Fabian aguirre austin psychology therapist university of texas


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Fabian Aguirre Austin a Psychology Therapist. Fabian Aguirre counselor of students.Fabian Aguirre recently received his PhD in the field of psychology. Fabian has received training from some of the top researchers affiliated with the University of California, Los Angeles and the University of Texas at Austin. He has a range of experiences in a number of areas, including (1) program development and coordination in academic and research settings; 2) independently teaching at a University level; and 3) working with students of various cultural and ethnic backgrounds.

Fabian has been actively involved in multiple programs geared toward facilitating the education process among underrepresented students, such as 1) Cal-SOAP, a program designed to provide students with resources to assist in post secondary education, 2) Latino Leadership Council, an organization designed to unite and empower Latino students and student organization, and 3) Summer Undergraduate Research Program, a program aimed at providing hands-on training that will give underrepresented students a competitive edge when applying to top doctoral training programs.

Fabian is a strong advocate of higher education. He grew up in a small, Mexican, migrant community in central California where education was not highly valued and access to quality education was nonexistent. Fabian, like many first-generation college students, could not consult with family member about higher education. In turn, he had to overcome many educational challenges and is willing to provide academic advice to students seeking higher education in Liberal Arts.

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Fabian aguirre austin psychology therapist university of texas

  1. 1. CALIFORNIA STATE UNIVERSITY, NORTHRIDGE COPING STRATEGIES IN PERSONS WITH SCHIZOTYPY A thesis submitted in partial fulfillment of the requirementsFor the Master of Arts degree in Psychology, Clinical Psychology By Fabian Aguirre June 2006
  2. 2. The thesis of Fabian Aguirre is approved:________________________________________ ____________________Mr. Andrew Ainsworth Date________________________________________ ____________________Dr. Dee Shepherd-Look Date________________________________________ ____________________Dr. Mark Sergi, Chair Date California State University, Northridge ii
  3. 3. Acknowledgements I would like to acknowledge all the faculty and staff in the psychology departmentat California State University, Northridge. The faculty members have played an integralrole in my professional development. I acknowledge Dr. Mark Sergi for all his help andsupport. As my thesis adviser, Dr. Sergi has guided my growth from a student writing areport to a scholar writing an academic thesis. Not only is he a mentor, Dr. Sergi is trulyan aspiration in the research development of persons with schizotypy. His expertise inthis area led me to be more interested in psychosis prevention. I would also like to acknowledge Dr. Dee Shepherd-Look. Her kindness and goodheartedness aided my development not only as a professional but also as a person.Through her practicum, I received a genuine feel and understanding of the challengesfaced by parents with special need children. This experience also enabled me to see theimpact we, as professionals in psychology, have on people’s lives. I would further like to acknowledge, Professor Andrew Ainsworth. He introducedme to the world of statistics. His energy and enthusiasm for such a dry topic was soinfectious and enjoyable that I actually took an additional course that did not counttowards my course requirements. I admire Mr. Ainsworth as a professor and consider hima friend. Additionally, I would like to acknowledge all the other professors within theirspecialties; Dr. Donald Butler, Dr. Ronald Doctor, Dr. Jean Elbert, and Dr. LucianaLaganá. They have all been instrumental to my education. Lastly, but not least, I wouldlike to acknowledge all the research assistants in Dr. Sergi’s lab. It was through their hardwork and dedication that this thesis project was made possible. iii
  4. 4. Table of ContentsSignature Page iiAcknowledgements iiiAbstract viChapter 1: Introduction 1 a. Schizotypy 1 b. Coping & Stress 2 c. Assessing Coping Strategies 4 d. Research in Coping on the Schizophrenia Spectrum 5 e. Neurocognition and the effects on coping 6 f. Hypotheses 8Chapter 2: Methods 9 a. Participants 9 b. Design Procedures 9 c. Apparatus 9 d. Data Analysis 12Chapter 3: Results 14 a. Demographics 14 b. Coping styles and schizotypy status 14 c. Cognitive appraisal and coping styles 16 d. Neurocognitive factors with schizotypy status and coping styles 16Chapter 4: Discussion 18 iv
  5. 5. References 21Appendix 26 A. Schizotypal Personality Questionnaire-Brief (SPQ-B) 26 B. Revised Social Anhedonia Scale (R-SAS) 28 C. Coping Response Inventory (CRI) 30 D. Cognitive Appraisal of Life Events Scale (CALES) 37 v
  6. 6. ABSTRACT COPING STRAGIETS IN PERSONS WITH SCHIZOTYPY By Fabian Aguirre Master of Arts degree in Psychology, Clinical PsychologyAmple studies have shown that persons with schizotypy are very similar to individualswith schizophrenia. However, little is known about the way persons with schizotypy usecoping strategies. This study compares 71 college students, identified as either high orlow in schizotypy with the use of the Schizotypal Personality Questionnaire-Brief (SPQ-B), on coping strategies while controlling for cognitive appraisal and neurocognition. Wefound that, when controlling for cognitive appraisal, persons high in schizotypy weresignificantly more likely to use avoidance coping than persons low in schizotypy.However, persons high and low in schizotypy show little to no difference in approachcoping. We also found that neurocognition does not correlate with coping strategies.Therefore, college students high in schizotypy may be using less effective coping, aspatients diagnosed with schizophrenia do. vi
