Background: Epidemiological data indicate that 75% of subjects with major psychiatric disorders have their onset of illness in the age range of 17-24 years. An estimated 35-50% of college and university students drop out prematurely due to insufficient coping skills under chronic stress, while 85% of students receiving a psychiatric diagnosis withdraw from college/university prior to the completion of their education. In this study, we aimed at developing standardized means of identifying students with insufficient coping skills under chronic stress and at risk for mental health problems. Sampling and Methods: A sample of 1,217 college students from 3 different sites in the USA and Switzerland completed 2 self-report questionnaires: the Coping Strategies Inventory (COPE) and the Zurich Health Questionnaire (ZHQ), which assesses ‘regular exercises', ‘consumption behavior', ‘impaired physical health', ‘psychosomatic disturbances' and ‘impaired mental health'. The data were subjected to structure analyses by means of a neural network approach. We found 2 highly stable and reproducible COPE scales that explained the observed interindividual variation in coping behavior sufficiently well and in a socioculturally independent way. The scales reflected basic coping behavior in terms of ‘activity-passivity' and ‘defeatism-resilience', and in the sense of stable, socioculturally independent personality traits. Results: Correlation analyses carried out for external validation revealed a close relationship between high scores on the defeatism scale and impaired physical and mental health. This underlined the role of insufficient coping behavior as a risk factor for physical and mental health problems. Conclusion: The combined COPE and ZHQ instruments appear to constitute powerful screening tools for insufficient coping skills under chronic stress and for risks of mental health problems.

Using speech samples of 100 patients suffering from schizophrenia, bipolar illness and major depression, we addressed the question of the extent to which the linguistic abnormalities in the speech of these patients represent diagnosis-specific characteristics or constitute independent, syndrome-like dimensions of the illnesses. All speech samples were transcribed by a professional linguist who was blind to both identity and diagnosis of the patients. The majority of the deviant linguistic variables was found to be common to all three diagnostic groups under comparison, while only a few linguistic variables exhibited statistically significant between-group differences. On the other hand, when the respective variables were analysed as a multivariate entity, the variety of subtle between-group differences allowed us to discriminate between the diagnostic groups at an overall performance of 72.7% correctly classified patients. There was an almost complete lack of association between linguistic abnormalities and psychopathology syndromes. In particular, we found no correlation between the syndrome ‘formal thought disorder’ and the large variety of linguistic variables used in this investigation. In consequence, we conjecture that linguistically deviant speech characteristics represent an independent syndrome complex manifested at varying intensities across mental illnesses, and that this syndrome complex deserves greater attention, not only with respect to the principal understanding of the underlying disturbances, but also as a potential target of therapeutical intervention.

The question of how to quantify insufficient coping behavior under chronic stress is of major clinical relevance. In fact, chronic stress increasingly dominates modern work conditions and can affect nearly every system of the human body, as suggested by physical, cognitive, affective and behavioral symptoms. Since freshmen students experience constantly high levels of stress due to tight schedules and frequent examinations, we carried out a 3-center study of 1,303 students from Italy, Spain and Argentina in order to develop socioculturally independent means for quantifying coping behavior. The data analysis relied on 2 self-report questionnaires: the Coping Strategies Inventory (COPE) for the assessment of coping behavior and the Zurich Health Questionnaire which assesses consumption behavior and general health dimensions. A neural network approach was used to determine the structural properties inherent in the COPE instrument. Our analyses revealed 2 highly stable, socioculturally independent scales that reflected basic coping behavior in terms of the personality traits activity-passivity and defeatism-resilience. This replicated previous results based on Swiss and US-American data. The percentage of students exhibiting insufficient coping behavior was very similar across the study sites (11.5-18.0%). Given their stability and validity, the newly developed scales enable the quantification of basic coping behavior in a cost-efficient and reliable way, thus clearing the way for the early detection of subjects with insufficient coping skills under chronic stress who may be at risk of physical or mental health problems.

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