Stress Reduction for Family Caregivers in Chronic Mental Illness: Implications of a Work Stress Management Perspective

In several studies involving a total of 291 family caregivers for schizophrenia sufferers, the stressors that arise from caregiving were identified. Also identified were the outcomes for caregivers, which often include psychological distress. Caregivers develop various stress-reduction techniques, but this article explores the utility of applying the principles of work stress management to caregiver well-being. An organizational psychology perspective suggests that a comprehensive focus must include not only how individuals can learn to manage the emotional demands of their work, but also how the work of caregiving can be made less stressful for them. Suggestions from a work stress management perspective highlight the possible contributions of worker participation in policy formulation and a collaborative relationship between family and professional caregivers. Potentially fruitful research directions are noted.     

A Cost Analysis of Self-Management Programs for People with Chronic Illness

The soaring cost of health care is a national problem that needs response at multiple levels, including that of the community. Reducing or limiting health care costs through interventions that emphasize the self-management of health may promote broader health care coverage, better quality of health care, and a sense of control over one's health. Therefore, it behooves community psychologists to perform cost analyses when testing interventions for people in a community. The present study investigated the effects of social support and education interventions on psychosocial variables, health status, and health care costs in older people with osteoarthritis. Participants were 363 members of a health maintenance organization (HMO), 60 years of age and older, with osteoarthritis. Participants were randomly assigned to one of three intervention groups (social support, education, or a combination of both) or to a control group. The results indicated that feelings of helplessness decreased in the intervention groups but not in the control group. All groups showed increases in self-efficacy and overall health status. In addition, health care costs increased less in the intervention groups than in the control group. Cost analysis was used to demonstrate that the monetary savings of the intervention greatly outweighed the cost of conducting the intervention. It appears that interventions can limit health care costs while improving health and increasing feelings of control for older people with osteoarthritis. Further, this paper demonstrates how a cost-benefit focus can benefit community studies.     

Personality Disorders in Older Adult Inpatients with Chronic Mental Illness

It has been hypothesized that some types of personality disorders tend to remit with age whereas others may become more prominent. The present study determined the prevalence and nature of 13 personality disorders with a self-report inventory (Coolidge Axis II Inventory) in an older group of chronically mentally ill inpatients (N = 30, mean age = 63 years) and a younger group of similar patients (N = 30, mean age = 39 years). All patients met DSM-IV criteria for either Schizophrenia, Schizoaffective Disorder, Bipolar Disorder, or recurrent severe Major Depression with psychotic features. The prevalence rate of personality disorders was high for both groups: 58% for the older sample and 66% for the younger group. The younger group was more likely to be diagnosed Antisocial, Borderline, Passive-Aggressive, Sadistic, and Schizotypal, but the groups were not different in the rates of Obsessive-Compulsive Disorder. This study supports the hypothesis that some personality disorders remit with age. However, no evidence was found to suggest that other personality disorders become more prominent in older adult psychiatric populations. Suggestions for future research are offered.     

The Effects of Introducing Peer Support to Young People with a Chronic Illness

Peer support groups have been an increasingly popular way of limiting the adverse effects of life with a chronic illness for adolescents although few groups have been rigorously evaluated. This paper reports the findings of a realistic evaluation of a hospital based peer support program Chronic Illness Peer Support (ChIPS), in Sydney, Australia. We collected qualitative interview and focus group data from four participant groups; new ChIPS members, their parents, older members who had been in ChIPS for two or more years, and ChIPS co-ordinators past and present. Results of qualitative data have been aggregated and organised into three categories; program attendance: getting in and staying in; program outcomes for young people: personal growth and development; and social connection. Questionnaires were also administered to fourteen new ChIPS members but no significant changes in distress or self-esteem were recorded between the beginning and the end of the short study period. The ChIPS Introductory Program fulfilled its aim, entering young people with chronic illness into the peer support program. There was evidence of initial personal growth and development in those young people, with potential for enhanced social connection from ongoing participation in ChIPS activities.     

Profiles of Chronic Illness Knowledge in a Community Sample of American Adults

The author identified profiles of chronic illness knowledge (i.e., heart disease, cancer, diabetes) in a community sample of American adults and examined the effect of sociodemographic influences on relations of illness knowledge to health practices and well-being. Participants were 181 women and 120 men who completed measures of illness knowledge, sociodemographics, personal health practices (e.g., diet, exercise, substance abuse, adaptive healthcare use), well-being (e.g., self-rated physical health, depression, social support), and perceived illness risk. Two-step cluster analyses performed on random subsets of the sample identified three levels of illness knowledge: low, medium, and high. Knowledge groups were differentiated on most measures of health practices, well-being and perceived illness risk. However, effects were substantially attenuated after controlling for differences in age and SES. Findings indicate that age and other sociodemographic factors are related not only to levels of illness knowledge but also to the application of knowledge in relation to health practices and well-being.     

