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A Study on the coping strategies, perceived social support, attitudes towards mental health problems on the overall wellbeing among adolescents of parents diagnosed with schizophrenia

This hospital-based study of 45 adolescents with parents diagnosed with schizophrenia reveals that while they primarily rely on self-reliance, optimism, and strong personal networks for coping, they face moderate emotional wellbeing challenges and stigma, highlighting the need for targeted interventions to enhance their resilience.

Original authors: Yatheesh Bharadwaj, Sateesh Rangarao Koujalgi

Published 2026-08-14

📖 6 min read🧠 Deep dive

CC BY 4.0

Original authors: Yatheesh Bharadwaj, Sateesh Rangarao Koujalgi

Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). ✨ This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer

Imagine your life is a giant, complex video game. In this game, "Wellbeing" isn't just about having a high score or lots of gold coins; it's about how happy you feel inside, how strong your character is, and how smoothly your story is playing out. Sometimes, the game throws you a "Boss Battle" that you didn't ask for. For some teenagers, that boss battle is having a parent who is fighting a severe mental health condition called schizophrenia. This isn't a game glitch; it's a real-life storm that can shake the whole family.

To survive these storms, players usually have two main tools. The first is their "Coping Strategy"—the internal mechanisms they use to handle stress, like taking a deep breath, solving the puzzle themselves, or just staying positive. The second tool is "Social Support," which is like having a team of allies, friends, or family members who can jump in to help when things get tough. But there's a third, invisible factor: "Attitudes." If a player feels ashamed or thinks the game is "broken" because of their family, they might hide their character or refuse to ask for help. This study dives into how these three things—how teens handle stress, who they think is helping them, and what they believe about mental health—mix together to determine how well they are doing in the game of life.

The Study: Teenagers Navigating the Storm

This research is like a deep-dive documentary into the lives of 45 teenagers (aged 12 to 19) whose parents have been diagnosed with schizophrenia. The researchers wanted to see how these young people are coping, who they feel is in their corner, and how their feelings about mental illness affect their overall happiness. They didn't just guess; they used special questionnaires (like a "Coping Orientation" map and a "Social Support" radar) to get the real numbers.

The Main Findings: What the Data Says

The study found that these teenagers are surprisingly resilient, but they are also carrying a heavy load. Here is the breakdown of their world:

The "Do-It-Yourself" Superpower: When things get tough, these teens mostly rely on self-reliance and optimism. On a scale where higher numbers mean more use, they scored a 3.30 for these positive strategies. They are the type of players who say, "I can fix this," and "It's going to be okay." However, they are much less likely to call in the "professional support" team, scoring only 1.82 for seeking help from experts. They prefer to handle the boss battle on their own.
The Support Squad: Even though they don't ask for professional help, they feel they have a strong team nearby. They reported very high levels of support from "significant others" (like a close friend or a special person), with a score of 5.10. They also felt good support from family. It seems their personal networks are strong, acting like a safety net.
The Shadow of Shame: Despite having a support net, there is a shadow hanging over them. The study measured "shame" (feeling bad about the family situation) and found moderate levels of both internal shame (feeling bad about oneself) and external shame (worrying about what others think). The scores were 0.91 for internal shame and 0.81 for external shame. This suggests that even with help, the stigma of having a parent with schizophrenia is still a real, heavy backpack they are carrying.
Health vs. Happiness: Interestingly, their physical health is quite good (scoring 3.47), but their emotional wellbeing is only moderate (scoring 1.98). It's like having a healthy body but a tired heart.

The Big Connection: What Actually Makes a Difference?

The researchers ran the numbers to see which tool was the real magic wand for wellbeing.

Coping is King: The study found a strong, significant link between how well a teen copes and their overall wellbeing. The math showed a correlation of 0.629, which is a big number in science-speak. This means that the more these teens use positive coping strategies (like staying optimistic), the happier and more well-adjusted they tend to be. It's a direct line: better coping = better life.
Support is... Complicated: Here is the twist. Even though these teens felt they had great support from friends and family, the study found that this support did not significantly predict their overall wellbeing. The statistical link was weak and not strong enough to be considered a "sure thing." It suggests that just having people around isn't enough if the teen isn't actively using their own internal tools to manage the stress.
Attitudes Matter (But Maybe Not How We Thought): The study looked at whether negative attitudes toward mental health hurt wellbeing. While there was a correlation suggesting that more negative attitudes (more shame) were associated with lower wellbeing, the researchers were careful to note that when testing this as a specific predictor, the result was not statistically significant. The data showed a p-value of 0.122, which is higher than the 0.05 cutoff needed to be sure. So, while the numbers hint that shame might be a problem, the study cannot definitively say it is the main cause of lower wellbeing based on this specific analysis, though it certainly doesn't help.

What the Study Rules Out

The researchers were careful not to overpromise. They explicitly found that perceived social support, while feeling good to the teens, is not the main driver that fixes their overall wellbeing in this specific group. You can't just say, "Give them more friends, and they will be fine," because the data suggests that their own internal coping strategies are the real engine of their happiness.

How Sure Are We?

The authors are confident in their findings about the link between coping and wellbeing, calling it a "significant relationship." However, they are more cautious about the social support and attitude links, noting that the sample size was small (only 45 teens) and that the study was done in just one hospital. They admit that because they used self-reporting (asking the teens to grade their own feelings), there might be some bias. So, while the story of "Coping is King" is strong, the full picture of how social support and attitudes work might need more research to be fully understood.

