The validity of Antonovsky's Sense of Coherence measure in a sample of schizophrenic patients living in the community

Aim of the study. To examine the construct and predictive validity of Antonovsky's Sense of Coherence (SOC) concept in a sample of schizophrenic persons living in the community. Background. The salutogenic model of Antonovsky proposes that the individual's sense of coherence, which is a personal orientation towards life, determines the health experience. The salutogenic perspective might in several advantageous aspects contribute to the care and support for patients with a long and persistent mental illness like schizophrenia. Design. The study is a 18-month follow-up study. Structured interviews were used to interview 120 patients with a diagnosis of schizophrenia or a schizoaffective disorder. Pearlin's mastery scale, Rosenberg's self-esteem scale, the Interview Schedule for Social Interactions (ISSI) and the Brief Psychiatric Rating Scale (BPRS) were used as construct validity measures of the SOC scale. Health related measures such as quality of life, global well-being, satisfaction with health assessed by the Lancashire Quality of Life Profile (LQOLP) and global psychosocial functioning (GAF) were used in calculations of the predictive validity of SOC. Results. The SOC was positively related to mastery, self-esteem and social support but negatively associated to psychopathology. In total, mastery, self-esteem and adequacy of social integration explained 61.1% of the variance in SOC, and mastery contributed with the greatest part of the variance, 46.3% SOC was positively associated to all health related measures and changes in SOC during an 18-month follow-up was positively correlated to changes in overall subjective quality of life, general health, global well-being and global psychosocial functioning. Conclusion. The results gave support to the construct and predictive validity of the SOC measure in individuals suffering from a diagnosis of schizophrenia.