychological resilience is associated with a better positive coping style. The findings suggest that psychological education and health promotion programmes that target strengthening psychological resilience among undergraduate students may help foster positive coping styles to benefit their mental health and psychological well-being.

The relationship between optimism and job satisfaction for Chinese specialist nurses: A serial-multiple mediation model

AIM

This study aimed to examine the relationship between optimism, core self-evaluations, positive coping strategies, and job satisfaction for Chinese specialist nurses.

METHODS

A cross-sectional design was used. Two hundred and seventy-eight Chinese specialist nurses answered the Chinese Minnesota Satisfaction Questionnaire, the Chinese Revised Life Orientation Test, the Chinese Core Self-Evaluations Scale, and the Chinese Simplified Coping Style Scale. Descriptive analysis, independent-sample T-tests, one-way analysis of variance, Pearson correlation analyses, and bootstrap method were conducted to analyze data.

RESULTS

Total effect (c = 0.860, SE = 0.143, 95% CI 0.579-1.142) of optimism on job satisfaction was significant. The path through single mediation of core self-evaluations (point estimate = 0.165; 95% CI 0.041-0.318), the path through the single mediation of positive coping (point estimate = 0.124; 95% CI 0.042-0.254), and the path through both mediators (point estimate = 0.033; 95% CI 0.005-0.085) were all statistically significant. The total indirect effect was also statistically significant (point estimate = 0.322; 95% CI 0.151-0.535).

CONCLUSIONS

This study concluded that optimism was first sequentially associated with core self-evaluations and then associated with positive coping strategies, which was in turn related to job satisfaction of Chinese specialist nurses. Clinical nursing administrators should take measures that focus on improving specialist nurse job satisfaction to further improve their retention rates.