UNDERSTANDING THE QUALITY OF LIFE AMONG INDIVIDUALS WITH SCHIZOPHRENIA: AN EXPLORATION OF RISK AND RESILIENCE FACTORS

Abstract

The objective of this dissertation was to examine the relation between shyness and quality of life (QoL) among adults with schizophrenia in a series of three studies. I first began by understanding whether commonly used measures of shyness and sociability were reliable in this population (Study 1). Next, I examined two moderating variables related to stress-responses subserved by the central (Study 2) and peripheral (Study 3) nervous systems. Study 1, used self-report questionnaires of shyness and sociability to determine whether individuals with schizophrenia responded to these questionnaires in the same way as healthy controls. Studies 2 and 3 used linear regression analyses to determine whether passive neural responses (ERP’s) to social stimuli (emotional faces) and hormonal levels (baseline salivary cortisol and testosterone), respectively, moderated the relation between shyness and QoL. I found that individuals with schizophrenia responded to self-reported shyness and sociability items in a similar way as their nonclinical peers, suggesting that self-reported shyness and sociability are equivalent across populations (Study 1). Study 2, found that individuals who were shy and displayed a hyposensitivity to the processing of fearful faces displayed the lowest QoL. Those who were shy and took longer to process happy faces also demonstrated hindered QoL. Finally, individuals who were shy and had relatively lower baseline salivary cortisol levels also had the lowest QoL. In all circumstances, individuals who were relatively less shy were not susceptible to factors relating to the central and peripheral nervous system. The results of these three studies show that interpretations of findings using self-reported measures of shyness and sociability can be made with confidence in this population. The results also provide support that factors related to processing stressful stimuli can influence the relation between shyness and QoL, thereby further increasing our understanding of this nuanced relation. Theoretical and practical implications of these findings are discussed.