  7. 7. Chapter 1 IntroductionSchizotypy What is Schizotypy? The personality organization schizotypy was originallydescribed by Meehl (1962) as a person who has pleasure deficits, cognitive slippage,ambivalence, and interpersonal aversiveness. These individuals may experience ideas ofreference, magical thinking, unusual perceptual experiences, eccentric behavior orappearance, suspiciousness/paranoia, disorganized/odd speech, constricted affect,excessive social anxiety, and a dearth of social relationships (Meehl, 1990). Thisschizotypic behavior may be observed within the normal population and, by itself, does notnecessarily cause dysfunction. Thus, schizotypy is a dimensional clinical construct, not acategorical psychiatric diagnosis. Schizotypy on the schizophrenia spectrum. In the field of research, schizotypy isconceptualized as involving mild symptoms of Schizotypal Personality Disorder (SPD) andschizophrenia. Hence, schizotypic behavior may represent the prodromal manifestations ofschizophrenia or the less impairing SPD (Claridge, 1994; Claridge & Beech, 1995).Persons with schizotypy may be assigned the diagnosis of SPD if their schizotypicbehaviors cause sufficient social dysfunction. In order to be diagnosed with SPD, at leastfive of the following criteria must be present: ideas of reference, odd beliefs of magicalthinking which influence behavior, unusual perceptual experiences, odd thinking andspeech, suspiciousness, inappropriate affect, odd behavior or appearance, lack of closefriends, and excessive social anxiety (American Psychiatric Association, 1994). While 1
  8. 8. SPD affects approximately three percent of the U.S. population, it is estimated that at leastfive to ten percent of the population possess traits of schizotypy. Furthermore, persons with schizotypy may reflect the initial stages of schizophrenia(Horan et al., 2004; Meehl, 1990) and are considered to fall within the schizophreniaspectrum. Research has shown that persons with schizotypy present the same positivesymptoms, negative symptoms, and cognitive deficits of patients with schizophrenia,except, with a lesser severity (Matsui et. al., 2004). For instance, patients withschizophrenia will experience positive symptoms, such as hallucinations and delusions,and negative symptoms, such as flat affect, which disrupt their everyday living ability.Schizotypy individuals, however, may believe that people can read his or her mind, but thisthought does not impede upon their daily functioning. These schizotypy individuals do notbecome consumed by this belief to the point of wearing a hat made to foil to keep peoplefrom reading his thoughts. For this reason, persons with schizotypy are considered tobelong within the schizophrenia spectrum. Thus, due to the dearth of research onschizotypy subjects in respect to coping and stress, studies on patients with schizophreniawill drive expected similar findings with schizotypy individuals.Coping & Stress The relationship between coping styles and mental/physical health has grown asan area of investigation over the past 20 years (Somerfield & McCrae, 2000). It has beenaccepted that coping and stress are strongly related. People become more stressed whentheir efforts (cognitive and behavioral) are not able to manage the external or internaldemand (Lazarus & Folkman, 1984). For example, John is uninsured and drives his carinto a rail. In this case, John needs money to repair the damage to his car (external 2
  9. 9. demand). If John has the necessary financial resources (efforts) to meet the externaldemand, then this event will not be stressful. However, if John does not have the financialresources, then John will experience a great deal of stress because his efforts did not meetthe external demand. Aldwin (1994) stated two purposes of coping research: 1) to understand whypeople differ so greatly in how they cope with stress and 2) to understand how differentresponses relate to well-being. These two purposes have lead researchers to investigatethe importance of coping and the impact of stress on individuals with mental disorders.Various studies have looked at particular mental illnesses to assess the role of coping andstress. Ventura & Liberman (2000) state that all biomedical disorders are stress-relatedbiological illnesses. They reason that stressors impinge on the individual, triggeringepisodes of symptom exacerbation, dysfunction, and hospitalization. Take bacterialinfections for instance. Campisi et al. (2003) showed that stress-induced rats were moresusceptible and took longer to recover from the bacteria injected into their bodies.Although this cannot be tested on humans, for ethical reasons, theories have alsosupported the idea that stress can exacerbate symptoms. For example, it has beenaccepted for many years that stress influences the onset and course of schizophrenia(Ventura & Liberman, 2000). This vulnerability-stress model asserts that schizophrenia isnot purely genetic. Zubin and Spring (1977) theorized that some individuals have apredisposition (genetic vulnerability) to schizophrenia that is triggered by anenvironmental stressor. 3
  10. 10. To illustrate, suppose Matthew has a genetic vulnerability of schizophrenia sincehis grandfather (who he never met) was diagnosed with this disorder. Matthew led anormal life until the age of 18, when he started college. In college, Matthew becameoverwhelmed and stressed with the adjustment to college life. These environmentalstressors triggered Matthew’s delusions of aliens stealing his ideas. This sparks twoimportant questions: (a) would Matthew have developed delusions if he knew how toproperly cope with his environmental stressors, and (b) how do we identify theseindividual prior to the onset of psychotic symptoms?Assessing Coping Strategies Since stressful events can exacerbate symptoms, successful coping strategiesseem to be a protective factor (Ventura et al., 2002). Before any coping intervention canbe used on this population, we have to assess coping styles in this population. There arevarious ways to assess coping. One theory distinguishes problem-focused coping fromemotion-based coping. Problem-focused coping focuses on the evaluation of the situationand the creation of possible solutions that actively reduce the level of stress. In contrast,emotion-based coping centers on how the individual changes his or her feelings about thestressful situation (Carver et al., 1989). Moos and Schaefer (1993) developed an alternative model that distinguishesbetween approach-coping and avoidance-coping. In approach-coping, the individual usescognitive and/or behavioral attempts to resolve the conflict situation. In contrast,avoidance coping involves minimizing the importance of the stressful event or distractingoneself from the stressful event. Moos (2002) found that using approach-coping strategies 4