The Perspectives of Young People of Parents with a Mental Illness Regarding Preferred Interventions and Supports

Young people of parents with a mental illness are at significant risk of developing a mental illness. This risk may be reduced if appropriate interventions are provided. While there are several supports available, their needs are rarely heard in either intervention development or evaluation. This study presents young people’s perspectives of the types of supports they want. One hundred and seventy-two young people (13–17 years) whose parent has a mental illness completed a self-constructed questionnaire and six of these participants engaged in individual follow-up interviews. Frequency data indicated that youth want to learn how to cope or manage their parent’s mental illness and highlighted a need to access support online. Interview thematic analysis reflected a need for psycho-education, confidential and/or anonymous support, and a preference to access information from health care professionals. Given the diversity of views presented, this study suggests that “not one size fits all”.     

Exercise and Movement as an Adjunct to Group Therapy for Women with Chronic Mental Illness

Abstract

Feminist therapists value the empowerment of clients and the appropriate sharing of the therapist's institutionalized power. As therapists who are also “mandated reporters,” we are obligated under certain circumstances to use our power to warn potential victims of harm, to prevent clients from harm to self or others, or make reports to institutions which have a great impact on clients' lives. Using four case examples, this paper will present clinical situations where the use of the therapist's power interfaces with homophobia, racism, and paternalism in the lives of low-income clients.     

Perceived Stress and Comorbid Illness Predict Depressive Symptomatology in People with Coeliac Disease

A high prevalence of depression is found in people with coeliac disease (CD). People with CD who are depressed are less likely to manage their illness effectively, which may lead to complications. Identification of variables associated with depression in people with CD may facilitate early detection and intervention. Participants were 749 members (125 males, 622 females) of the Queensland Coeliac Society (aged 18–88 years), recruited via a mailout. Participants completed the Modified Zung Self‐Rating Depression Scale, the Perceived Stress Scale, and the Perceived Consequences Subscale (from the Revised Illness Perception Questionnaire). Stress (p = .001) and comorbid medical illness (p = .01) were significantly associated with depression in CD. The current study made an original contribution to the body of literature by identifying stress and comorbid medical illness as predictors of depression in CD.     

Exploring the Experiences of Individuals With Serious Mental Illness in a Modified Treatment Mall: Centralized Off-Unit Programing With Extended Hours,a Mixed Methods Study

Abstract

Centralized Off-Unit Programing With Extended hours (COPE) is a recovery-oriented model of service that aims to address limited occupational engagement and social isolation among inpatient clients with serious mental illness. This study explored the self-reported outcomes of 12 clients using semi-structured interviews and pre- and post- administration of the Personal Recovery Outcome Measure. These outcomes were supported by significant improvements in personal recovery and included sense of choice, occupational engagement, socialization, change in environment, skill learning, and improved sense of wellness. These findings provide preliminary evidence on the COPE model of service and its potential role in promoting personal recovery.     

Personality Dysfunction and the Management of Chronic Medical Illness: A Community Health Sample

The purpose of this study was to determine the influence of personality disorders on perceived health status, self-efficacy for management of the chronic illness, and physician perception of patient health. A total of 607 patients with self-identified chronicillness(es) volunteered to participate in the study. Out of this sample, 147 had collaborative physician data indicating a chronic illness. The final sample was 143 due to incomplete data. Results suggested that maladaptive personality characteristics, as measured by the Short-Form of the Coolidge Axis II Inventory (SCATI), were related to a number of important factors that influence self-management of chronic illnesses. When the personality constellations were broken into 3 groups (normal, subclinical, and clinical) significant differences were found on the 3 groups of dependent variables (Subjective Health, Self-Efficacy, Physician Appraisal) for the different personality disorders. These data provide useful information on several factors that influence effective disease management. Clinical implications and directions for future research are provided.     

Psychometric Properties of the Perceived Stress Scale in Youth with Mental Illness

Journal of Child and Family Studies - The Perceived Stress Scale (PSS) is a widely used measure of psychological stress and has demonstrated robust psychometric properties in adult populations....     

