Dysfunctional coping with stress in psychosis. An investigation with the Maladaptive and Adaptive Coping Styles (MAX) questionnaire

Steffen Moritz, Thies Lüdtke, Stefan Westermann, Joy Hermeneit, Jessica Watroba, Tania M. Lincoln

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)


Objective Psychotic episodes have long been conceptualized as inevitable incidents triggered by endogenous biological impairments. It is now well-accepted that the ability of an individual to deal with social and environmental challenges plays an important role in regard to whether or not a vulnerability to psychosis translates into symptoms. For the present study, we examined symptomatic correlates of dysfunctional coping in psychosis and aimed to elucidate a profile of coping strategies that distinguishes patients with schizophrenia from those with depression. Method The newly devised Maladaptive and Adaptive Coping Styles Scale (MAX) was administered to 75 individuals with psychosis, 100 individuals with depression and 1100 nonclinical controls. Results Schizophrenia patients showed compromised coping abilities relative to nonclinical controls, particularly a lack of engaging in adaptive coping. Depression was more closely tied to dysfunctional coping than were positive symptoms as indicated by group comparisons and correlational analyses. Correlations between positive symptoms, particularly paranoid symptoms, and avoidance and suppression remained significant when depression was controlled for. Conclusions Although maladaptive and adaptive coping are unlikely to represent proximal mechanisms for the pathogenesis of positive symptoms, fostering coping skills may reduce positive symptoms via the improvement of depressive symptoms, which are increasingly regarded as risk factors for core psychotic symptoms. Furthermore, the reduction of avoidance and suppression may directly improve positive symptoms.

Original languageEnglish
Pages (from-to)129-135
Number of pages7
JournalSchizophrenia Research
Issue number1-3
Publication statusPublished - Aug 2016
Externally publishedYes


  • Coping
  • Depression
  • Emotion regulation
  • Positive symptoms
  • Schizophrenia


Dive into the research topics of 'Dysfunctional coping with stress in psychosis. An investigation with the Maladaptive and Adaptive Coping Styles (MAX) questionnaire'. Together they form a unique fingerprint.

Cite this