Can we predict coping abilities in Schizophrenia?

A recent study about schizophrenia was published in BMC Psychiatry. The question being asked was – can we predict how well people with schizophrenia cope by looking at their executive abilities?. Coping is something we understand intuitively. However in the Maastricht Assessment of Coping Strategies-24 (MACS-24) coping is finely detailed and tailored to mental health symptoms. For each type of symptom there are different categories of responding (e.g. passive, symptomatic coping etc). So the idea is that a number can be given to someone’s ability to cope with mental health symptoms. There is some support in the literature for people with schizophrenia having impaired executive abilities. Executive functioning can be thought of as a planning ability that regulates other types of thinking we engage in – a kind of thinking about thinking. So we see it in action when we have to think about what type of problem solving we need to use. The researchers used a number of tasks including the Trail Making Test and the Stroop Test. The Trail Making Test is made up of two parts. In the first part, the subject joins up numbered circles sequentially. In the second part, the subject joins up alternating numbered and lettered circles (see here for more details). They are scored according to the time taken. In the stroop test, the subject must choose words of different colours according to increasingly complex rules. This is primarily a test of attention (see here for more details). There were 32 subjects, 20 men (mean age 32) and 12 women (mean age 45) with a mean IQ of 101. The findings showed no significant relationship between executive functioning and coping abilities – perhaps the opposite of what we might expect. However there were a number of explanations given by the authors that might explain why these are the opposite of what we would expect. Firstly there were a small number of people in the study. The more people, the better the chance of picking up any relationships if they exist. Executive functioning is just one type of thinking that we use. Other types of thinking might be related to better coping abilities. Another point is that sometimes people cope with problems without even realising it. The MACS-24 taps into people’s conscious coping abilities – i.e. the methods of coping of which they are explicitly aware. The study raises a number of questions and it will be interesting to see the results of further studies in this area.

References

Bak, M et al. Executive function does not predict coping with symptoms in stable patients with a diagnosis of schizophrenia. BMC Psychiatry. 2008. 8. 39.

Disclaimer

The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor.

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