  11. 11. contributes to favorable outcomes and avoidance-coping strategies generally indicateworse outcomes.Research in Coping on the Schizophrenia Spectrum Due to the scarce amount of research on schizotypy and coping strategies, areview of studies of coping in schizophrenia may improve our ability to anticipate theforms and effectiveness of coping in individuals with schizotypy. As mentioned earlier,the vulnerability-stress model asserts that a predisposition to schizophrenia andenvironmental stressors trigger the illness. Although one study found that the relationshipbetween the amount of stress and relapse to be relatively weak (Hirsch et. al, 1996),recent studies have shown that stressful events indeed increase the risk of psychosis andexacerbate psychotic symptoms (Ventura et al., 2002). Therefore, when assessing copingstyles in a sample, the experimenter must control for the amount of stress that is reportedby the experimental and comparison groups. In addition, research has established that patients with schizophrenia fail to useappropriate coping strategies in response to stressful events. For instance, Horan et al.(2003) found that maladaptive coping approaches associated with emotional responses topsychosocial stressors are one of the dividing factors among patients with schizophreniaand the general population. Hence, patients with schizophrenia are less able to cope withstressful situations. This lack in coping ability has been linked to an increase in theirpsychotic symptoms. Because of these findings, researchers’ efforts have been spent onreducing stressful events to decrease psychotic symptoms. However, most of their effortsare geared toward establishing effective coping mechanisms in response to stressfulsituations, since such situations are unavoidable. Various studies indicate that coping 5
  12. 12. interventions reduce stress (Ponizovsky et al., 2004), as well as symptoms and thelikelihood of rehospitalization (Norman et al., 2002). In the Norman et al. (2002) study,they found that training in stress management provided the patient with additionalstrategies for coping, which in turn reduced the possibility of subsequent symptomexacerbations and reduced the risk of rehospitalization. The limited studies of coping inschizophrenia have examined approach- and avoidance-coping. These studies have foundthat patients with schizophrenia frequently utilize more avoidance-coping and lessapproach-coping (Hultman et al., 1997; Jansen et al., 1999; van den Bosch et al., 1992;Ventura et al., 2004). Furthermore, Ventura et al. (2004) revealed that normal controlsused significantly more approach coping strategies than patients with schizophrenia. These findings suggest that approach-coping is successful coping, whileavoidance-coping may increase psychotic symptoms and rehospitalization. However,there is a scarcity of research on the evaluation of coping skills among the lesssymptomatic and more functional schizotypy population. One study found that patientsdiagnosed with Paranoid Personality Disorder (PD), Schizoid PD, or Schizotypal PD,seek less social support and utilize more avoidance coping strategies (Bijttebier et al.,1999). This intriguing finding points to the need for further study of coping in schizotypy.By examining the coping of persons with schizotypy we will determine whether they“overuse” avoidance-coping strategies and “under use” approach-coping strategies aspersons with schizophrenia reportedly do.Neurocognition and the effects on coping Coping may be influenced by neurocognitive abilities. Many domains ofneurocognition are impaired in schizophrenia, and these deficits result in impaired social 6
  13. 13. functioning (Green, 1996; Green et al., 2000). For instance, Green (1996) concluded thatsecondary verbal memory and sustained attention (vigilance) were significant predictorsof social problem solving. This leads us to expect that neurocognitive factors mightcontribute to the use of distinctive coping strategies. Recent studies identify a strongcorrelation between neurocognition and approach coping, but not for avoidance coping.Ventura et al. (2004) found that low self-efficacy (low appraisal of ability to handleadversity and low self-esteem) was associated with the lower frequency of approachcoping strategies. Furthermore, they found that greater cognitive capacity (e.g. executivefunctioning assessed with the WCST, secondary verbal memory assessed with the CVLT)was associated with higher rates of approach problem solving. Schizotypy and Neurocognition. Research indicates that persons with schizotypyexperience cognitive deficits similar to those experienced by persons with schizophrenia.Matsui et al. (2004) demonstrated that verbal memory and visual-motor abilities arelacking in both groups. However, schizotypy individuals did not show executivefunctioning difficulties, as did patients with schizophrenia. In fact, schizotypy individualsperform as well as the “normal” controls in executive functioning. Therefore, “cognitivedeficits in patients with schizotypal features were qualitatively similar to, butquantitatively milder than, patients with schizophrenia” (Matsui et. al., 2004). Thesequalitative deficits have also been identified in neuro-imaging findings. One study foundthat those with SPD are similar to “normal” controls in most lateral frontal regions.However, they exhibited intermediate values, which fell between “normal” controls andschizophrenic subjects in the lateral temporal regions (Buchsbaum et al., 2002). Thesestudies suggest that persons with schizotypy are in the schizophrenia-spectrum, which 7
  14. 14. encourages research of parallel dysfunctions, such as coping skills, within thesepopulations.Hypotheses The theoretical and observed links between schizophrenia and schizotypy allowone to extrapolate schizophrenia findings into predictions for studies of persons withschizotypy. In this case, coping has been more studied in schizophrenia; thus, thehypotheses of the present study are guided by the coping literature in schizophrenia. Theaims of this study are to explore coping styles in persons high in schizotypy and comparethem to persons low in schizotypy, while controlling for appraisal and neurocognitiveability. The primary hypothesis is that persons high in schizotypy will engage in moreavoidance coping and less approach coping than persons low in schizotypy (i.e., healthypersons). A secondary hypothesis is that persons high in schizotypy will perceive morestress than those low in schizotypy. It is also hypothesized that persons high inschizotypy will be impaired in neurocognition (secondary verbal memory and executivefunctioning) relative to persons low in schizotypy. However, neurocognitive functioningis not expected to effect the type of coping behaviors used by persons high or low inschizotypy. Thus, persons with better cognition will not necessarily use proportionallymore approach coping and persons with more impaired cognition will not necessarily useproportionally more avoidance coping. 8
