Hostname: page-component-848d4c4894-v5vhk Total loading time: 0 Render date: 2024-06-15T08:06:53.616Z Has data issue: false hasContentIssue false

Interpersonal conflict strategies and their impact on positive symptom remission in persons aged 55 and older with schizophrenia spectrum disorders

Published online by Cambridge University Press:  29 August 2012

Carl I. Cohen*
Affiliation:
Division of Geriatric Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York, USA
Dishal Solanki
Affiliation:
Division of Geriatric Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York, USA
Dimple Sodhi
Affiliation:
Division of Geriatric Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York, USA
*
Correspondence should be addressed to: Carl I. Cohen, MD, Distinguished Service Professor & Director, Division of Geriatric Psychiatry, SUNY Downstate Medical Center, Box 1203, 450 Clarkson Avenue, Brooklyn, NY 11203, USA. Phone: 718-287-4806; Fax: 718-287-0337. Email: carl.cohen@downstate.edu.

Abstract

Background: Although interpersonal interactions are thought to affect psychopathology in schizophrenia, there is a paucity of data about how older adults with schizophrenia manage interpersonal conflicts. This paper examines interpersonal conflict strategies and their impact on positive symptom remission in older adults with schizophrenia spectrum disorders.

Methods: The schizophrenia group consisted of 198 persons aged 55 years and over living in the community who developed schizophrenia before age 45. A community comparison group (n = 113) was recruited using randomly selected block-groups. Straus’ Conflict Tactics Scale (CTS) was used to assess the ways that respondents handled interpersonal conflicts.

Results: Seven conflict management subscales were created based on a principal component analysis with equamax rotation of items from the CTS. The order of the frequency of the tactics that was used was similar for both the schizophrenia and community groups. Calm and Pray tactics were the most commonly used, and the Violent and Aggressive tactics were rarely utilized. In two separate logistic regression analysis, after controlling for confounding variables, positive symptom remission was found to be associated significantly with both the Calm and Pray subscales.

