Spiritual and religious concerns of the hospitalized adolescent

One of the tasks of adolescence is the development of a value system. The way in which these values are expressed in relationship to illness in adolescence, however, has not been studied. The authors conducted a social science survey to study the spiritual concerns of hospitalized adolescents. One hundred and fourteen hospitalized adolescents, ranging in age from 11 to 19, answered a Likert scale questionnaire on Spiritual and Religious Concerns (SRQ). Analysis of variance was performed to correlate responses with sex, race, religion, type of school, and severity of illness. A subgroup of hospitalized adolescents, those with more serious disease, experienced intensified spiritual and religious concerns. In response to the questionnaire, over 15% of the patients requested further help. Our findings suggest that training in adolescent health care and the provision of services to teenagers ought to include teaching in the area of spiritual and religious values of teenagers, with emphasis on the hospitalized adolescent.     

Religious coping in highly religious psychiatric inpatients

This study among highly religious psychiatric patients in a mental hospital in the Netherlands focused on the following issues: their religious and spiritual beliefs and activities; their religious coping activities, measured using Pargament's three coping styles and a positive religious coping scale; the influence of religious coping on psychological and existential well-being; and the predictive value of general religiousness, as compared with religious coping activities, regarding psychological and existential well-being.

For this population of inpatients, religion had a positive influence on their ways of dealing with mental problems; religious coping was positively correlated with existential and psychological well-being. General religiousness as well as religious coping were positively correlated with existential well-being, whereas psychological well-being primarily was predicted by positive religious coping.

Results are discussed in the context of theoretical notions of religious coping, addressing in particular the positive influence of religious beliefs, relying on God, religious activities and religious social support in psychological and existential times of crisis.     

Spiritual well-being and spiritual practices in elderly depressed psychiatric inpatients

This study's aims were to describe the spirituality of depressed elderly psychiatric inpatients and to examine associations among spirituality, depression, and quality of life (QOL). Forty-five persons participated. Most reported frequent, stable spiritual practices and experiencing spiritual comfort and guidance. Some reported spiritual distress and changes in spirituality. During hospitalization, participants demonstrated increased spiritual well-being (SWB) and peacefulness, and reduced hopelessness, worthlessness, and guilt. Positive associations were found between SWB and QOL and negative associations between SWB and depression.     

Substance use by adolescent psychiatric inpatients and their parents

The relationship between adolescent psychiatric inpatients' and their parents' drug use was studied using a questionnaire format. The major finding was that there was no systematic relationship. It is hypothesized that due to recent family realignments, adolescents are turning away from their parents and toward peers for their role models in drug use.     

Minimal brain dysfunction in adolescent and young adult psychiatric inpatients

This paper presents data on a study of 100 consecutive young adult psychiatric admissions to Horsham Hospital, to determine the incidence of minimal brain dysfunction in this population, to define the subcategories of common psychiatric presentation, and to compare these data with those from the companion study conducted by our research group of fifty consecutive adolescent psychiatric admissions, reported by Horowitz, 1981.     

SCL-90-R symptom patterns for adolescent psychiatric inpatients

We collected Symptom Check List-90-Revised (SCL-90-R) symptom pattern and severity data from a sample of 486 adolescent psychiatric inpatients. Preliminary comparison of these data with previously published data for adolescent nonpatients suggested no meaningful differences in overall symptom severity, although the data suggested higher Positive Symptom Distress Index (PSDI) scores for inpatients, less severe somatization and psychoticism symptoms for inpatient males compared to nonpatient males, and more severe depressive symptoms for inpatient females compared to nonpatient females. Future studies should be directed toward further analyses of such data and the development of representative and generalizable adolescent inpatient norms for the SCL-90-R.     

Prevalence of DSM-III conduct and adjustment disorders for adolescent psychiatric inpatients

The prevalence of DSM-III conduct and adjustment disorders in two adolescent psychiatric facilities, both located near large U.S. cities, was investigated. Overall, 31.6% of the adolescent inpatients were conduct disordered while 12.5% were adjustment disordered. The conduct disorders were primarily "aggressive" subtypes suggesting that this characteristic may influence hospitalization and diagnostic decisions. Such data on prevalence assists future treatment planning, allowing anticipation of case loads.     