  15. 15. Chapter 2 MethodsParticipants Approximately 1000 undergraduate psychology students attending CaliforniaState University, Northridge received the 22-item Schizoptypal PersonalityQuestionnaire-Brief Version (SPQ-B) as part of the Department of Psychology’s pre-testing. In this pre-screening, students were divided into two groups: persons high inschizotypy were identified by total SPQ-B scores that fell between 15 and 22 and personslow in schizotypy were identified by total SPQ-B scores that fell between 0 and 2. Fromthis pool, seventy-one undergraduate students (36 persons high in schizotypy and 35persons low in schizotypy) participated in this study after providing their writteninformed consent. All participants received credit in their lower division psychologycourse for participating in this study.Design Procedures In this double-blind experiment, participants completed a two-hour batteryinvolving measures of coping, neurocognition, stress and appraisal, and functional status.The battery was administrated individually in quiet cubicles by undergraduate researchassistants. The four research assistants were trained on the all measures by the thesisadvisor and required to demonstrate correct administration of the measures.Apparatus Schizotypy. Raine and Benishay (1995) created the Schizotypal PersonalityQuestionnaire-Brief (SPQ-B) as a short version of the Schizotypal PersonalityQuestionnaire (SPQ). The SPQ-B consists of 22 yes/no items, each valued with 1 or 0. 9
  16. 16. The SPQ-B contains three subscales: Cognitive-Perceptual, Interpersonal, andDisorganized. In a sample of 220 undergraduate students, Raine and Benishay reportedinternal reliabilities ranging from .72 to .80, mean of .76. The test-retest, two-month timelapse, reliabilities range from .86 to .95, mean of .90. Inter-correlations between SPQ-Bfactors and SPQ factors range from .89 to .94 (mean=.91). Criterion validity wasestablished through correlations between SPQ-B subscales and clinical interviews ofindividuals with Schizotypal Personality Disorder. They reported high correlations forthe total scale (.66), as well as the cognitive-perceptual (.73) and interpersonal (.63)subscales. However, correlations were lower for the disorganized subscale (.36). Asecond psychometrics study of the SPQ-B yielded similar findings (Axelrod et al., 2001). Negative schizotypy. The Revised Social Anhedonia Scale (R-SAS; Eckblad et al.,1982), is a 40-item true or false test, which measures social withdrawal and a lack ofinterest in pleasure from social relationships. This self-report test includes statements thatare characteristic of negative symptoms, such as “Having close friends is not as importantas many people say,” and “I prefer watching television to going out with other people.”The R-SAS will be administered as part of the test battery. The purpose of this measure isto identify the negative schizotypy among the persons high in schizotypy and comparethem to the reminding persons high in schizotypy on coping styles and neurocognition.The negative schizotypy will be grouped by R-SAS scores 16 or greater for females and20 or greater for males, due to cutoff scored based on standardization by Eckblad et al.(1982). The estimated administration time of the R-SAS is ten minutes. Secondary verbal memory. The California Verbal Learning Test (CVLT; Delis etal., 1983) assesses secondary verbal memory by asking participants to recall 16 items 10
  17. 17. from four taxonomic categories presented over a series of five trials. Each word list isread aloud by the administrator. Additional elements of the measure assess short delayfree recall, short delay cued recall (“Name as many items as you can that are Fruits?”),long delay free recall, long delay cued recall, and recognition. The estimatedadministration time of the CVLT is 15 minutes. Executive functioning. The Wisconsin Card Sorting Test (WCST-64; Heaton et al.,1993) is a measure of frontal executive functioning and problem-solving skills. Thesubject is presented with four keycards. Each card has different shapes, numbers ofshapes, and colors. The subject is required to individually match the presented stimuluscards to one of four keycards. Each card presented can be matched according to the shape,number, or color of the symbols of the existing four cards. The computerized version ofthe WCST will be administered. The WCST requires about 20 minutes to administer. Coping. The Coping Responses Inventory (CRI; Moos & Schaefer, 1993)involves 48 items, which are rated along a 4-point Likert-type scale: “0 = not at all” to “4= yes, fairly often.” The interview is based on one open-ended question: In the past 12months, have you had any situations that you thought were stressful or difficult? Thesubject then narrows down the situations to deem one the most stressful, which is used inanswering the 48 items. The CRI is a revised version from the original 72-item version.Moos and colleagues established strong reliability through Cronbach’s alpha and derivedeight dimensions of coping under two broad headings: Approach Coping Responses: (a)Logical Analysis, (b) Positive Reappraisal, (c) Seeking Guidance and Support, and (d)Problem Solving; Avoidance Coping Responses: (e) Cognitive Avoidance, (f)Acceptance or Resignation, (g) Seeking Alternative Rewards, and (h) Emotional 11
  18. 18. Discharge. The Approach Coping Responses cluster consists of items such as, “Did youtry to step back from the situation and be more objective” and “Did you tell yourselfthings to make yourself feel better?” The Avoidance Coping Responses cluster consistsof items such as “Did you try to help others deal with a similar problem?” and “Did youtake it out on other people when you felt angry or depressed?” For these dimensions,Cronbach’s alpha ranged in a sample of males (n = 1194) from 0.61 to 0.74 and infemales (n = 722) from 0.58 to 0.71. The correlations among the four approach-copingstrategies are higher in men (r = 0.29) and women (r = 0.42) than the correlations amongthe four avoidance strategies for men (r = 0.29) and for women (r = 0.24). The estimatedadministration time of the CRI is 20 minutes. Stress and appraisal. The Cognitive Appraisal of Life Events Scale (CALES;Ventura & Nuechterlein, 1994) will be used to assess stress level and appraisal style. Thisis a self-administered scale that is used to measures the subject’s perception of thestressful event. The CALES investigates eight dimensions related to the stressful qualityof the event: desirability, familiarity, controllability, predictability, preoccupation,required readjustment, coping effectiveness, and upset. The measure’s nine questions arerated from 1 to 9, with the following anchors 1 = “not at all,” 3 = “somewhat,” 5 =“moderately,” 7 = “highly,” and 9 = “extremely.” The estimated time to complete thisquestionnaire is 5 minutes.Data Analysis In this cross-sectional study of pre-existing groups, a MANOVA was used tocompare the two levels of schizotypy status on the 12 dependent variables (Approach-Coping, Avoidance Coping, CVLT total, WCST-64 total, and all eight domains of the 12
