Could response bias on the COPE by schizophrenia participants be moderated by verbal cognitive abili

1
Could response bias on the COPE by schizophrenia
participants be moderated by verbal cognitive
abilities?

• Christina Hill
• Jennifer Aakre
• Annie St-Hilaire
• Nancy Docherty, Ph.D.
• Kent State University

2
Schizophrenia patients with severe positive
symptoms have shown an acquiescence response bias
on a self-report measure of coping style, the
COPE scale. They have not only been found to
endorse many maladaptive coping techniques, but
to also endorse many coping techniques in general
on the COPE, including both maladaptive and
adaptive coping methods (Hill, St-Hilaire,
Docherty, 2004). Previous research has shown that
such a response bias was present in responses of
mental retardation participants. Cognitive
limitations may be one of the reasons why
schizophrenia participants display such a
response bias. In the present study we assessed
verbal IQ as a possible moderator between
severity of positive symptoms and acquiescence
bias in schizophrenia patients. Thirty
schizophrenic participants completed the COPE
inventory and the Shipley vocabulary test. Verbal
IQ as defined by the vocabulary test was not
related to the response bias on the COPE. A
regression analysis was conducted looking at the
interaction between the severity of positive
symptoms and the Shipley verbal IQ in predicting
acquiescence response bias. The findings did not
reveal a significant moderation effect F change
1, 26 1.274 p .269. One possible reason
for the lack of effect may be that vocabulary
performance does not adequately reflect the
relevant cognitive limitation in this context.
The response bias found on the COPE inventory
might be related to suggestibility, or be a
product of working memory impairment, decreased
attention span, or a simple lack of motivation
when responding to complex questions.
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Background

• Schizophrenia patients with severe positive
  symptoms have been found to endorse many
  maladaptive coping methods, but to also endorse
  many coping methods in general (Hill, St-Hilaire,
  Docherty, 2004).
• Similar biases have also been pointed out in the
  schizophrenia population more generally
  (Baerwald, Tryon, Sandford, 2005). In their
  study, they found schizophrenia patients adopted
  a liberal, over-reporting way of responding to
  questionnaires.
• Acquiescence biases have also been present in
  other populations. For example, some have found
  mental retardation to be associated with such a
  bias (Kilsby, Bennert, Beyer, 2002 Sigelman,
  Viner, Schoenrock, 1982).
• Sigelman, Viner, and Schoenrocks (1982) study
  found lower intelligence quotient (IQ) to be
  associated with such a response bias.

4
Background

• Cognitive impairments are considered
  characteristic of the schizophrenia population
  (Gold Harvey, 1993 Goldberg Gold, 1995
  Heaton Crowley, 1981 Heaton Drexler, 1987).
• Cognitive impairments may be one of the reasons
  for this tendency to endorse most items on
  questionnaires.
• Reinforcing this idea, Choi (2001) found
  acquiescence in the responding of schizophrenia
  participants augmented as the tasks increased in
  difficulty.
• It seems that when cognitive abilities are
  limited, response biases appear in patients with
  schizophrenia.
• In schizophrenia patients, severity of positive
  symptoms, but not negative symptoms was
  previously found to be related to response bias
  on the COPE (Hill, St-Hilaire, Docherty (2004).

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The present study

• Myin-Germeys, Krabbendam, Delespaul, van Os
  (2003) proposed that during psychosis, patients
  may experience state-related cognitive
  difficulties and affective disturbance in
  response to a stressful event.
• Garety and colleagues (2001) described reasoning
  biases and problems in self-monitoring of actions
  and intentions as possible cognitive
  disturbances involved in the onset of psychosis.
• State-related cognitive difficulties may
  influence responding on complex scales leading to
  the development of a response bias.
• In the present study, we attempted to define the
  role of current verbal cognitive abilities in
  determining responses bias on the COPE by
  schizophrenia patients.
• We hypothesized that verbal cognitive abilities
  would moderate the relationship between positive
  symptom severity and response bias on the COPE.

6
Participants
7
Method

• Participants 25 male and 5 female stable
  outpatient schizophrenia participants.
• Measures
• COPE Inventory (Carver, Scheier, Weintraub, 1989)
  of preferred coping style self-report measure
  from which two subscales of adaptive and
  maladaptive style can be formed.
• Scale for Assessment of Positive Symptoms (SAPS
  Andreasen, 1984)
• The Shipley-Institute of Living Scale (SILS
  Shipley, 1940). The subscale used is a 40-item
  vocabulary test.

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Table 2 Means and Standard deviations
9

• Analysis
• A regression analysis was performed to assess the
  possibility that cognitive verbal ability would
  moderate the association between severity of
  positive symptoms and response bias.
• Results
• Cognitive verbal ability did not significantly
  influence the relationship between severity of
  positive symptoms and response bias on the COPE.

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Table 3 Summary of Hierarchical Regression
analysis of the moderation by verbal abilities on
the relationship between patients with positive
symptoms and their response bias (N30) F change
1, 26 1.274 p .269
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Table 4 Bivariate correlations
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Discussion

• The hypothesis was not supported
• Verbal abilities as measured by the
  Shipley-verbal IQ score did not moderate the
  relationship between positive symptoms and
  response bias on the COPE. In fact, it was not
  related to response bias at all.
• Explanation
• Shipley verbal may not have adequately assessed
  state-related cognitive limitations in the
  present sample.
• It is possible that other cognitive impairments,
  such as decreased attention span or working
  memory impairment influence responding on the
  COPE, rather than verbal ability.
• Others factors such as suggestibility or a simple
  lack of motivation could also drive response bias.

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Discussion

• Limitations
• The present sample was rather small, having only
  30 participants.
• Shipley verbal may not be an adequate measure to
  assess state-related cognitive impairment.
• Future research
• It may be important to test attention, working
  memory and motivation in future studies.

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References

• Andreasen, N. (1984). Scale for the Assessment of
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  University of Iowa.
• Baerwald, J., Tryon, W., Sandford, J. (2005).
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