Similarities and Differences of Strategies between Bipolar and Depressive Disorders on Stress Coping

The relationship between insight and coping attitudes in bipolar disorder patients

Bipolar disorder is thought to determine the insights and coping attitudes that affect a patient's compliance with treatment, which can positively affect the prognosis of the disease. This study aimed to investigate the relationship between insight and coping attitudes in bipolar disorder patients. This descriptive study was carried out with 127 volunteer patients who were diagnosed with bipolar disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and who were in a euthymic state. The Personal Information Form, Beck Cognitive Insight Scale (BCIS) and Scale of Coping Attitudes (COPE) were used as data collection tools. We found positive correlations between the total COPE score, the total BCIS score and the self-reflectivity subscale score of the BCIS. A positive and significant correlation was also determined between the BCIS subscales and total scores and coping attitudes toward adaptation with the COPE subscales (p < 0.05). A positive and significant relationship was found between the insight scores and total coping scores of the patients and their coping attitudes toward adaptation. We found that when patients' levels of insight increased, their coping attitudes toward adaptation were used more frequently. This study revealed that individuals with high self-reflectivity can cope more effectively with the situations they face.

Experiences of nurses providing care to hospitalized patients with acute mania in Türkiye: A phenomenological study

The main purpose of this study was to determine the experiences of nurses who care for hospitalized patients experiencing an acute manic episode. This qualitative study was carried out with 15 nurses working in a psychiatric ward in Türkiye. Data were collected through semi-structured in-depth individual interviews and focus-group interviews in which the face-to-face interview technique was used. Two main themes emerged from the analysis of the qualitative data: (1) the difficulties experienced and (2) the most effective elements of care. Under the first main theme, the following sub-themes emerged: difficulties in setting boundaries, safety concerns, difficulties in managing the patient's demands, inability to choose the appropriate word(s), and the "emotional whirlwind" experienced. The second main theme, on the other hand, included the following sub-themes: meeting basic needs, ensuring treatment compliance, encouragement to engage in physical activity, and having a sufficient number of qualified personnel. The study revealed that the nurses had difficulties in caring for their manic patients. On the basis of these results, it is recommended that nurses be given counseling and training on setting boundaries, ensuring safety, managing the patient's demands, coping with their own emotions, and communicating better. In addition, the study identified the importance of nursing interventions to meet patients' basic needs, encourage them to engage in physical activity, and ensure treatment compliance, and the importance of there being an adequate number of qualified personnel. These results may help students and other nurses in terms of assessing and setting priorities in cases needing acute psychiatric care.

Coping strategies and adherence in people with mood disorder: a cross-sectional study

Introduction

Non-adherence to treatment recommendations is a significant problem, as it contributes to the progression of the disease and to the exacerbation of distressing symptoms. Failure to cope with the disease and elevated levels of stress, in turn, influence the choice of strategy for coping with a difficult situation, and thus adherence to recommendations.

Objectives

The purpose of our study was to evaluate the impact of the subjects' stress coping styles on therapeutic adherence, life satisfaction, disease acceptance and quality of life (QoL) in people with mood disorders.

Methods

This survey-based study included 102 respondents diagnosed with mood disorders, living in the West Pomeranian Voivodeship. It was performed using the sociodemographic questionnaire and standardized tools: The Coping Inventory for Stressful Situations (CISS), The Satisfaction with Life Scale (SWLS), The Short Form-36 (SF-36) Health Survey, The Adherence to Refills and Medication Scale (ARMS), and The Acceptance of Illness Scale (AIS).

Results

Some 47.06% of the respondents suffered from depressive disorders, while 34.31% had depression or mixed anxiety disorder. Patients who made greater use of an emotion-focused style were found to have significantly lower life satisfaction than other patients. Moreover, this style was related to such SF-36 domains as general health, social functioning, role emotional, vitality, and mental health, as well as to physical component summary (PCS) and mental component summary (MCS).

Conclusion

Treatment non-adherence is a serious challenge in the treatment of patients with mood disorders. Individuals who do not adequately follow treatment recommendations often resort to alternative activities as a mechanism for coping with difficult situations. Patients who predominantly adopt an emotion-oriented coping style tend to experience lower life satisfaction and greater difficulty accepting their condition compared to their peers. Conversely, patients who adopt a task-oriented coping style report better quality of life than those who rely on emotion-oriented coping or alternative activities.