  19. 19. CALES) to control for an inflation of alpha. The analysis was followed up by ANOVAsto compare each dependent variable between persons high and low in schizotypy.Correlational analyses, Pearson product correlation coefficients were used to examinewhether neurocognitive ability was related to schizotypy status and coping. Last,ANCOVAs were used to determine if schizotypy status affects coping response whencontrolling for cognitive appraisal. 13
  20. 20. Chapter 3 ResultsDemographics Both groups shared relatively equal proportions in gender, ethnicity, age, andeducation. (See Table 1).Table 1. Sociodemographic and Clinical Characteristics of Subjects Schizotypy Group Low Schizotypy High SchizotypyCharacteristic (n=35) (n=36) N % N %Female 29 82.9 24 66.7Ethnicity African American 4 11.4 10 27.8 Armenian 1 2.9 2 5.6 Asian American 4 11.4 1 2.8 Hispanic 15 42.9 8 22.2 Caucasian 11 31.4 15 41.7 Mean SD Mean SDAge (years) 20.3 4.1 19.8 4.2Education (years) 13.0 1.0 12.5 0.9SPQ-B1 1.3 0.9 16.9 1.7R-SAS2 3.9 3.2 12.0 7.51 Schizotypal Personality Questionnaire-Brief total to 22. “0-2” (symptoms are not observed) and “15-22”(symptoms are observed).2 Revised Social Anhedonia Scale items total of “0-15 for females” and “0-19 for males” (symptoms are notobserved) and scores “ 16-40 for females” and “20-40 for males” (symptoms are observed). In Table 1 females are largely represented in both groups. This was anticipatedsince females represent the majority of students in the CSUN psychology department.Although there were no correlations between the sociodemographic factors, there wereexpected correlations among the demographic factors, such as age and education.Coping styles and schizotypy status The coping usage of persons high and low in schizotypy is displayed in Table 2.With the use of Wilks’ criterion, the combined 12 dependent variables were 14
  21. 21. Table 2. Statistics of High vs. Low Schizotypy on Coping Measures, CognitiveAppraisal, and Neurocognitive Measure Low High Schizotypy Group Schizotypy Schizotypy Main Effects n =35 n = 36 Mean (SD) Mean (SD) F df pCoping MeasuresApproach Response Coping 66.3 (11.8) 66.2 (12.7) 0.00 1,69 NS--Logical analysis 16.4 (3.1) 17.4 (3.5) 1.56 1,69 NS--Positive reappraisal 17.2 (3.9) 16.9 (4.8) 0.11 1,69 NS--Seeking guidance/support 15.4 (3.7) 14.5 (4.5) 0.80 1,69 NS--Problem solving 17.3 (4.0) 17.4 (3.5) 0.02 1,69 NSAvoidance Response Coping1 51.1 (12.3) 60.2 (11.7) 10.20 1,69 .002--Cognitive avoidance 14.2 (4.7) 17.1 (4.6) 6.96 1,69 .01--Acceptance or resignation 13.1 (4.0) 15.0 (4.3) 3.88 1,69 NS--Seeking Alternative Rewards 13.1 (3.7) 14.4 (4.2) 1.78 1,69 NS--Emotional Discharge 10.7 (2.8) 13.7 (3.9) 13.88 1,69 .000Cognitive AppraisalDesirability -1.9 (2.8) -2.3 (2.6) 0.32 1,69 NSFrequency of Event2 3.5 (2.8) 5.5 (3.3) 7.14 1,69 .009Controllability 4.0 (2.5) 4.0 (2.5) 0.01 1,69 NSPredictability 4.1 (2.5) 3.7 (2.7) 0.40 1,69 NSPreoccupation 5.9 (2.1) 6.5 (2.5) 0.92 1,69 NSRequired Readjustment 4.8 (2.6) 5.8 (2.6) 2.40 1,69 NSCoping Effectiveness 0.9 (2.1) 0.5 (2.3) 0.40 1,69 NSUpsetting or Uplifting3 -1.5 (2.5) -2.7 (2.1) 4.71 1,69 .034Neurocognitive MeasuresWCST--Total Correct 49.1 (5.0) 48.0 (8.6) 0.44 1,68 NS-- Perseverative Errors 7.3 (3.4) 7.4 (4.0) 0.04 1,68 NS--Categories Completed 3.5 (1.2) 3.5 (1.4) 0.00 1,68 NSCVLT--Total Correct (Trials 1 – 5) 57.3 (8.1) 54.7 (9.4) 1.60 1,69 NS1 Partial Eta Squared = .129.2 Partial Eta Squared = .094.3 Partial Eta Squared = .064. 15
  22. 22. significantly related to schizotypy status, F(12, 57) = 1.93, p = .049, There was a modestassociation between the dependent variables and schizotypy status, with partial η2 = .29.This was followed up by individual ANOVAs. Persons high in schizotypy reported usingmore avoidance coping than persons low in schizotypy, F(1,69) = 10.20, p = .002.However, persons high and low in schizotypy did not differ in their use of approachcoping. To further investigate this significant difference between schizotypy status andavoidance coping response, we divided this general category to four specific components:cognitive avoidance, acceptance or resignation, seeking alternative rewards, andemotional discharge. Persons high in schizotypy were more likely to use CognitiveAvoidance F(1,69) = 6.96, p = .01, and Emotional Discharge F(1,69) = 13.88, p < .001then persons low in schizotypy, when faced with a stressful situation.Cognitive appraisal and coping styles Persons high in schizotypy perceived that their stressful life events occurred morefrequently F(1,69) = 7.14, p = .009 and causes them greater emotional upset F(1,69) =4.70, p = .034 (See Table 2). Through an ANCOVA, holding the two CALES factors ascovariates, we found that the persons high in schizotypy remained significantly morelikely to use avoidance coping responses than persons low in schizotypy F(1,69) = 6.04,p = .017. Hence, even with frequency and emotional upset of the stressful event heldconstant, persons high in schizotypy still reported more avoidance coping.Neurocognitive factors with schizotypy status and coping styles Persons high and low in schizotypy did not differ in executive functioning orsecondary verbal memory (See Table 2). As predicted, executive functioning and 16
  23. 23. secondary verbal memory were not associated with avoidance or approach coping ineither the persons high in schizotypy or the persons low in schizotypy (See Table 3).Table 3. Pearson Correlations between Coping Response and NeurocognitiveMeasuresNeurocognitive Coping Response StylesMeasures Approach Coping Avoidance CopingCVLT Total Correct r = .04, p = .78 r = -.09, p = .46WCST Total Correct r = -.16, p = .18 r = -.05, p = .66 Perseverative Errors r = .22, p = .07 r = -.01, p = .96 Categories Completed r = -.18, p = .13 r = .06, p = .62 17
