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Maladaptive coping reactions to stress. A study of illness inception.

Eleven ways in which people might react to life stress were studied in a sample of 576 Edinburgh women. For each item the subjects were asked whether they had reacted that way in general in the past 6 months and whether they had reacted in that way in response to any specific life stresses they had experienced. Being angry with oneself, being angry with others, rumination, use of alcohol, and use of tobacco all discriminated between those who were well and those who were psychiatrically ill at first interview and these items were formed into a 6-point scale of maladaptive reaction, based largely on specific response. The researchers conducted a follow-up analysis of 306 women who were well at first interview, 35 of whom suffered a psychiatric illness episode (23 depression, 12 anxiety) within the subsequent year. Maladaptive reaction at interview one predicted later illness inception, even after taking life stress into account. Several extraneous variables were considered, none of which could explain this effect. Maladaptive reaction seemed sometimes to lead to illness even when there was only minimal later life stress. Attempts to find coping reactions which afford protection against illness inception were unsuccessful.