Abstract
Episodes of severe mental disorder (schizophrenia, schizoaffective disorder, major depressive disorder, bipolar disorder) are debilitating and stressful events that require a coping response. In this prospective study, coping strategies were explored among inpatients diagnosed with these disorders. Seventy participants were interviewed during their stay on the ward (T1), and 30 of them were also available for a follow-up interview approximately six weeks later (T2). A framework was explored that links optimistic expectancies and coping in the prediction of adjustment after psychiatric hospitalization. Three main hypotheses were tested: (1) Optimism was hypothesized to predict improved adjustment over time, (2) the beneficial effects of optimism were hypothesized to be mediated by coping, and (3) optimistic expectancies were hypothesized to moderate the effectiveness of coping. Support for each of these hypotheses was weak, presumably partly because of limited power. Several significant associations emerged between coping and symptom severity in the T1 data set. Specifically, psychosis severity was linked with broad impairments in adaptive coping, whereas depression severity was linked with elevated self-blame and behavioral disengagement coping. These associations were moderated by perceived stress, and they remained significant even when controlling for alternative symptom dimensions and potential confounds. These findings add to the emerging literature on coping among patients with severe psychopathology.