Samband mellan psykisk ohälsa, copingstrategier och attachment hos personer med PWS

Previous research have studied whether people with PWS are having more symptoms of anxiety or depression or other psychological problems than a comparable group of controls, and also what kind of symptoms this kind of problem can cause. Further more have studies tried to determine which factors most affect pychological wellbeing in this group. Some research have shown that size, colour and localisation of the PWS have great effects and others have demonstrated that family support and good attachment between parents and children have great impact upon how people with PWS feel and cope with the stress that living with this kind of stigma brings. The stress can be described as daily and constant and is especially noticeable in social interplay. To have a different child can negatively affect the relations between child and parent. It puts an extra pressure upon the parent, and it takes more effort and more strength to handle the reactions from others and be able to in the best way help and support the child. This unsecurity can affect the relation between parent and child. And the quality of the attachment between parent and child can in it´s turn also affect how the PWS-ers as grown ups handle their relations with others. Our earliest relations become a model for how we later in life trust and relate to others. And how we handle stress, conflicts and problems is not just something we learn out of daily experiences, but is grounded in our earliest relationships with others. To handle stress we use coping strategies. These can be described as either active or passive, and differ in the way that active strategies are aimed to get rid of the causes of the stress and the passive ones are used to work on the feelings and emotions that the stress creates. Active strategies here are considered to be cognitive and behavioural efforts to reduce or minimize stress by organising, reorganising and adaption of your own behavoiur or thinking. Positive thinking and optimism, seeking support from others, gathering knowledge about pws and about how people react on pws are some examples. Passive coping is about avoiding situations where stressors can occur, by staying out of social situations, isolating yourself and trying to nullify PWS by acting as if it does not exist. That is focusing on avoiding the effects of stressors, instead of working on their causes.

This web-based correlational study was designed to investigate whether:
• People with PWS differ in psychological wellbeing from a group of controls.
• People with PWS differ in their attachment styles from a group of controls.
• Any psychological problems that people with PWS experience are related to attachment styles.
• What kind of copingstrategies people with PWS mainly use, and if their ways of coping are related in any way to attachment style and / or psychological wellbeing.
• Factors like colour, size or localisation of PWS or age and gender in any way affects patterns of responses.

Psychological wellbeing was here measured with HADS (the Hospital Anxiety and Depression Scale, Snaith & Zigmond, 1994), and attachment style with AAS (the Adult Attachment Scale, Collins & Read, 1990). PWS CQ , (Port Wine Stain Coping Questionnarie) was developed for this study as a measure of PWS related coping strategies.

Metod and participants
Participants in the study were 27 adults (20-55 years), 23 women and 4 men. A group of controls was created similar in size, age and gender.

People with PWS in this study were significantly more depressed and showed higher levels of anxiety than the controls. They were also in a higher degree more insecurely attached. There were significant correlations between high levels of symptoms of anxiety and depression and more unsecure attachment styles. People with PWS seem to use active and passive coping strategies to a rather similar degree. The active coping strategies have no significant relation to less symptoms of psychological problems. Factors like colour, size, localisation of PWS, age or gender appear in this study to have no specific effect on how you feel about or cope with having a PWS.

The results are very hard to generalize, because of the size and composition of the sample. Too few men participated, and the group was small. But one conclusion to be made, can be that the issue whether physical factors, like size, localisation and colour of the PWS, or psychological factors, related to how people are brought up, are more important for how you cope with or experience having a PWS, remains unsettled. People with PWS seem to differ between each other just as much as everyone else and there are many unique and personal ways of experiencing and coping with it. But as with all of us humans there is a strong connection between good attachment and psychological wellbeing. Our earliest as well as our present relations are important for us. Another conclusion is that it seems to be important to cope both actively and passively when you are under this kind of life long stress. To keep your strength up and be able to confront and actively handle peoples daily reactions upon you, you sometimes need to just lay back and take some time off, “lick your wounds” and relax. That perhaps gives you strength to carry on meeting and preventing any eventually negative reactions. A final conclusion is that the measure produced to rate coping with PWS (PWS CQ) needs to be further developed and tested. This can been seen as a start, but more needs to be done before it can be used as a truly reliable measure.