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Stress and coping have been found to be strongly associated with quality of life (QOL). Compared to community controls (CC), individuals diagnosed with schizophrenia (SZ) report a lower QOL. Lower QOL in SZ may be explained by patients' tendency to react differently to stress and to use less effective coping strategies than CC, but no studies to date have examined these possible associations. A main goal of this study, therefore, was to examine the roles of stress response and coping style in explaining QOL in SZ and CC, while controlling for potential confounds including personality. Subjects were 30 SZ patients and 29 matched controls who completed the Trier Social Stress Test (TSST). Salivary cortisol was used as an objective measure of stress response. Participants rated their coping strategies with the Brief COPE, judged their QOL with the Satisfaction with Life Scale, and rated their personality using the NEO-Five Factor Inventory. Results indicate that, even when confounds are controlled for, blunted cortisol response predicts better QOL in SZ patients. Additionally, results suggest that more frequent use of coping strategies is associated with better QOL but only in patients with blunted cortisol response; those who showed an increase in cortisol in response to the TSST have better QOL the lower their coping score. Possible explanations and clinical implications of these findings are discussed., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Psychotic symptoms are exacerbated by stressful life events in schizophrenia patients as a group. Some individuals appear to be more vulnerable than others in this regard. This study tested whether schizophrenia patients are highly emotionally reactive compared with controls and whether the level of trait emotional reactivity in patients influences the degree to which they respond to life stressors with exacerbations of psychosis. Schizophrenic outpatients and nonpsychiatric controls were assessed for levels of trait emotional reactivity, arousability, and trait anxiety. Severity of symptoms was also rated in the patients. Patients were then followed up 9 months later, assessed for independent stressful life events occurring during the month before the follow-up session, and reassessed for symptom levels. The patients scored higher than the control subjects on all 3 measures of reactivity at the initial assessment. At follow-up, the occurrence of potentially stressful life events predicted increases in psychotic symptoms in patients, and there was a significant interaction between level of initial trait reactivity and the occurrence of life events in the prediction of these increases. High-trait-reactive patients showed increases in psychotic symptoms in response to life stressors, whereas low-trait-reactive patients did not. These findings support the idea that patients as a group have higher than normal levels of trait reactivity and also that patients with very high levels of trait reactivity are at elevated risk of psychotic relapse under stress. Such patients might benefit particularly from interventions designed to assist them in coping with potentially stressful life events and circumstances.

Introduction: Many recent studies have found that, although schizophrenia patients tend to display diminished facial expressions of emotion, they report levels of emotional experiences that are similar to those of controls. Although these findings are very informative, it is unknown whether such dissociation exits for other modalities such as verbal expression of emotion. The purpose of this study was to investigate the association between the use of emotion words during a free speech task and subjective experience of emotion in schizophrenia patients and controls., Methods: Speech samples of 48 schizophrenia patients and 48 nonpsychiatric control individuals were compared on the type and amount of emotional words used, as well as on the level of self-reported stress experienced while providing descriptions of themselves., Results: Groups did not differ in the amount or type of emotion words uttered during the free speech task. Patients, however, found the task more stressful than controls. Emotion word use and subjective emotional experience were not related in either group., Conclusions: Results do not fully support prior findings, but are consistent with the notion of a lack of correspondence between the expression and experience of emotion.

Over the past 50 years, parents have become more involved in the care of their schizophrenic sons and daughters. Although such responsibility can be gratifying, parents frequently report feeling burdened and distressed. These feelings may affect parents' coping strategies in times of stress. This study examined the effects of family history of psychosis on coping styles in parents of patients. Coping strategies of parents with and without additional first-degree relatives suffering from psychosis (besides the index son or daughter) and controls were compared. As predicted, more family history of psychosis was negatively related to coping ability in parents. Findings suggest that greater familial exposure to psychosis may have an adverse effect on their ability to deal with life stressors. Results are discussed in light of the possible influence of genetic and environmental factors.

Objective: Cognitive impairments associated with schizophrenia might be expected to have a marked impact on the ability to produce coherent speech, yet associations between cognitive performance and speech disorder have typically been weak. Findings on this question may have been limited by measurement methods and by the heterogeneity of speech disorder. This study examined the contributions of impairments in sustained attention and sequencing abilities to schizophrenic speech disorder, measured in terms of communication failures and divided into different types of disorder., Method: Samples of natural speech were collected from severely ill inpatients with schizophrenia and nonpsychiatric comparison subjects and rated for frequencies of six types of communication failures: four structural and two nonstructural types. Subjects also completed a battery of cognitive tests assessing several facets of attention and sequencing ability. Hierarchical regression was used to identify cognitive contributors to communication failures., Results: Impaired sustained attention was associated with more frequent structural and nonstructural communication failures. As predicted, impaired sequencing, and in particular conceptual sequencing, also made a substantial contribution to the structural communication failures, but not to the nonstructural ones. These findings held when global level of impairment was controlled statistically. Performance on the tests of attention and sequencing explained 56% of the variance in structural speech disorder., Conclusions: Schizophrenic speech disorder is heterogeneous in form and in cognitive underpinnings. Impairments in attention and sequencing abilities are highly predictive of communication failures related to language structure.

Some studies have found that the speech of certain schizophrenia patients becomes more disordered in stressful laboratory situations. It is unknown, however, whether affective reactivity of speech is associated with stress responsiveness of symptoms in the real world. This study examines whether language-reactive patients report more stress-related impairments in work functioning than language-nonreactive patients. Forty-six patients provided speech samples and completed a work history interview. It was found that the language-reactive patients were more likely than the language-nonreactive patients to endorse items pertaining to social anxiety and difficulty relating to others as reasons for their work difficulties. This suggests that language-reactive patients are more sensitive to social stressors than language-nonreactive patients.

Unlabelled: Several studies have shown that patients with schizophrenia are more likely to be born in the winter and early spring than at any other time of the year. Furthermore, some studies have reported that winter-born patients differ from non-winter-born patients in terms of risk factors, symptoms, sensory abnormalities and brain morphology. Associations between season of birth and premorbid adjustment (PMA), however, are still unclear., Objective: The main purpose of this study was to determine whether winter-born and non-winter-born schizophrenia patients differ in terms of PMA and to examine how family history of schizophrenia-spectrum disorders may influence the association., Method: Data on four PMA dimensions (attention, internalizing, externalizing and social problems) and family history were gathered from 37 schizophrenia patients (26 males and 11 females) and their mothers., Results: Non-winter-birth and a positive family history of schizophrenia-spectrum disorders were associated with worse PMA. Results suggest that, although no significant interaction was found, season of birth and family history appear to work together in explaining distinct dimensions of PMA.