Journal of Psychopathology and Behavioral Assessment, Vol. 23, No. 4, December 2001 ( c  2001) Coping With Severe Mental Illness: Relations of the Brief COPE With Symptoms, Functioning, and Well-Being 1 Bj¨ orn Meyer 2,3 The way patients cope with the experience of having an episode and being hospitalized for psychiatric disorder may relate to symptom severity, social functioning, and psychological well-being. Coping was assessed among 70 psychiatric inpatients diagnosed primarily with schizophrenia, major depres- sive disorder, and schizoaffective disorder. The Brief COPE—a questionnaire developed in health psychology (C. S. Carver, 1997)—was administered in interviewer-assisted format during patients’ stay on the ward. Thirty patients were re-interviewed an average of 6 weeks after discharge. Among patients with schizophrenia, schizophrenia symptom severity correlated inversely with adaptive cop- ing (e.g., acceptance, planning, seeking support) but did not correlate with maladaptive coping (e.g., self-blame, denial). Among those with schizophrenia, deficits in adaptive coping also predicted rela- tive increases in schizophrenia symptoms over time, controlling for intake symptom severity. Among patients without schizophrenia, maladaptive coping correlated concurrently with depressive symp- toms. Several hypothesized associations between concurrent coping, functioning, and well-being were also documented. KEY WORDS: coping; schizophrenia; depression; social functioning; psychological well-being. INTRODUCTION Being diagnosed with severe mental illness is typ- ically a stressful and unsettling experience. People with schizophrenia, for example, encounter a host of psycho- logical and social stressors, ranging from altered percep- tions and identity confusion to societal stigma and dis- crimination (Hatfield, 1989). As many as 81% of patients with schizophrenia are distressed by their symptoms, and up to 66% make some effort to cope (Carter, Mackinnon, & Copolov, 1996). The coping challenge for patients with severe mental illness is at least twofold: First, they must cope with the experience of having symptoms and, second, with the disorder’s broader implications for their personal 1 Versions of this paper were presented at the 12th annual convention of the American Psychological Society, Miami Beach, FL, June 2000; and at the 14th annual meeting of the Society for Research in Psychopathol- ogy, Montreal, Canada, November 1999. 2 Louisiana State University, Baton Rouge, Louisiana. 3 To whom correspondence should be addressed at Department of Psy- chology, 236 Audubon Hall, Louisiana State University, Baton Rouge, Louisiana 70803; e-mail: bmeyer@lsu.edu. life and social role (Hatfield & Lefley, 1993). The present study aimed to investigate how psychiatric patients cope with the stress of experiencing symptoms and being hos- pitalized for their illness. Coping With Severe Mental Illness Over the past 20 years, more has become known about how patients cope with the symptoms of mental illness. For example, Knudson and Coyle (1999) identi- fied four strategies patients with psychosis use to cope with auditory hallucinations: modulating social contact, employing sensory stimulation, modifying physiological arousal, and using cognitive strategies. Others have noted that some of the “symptoms” of schizophrenia may them- selves reflect coping efforts (Carr, 1988; Van den Bosch & Rombouts, 1997). For instance, seemingly disorganized behavior may reflect efforts to control intrusive thoughts or images. Some evidence suggests that active, behavioral coping strategies are among the most helpful in terms of leading to better psychosocial functioning (Boschi et al., 2000). Seeking instrumental social support (obtaining 265 0882-2689/01/1200-0265/0 C  2001 Plenum Publishing Corporation