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The British Journal of Psychiatry (2004) 185: 410-415
© 2004 The Royal College of Psychiatrists

Adapting to the challenge of psychosis: personal resilience and the use of sealing-over (avoidant) coping strategies

Lynda Tait, PhD

School of Psychology, University of Birmingham, Birmingham, UK

Max Birchwood, DSc

Birmingham Early Intervention Service, Birmingham and Solihull Mental Health Trust and School of Psychology, University of Birmingham, Birmingham, UK

Peter Trower, PhD

School of Psychology, University of Birmingham, Birmingham, UK

Correspondence: Professor Max Birchwood, School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. E-mail: m.j.birchwood.20{at}bham.ac.uk

Declaration of interest None. Funded by the School of Psychology, University of Birmingham, UK.

Background Avoidance coping (e.g. sealing over) is common in people recovering from psychosis, but it is not understood why some individuals ‘seal over’.

Aims We examined the hypothesis that individuals who ‘seal over’ do not have the personal resilience to withstand this major life event.

Method Fifty participants were interviewed during an acute episode of psychosis and reassessed at 3-month and 6-month follow-up. Measures included psychotic symptoms, recovery style, service engagement, parental and adult attachment and self-evaluative beliefs.

Results Sealing-over recovery styles are associated with negative early childhood experience, insecure adult attachment, negative self-evaluative beliefs and insecure identity. Insecure adult attachment was associated with less engagement with services.

Conclusions Sealing over was associated with multiple signs of low personal resilience in adapting to psychosis.




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