Integrated Coping and Awareness Therapy is a novel therapeutic intervention combining
strategies to improve stress reactivity and increase meaningful coping, as well as a range
of possible proximal (e.g. immune indices of stress reactivity, symptom severity) and distal
measures (e.g. relapse, quality of life).
Schizophrenia is one of the most devastating disorders that often results in a lack of
functional recovery. Current treatments focused on remediating symptoms have shown only
small successes in a return to functioning despite evidence of a dysregulated stress
response. There is a fundamental gap in understanding the impact of allostatic overload in
persons with schizophrenia that the investigators theorize is associated with deficits in
functioning and with an increased vulnerability and relapse risk. The long-term goal is to
test an intervention aimed at improving stress reactivity. The objective in this application
is to develop and test the feasibility of a novel therapeutic intervention combining
strategies to improve stress reactivity and increase meaningful coping. The central
hypothesis is that an intervention that improves stress reactivity as measured proximally by
endocrine, immune, and autonomic indices will result in improved adaptive capacity, better
role functioning, reduced risk of relapse, and decreased likelihood of disability for people
in the early stages of schizophrenia.
The rationale for the proposed research is that stress reactivity may be a modifiable risk
factor underlying functional deficits in schizophrenia. The intervention integrates two
treatment approaches. The first is based on research showing that mindfulness meditation
practice is associated with alterations in the neural processing of stressful events and
targets adaptive responses to stress. The second focuses on providing a buffer against
stress by using the self-generation of adaptive emotions with a positive psychology
intervention, which is potentially associated with building protective social resources.
These complimentary interventions provide a comprehensive synergistic approach for this
population that could lead to more adaptive coping responses and create a buffer against
- Current or past diagnosis of a schizophrenia spectrum disorder.
- Has been receiving treatment for psychosis or taking medication for psychosis for
less than 5 years.
- Has been hospitalized in the last 3 months.
- Currently practicing meditation
- Current dependence on alcohol or drugs.
- History of significant neurological disorder.
- History of serious head injury (i.e., loss of consciousness longer than 15 minutes,
no neuropsychological sequelae, no cognitive rehabilitation treatment post head
- Sensory limitation including visual (e.g., blindness, glaucoma, vision uncorrectable
to 20/40) or hearing (e.g. hearing loss) impairments.
Diana O Perkins, MD, MPH
University of North Carolina, Chapel Hill