| Description |
The purpose of this study was to describe self-regulation processes individuals with schizophrenia used to understand their illness, manage symptoms, and maintain wellness. Theories of illness cognition and stress vulnerability served as guides for selection of study variables. A cross-sectional, descriptive design was used to determine subjects' beliefs about and experiences with their illness. Data were collected on measures of illness representation (Illness Perception Questionnaire [IPQ]), early warning symptoms (Early Symptom Scale [ESS]), daily hassles (Daily Hassles Scale-Revised [DHS-R]), mood (Profile of Mood States-Short Form-[POMS-SF]), current symptoms (Psychiatric Assessment Scale [PAS] and the Symptom Scale of the IPQ [IPQ-S]). Semistructured interviews provided information about illness history, knowledge of illness processes, and learned methods for illness management. Sixty-nine subjects were recruited from five settings. Their mean age was 44.3 years; 54% were female, and 86% were single, divorced, or widowed. Forty-nine percent were diagnosed with schizophrenia, 36% with schizo-affective disorders, and 14% with psychosis, NOS. Average years of treatment were 19.2 and mean number of hospitalizations were 6.14. The IPQ measured subjects' beliefs about cause, time line, consequences, and control/cure of their illness. Causes were attributed to stress, heredity, state of mind, and other people. Subjects noted consequences from their long-term illness but believed they could control aspects of their illness. Internal consistency reliability was noted for consequences and symptom subscales only. Subjects selected similar symptoms across mood states, early warning symptoms, and current symptoms. Common experiences were trouble concentrating, difficulty remembering things, depression, worry, fatigue, tension, and nervousness. Subjects reported daily hassles concerning weight; trouble relaxing; regrets over past decisions; troubling thoughts about the future; being lonely; trouble with spelling, reading, and arithmetic; and filling out forms. Study variables that correlated with IPQ consequence and symptoms subscales were DHS-R and three subscales of the POMS-SF (e.g., fatigue, tension, and confusion). Illness histories noted symptom awareness, consequences, and efforts to control symptoms. Self-regulation activities suggested subjects used early warning symptoms, stress reduction activities, and help seeking from providers or self-help groups. The cross-sectional design of the study did not allow for prospective confirmation of subjects' self-regulation activities during illness instability. |
