Abstract
Background. Cognitive models of psychosis propose that coping responses to psychotic experiences (PEs) play an important role in the development of need-for-care. One limitation of the existing literature on coping with PEs is that studies focus primarily on clinical groups, and comparisons are usually made to healthy groups without PEs. Individuals with persistent PEs who do not experience distress or impairment are also highly pertinent to understanding factors that protect from need-for-care in the context of PEs. We therefore aimed to identify and summarise literature exploring the coping responses of healthy individuals with PEs.Methods. We systematically reviewed quantitative, qualitative and mixed methods studies exploring coping either solely in nonclinical individuals with persistent PEs or studies comparing these individuals with a clinical group.
Results. Seventeen studies met the inclusion criteria. Most studies met the majority of quality criteria as assessed by the Mixed Methods Appraisal Tool (MMAT; Hong et al.,2018). Findings indicated that PEs are responded to with different types of engagement in the clinical and nonclinical groups. Safety seeking behaviours were more commonly reported by clinical individuals, with less consistent findings for distraction. More neutral/mindful types of responding were found to be more commonly associated with nonclinical group membership. For reappraisal,findings were inconclusive. The differing methods of measuring coping across studies were a key limitation of the existing literature, and this may account for some inconclusive findings.
Conclusions. Unlike previous findings on symptomatic coping styles suggesting that engaging and getting involved in the content of PEs is maladaptive, this review suggests that it is possible to engage with PEs in a healthy way, from a relative position of control. Disengaging response styles are likely to be more helpful from a position of acceptance of experiences rather than resistance/avoidance. It is likely that group differences in perceived controllability, perceived threat, and phenomenology of PEs play a role in determining how an individual responds and whether engaging or disengaging from PEs is helpful. Future research should focus on developing a clear and comprehensive taxonomy of coping to capture the complex nature of responding across the psychosis continuum.
| Date of Award | 1 Oct 2020 |
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| Original language | English |
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| Supervisor | Emmanuelle Peters (Supervisor) & Thomas Ward (Supervisor) |