Understanding Differences in Mental Health History and Behavioral Choices in a Community Sample of Individuals with and without Body Modifications

This study investigated the differences in mental health history and social, health, alcohol and substance, and sexual behaviors of individuals with and without body modification in a community sample. Previous research primarily focused on negative behavioral and psychological correlates of body modification practices in college student, juvenile delinquent, inpatient, and incarcerated populations. This tendency does not take into account changes in the demographics and motivations of individuals who obtain body modifications in the last two decades. The Community Body Modification Checklist was developed based on previous studies; reliability and validity for the measure were established using Cronbach’s alpha and factor analysis. The results indicated that individuals with body modifications were not more likely to engage in risky behaviors or report a history of mental health problems when compared to non-modified persons; however, they were more likely to engage in social and health behaviors. These findings may be best explained by the body modification community becoming diversified by the middle class whose meanings, motivations, and usage of tattoos and piercings are unique.     

合并精神疾病患者剖宫产术麻醉优化与医患安全保障

合并精神疾病患者接受剖宫产术时,由于此类患者的特殊性,患者以及其家属、医务人员心理表现都有别于普通情况。合理遵守此类患者的如下麻醉方案优化原则：麻醉操作可以实施原则、麻醉效能有效控制原则、避免诱发或加重精神疾病原则、患者无痛和新生儿安全原则、术后镇痛衔接原则、全程心理干预原则和替代麻醉预案制定原则,同时科学制定患者围术期如下管理规章制度：应急程序的及时启动、患者家属及监护人的沟通与知情同意、麻醉前后特定病房或医疗单位的建立和麻醉医疗期间医患合法权益的保障,只有这样医患双方安危和权益才能得到最佳保障。     

Maintaining High Subject Retention in Follow-Up Studies of Children with Mental Illness

Measuring a program's success in enabling a child to improve functioning at home, school, and the community requires careful tracking of children's progress during the intervention and after it is completed. Attrition is often a major problem in carrying out longitudinal research. I present a number of strategies for maintaining high rates of response in follow-up studies, including how to choose a study design that enhances participation, how to locate study participants, how to engage study participants, and how to select and train high quality interviewers. The strategies presented have been used with success by a children's mental health agency and may be helpful to other researchers as they evaluate programs, measure outcomes, and study the life course of children with mental illness.     

Coping with Social Stress: Implications for Psychopathology in Young Adolescent Girls

This study investigated the impact of social stress on symptoms of psychopathology at the entry into adolescence (111 girls, Mage = 11.84, SD = 0.77). We examined whether peer stress and pubertal timing were associated with internalizing distress and aggression, and whether responses to stress and cortisol reactivity mediated or moderated these associations. Cortisol samples were collected from saliva samples during in-home visits, and the YSR was used to assess psychopathology. Interestingly, pubertal timing demonstrated a trend association with cortisol. Responses to stress mediated the association between social stress and symptoms of internalizing distress and aggression. Specifically, early maturers and girls with higher levels of peer stress exhibited more problematic responses to stress, in turn demonstrating higher levels of internalizing distress and aggression. Significant moderation effects also emerged. For example, early maturers who experienced higher levels of emotional/cognitive numbing in response to peer stress were at greater risk for aggression. Findings identify coping strategies that may be used in evidence-based programming to help girls transition more successfully into adolescence will be discussed.

A Psycho-Educational Intervention for People with a Family History of Depression: Pilot Results

We developed and pilot-tested the first online psycho-educational intervention that specifically targets people with a family history of depression (‘LINKS’). LINKS provides genetic risk information and evidence-rated information on preventive strategies for depression and incorporates a risk assessment tool and several videos using professional actors. LINKS was pilot-tested in the general practitioner (GP) setting. The patient sample included people with a family history of at least one first-degree relative (FDR) with major depressive disorder (MDD) or bipolar disorder (BD). Patients attending participating GP practices were invited to enroll in the study by letter from their GP. Patients who self-identified as having at least one first-degree relative (FDR) with MDD or BD were eligible. Patients completed questionnaires, pre-post viewing LINKS, with measures assessing satisfaction, relevance, emotional impact and perceived improvement of understanding. Six GP practices participated, and 24 patients completed both questionnaires. Of these, all reported that they were satisfied or very satisfied with LINKS, and 74 % reported that LINKS met their expectations, and 21 % that it exceeded their expectations. LINKS was judged highly acceptable by this sample of GP attendees, and results indicate that an assessment of its effectiveness in a larger controlled trial is warranted.