Differences in coping strategies in adult patients with bipolar disorder and their first-degree relatives in comparison to healthy controls / Diferenças entre as estratégias de coping em pacientes adultos com transtorno bipolar e seus familiares em comparação com controles saudáveis

Abstract Introduction: The objective of this study was to compare patients with bipolar disorder (BD), their first-degree relatives and a group of healthy controls in terms of use of adaptive and maladaptive coping strategies, exploring differences between specific types of strategies and their correlations with clinical variables. Methods: This was a cross-sectional study enrolling 36 euthymic patients with BD, 39 of their first-degree relatives and 44 controls. Coping strategies were assessed using the Brief COPE scale. Results: Significant differences were detected in the use of adaptive and maladaptive strategies by patients, their first-degree relatives and controls. Patients used adaptive strategies less often than the patients' relatives (p<0.001) and controls (p = 0.003). There was no significant difference between first-degree relatives and controls (p=0.707). In contrast, patients (p<0.001) and their relatives (p=0.004) both exhibited higher scores for maladaptive coping than controls. There was no significant difference regarding the use of maladaptive strategies between patients and their relatives (p=0.517). Conclusions: First-degree relatives were at an intermediate level between patients with BD and controls regarding the use of coping skills. This finding supports the development of psychosocial interventions to encourage use of adaptive strategies rather than maladaptive strategies in this population.

Resumo Introdução: O objetivo deste estudo foi comparar os pacientes com transtorno bipolar (TB), seus familiares de primeiro grau e um grupo de controles saudáveis em termos de uso de estratégias adaptativas e não adaptativas, explorando diferenças entre tipos específicos de estratégias e suas correlações com variáveis clínicas. Métodos: Estudo transversal, envolvendo 36 pacientes com TB eutímicos, 39 familiares de primeiro grau e 44 controles. As estratégias de enfrentamento foram avaliadas usando a escala Brief COPE. Resultados: Foram detectadas diferenças significativas no uso de estratégias adaptativas e não adaptativas por pacientes, seus familiares e controles. Os pacientes usaram estratégias adaptativas com menos frequência do que os familiares (p<0,001) e controles (p=0,003). Não houve diferença significativa entre familiares dos pacientes e controles (p=0,707). Por outro lado, os pacientes (p<0,001) e seus familiares (p=0,004) exibiram pontuações mais elevadas para coping não adaptativo em relação aos controles. Não houve diferença significativa quando os pacientes foram comparados com seus familiares (p=0,517). Conclusões: Familiares de primeiro grau estavam em um nível intermediário entre pacientes com TB e controles no que diz respeito ao uso de habilidades de enfrentamento. Esta descoberta apoia o desenvolvimento de intervenções psicossociais para incentivar o uso de estratégias adaptativas em vez de estratégias inadequadas nessa população.

Psychometric properties of the Brief-COPE for the evaluation of coping strategies in the Chilean population

Abstract The Brief-COPE is an abbreviated version of the COPE (Coping Orientation to Problems Experienced) Inventory, a self-report questionnaire developed to assess a broad range of coping responses. Currently, it is one of the best validated and most frequently used measures of coping strategies. The aim of this study was to validate a culturally appropriate Chilean version of the Brief-COPE, assess its psychometric properties and construct and congruent validity. The Spanish version of the Brief-COPE was administrated in a community sample of 1847 Chilean adult (60.4% women) exposed to a variety of stressful experiences. The factorial structure of the inventory was examined by comparing four different models found in previous studies in Latin American population. The results of confirmatory factor analyses revealed, as in the original studies, a 14-factor structure of the Brief-COPE. These dimensions showed adequate internal structure and consistency. The factorial invariance comparing women and men confirmed strict invariance. Additionally, the results showed significant correlation between some Brief-COPE scales, such as denial and substance use, with perceived stress and emotional support and active coping with subjective well-being. Overall, the present work offers a valid and reliable tool for assessing coping strategies in the Chilean population.

COPE-28: un análisis psicométrico de la versión en español del Brief COPE / COPE-28 / COPE-28: a psychometric analysis of the spanish version of the brief COPE

El propósito del presente estudio es analizar las propiedades psicométricas del cuestionario Brief COPE en población española, considerando la estructura y dimensiones básicas del cuestionario, llamado COPE-28 con la versión española del mismo. La muestra fue de 260 adultos. Para analizar la estructura factorial, se realizó un análisis factorial exploratorio con el método de componentes principales y rotación varimax. Posteriormente, se realizó un análisis factorial de segundo orden con las subescales que forman el COPE-28. El resultado de la prueba KMO pone en duda la factibilidad de realizar un análisis factorial; el análisis no confirma la estructura factorial original del instrumento. Con base en los resultados obtenidos se afirma que la validez del COPE-28 no es concluyente.

The aim of this paper was to analyze psychometric properties of Spanish version of the Brief COPE questionnaire, analyzing its factor structure. The Spanish version of the Brief COPE was named COPE-28. The sample was 260 adult people. Exploratory factor analysis with principal components method and varimax rotation was used to extract the factors; as well as a second order analysis. The KMO result showed a non adequate value;nevertheless the analysis was performed and factor analysis did not confirm the factor structure of the Brief COPE. Due to the obtained results, the validity of the COPE-28 is not conclusive.