A PATH ANALYSIS OF PSYCHOTIC SYMPTOMS AMONG PERSONS WITH SCHIZOPHRENIA AND METHAMPHETAMINE MISUSE

Abstract

This cross-sectional, descriptive correlation study aimed to explore the relationships among coping, medication use self-efficacy, expressed emotion, stressful life events, social support, and social functioning, and to test a model that explained the influences of these factors on the psychotic symptoms among schizophrenic persons that were misusing methamphetamines. The conceptual framework was guided by the Vulnerability-Stress Model of Schizophrenia (Nuechterlein & Dawson, 1984). A sample of 313 schizophrenic persons misusing methamphetamines was recruited using multi-stage sampling. All of the participants responded to a set of seven questionnaires, including the Demographic Data Questionnaire, the Brief Psychiatric Rating Scale, the Brief COPE, the Self-efficacy for Appropriate Medication Use Scale, the Family, Expressed Emotional Scale, the Thai version of the Stressful Life Events Questionnaire, and the Social Functioning Scale. A linear structural relationship (LISREL 8.72) was used to test the hypothesized path model. The study findings revealed that the hypothesized model fit the empirical data and explained 54% of the variance of the psychotic symptoms among schizophrenic persons and misusing methamphetamines (X2 = 8.28, df = 8, p-value = 0.41, X2 /df = 1.0, GFI = 0.99, AGFI = 0.96, CFI = 1.00, RMSEA = 0.01). In addition, the highest total effect and the factors directly affection the psychotic symptoms were emotionally focused coping strategies (-.12, p < .01), medication use self-efficacy (-.09, p < .01), social functioning (.07, p < .01), positively expressed emotion (-.04, p < .05), and stressful life events (-.01, p < .05). In addition, the factors with the strongest indirect effect on the psychotic symptoms through medication use self-efficacy were problem-focused coping strategies (-.02, p < .01) stressful life event (-0.01, p < .05), and social functioning (- 0.01, p < .05). These findings demonstrated that emotional coping strategies, medication use self-efficacy, social functioning, positively expressed emotion, and stressful life events were important factors that influenced the psychotic symptoms among these individuals. Therefore, nursing interventions that are designed to manage these factors are crucial in order to reduce the psychotic symptoms in this population.