  24. 24. Chapter 4 Discussion Undergraduates identified as high in schizotypy used more avoidance coping thanthose identified as low in schizotypy, even when appraisals of stressor frequency andupset were statistically controlled. In contrast, persons high and low in schizotypy did notdiffer in approach coping. The cognitive appraisals of persons high in schizotypy differedfrom those low in schizotypy in that persons high in schizotypy perceived that stressfulevents occurred with greater frequency and reported more upset about stressful events. The finding that persons high in schizotypy use more avoidance coping isconsistent with earlier studies. Bijttebier et al. (1999) found that individuals withpersonality disorders (i.e., Paranoid Personality Disorder (PD), Schizoid PD, andSchizotypal PD) utilized more avoidance coping strategies than persons withoutpersonality disorders. Research on patients with schizophrenia, on the other hand,suggests that these persons use more avoidance coping and less approach coping thanunaffected persons (Hultman et al., 1997; Jansen et al., 1999; van den Bosch et al., 1992;Ventura et. al, 2004). We also found that neurocognitive factors (executive functioning and secondaryverbal memory) did not correlate with coping styles, and that there was no significantdifference on neurocognitive factors between persons high and low in schizotypy. Thelatter finding is inconsistent with earlier research. Some studies have found a significantdifference in both executive functioning and secondary verbal memory when comparingpersons high in schizotypy to “normals.” In executive functioning, studies have reportedan increase in perseverative errors in the high schizotypy group (Gooding et al., 1999, 18
  25. 25. 2001; Lenzenweger & Korfine, 1994). In secondary verbal memory, Voglmaier et al.(1993) found significant decrements in the CVLT in subjects with nonfamilialschizotypal personality disorder. We reasoned that since both our samples werecomposed of college students, both groups have average cognitive ability. In addition, theimportance of neurocognitive measures for the purpose of this study was to assure thatneurocognition did not correlate with coping styles. The current study’s limitations must be mentioned. First, the sample wascomposed of only CSUN college students. This limits our ability to generalize beyondcollege students. The high educational attainment of the sample likely affected the nullfindings regarding approach coping, executive functioning, and secondary verbalmemory. Future studies should examine coping and neurocognition in communitysamples of schizotypes. A second limitation is that subjects were only tested at one timepoint. Although, the research indicates that coping styles are stable over time, this is notnecessarily true in persons with schizotypy. Therefore, longitudinal studies of coping inschizotypy are needed. Despite these limitations, this study provides useful information about personshigh in schizotypy and has implications for treatment and future research. In recent years,researchers have attempted to identify prodromal symptoms of psychosis and, usingvarious types of interventions, decrease symptoms and/or the rate of persons who willconvert to schizophrenia. For instance, Liberman and Robertson (2005) used the fullversion of the SPQ to identify high school students that are high in schizotypy as “high-risk” individuals for schizophrenia-spectrum disorders. They used an eight-week socialskills training program on these students high in schizotypy and found a significant 19
  26. 26. reduction (at post-test) in schizotypal traits, as well as an improvement in social skills andself- esteem. O’Brien et al. (2006) recently found that an early intervention with youths atrisk for schizophrenia reduced psychotic features. Training in effective coping strategies has not been studied in persons at risk forschizophrenia. Evidence shows that the positive symptoms in schizophrenia areexacerbated by stressful situations. It follows that teaching coping techniques may helppersons with schizophrenia prevent or lessen the effects of future psychotic episodes.Future research should implement a coping strategies intervention with persons high inschizotypy to determine whether earlier detection of schizotypy features will reducefrequency in stressful events and pathogenic impact of those events. 20
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  32. 32. Appendix A Schizotypal Personality Questionnaire-Brief (SPQ-B)Please answer each item by circling Y (Yes) or N (No). Answer all items even if unsureof your answer. When you have finished, check over each one to make sure you haveanswered them all.Y N 1. People sometimes find me aloof and distant.Y N 2. Have you ever had the sense that some person or force is around you, even though you cannot see anyone?Y N 3. People sometimes comment on my unusual mannerisms and habits.Y N 4. Are you sometimes sure that other people can tell what you are thinking?Y N 5. Have you ever noticed a common event or object that seemed to be a special sign for you?Y N 6. Some people think that I am a very bizarre person.Y N 7. I feel I have to be on my guard even with friends.Y N 8. Some people find me a bit vague and elusive during a conversation.Y N 9. Do you often pick up hidden threats or put-downs from what people say or do?Y N 10. When shopping do you get the feeling that other people are taking notice of you?Y N 11. I feel very uncomfortable in social situations involving unfamiliar people.Y N 12. Have you had experiences with astrology, seeing the future, UFOs, ESP or a sixth sense?Y N 13. I sometimes use words in unusual ways.Y N 14. Have you found that it is best not to let other people know too much about you?Y N 15. I tend to keep in the background on social occasions.Y N 16. Do you ever suddenly feel distracted by distant sounds that you are not normally aware of? 26
  33. 33. Y N 17. Do you often have to keep an eye out to stop people from taking advantage of you?Y N 18. Do you feel that you are unable to get “close” to people?Y N 19. I am an odd, unusual person.Y N 20. I find it hard to communicate clearly what I want to say to people.Y N 21. I feel very uneasy talking to people I do not know well.Y N 22. I tend to keep my feelings to myself. 27
