General coping strategies and their impact on quality of life in older adults with schizophrenia

Background: Both symptom specific and general coping strategies may affect the well-being of persons with schizophrenia. There are little data on how older adults with schizophrenia employ various coping styles. This study examines the types of general coping strategies used by older persons with schizophrenia and examines the extent to which the various coping strategies affect quality of life. Methods: The schizophrenia group consisted of 198 persons aged 55 and over living in the community who developed schizophrenia before age 45. A community comparison group (n = 113) was recruited using randomly selected block-groups. Cognitive, instrumental, and avoidant coping scales were created based on a principal component analysis with equamax rotation of items from a self-report coping inventory. A modified version of Yanos and Moos' integrative model was used to assess the direct and mediating effects of each of the coping strategies scales on the Quality of Life Index. Results: Older adults with schizophrenia and their age peers in the general community most commonly use cognitive coping strategies, and there was no significant difference in their scores on this scale. For persons with schizophrenia, the active coping strategies - cognitive and instrumental - were used more frequently than the avoidant strategies. Both active and avoidant strategies mediated the impact of psychiatric symptoms on quality of life as well as contributing independently to improving life quality; however, they had no impact on the other stressor variables. Conclusion: This study suggests that general coping strategies, especially more active approaches, may be useful in diminishing the adverse impact of psychiatric symptoms on quality of life as well as having direct effects on life quality. Such strategies can complement symptom specific approaches. (C) 2011 Elsevier B.V. All rights reserved.