In short, these teenagers are tough, optimistic, and have a good support system, but they are still wrestling with shame and a lack of professional help. The key to their happiness seems to be their own ability to stay positive and handle stress, rather than just relying on others to save the day.

Technical Summary: Coping Strategies, Social Support, and Wellbeing in Adolescents of Parents with Schizophrenia

Problem Statement
Schizophrenia is a severe mental health disorder that extends its impact beyond the diagnosed individual to family members, particularly children and adolescents. These offspring face unique psychological and emotional challenges that can compromise their developmental trajectory. While existing literature addresses the general strain on family dynamics and parenting, there is a specific gap in understanding how adolescents of parents with schizophrenia navigate their environment through specific coping mechanisms, perceived social support, and attitudes toward mental health, and how these factors collectively influence their overall wellbeing. This study aims to address this gap by examining the interplay between these variables in a clinical setting.

Methodology
The research employed a hospital-based, single-centered, cross-sectional descriptive design conducted at the Dharwad Institute of Mental Health and Neuro Sciences (DIMHANS).

Participants: The study utilized purposive sampling to select 45 adolescents (aged 12–19 years) who are offspring of parents diagnosed with schizophrenia.
Exclusion Criteria: Adolescents whose parents had other psychiatric comorbidities or intellectual development disorders were excluded.
Data Collection Tools:
1. Socio-demographic Proforma: Captured family type, socioeconomic status, age, gender, and clinical history.
2. Adolescent Coping Orientation for Problem Experiences (A-COPE): A 54-item self-report inventory measuring coping behaviors on a 5-point Likert scale.
3. Multidimensional Scale of Perceived Social Support (MSPSS): A 12-item scale assessing support from family, friends, and significant others on a 6-point Likert scale.
4. KIDSCREEN-52: A validated tool measuring ten dimensions of wellbeing, including physical health, psychological wellbeing, autonomy, and peer relations.
5. Attitudes Towards Mental Health Problems (ATMHP): A 35-item scale measuring internal, external, and reflected shame related to mental illness.
Statistical Analysis: Data were analyzed using Pearson's correlation coefficients and multiple regression analysis to determine relationships between independent variables (coping, social support, attitudes) and the dependent variable (overall wellbeing).

Key Results

Demographics: The sample consisted of 60% males and 40% females, predominantly from nuclear families (77.8%) and Hindu backgrounds (91.1%). A significant portion of families reported monthly incomes below 10,000 INR. Notably, 88.9% of respondents reported poor medication adherence among their parents.
Coping Strategies: Adolescents primarily relied on "self-reliance and optimism" (Mean = 3.30) and "developing social support." Conversely, "seeking professional support" was the least utilized strategy (Mean = 1.82).
Perceived Social Support: Participants reported high levels of support from "significant others" (Mean = 5.10), followed by family (Mean = 4.79) and friends (Mean = 4.07).
Attitudes and Stigma: Moderate levels of internal shame (Mean = 0.91) and external shame (Mean = 0.81) were observed, indicating persistent stigma.
Wellbeing: Physical health scores were good (Mean = 3.47), while emotional wellbeing was moderate (Mean = 1.98).
Correlations and Regression:
- Coping Strategies: Showed a strong, significant positive correlation with overall wellbeing ( $r = 0.629, p < 0.01$ ). Regression analysis confirmed that coping strategies significantly predict wellbeing ( $\beta = 0.576, p < 0.001$ ).
- Perceived Social Support: Showed a weak, non-significant relationship with overall wellbeing in the regression model ( $\beta = 0.009, p = 0.943$ ), despite moderate-to-high mean scores.
- Attitudes: Negative attitudes towards mental health showed a moderate negative correlation with wellbeing ( $r = -0.342, p < 0.05$ ), though this was not statistically significant in the regression model ( $p = 0.122$ ).

Key Contributions
The study contributes to the literature by quantifying the specific coping mechanisms and support structures of adolescents living with a parent diagnosed with schizophrenia in an Indian context. It highlights that while these adolescents demonstrate resilience through self-reliance and optimism, they underutilize professional support. Furthermore, the research identifies a discrepancy between the presence of perceived social support and its predictive value for wellbeing, suggesting that the mere existence of a support network does not automatically translate to improved emotional outcomes for this demographic. The study also documents the prevalence of internalized and external shame, linking these attitudes to lower wellbeing scores.

Significance and Claims
The authors claim that the study underscores the critical role of active coping mechanisms, specifically self-reliance and optimism, in maintaining the overall wellbeing of adolescents with parents suffering from schizophrenia. The findings suggest that interventions should focus on strengthening these adaptive coping skills.

Regarding social support, the paper claims that while adolescents feel supported by significant others, this support does not significantly predict their wellbeing in the statistical model. The authors attribute this to potential barriers such as stigma, which may lead adolescents to hide their family situation, or the emotional unavailability of family members who are themselves under strain.

The study concludes that addressing stigma and improving emotional resilience through targeted interventions are crucial. However, the authors maintain a modest stance regarding the generalizability of these findings, explicitly acknowledging limitations such as the small sample size (N=45), the single-center design, the use of purposive sampling, and the reliance on self-report measures which may be subject to social desirability bias. The paper does not propose specific future experimental protocols but emphasizes the need for targeted interventions to improve emotional resilience and reduce stigma based on the observed correlations.

The Study: Teenagers Navigating the Storm

Technical Summary: Coping Strategies, Social Support, and Wellbeing in Adolescents of Parents with Schizophrenia

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