Coping styles predict responsiveness to cognitive behaviour therapy in psychosis
Preethi Premkumar1, Emmanuelle R Peters, Dominic Fannon
1Department of Psychology, Institute of Psychiatry, King's College London, London, UK. preethi.premkumar@iop.kcl.ac.uk
Psychiatry Research
|January 26, 2011
Summary
Patients receiving cognitive behavioural therapy for psychosis (CBTp) alongside standard care (SC) showed greater symptom improvement. Pre-therapy coping skills and cognitive insight predicted better outcomes in the CBTp group.
Area of Science:
- Psychiatry
- Clinical Psychology
- Neuroscience
Background:
- Cognitive Behavioural Therapy for Psychosis (CBTp) is an established treatment for schizophrenia spectrum disorders.
- Predictors of treatment response in CBTp remain incompletely understood, necessitating further investigation.
- Identifying factors that enhance CBTp effectiveness is crucial for optimizing patient care.
Purpose of the Study:
- To identify clinical and neuropsychological predictors of responsiveness to CBTp in patients with schizophrenia or schizoaffective disorder.
- To compare the efficacy of CBTp plus standard care (SC) versus SC alone in improving symptoms and self-esteem.
- To explore the relationship between baseline characteristics and treatment outcomes.
Main Methods:
- A randomized controlled trial involving 60 patients with schizophrenia or schizoaffective disorder and 25 healthy controls.
- Patients were assigned to either CBTp + SC or SC alone, with assessments before and after treatment.
- Symptom severity was measured using the Positive and Negative Syndrome Scale (PANSS); clinical and neuropsychological functions were also assessed.
Main Results:
- The CBTp + SC group demonstrated significantly greater improvements in symptoms and self-esteem compared to the SC-only group.
- Higher pre-therapy coping ability and greater self-reflectiveness (a dimension of cognitive insight) predicted symptom improvement in the CBTp + SC group, accounting for up to 21% of the variance.
- Pre-therapy neuropsychological function, illness duration, clinical insight, and gender did not predict CBTp responsiveness.
Conclusions:
- Pre-therapy coping strategies and cognitive insight, specifically self-reflectiveness, are key predictors of positive outcomes in CBTp.
- These findings suggest that enhancing coping mechanisms and fostering cognitive insight may improve treatment response for individuals undergoing CBTp.
- CBTp, when combined with standard care, offers significant benefits for symptom management in psychosis.
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