  34. 34. Appendix B Revised Social Anhedonia Scale (R-SAS)Please read each of the statements below and circle True (T) or False (F)T F 1. Having close friend is not as important as many people say.T F 2. I attach very little importance to having close friends.T F 3. I prefer watching television to going out with other people.T F 4. A car ride is much more enjoyable if someone is with me.T F 5. I like to make long distance phone calls to friends and relatives.T F 6. Playing with children is a real chore.T F 7. I have always enjoyed looking at photographs of friends.T F 8. Although there are things that I enjoy doing by myself, I usually seem to have more fun when I do things with other people.T F 9. I sometimes become deeply attached to people I spend a lot of time with.T F 10. People sometimes think that I am shy when I really just want to be left alone.T F 11. When things are going really good for my close friends, it makes me fell good too.T F 12. When someone close to me is depressed, it brings me down also.T F 13. My emotional responses seem very different from those of other people.T F 14. When I am alone, I often resent people telephoning me or knocking on my door.T F 15. Just being with friends can make me feel really good.T F 16. When things are bothering me, I like to talk to other people about it.T F 17. I prefer hobbies and leisure activities that do not involve other people.T F 18. It’s fun to sing with other people.T F 19. Knowing that I have friends who care about me gives me a sense of security.T F 20. When I move to a new city, I feel a strong need to make new friends. 28
  35. 35. T F 21. People are usually better off if they stay aloof from emotional involvements with most others.T F 22. Although I know I should have affection for certain people, I don’t really feel it.T F 23. People often expect me to spend more time talking with them than I would like.T F 24. I feel pleased and gratified as I learn more and more about the emotional life of my friends.T F 25. When others try to tell me about their problems and hang-ups, I usually listen with interest and attention.T F 26. I never had really close friend in high school.T F 27. I am usually content to just sit alone, thinking and daydreaming.T F 28. I’m much too independent to really get involved with other people.T F 29. There are few things more tiring than to have a long, personal discussion with someone.T F 30. It made me sad to see all my high school friends go their separate ways when high school was over.T F 31. I have often found it hard to resist talking to a good friend, even when I have other things to do.T F 32. Making new friends isn’t worth the energy it takes.T F 33. There are things that are more important to me than privacy.T F 34. People who try to get to know me better usually give up after awhile.T F 35. I could be happy living all alone in a cabin in the woods or mountains.T F 36. If given the choice, I would much rather be with others than be alone.T F 37. I find that people too often assume that their daily activities and opinions will be interesting to me.T F 38. I don’t really feel very close to my friends.T F 39. My relationships with other people never get very intense.T F 40. In many ways, I prefer the company of pets to the company of people. 29
  36. 36. Appendix C Coping Response Inventory (CRI)Subject ID: ____________________Date: _________________________Interviewer: ____________________Date of Life Event: ______________Part I:Please think about the most important problem or stressful situations you haveexperienced DURING THE LAST 12 MONTHS (for example, having troubles withfriends or significant others, having academic problems, having financial or workproblems). Describe the problems. If you have not experienced a major problem, then lista minor problem that you have had to deal with.DESCRIBE THE PROBLEM OR SITUATION:1) _____________________________________________________________________2) _____________________________________________________________________3) _____________________________________________________________________4) _____________________________________________________________________5) _____________________________________________________________________WHICH OF THESE CAUSED THE MOST STRESS: _______CONTENT: _____(1 = School, 2 = Work, 3 = Relationship, 4 = Transportation, 5 = Family, 6 = Residence, 7 = Crime and legal matters, 8 = Finance, 9 = Social Activities, 10 = Health, 11 = Earthquake, 12 = Middle East War, 13 = Misc. Crisis or Traumatic event, 16 = Malibu fires, 17 = Training Program, 18 = September 11th, 19 = Iraq War, 20 = Other)INDEPENDENCE: _____(1 = Independent, 2 = Possible independent, 3 = Dependent, subject could influence it, 4 = Dependent, due to current symptomatology, 5 = Dependent, possibly due to current symptomatology, 6 = Dependent, due to past symptomatology)INTERPERSONAL: _____(0 = No, 1 = Yes) 30
  37. 37. DEALING WITH A PROBLEM OR SITUATIONPART II:Please answer the following questions about the problem you have listed. Place an “X” inthe appropriate box: Definitely Mainly Mainly Definitely No No _ Yes Yes__ 1. Have you ever faced a problem like this before?..…………………… 2. Did you know this problem was going to occur?................................... 3. Did you have enough time to get ready to handle this problem?............ 4. When this problem occurred, did you think of it as a threat?.................. 5. When this problem occurred, did you think of it as a challenge?........... 6. Was this problem caused by something you did?........................... 7. Was this problem cause by something someone else did?............. 8. Did anything good come out of dealing with this problem?................. 9. Has this problem or situation been resolved?.................................... 10. If the problem has been worked out, did it turn out all right for you?.......... 31
  38. 38. PART III:Please think again about the problem you described on PART I; indicate which of thefollowing you did in connection with that situation. YES, YES, YES, once or some- fairly No twice _times_ often__DID YOU: 1. Think of different ways to deal with the problem…………………… 2. Tell yourself things to make yourself feel better?............................ 3. Talk with your spouse or other relative about the problem?............... 4. Make a plan of action and follow it?. 5. Try to forget the whole thing?.......... 6. Feel that time would make a differance --the only thing to do was wait? .............. 7. Try to help others deal with a similar problem?................................. 8. Take it out on other people when you felt angry or depressed?............... 9. Try to step back from the situation and be more objective?...................... 10. Remind yourself how much worse things could be?................................. 11. Talk with a friend about the problem?............................................ 12. Know what had to be done and try hard to make things work?.................. 13. Try not to think about the problem?.. 14. Realize that you had no control over the problem?.............................. 32