Kinetic Family Drawings and MMPI diagnostic indicators in adolescent psychiatric inpatients

Correlations among Kinetic Family Drawings and MMPI indicators of depressive, anxiety, behavioral, and thought disorders and diagnostic category were estimated for a group of 52 adolescent psychiatric inpatients. No statistically significant values were found between test indicators and corresponding MMPI scales or diagnoses, although MMPI D and Sc scales were significantly related to diagnosis. Results do not support the concurrent or construct validity of the drawings.     

Reliability and validity of the Beck depression inventory--II with adolescent psychiatric inpatients

This investigation was conducted to validate the Beck Depression Inventory--II (BDI-II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996) in samples of adolescent psychiatric inpatients. The sample in each substudy was primarily Caucasian. In Study 1, expert raters (N=7) and adolescent psychiatric inpatients (N=13) evaluated the BDI-II items to assess content validity. In Study 2, confirmatory factor analyses of several first-order solutions failed to provide adequate fit estimates to data for 205 boys, 203 girls, and the combined sample. Exploratory factor analyses identified new item-factor solutions. Reliability estimates were good (range =.72 to.91) for the BDI-II total and scale scores. In Study 3 (N=161 boys and 158 girls from Study 2), preliminary evidence for estimates of concurrent, convergent, and discriminant validity were established for the BDI-II.     

Assessment of mode of anger expression in adolescent psychiatric inpatients.

Anger can play an important role in depression and suicide risk among adolescents. The present study evaluated internalized and externalized anger in 92 adolescent psychiatric inpatients. Results indicated that adolescents who internalized their anger were more likely to be depressed and to experience feelings of hopelessness. In addition, adolescents who internalized their anger made more serious suicide attempts than did those who externalized their anger. In contrast, adolescents who externalized their anger were more likely to have alcohol-related problems. Thus, different modes of anger expression appear to be related to different manifestations of psychopathology. It was concluded that assessment of mode of anger expression in adolescents may enhance our understanding of suicide and its risk factors.     

Validity of the Devereux Scales of Mental Disorders with adolescent psychiatric inpatients

Tested the validity of the Devereux Scales of Mental Disorders (DSMD; Naglieri, LeBuffe, & Pfeiffer, 1994) in a sample of 108 adolescent psychiatric inpatients. DSMD scales were compared to parent-report, interview-based, self-report and diagnostic measures. DSMD measures of conduct problems and delinquency were significantly associated with the predicted parent-report, interview-based, and diagnostic measures of conduct disorder and substance abuse and not with any measures of anxiety or depression. DSMD measures of anxiety and depression were related to other parent-report ratings of internalizing symptoms but had more limited convergent and discriminant validity. The DSMD was compared to the Child Behavior Checklist (CBCL; Achenbach, 1991) for diagnostic classification accuracy. The two measures were comparable in classifying oppositional or conduct disorder. The CBCL was superior for classification of major depression. The DSMD was superior for classification of substance abuse.     

Suicidal ideation in adolescent psychiatric inpatients as associated with depression and attachment relationships

Examined suicidal ideation in adolescent psychiatric inpatients as associated with depressive symptoms and attachment to mother, father, and peers. Fifty-nine adolescent psychiatric inpatients (25 male, 34 female) completed self-report measures of suicidal ideation, depressive symptoms, and attachment. Attachment to mother accounted for significant variation in levels of depressive symptoms and suicidal ideation. In addition, attachment to peers accounted for significant variation in suicidal ideation and girls' (but not boys') depressive symptoms. However, after adjusting for depressive symptoms, attachment variables failed to contribute additional variance in suicidal ideation. Self-reported depressive symptomatology remained the strongest predictor of suicidal ideation, regardless of its order in the regression analyses. Prevention and treatment efforts may focus on mother-adolescent attachment and peer attachment (particularly in girls) to reduce risk for depression and suicidal ideation.     

The multi-attitude suicide tendency scale: further validation with adolescent psychiatric inpatients

The present study was designed to examine the construct validity and psychometric properties of the Multi-Attitude Suicide Tendency Scale in adolescent psychiatric inpatients. This new scale has four subscales: attraction to life, repulsion by life, attraction to death, and repulsion by death. Confirmatory factor analysis of the scale items provided support for the fit of the 28-item, four-factor model. Results of logistic regression analyses revealed that high scores on the repulsion by life and the attraction to death subscales were useful in assessing the risk for suicide attempts. Results of the hierarchical regression analysis showed that high repulsion by life and low attraction to life subscale scores contributed to the prediction of scores on the suicide probability scale. We also examined gender differences on the four subscales and the psychological correlates of each subscale.     

