Youth Mental Illness and the Family: Parents’ Loss and Grief

Parents and family members whose adult child or relative has a mental illness endure significant losses, to which they respond with grief. Such grief may negatively affect family members’ physical and psychological health and also the relationship with their relative. Yet, research in this field is sparse. Very few studies have examined parents’ loss and grief in the context of the patient being a child or teen. It is not clear the extent to which parents’ loss and grief in response to their child or adolescent’s mental illness is similar or different to the accounts of older parents and family members caring for an adult relative with major psychopathology (e.g., Schizophrenia, Bipolar disorder). Parental loss and grief is not often addressed in child and adolescent mental health services’ provision of care; alarmingly, little is known about how best to support parents who access these services. The present study aimed to bridge this knowledge gap and identify the therapeutic needs of this younger parent population. Comprehensive interviews were conducted with 14 parents and one custodial grandparent of a youth aged 18 years or younger who was currently attending a child and adolescent mental health service. An inductive thematic analysis identified six themes; parents’ narrative of finding out, profound and pervasive loss, complex grief, waning support, the challenges of caregiving and a call for assistance. It can be inferred from these results that youth mental illness can constitute a source of loss and grief for parents. Participants’ loss and grief was largely consistent with the experience of families caring for an adult relative with major psychopathology. Opportunities for mental health practitioners to support families’ loss and grief were identified. Further studies are needed to enhance understanding of this complex and, to a large extent, ignored familial experience. Results do underscore the importance of clinicians acknowledging parents’ loss and grief and working directly with this experience over the course of youths’ treatment, perhaps in conjunction with family psychoeducation approaches.     

Assessing Individual Differences: Effects of Responding to Prior Questionnaires on the Substantive and Psychometric Properties of Self-Esteem and Depression Assessments

It has become a common practice among psychological researchers to administer batteries of individual difference assessments to research participants, although little is known about whether the substantive and psychometric integrity of the questionnaires are maintained when they are administered after the subject has completed other instruments. The studies presented here consider these issues in relation to the assessment of self-esteem and depression. In the first study, college students responsed to a self-esteem inventory (a) by itself (control group), (b) after one prior questionnaire, (c) after three prior questionnaires, or (d) after five prior questionnaires. Results indicated that filling out one or more questionnaires before an assessment of self-esteem resulted in repots of lower self-esteem relative to the control condition. Additional analyses revealed that filling out three or five prior questionnaires created lower reliabilities of subscale scores and lower estimates of concurrent validity between self-esteem and depression. When the effect of prior questionnaires on the General Self-Esteem subscale was examined, the aforementioned results were replicated, and the prior questionnaire treatment created heterogeneous variances across the experimental groups. The second study was designed as a replication of the first study, using an assessment of depression as the target questionnaire. These results revealed that reports of depressive symptomatology increased as the number of prior questionnaires increased. Again, the prior or questionnaire treatment created heterogeneity of variance between the groups, but did not adversely affect its internal consistency.     

The Rorschach Index of Repressive Style and Scale Checking Style: A Study of Sex Differences

Males and females, subdivided into contrasting groups on the Rorschach Index of Repressive Style (RIRS), completed semantic differentials using themselves and their own art productions as the objects rated. Analysis was made of the relationship between sex and verbal style, and a scale checking style (use of end points versus use of intermediate points) believed to reflect a dimension of rapid, extreme decisions versus careful consideration of nuances. Results showed that males characterized by rich and fluid verbal processes tended toward cautious ratings (use of intermediate points) while females who were verbally free exhibited more extreme ratings (use of end points). It is concluded that a test variable may have different predictive significance in males and females, even though there is no sex difference in the magnitudes of the variables involved. There may be sex differences in the organization of cognitive processes.     

Suggestion for Gaining Rapport with Children who Appear Resistant to Testing

A story-drawing technique designed to gain rapport with children who appear resistant to testing is described. The technique involves the child with the examiner in a question answering procedure around the development of a picture the examiner draws for the child. The drawing has intrinsic interest, permitting the examiner to shape the set of responding to questions in an enjoyable, non-evaluative setting prior to the introduction of test materials. The drawing, requiring no artistic skill on the part of the examiner, is suitable for children up to about eight or nine years of age.     

