Hope, Awareness of Illness, and Coping in Schizophrenia Spectrum Disorders

Roudebush VA Medical Center, Indianapolis, Indiana 46202, USA.
Journal of Nervous & Mental Disease (Impact Factor: 1.69). 05/2005; 193(5):287-92. DOI: 10.1097/01.nmd.0000161689.96931.0f
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Controversy exists regarding whether awareness of schizophrenia is linked with healthier or poorer psychosocial function. This study examined whether hope might interact with insight to affect function at the level of active versus avoidant coping preferences among 96 persons with schizophrenia spectrum disorders. Factorial multivariate analysis of variance comparing groups classified on the basis of hope and insight scores revealed a significant interaction between hope and insight (Wilks lambda = 2.7; p< 0.05). Post hoc analyses indicated that persons with high insight and high hope demonstrated the most adaptive coping preferences, whereas those with high insight and lower hope demonstrated the least.

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Available from: Paul H Lysaker, Jun 08, 2015
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    • "Some have argued that stronger hope and self-esteem might lead to less avoidance, more problem-oriented strategies and more social interaction [2]. Previous research has shown that persons with more hope and insight in their illness use more problem-oriented and less avoidant coping strategies [22] and that poor confidence is connected to using avoidant strategies [23]. These findings are in line with the present study, which also illustrates Bandura’s idea of self-efficacy [24]. "
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    ABSTRACT: Several hospitals in Norway provide short self-referral inpatient treatment to patients with severe mental diagnosis. No studies have compared the experiences of patients who have had the opportunity to self-refer to inpatient treatment with patients who have received treatment as usual. This qualitative study was nested within a randomised controlled trial investigating the effect of self-referral to inpatient treatment. The aim was to explore how patients with severe mental diagnosis coped four months after signing a contract for self-referral, as compared to patients receiving treatment as usual. Data was collected using qualitative individual interviews with patients with severe mental diagnosis, conducted four months after being randomised either to a contract for self-referral (intervention group) or to treatment as usual (control group). Twenty-five patients participated in interviews - 11 from the intervention group and 14 from the control group. Results four months after randomisation showed that patients with a contract for self-referral appeared to have more confidence in strategies to cope with mental illness and to apply more active cognitive strategies. Patients with a contract also expressed less resignation, hopelessness and powerlessness than patients without a contract. In addition, patients with a contract seemed to be closer to the ideal of living a "normal" life and being a "normal" person. The results indicate that the patients who had a contract for self-referral had come further in the recovery process and should possibly be better off during treatment.
    BMC Health Services Research 08/2014; 14(1):347. DOI:10.1186/1472-6963-14-347 · 1.71 Impact Factor
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    • "The exact nature of this relationship remains unclear [8,10]. The relationship between depression and insight is thought to be mediated by internalized stigma: insight is only associated with depression in patients who hold stigmatizing beliefs about mental illness [12,13]. "
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    ABSTRACT: Insight is impaired in a majority of people with schizophrenia. Impaired insight is associated with poorer outcomes of the disorder. Based on existing literature, we developed a model that explains which processes may possibly play a role in impaired insight. This model was the starting point of the development of REFLEX: a brief psychosocial intervention to improve insight in schizophrenia. REFLEX is a 12-sessions group training, consisting of three modules of four sessions each. Modules in this intervention are: "coping with stigma", "you and your personal narrative", and "you in the present". REFLEX is currently evaluated in a multicenter randomized controlled trial. Eight mental health institutions in the Netherlands participate in this evaluation. Patients are randomly assigned to either REFLEX or an active control condition, existing of cognitive remediation exercises in a group. In a subgroup of patients, fMRI scans are made before and after training in order to assess potential haemodynamic changes associated with the effects of the training. REFLEX is one of the few interventions aiming specifically to improving insight in schizophrenia and has potential value for improving insight. Targeting insight in schizophrenia is a complex task, that comes with several methodological issues. These issues are addressed in the discussion of this paper. Current Controlled Trials: ISRCTN50247539.
    BMC Psychiatry 10/2011; 11(1):161. DOI:10.1186/1471-244X-11-161 · 2.21 Impact Factor
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    • "For instance, Hasson-Ohayon et al. (2009) have found that hope increases the strength of association between insight and positive QoL. Lysaker et al. (2005) found that patients with high Psychiatry Research 189 (2011) 190–194 ⁎ Corresponding author at: School of Psychology, Campus de Somosaguas, 28223 Madrid, "
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    ABSTRACT: In schizophrenia, poor insight has been associated with negative outcome. In fact, some studies have found insight to be associated with greater treatment adherence and lower levels of symptomatology, as well as better psychosocial functioning. However, others have found that insight into illness is associated with an increase in depression, low self-esteem, and possibly higher risk of suicide. We investigated the relationship between insight and well-being in a sample of 40 people presenting paranoid symptoms and diagnosed with schizophrenia or other psychotic disorder. Independent-samples t-tests revealed that compared to a paranoid group with high insight, paranoid participants with low insight had more self-acceptance, higher sense of autonomy and personal growth, and greater orientation towards gratification. Moderation analyses showed that when experiential avoidance was high, insight into paranoia had a detrimental effect on self-acceptance. Overall, our results support the need to explore which psychological variables moderate insight in patients with persecutory beliefs. We discuss the implications of these results for the research of paranoia.
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