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Coping with hallucinations: exploring stress and coping framework

J Farhall1, M Gehrke

  • 1School of Psychological Science, La Trobe University, Bundoora, Victoria, Australia.

The British Journal of Clinical Psychology
|May 1, 1997
PubMed
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This study on schizophrenia found that while active and passive coping strategies help manage hallucinations, resistance-based coping, even when hallucination-specific, surprisingly worsened distress. Understanding these coping mechanisms is key for treatment.

Area of Science:

  • Psychiatry and Psychology
  • Clinical Neuroscience
  • Mental Health Research

Background:

  • Hallucinations are a core symptom of schizophrenia, significantly impacting patient distress and functioning.
  • Coping strategies are crucial for managing distressing symptoms, but their effectiveness in schizophrenia requires further investigation.
  • The Lazarus & Folkman (1984) transactional model of stress and coping provides a framework for understanding appraisal and coping processes.

Purpose of the Study:

  • To apply Lazarus & Folkman's (1984) theoretical framework to understand coping mechanisms used by individuals with schizophrenia experiencing hallucinations.
  • To identify and categorize coping strategies employed in response to hallucinations.
  • To examine the relationship between different coping factors and distress reduction in schizophrenia patients.

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Main Methods:

  • A structured interview schedule was administered to 81 patients diagnosed with schizophrenia.
  • Unprompted reports of coping strategies were collected and analyzed.
  • Factor analysis of a coping checklist identified key coping factors, which were then used in regression analyses to predict distress reduction.

Main Results:

  • Patients reported using a wide range of both 'hallucination-specific' and 'general' coping strategies.
  • Factor analysis yielded three distinct coping factors: active acceptance, passive coping, and resistance.
  • The active acceptance factor was associated with hallucination control, passive coping with distress reduction, and unexpectedly, the resistance factor (including hallucination-specific strategies) predicted poorer distress reduction.

Conclusions:

  • The findings highlight the diverse coping strategies utilized by schizophrenia patients experiencing hallucinations.
  • Different coping factors have differential effects on distress, with resistance-based strategies potentially being counterproductive.
  • Implications for clinical practice and future research include refining therapeutic interventions to promote adaptive coping and reduce distress associated with hallucinations in schizophrenia.