Diazepam (Valium): Its Dependency Liability

Reports of the withdrawal syndrome following discontinuation of diazepam and drug dependence fears have contributed to diazepam's displacement as the most popular anxiolytic agent. Reports of the withdrawal syndrome, the factors involved in withdrawal, and the remedies proposed for diazepam withdrawal symptoms are reviewed.     

Phencyclidine (PCP): A Dangerous Drug,but Useful in Schizophrenia Research

Phencyclidine (PCP) is a dangerous drug, and the federal government has placed it on Schedule II of the Controlled Substance Act (see http://www.mninter.net/～publish/csa2.htm#Schedule%20III). Typically, users smoke PCP, and it is often mixed with parsley, marijuana, or cocaine. Most researchers have conducted experiments on animals rather than on people, and a few have been done on persons diagnosed with schizophrenia, so answers to questions about its addictive potential or development of tolerance are not clear. In healthy volunteers, PCP can induce symptoms that mimic those of schizophrenia, lasting from a few days to more than a week. The neurotransmitter glutamate and N-methyl-D-aspartate (NMDA) appear to play a role in the mechanism by which PCP induces positive and negative schizophrenic symptoms and cognitive defects (D. C. Javitt & S. R. Zukin, 1991; A. Lahti, B. Koffel, D. LaPorte, & C. A. Tarnminga, 1995; T. W. Robbins, 1990). Because PCP can induce symptoms that are almost indistinguishable from those associated with schizophrenia, further research may lead to new medications that could be helpful to people who do not respond to neuroleptics that are currently available.     

Social support: main and moderating effects on the relation between financial stress and adjustment among college students with disabilities

Students with disabilities are underrepresented in 4-year colleges and universities in the United States and those that do attend are at an increased risk of performing poorly in these settings. These difficulties for college students with disabilities may be compounded by additional stress related to financial concerns. The current study was designed to investigate the effects of social support on the adjustment of college students with disabilities generally, and among college students experiencing financial stress specifically. Results indicated that two types of social support (total support and satisfaction with support) had positive effects on the post-secondary adjustment of college students with disabilities. Moreover, both forms of support moderated the effects of financial stress on some, but not all, indicators of adjustment. The implications of these findings for future research and practice are discussed.     

Memory and comprehension for health information among older adults: Distinguishing the effects of domain-general and domain-specific knowledge

While there is evidence that knowledge influences understanding of health information, less is known about the processing mechanisms underlying this effect and its impact on memory. We used the moving window paradigm to examine how older adults varying in domain-general crystallised ability (verbal ability) and health knowledge allocate attention to understand health and domain-general texts. Participants (n = 107, age: 60–88 years) read and recalled single sentences about hypertension and about non-health topics. Mixed-effects modelling of word-by-word reading times suggested that domain-general crystallised ability increased conceptual integration regardless of text domain, while health knowledge selectively increased resource allocation to conceptual integration at clause boundaries in health texts. These patterns of attentional allocation were related to subsequent recall performance. Although older adults with lower levels of crystallised ability were less likely to engage in integrative processing, when they did, this strategy had a compensatory effect in improving recall. These findings suggest that semantic integration during reading is an important comprehension process that supports the construction of the memory representation and is engendered by knowledge. Implications of the findings for theories of text processing and memory as well as for designing patient education materials are discussed.     

Assessing the accuracy of the WISC-IV seven-subtest short form and the child and adolescent intellectual disability screening questionnaire in identifying intellectual disability in children

Little research has been conducted into the accuracy of abbreviated assessments in identifying children and young people with an intellectual disability (ID). The present study compared two such methods in a clinical population of individuals with (n = 106) and without (n = 170) ID: a 7-subtest short form of the Wechsler Adult Intelligence Scales for Children—fourth edition (WISC-IV) proposed by Crawford and colleagues and the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q). Both the CAIDS-Q and the WISC-IV short form had high and comparable levels of predicting group classification (88% and 91% correct classification, respectively). Both methods would appear to offer clinicians and researchers an efficient and accurate means of identifying those who are likely to have ID. The WISC-IV short form was slightly more accurate, but the CAIDS-Q may offer the advantages of being shorter to administer and having no requirement for the user to have a particular qualification or training.