A naturalistic study on the relationship among resilient factors, psychiatric symptoms, and psychosocial functioning in a sample of residential patients with psychosis

Abstract

ObjectiveResilience is a multidimensional process of adaptation aimed to overcome stressful or traumatic life experiences; only in the last few years it has been considered as a personal resource in psychosis and schizophrenia. This study aimed to assess the relationship between intrapersonal and interpersonal resilience factors and schizophrenia, particularly whether and how resilience can improve the course of psychotic illness.Patients and methodsIn this observational study, all patients recruited had to fulfill the following inclusion criteria: diagnosis of schizophrenia spectrum disorder (Diagnostic and Statistical Manual of Mental Disorders-5); aged between 18 and 65 years; provided written informed consent; to be clinically stable (Clinical Global Impression Scale <3); history of illness ≥5 years; to be compliant with antipsychotic therapy over the last year; and regular submission to periodic monthly psychiatric visits. Patients were evaluated through the following scales: Resilience Scale for Adults (RSA) for resilience; Brief Psychiatric Rating Scale-Anchored version (BPRS-A), Scale for the Assessment of Negative Symptoms (SANS), and Scale for the Assessment of Positive Symptoms (SAPS) for psychotic symptomatology; and Life Skills Profile (LSP) for psychosocial functioning. Statistical analysis was performed by SPSS. Partial correlations were evaluated to assess the relationship between RSA total scores and subscores and BPRS-A, SANS, SAPS, and LSP total scores, removing the common variance among variables. Then, a series of hierarchical multiple linear regression models were used to examine the association between resilience, psychopathology, and psychosocial functioning.ResultsA statistically significant negative correlation among intrapersonal resilience factors and BPRS-A total score emerged, predicting psychiatric symptoms severity and explaining approximately 31% of the BPRS-A variance; otherwise, only the interpersonal resilience factors associated with social support were statistically and positively correlated with LSP total score, predicting psychosocial functioning and explaining the 11% of LSP variance.ConclusionThe specific contribution that resilience factors may have in predicting the severity of symptoms and the extent of psychosocial functioning emphasizes the importance of personalizing treatment for patients affected by schizophrenia, promoting personal resources, and translating them into better outcomes.

<p>Resilience and recovery style: a retrospective study on associations among personal resources, symptoms, neurocognition, quality of life and psychosocial functioning in psychotic patients</p>

“…Among the personal resources, the integration recovery style was found to be significantly associated with a good functional outcome: thanks to greater acceptance of their psychotic experience and awareness of the need for support and care, the integrator patients are more likely to maintain their social role and to invest in interpersonal relationships 14,43. In spite of other research,14,22 in our study, no significant correlations between resilience and psychosocial functioning emerged, probably due to the use of a measurement tool built exclusively on the basis of individual abilities and predispositions, and not on family and external support too; indeed, some studies have highlighted the greater importance of intrapersonal resilience factors, such as family and social support, compared to intrapersonal factors in predicting psychosocial functioning 22…”

“…Resilience is the psychological competence to deal with and go beyond traumatic or stressful events, resulting in being positively changed and strengthened. In other words, resilience is the ability to repair oneself after damage, to cope, to resist something, but also to build and succeed in a positive reorganizing life, despite difficult situations 18–22. Resilient individuals have the proficiency to rebuild the relations within their environment, enhancing themselves 23.…”

Factors Associated With Psychosocial Functioning and Outcome of Individuals With Recent-Onset Schizophrenia and at Ultra-High Risk for Psychosis

“…Regarding the protective factors, resilience has been associated with social functioning in patients with schizophrenia (20, 21). Self-esteem has also been reported to correlate with social functioning in psychiatric outpatients, including those with schizophrenia (22).…”

Functioning in schizophrenia from the perspective of psychologists: A worldwide study

“…This level of agreement supports the relevance of personal factors to the assessment and treatment of individuals with schizophrenia. Personal factors, such as resilience [36,37], premorbid cognitive skills [38], premorbid social skills [39], personal history and biography [40], premorbid drug use and lifestyle [41], and premorbid personality [42] have been considered to influence how people with schizophrenia cope with their illness. Most of the categories that psychologists regarded as important coincide with those identified in the validation study from the perspective of psychiatrists [14], suggesting that the proposed list of Personal factors captures the aspects that merit particular consideration in this population.…”