  39. 39. Questions about how you handled the problem you listed on PART I (continued) YES, YES, YES, once or some- fairly No twice _times_ often__DID YOU: 15. Get involved in new activites?........... 16. Take a chance and do something risky?.................................................. 17. Go over in your mind what you would say or do?................................ 18. Try to see the good side of the situation?............................................ 19. Talk with a professional person (e.g., doctor, lawyer, clergy)?............. 20. Decide what you wanted and try hard to get it?..................................... 21. Daydream or imagine a better time or place than the one you were in?...... 22. Think that the outcome would be decided by fate?................................. 23. Try to make new friends?.................. 24. Keep away from people in general? .. 25. Try to anticipate how things would turn out?.................................. 26. Think about how you were much better off than other people with similar problems?............................... 27. Seek help from persons or groups with the same type of problems?........ 28. Try at least two different ways to solve the problem?............................. 33
  40. 40. Questions about how you handled the problem you listed on PART I (continued) YES, YES, YES, once or some- fairly No twice _times_ often__DID YOU: 29. Try to put off thinking about the situation, even though you knew you would have to at some point?...... 30. Accept it; nothing could be done?........ 31. Read more often as a source of enjoyment?......................................... 32. Yell or shout to let off steam?............ 33. Try to find some personal meaning in the situation?................... 34. Try to tell yourself that things would get better?.......................................... 35. Try to find out more about the situation?............................................. 36. Try to learn to do more things on your own?........................................... 37. Wish the problem would go away or somehow be over with?................. 38. Expect the worst possible outcome?.. 39. Spend more time in recreational activities?........................................... 40. Cry to let your feelings out?............... 41. Try to anticipate the new demands that would be placed on you?............ 42. Think about how this event could change your life in a positive way ?.... 34
  41. 41. Questions about how you handled the problem you listed on PART I (continued) YES, YES, YES, once or some- fairly No twice _times_ often__DID YOU: 43. Pray for guidance and/or strength?.... 44. Take things a day at a time, one step at a time?............................................ 45. Try to deny how serious the problem really was?......................................... 46. Lose hope that things would ever be the same?........................................... 47. Turn to work or other activities to help you manage things?.................... 48. Do something that you didn’t think would work, but at least you were doing something?............................... 49. Turn to drugs, alcohol, or food to help you deal with the problem?........ 50. Not know what to do, so you did nothing?.............................................. 51. Try the same solution over and over even though it didn’t work the first time?................................................... 52. Not even know there was a problem until it was too late?........................... 53. Hope that someone else would fix the problem for you?.......................... 54. Sleep more than usual after encountering the problem?................. 55. Use any form of humor (e.g. make joke) to deal with the problem?.......... 35
  42. 42. Questions about how you handled the problem you listed on PART I (continued)DID YOU: 56. Did you use any coping methods that were not listed? Yes______ No______ If yes, please list them. 57. __________________________________________________________________ 58. __________________________________________________________________ 59. __________________________________________________________________ 60. __________________________________________________________________ 61. Were your coping efforts successful? Yes______ No______ If yes, please list which coping methods were most helpful for you? 62. __________________________________________________________________ 63. __________________________________________________________________ 64. __________________________________________________________________ 36
  43. 43. Appendix D Cognitive Appraisal of Life Events Scale (CALES)Subject ID: ____________________Date: _________________________Interviewer: ____________________Date of Life Event: ______________Instructions: Please answer each question by circling the point on the scale which mostclosely describes the way you felt about the event.1. Has this event ever happened to you before?1 2 3 4 5 6 7 8 9Not at all Somewhat Moderately Highly Extremelyfamiliar familiar familiar familiar familiar2. How much control did you have over whether this event happened?1 2 3 4 5 6 7 8 9No control Some degree Moderate High degree Extremeat all of control degree of of control degree of control control3. Did you have any advance notice about the event?1 2 3 4 5 6 7 8 9No advance Some degree Moderate High degree Extremenotice at all of advance degree of of advance degree of notice advance notice advance notice notice4. How much of the time has the event been on your mind?1 2 3 4 5 6 7 8 9Not at all On my mind On my mind On my mind On my mindon my mind some of the much of the most of the all of the time time time time5. How much of a change in your daily routine has the event caused?1 2 3 4 5 6 7 8 9No change Some degree Moderate High degree Extremeat all of change degree of of change degree of change change 37
  44. 44. 6. How desirable was this event?-4 -3 -2 -1 0 1 2 3 4Extremely Highly Moderately Somewhat Neither Somewhat Moderately Highly Extremelyundesirable undesirable undesirable undesirable desirable desirable desirable desirable desirable nor undesirable7. Were you successful at handling the event?-4 -3 -2 -1 0 1 2 3 4Extremely Highly Moderately Somewhat Neither Somewhat Moderately Highly Extremelyunsuccessful unsuccessful unsuccessful unsuccessful successful successful successful successful successful nor unsuccessful8. How upsetting or uplifting was this event for you?-4 -3 -2 -1 0 1 2 3 4Extremely Highly Moderately Somewhat Neither Somewhat Moderately Highly Extremelyupsetting upsetting upsetting upsetting upsetting uplifting uplifting uplifting uplifting nor uplifting9. How upsetting or uplifting has this past month been for you?-4 -3 -2 -1 0 1 2 3 4Extremely Highly Moderately Somewhat Neither Somewhat Moderately Highly Extremelyupsetting upsetting upsetting upsetting upsetting uplifting uplifting uplifting uplifting nor uplifting 38