Adaptation of Questionnaire about Aggressive Beliefs and Attitudes in Spanish Adolescents

Aggressive beliefs and attitudes are increasingly present in adolescents, and it can be argued that they are a prevalent feature of adolescence. Michel, Pace, Edun, Sawhney, and Thomas’s (2014) original thirty-item scale was later shortened to a more parsimonious eight-item scale (ABA-SF). This study addresses the adaptation and validation of the brief Aggressive Beliefs and Attitudes Scale to Spanish adolescents. The sample comprised a group of Spanish adolescents (N = 771, M age = 14.01 years). A total of two studies were undertaken: (1) the scale was translated into Spanish and its internal consistency, factorial structure and convergent validity were established; and (2) factorial analysis was undertaken to confirm the questionnaire. The results yielded high scores for internal consistency, reliability (α = 0.82; Ω = 0.83) and convergent validity. The examination of the underlying nomological network revealed links with positive and negative feelings, anxiety and aggression. According to the Exploratory Factorial Analysis (EFA), the aggregate variance of the factors in the scale was 65.814%, indicating that they can explain variations in aggression levels in adolescents. For its part, the Factorial Confirmatory Analysis (FCA) confirmed the match between the translation and the model, leading to a sustainable model composed by the three factors identified and eight items: χ2 (17) = 30.693; p < 0.001; χ2/gL = 1.805; CFI = 0.968; NFI = 0.837; TLI = 0.944; RMSEA = 0.060, IC del 95% (0.048−0.072). The short scale is easy to understand and quick to complete and is thus considered a useful instrument to assess aggression levels in adolescents.

Cognitive attentional syndrome and metacognitive beliefs as potential treatment targets for metacognitive therapy in bipolar disorder

Most treatment guidelines emphasize the use of psychotropic drugs for both the acute and maintenance treatment of bipolar disorder (BD). However, relying only on psychotropics without adjunctive psychosocial interventions may be insufficient in treating patients with BD. Given its unique view in the explanation of psychopathological states, metacognitive therapy (MCT) might be helpful for BD. Metacognitive theory posits that psychopathology is a result of the cognitive attentional syndrome (CAS) and that it is influenced and maintained by dysfunctional metacognitive beliefs, perseverative thinking, attentional biases, and dysfunctional coping strategies. In this review, literature data regarding these areas in BD are examined. Studies suggest that perseverative thinking might be among the emotion regulation strategies endorsed in individuals with BD. Regarding attentional biases, literature data show that state-dependent, mood-changing attentional biases and a ruminative self-focused attention are present. Studies also suggest that cognitive self-consciousness is higher in BD compared to controls. It is seen that maladaptive coping strategies are frequently reported in BD, and that these strategies are associated with depression severity, negative affect and relapse risk. Studies focusing on dysfunctional metacognitive beliefs in BD reported that individuals with BD had higher scores for negative metacognitive beliefs, self-consciousness, need to control thoughts, and a lack of cognitive confidence. Also, dysfunctional metacognitive beliefs were associated with depressive symptomatology. These findings suggest that the components of CAS and dysfunctional metacognitive beliefs are evident in BD. For a subgroup of patients with BD who fail to respond to evidence-based psychopharmacological and adjunctive psychotherapeutic interventions, MCT might be an alternative way to consider as a treatment option. In conclusion, taken the available data together, we propose a sequential treatment protocol for BD, mainly based on the MCT treatment plan of depressive disorders.

The Impact of Coping Strategies on Suicide Attempts and Suicidal Ideation in Bipolar Disorder

ABSTRACT

The stress coping strategies of patients with bipolar disorder (BD) may affect their suicide risk. We examined coping behaviors and impact of coping strategies and clinical characteristics on suicide attempts and lifetime suicidal ideation in patients with BD I, compared with a healthy control group. We recruited 185 euthymic patients with BD and 94 healthy controls. Participants completed the Coping Orientation to Problems Experienced Inventory. Suicide attempt prevalence in patients with BD was around 34%, and frequency of lifetime suicide ideation was around 60%. Binary logistic regression analysis revealed greater use of behavioral disengagement and religious coping strategies among patients with BD, compared with controls. Patients with previous suicide attempts presented a more severe illness course, notably early onset, with more depressive and mixed episodes and a more dysfunctional coping style than nonsuicidal patients. Behavioral interventions can target avoidant coping behavior, such as denial, especially in patients with suicide attempts.

Psychometric Properties of Behavioral Checklist for Coping with Stress in Patients with Mood Disorders

OBJECTIVE

Even though the importance of stress-coping, there is no reliable and valid scale to measure the stress-coping behavior yet. The purpose of this study is to explore the psychometric properties of Behavioral Checklist for Coping with Stress (BCCS).

METHODS

A total of 458 subjects including healthy subjects and patients with bipolar or depressive disorders were analyzed. The reliability and validity of BCCS were examined by Chronbach's alpha and exploratory factor analysis using Principal Component Analysis. In order to evaluate criterion-related validity, the Pearson's correlation analyses between factors of BCCS and relevant scales were performed.

RESULTS

BCCS showed good Chronobach's alpha (0.695-0.833) and had acceptable validity. Factor 1 and factor 4 of BCCS were negatively correlated with depression, anxiety and positivity correlated with task and problem-solving, avoidance, tension-releasing copings in common. Factor 2 and 3 were positively correlated with impulsivity, emotionality, avoidance, behavioral and verbal aggression and tension-releasing copings in common. Different from factor 2, factor 3 was positively correlated with depression, anxiety and anger-suppression.

CONCLUSION

The results of this study suggest that this BCCS might be a reliable and valid scale for measuring stress-coping behaviors. This scale could facilitate research to investigate clinical implications related to behavioral stress-coping.