Risk of future suicide attempts in adolescent psychiatric inpatients at 18-month follow-up

This study investigated potential predictors of suicidal behavior in adolescents during an 18-month follow-up period. Subjects included 60 adolescent psychiatric inpatients initially assessed in a private psychiatric hospital. Follow-up suicidality was most strongly predicted by high intake levels of hopelessness, and an increase in or persistent problems with depression during follow-up. Some family functioning variables measured at intake were predictive of suicidal behavior at the univariate level but did not add to the predictive ability of individual functioning variables. A mediational model was proposed in which the impact of family functioning on adolescent suicidality is mediated by its impact on individual functioning.     

Depression, hopelessness, and self-esteem: accounting for suicidality in adolescent psychiatric inpatients

The present study was designed to examine depression, hopelessness, and self-esteem as related to suicidal behavior in three groups of depressed adolescent psychiatric inpatients. Depressed adolescents who had never attempted suicide were compared to depressed adolescents who had attempted suicide once and to depressed adolescents who had attempted suicide on several different occasions. Results showed that suicidal adolescents experienced significantly greater depression and hopelessness than did the nonsuicidal adolescents. However, all three groups of depressed adolescents reported similar low levels of self-esteem. Measures of depression and hopelessness were useful in classifying the adolescents based on their suicidal behavior. Results suggest that the treatment of suicidal adolescents could benefit from strategies that focus on reducing feelings of depression and hopelessness.     

Perceived stress,life events,dysfunctional attitudes,and depression in adolescent psychiatric inpatients

Hewitt, Flett, and Mosher (1992) examined the factor structure of the Perceived Stress Scale (PSS) and its relation to depression in adult psychiatric patients. This study sought to replicate and extend their findings, using a sample of 203 adolescent psychiatric inpatients. All patients admitted to the adolescent unit in a psychiatric hospital over a 3-year period were administered the PSS, as well as measures of depression, life events, dysfunctional attitudes, and intellectual abilities. Consistent with Hewittet al., two factors were found in the PSS, reflecting perceived distress and perceived coping ability. Regression analyses indicated that, for males, both factors account for independent variance in depression, whereas for females, only the distress factor is related to depression. In addition, for both male and female, dysfunctional attitudes account for significant variance in depression in addition to PSS, but negative life events do not. None of the variables were related to intellectual abilities. Implications for clinical assessment and intervention are discussed.     

Spiritual pathology and religious coping as predictors of forgiveness

Spiritual pathology, religious coping, and dispositional forgiveness were investigated in two studies with graduate students at a Christian university-based seminary. Spiritual pathology was operationalised using measures of spiritual instability and spiritual grandiosity. Study 1 (N?=?194) examined patterns of correlation between positive and negative religious coping items, spiritual pathology, and dispositional forgiveness. Spiritual instability correlated with numerous positive and negative religious coping items while spiritual grandiosity did not. Dispositional forgiveness correlated with more positive than negative religious coping items. Study 2 (N?=?214) tested regression models with these variables. Spiritual grandiosity showed a significant quadratic (concave down) effect in predicting dispositional forgiveness while the linear effect was not significant. A hierarchical regression model showed positive religious coping, spiritual instability, and the quadratic effect for spiritual grandiosity each predicted unique variance in dispositional forgiveness after controlling for spiritual impression management. Negative religious coping was not related to dispositional forgiveness when included with these variables.     

Characteristics of readmitted psychiatric inpatients

This study examined sociodemographic, diagnostic, psychological, and episode-based variables in a sample of 130 psychiatric patients admitted to treatment at least twice in a 6-yr. period. Short length of initial hospitalization (r = -.30, p < .01) and younger age on initial admission (r = -.20, p < .05) were significantly correlated with frequent hospital admissions. Scores on four of the subscales of the WAIS-R were significantly correlated with readmission, confirming that patients who have fewer cognitive resources are at risk of frequent admissions. A multiple regression analysis combining variables to predict readmission accounted for only 12% of the common variance (r128 = .34, p < .01), however, indicating that a prediction equation with these variables has limited clinical utility.