Psychological models of schizophrenia and other psychotic disorders suggest that poor coping responses to life stressors and to symptoms of illness is central to their development and maintenance and influences recovery. These models are widely accepted and inform psychological treatments for psychotic disorders. In this paper, 85 studies that explore how individuals with established psychotic disorders cope with symptoms associated with their illness, and with independent life events and stressors are comprehensively reviewed. Reviewed research included cross-sectional and longitudinal investigations of self-initiated coping. Despite limitations in the existing research, it is concluded that most individuals experiencing psychosis implement at least one strategy to cope with symptoms, and life events and most implement more than one strategy. It appears that having a repertoire of strategies to employ leads to greater effectiveness than simply relying on one strategy. This suggests that treatment strategies that aim to enhance the coping of individuals with psychosis should emphasize the development of a range of coping strategies. It also seems that there is no one coping strategy that is universally effective and situational, or other factors may influence both the choice of coping strategy implemented and its efficacy.
Caring for a family member or friend dying of cancer can be extremely stressful. Past research identified that lay caregivers frequently report unmet needs related to guidance and support to assist them to provide care. This study sought to extend prior needs-based research towards the development of a new nursing intervention focused on the guidance and support provided to persons caring for a relative or friend dying of cancer. Focus groups were conducted with current lay caregivers, bereaved lay caregivers and palliative care nurses. The findings endorsed the applicability of previous caregiver need research to the Australian context. Participants revealed that caregivers were commonly unprepared for their role and desired much more guidance and support from health professionals. Importantly, the research provided the essential ingredients for the future development of a new intervention aimed at augmenting home lay palliative caregiver guidance and support.
A growing body of research indicates that the stress system, and its interactions with the immune system, play a pivotal role in the aetiology and progression of rheumatoid arthritis (RA). The stress system has multiple levels and comprises physiological, psychological and environmental components. However, most investigations in RA that involve the stress system tend to focus on the interrelationships between neuroendocrine and immune function, and related disease activity, with little regard for the role of other aspects of stress system activation, including psychological variables. This is despite the fact that psychological stressors, and related psychological variables, are known to influence RA disease activity. This article aims to explore the multiple levels of stress system activation and how they may ultimately influence disease-related outcomes in RA. Some measurement issues of psychological stress will also be examined.
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