Stress and coping responses to a natural disaster in people with schizophrenia

Horan, William P.; Ventura, Joseph; Mintz, Jim; Kopelowicz, Alex; Wirshing, Donna; Christian-Herman, Jennifer; Foy, David; Liberman, Robert P.

doi:10.1016/j.psychres.2006.10.009

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Volume 151, Issue 1 , Pages 77-86, 30 May 2007

Stress and coping responses to a natural disaster in people with schizophrenia

William P. Horan
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- Corresponding author. Department of Psychiatry and Biobehavioral Sciences 300 UCLA Medical Plaza, Room 2240 Los Angeles, CA 90095, USA. Tel.: +1 310 206 8181; fax: +1 310 206 3651.
Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
Jim Mintz
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
Alex Kopelowicz
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- San Fernando Mental Health Center, Los Angeles, CA, USA
Donna Wirshing
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- West Los Angeles Veterans Administration Medical Center, Los Angles, CA, USA
Jennifer Christian-Herman
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
David Foy
- Pepperdine University, Los Angeles, CA, USA
Robert P. Liberman
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- West Los Angeles Veterans Administration Medical Center, Los Angles, CA, USA

Received 23 December 2005; received in revised form 31 July 2006; accepted 24 October 2006.

Abstract

Investigations of how individuals with schizophrenia differ from non-patients in their responses to stressful life events are subject to the criticism that any between-group differences might merely reflect differences in the types of stressful events that each group experiences. This report presents new analyses of data collected from schizophrenia patients (n=96), bipolar disorder patients (n=18), and healthy controls (n=18) immediately after the Northridge Earthquake that struck Southern California in 1994, a natural experiment that confronted all groups with the same stressful event. Participants completed the Impact of Events Scale (IES; [Horowitz, M.J., Wilner, N., Alvarez, W., 1979. Impact of Events Scale. A measure of subjective stress. Psychosomatic Medicine 41, 209–218]) at 1 week and 5 weeks post-earthquake. At the 5-week follow-up, measures of coping, social support, and self-esteem were also completed. Both patient groups reported higher IES avoidance symptoms than controls immediately after the earthquake. The schizophrenia group also reported lower approach coping, self-esteem, and social support than controls, with the bipolar group reporting intermediate levels. Within the schizophrenia group, higher levels of avoidance coping predicted higher residual stress symptoms at follow-up. Results support the validity of prior reports of altered responses to stressful life events in schizophrenia and demonstrate the clinical relevance of individual differences in coping among affected individuals.