Conclusions: The findings suggest that older persons with schizophrenia approximate normal distribution patterns of conflict management strategies and the most commonly used strategies are associated with positive symptom remission.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Appelo, M. T., Woonings, F. M. J., Van Nieuwenhuizen, C. J., Emmelkamp, P. M. G., Slooff, C. J. and Louwerens, J. W. (1992). Specific skills and social competence in schizophrenia. Acta Psychiatrica Scandinavica, 85, 419422.CrossRefGoogle ScholarPubMed
Bankole, A. O., Cohen, C. I., Vahia, I., Diwan, S., Kehn, M. and Ramirez, P. M. (2007). Factors affecting quality of life in a multiracial sample of older persons with schizophrenia. American Journal of Geriatric Psychiatry, 15, 10151023.CrossRefGoogle Scholar
Bergman, B. and Ericsson, E. (1996). Family violence among psychiatric in-patients as measured by the Conflict Tactics Scale (CTS). Acta Psychiatrica Scandanavica, 94, 168174.CrossRefGoogle ScholarPubMed
Birditt, K. S. and Fingerman, K. L. (2005). Do we get better at picking our battles? Age group differences in descriptions of behavioral reactions to interpersonal tensions. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 60, 121128.CrossRefGoogle ScholarPubMed
Blanchard-Fields, F. and Beatty, C. (2005). Age differences in blame attributions: the role of relationship outcome ambiguity and personal identification. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 60, 1926.CrossRefGoogle ScholarPubMed
Carstensen, L. L., Gottman, J. M. and Levenson, R. W. (1995). Emotional behavior in long-term marriage. Psychology of Aging, 10, 140149.CrossRefGoogle ScholarPubMed
Ciompi, L. (1987). Review of follow-up studies on long-term evolution and aging in schizophrenia. In Miller, N. E. and Cohen, G. D. (eds.), Schizophrenia and Aging (pp. 3751). New York: Guilford Press.Google Scholar
Coblentz, J. M., Mattis, S., Zingesser, L. H., Kasoff, S. S., Wisniewski, H. M. and Katzman, R. (1973). Presenile dementia. Clinical aspects and evaluation of cerebrospinal fluid dynamics. Archives of Neurology, 29, 299308.CrossRefGoogle ScholarPubMed
Cohen, C. I. and Kochanowicz, N. (1989). Schizophrenia and social network patterns: a survey of black inner-city outpatients. Community Mental Health Journal, 25, 197207.CrossRefGoogle ScholarPubMed
Cohen, C. I., Ramirez, M., Teresi, J., Gallagher, M. and Sokolovsky, J. (1997). Predictors of becoming redomiciled among older homeless women. The Gerontologist, 37, 6774.CrossRefGoogle ScholarPubMed
Consedine, N. S. and Magai, C. (2002). The uncharted waters of emotion: ethnicity, trait emotion and emotion expression in older adults. Journal of Cross Cultural Gerontology, 17, 71100.CrossRefGoogle ScholarPubMed
Ewing, J. A. (1984). Detecting alcoholism. The CAGE questionnaire. JAMA, 252, 19051907.CrossRefGoogle ScholarPubMed
Fingerman, K. L., Miller, L. and Charles, S. (2008). Saving the best for last: how adults treat social partners of different ages. Psychology of Aging, 23, 399409.CrossRefGoogle ScholarPubMed
Granholm, E.et al. (2005). A randomized, controlled trial of cognitive behavioral social skills training for middle-aged and older outpatients with chronic schizophrenia. American Journal of Psychiatry, 162, 520529.CrossRefGoogle ScholarPubMed
Harding, C. M., Zubin, J. and Strauss, J. S. (1987). Chronicity in schizophrenia: fact, partial fact, or artifact? Hospital and Community Psychiatry, 38, 477486.Google ScholarPubMed
Jaramillo, P., Inmaculada Fuentes, I. and Ruiz, J. C. (2009). Cognition, social cognition and social functioning in schizophrenia. Psychology, Society, & Education, 1, 1324.Google Scholar
Jeste, D. V., Symonds, L. L., Harris, M. J., Paulsen, J. S., Palmer, B. W. and Heaton, R. K. (1997). Nondementia nonpraecox dementia praecox? Late-onset schizophrenia. American Journal of Geriatric Psychiatry, 5, 302317.CrossRefGoogle ScholarPubMed
Kavanagh, D. J. (1992). Recent developments in expressed emotion and schizophrenia. British Journal of Psychiatry, 160, 601620.CrossRefGoogle ScholarPubMed
Kay, S. R., Opler, L. A. and Fiszbein, A. (1992). The Positive and Negative Syndrome Scale (PANSS) Manual. New York: Multi-Health Systems Inc.Google Scholar
Lawton, M. P., Moss, M., Fulcomer, M. and Kleban, M. H. (1982). A research and service oriented multilevel assessment instrument. Journal of Gerontology, 37, 9199.CrossRefGoogle ScholarPubMed
Mueser, K. T., Bellack, A. S., Morrison, R. L. and Wixted, J. T. (1990). Social competence in schizophrenia: premorbid adjustment, social skill, and domains of functioning. Journal of Psychiatric Research, 24, 5163.CrossRefGoogle ScholarPubMed
Mueser, K. T.et al. (2010). Randomized trial of social rehabilitation and integrated health care for older people with severe mental illness. Journal of Consulting and Clinical Psychology, 78, 561573.CrossRefGoogle ScholarPubMed
Nunnally, J. C. (1967). Psychometric Theory. New York: McGraw Hill.Google Scholar
Pearlin, L. I., Lieberman, M. A., Menaghan, E. G. and Mullan, J. T. (1981). The stress process. Journal of Health and Social Behavior, 22, 337356.CrossRefGoogle ScholarPubMed
Penn, D. L., Sanna, L. J. and Roberts, D. L. (2008). Social cognition in schizophrenia: an overview. Schizophrenia Bulletin, 34, 408411.CrossRefGoogle ScholarPubMed
Radloff, L. S. (1977). The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385401.CrossRefGoogle Scholar
Scott, R. D., Fagin, L. and Winter, D. (1993). The importance of the role of the patient in the outcome of schizophrenia. British Journal of Psychiatry, 163, 6268.CrossRefGoogle ScholarPubMed
Semple, S. J., Patterson, T. L., Shaw, W. S., Grant, I., Moscona, S. and Jeste, D. V. (1999). Self-perceived interpersonal competence in older schizophrenia patients: the role of patient characteristics and psychosocial factors. Acta Psychiatrica Scandanavica, 100, 126135.CrossRefGoogle Scholar
Sokolovsky, J. and Cohen, C. I. (1981). Toward a resolution of methodological dilemmas in network mapping. Schizophrenia Bulletin, 7, 109116.CrossRefGoogle Scholar
Straus, M. A. (2007). Conflict tactics scales. In Jackson, N. A. (ed.), Encyclopedia of Domestic Violence (pp. 190197). New York: Routledge: Taylor and Francis Group.Google Scholar
Zarit, S. H., Miller, N. E. and Kahn, R. L. (1978). Brain function, intellectual impairment and education in the aged. Journal of the American Geriatrics Society, 26, 5867.CrossRefGoogle ScholarPubMed