Although stressful life events can trigger psychotic and depressive symptom exacerbation in schizophrenia, many patients who experience stress do not subsequently relapse. Recent versions of the vulnerability-stress-protective factors model of schizophrenia suggest that coping responses may serve as critical mediating variables. Most of the research on coping behavior in schizophrenia has focused on strategies for dealing with symptoms of the illness rather than with interpersonal stressors. Using the Coping Responses Inventory developed by Moos, we examined how 13 chronic, but clinically stable, schizophrenia outpatients and 11 demographi-cally matched normal subjects responded to a negative interpersonal life event. Cog-nitively oriented problem-focused approaches ("Think of different ways to deal with the problem") and behaviorally oriented problem-solving strategies ("Make a plan of action and follow it") were used significantly more often by normal controls than by schizophrenic patients (p < 0.01). However, the use of cognitive or behavioral avoidance coping did not differ significantly between groups. Whereas normal controls use a wide range of coping behaviors that involves both approach and avoidance responses, the repertoire of coping responses of chronic schizophrenia patients appears, on average, to be relatively more focused on avoidance.
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