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

Abstract

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.