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Bonfils KA, Adams EL, Firmin RL, White LM, Salyers MP. Parenthood and severe mental illness: relationships with recovery. Psychiatr Rehabil J 2014; 37:186-93. [PMID: 24819698 PMCID: PMC4152421 DOI: 10.1037/prj0000072] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Parenting is an important life domain for many people, but little research examines the parenting experience and its role in recovery for those with a severe mental illness. The current study provides preliminary evidence of how these concepts are related in a sample of individuals living with severe mental illness attending a community mental health center. We also explored potential differences between mothers and fathers, which could help better tailor services to meet the needs of parents with severe mental illness. METHOD Data were obtained during baseline interviews for a study testing an intervention designed to increase shared decision making in psychiatric treatment. Participants (N = 167) were administered measures of patient activation, recovery, autonomy preference, hope, and trust in providers. We compared parents and nonparents and compared mothers and fathers using chi-square tests, t tests, and, when appropriate, analysis of covariance. RESULTS Parents had a significantly higher level of trust in their psychiatric care provider than nonparents. Contrary to hypotheses, parents were less active in their treatment and preferred less information-seeking autonomy than did nonparents, but did not differ on other recovery-related indices. No differences on recovery-related indices were detected between mothers and fathers. Secondary analyses revealed parents with minor children had more hope than parents of older children. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Although parents may have higher levels of trust in their physicians, our preliminary findings suggest that parents with severe mental illness may benefit from increased efforts to help them be more active and interested in information about their illnesses.
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Lysaker PH, Vohs J, Hamm JA, Kukla M, Minor KS, de Jong S, van Donkersgoed R, Pijnenborg MHM, Kent JS, Matthews SC, Ringer JM, Leonhardt BL, Francis MM, Buck KD, Dimaggio G. Deficits in metacognitive capacity distinguish patients with schizophrenia from those with prolonged medical adversity. J Psychiatr Res 2014; 55:126-32. [PMID: 24811777 DOI: 10.1016/j.jpsychires.2014.04.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 03/20/2014] [Accepted: 04/10/2014] [Indexed: 12/31/2022]
Abstract
Research has suggested that many with schizophrenia experience decrements in synthetic metacognition, or the abilities to form integrated representations of oneself and others and then utilize that knowledge to respond to problems. Although such deficits have been linked with functional impairments even after controlling for symptoms and neurocognition, it is unclear to what extent these deficits can distinguish persons with schizophrenia from others experiencing significant life adversity but without psychosis. To explore this issue we conducted logistic regression analysis to determine whether assessment of metacognition could distinguish between 166 participants with schizophrenia and 51 adults with HIV after controlling for social cognition and education. Metacognition was assessed with the Metacognitive Assessment Scale Abbreviated (MAS-A), and social cognition with the Bell Lysaker Emotion Recognition Test. We observed that the MAS-A total score was able to correctly classify 93.4% of the schizophrenia group, with higher levels of metacognition resulting in increased likelihood of accurate categorization. Additional exploratory analyses showed specific domains of metacognition measured by the MAS-A were equally able to predict membership in the schizophrenia group. Results support the assertion that deficits in the abilities to synthesize thoughts about oneself and others into larger representations are a unique feature of schizophrenia.
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Affiliation(s)
- Paul H Lysaker
- Roudebush VA Med Center (116H), Roudebush VA Medical Center, 1481 West 10th St, Indianapolis, IN 46202, USA; Indiana University School of Medicine Indianapolis, IN, USA.
| | - Jenifer Vohs
- Indiana University School of Medicine Indianapolis, IN, USA; Larue D. Carter Memorial Hospital, IU Psychotic Disorders Research Program, Indianapolis, IN, USA
| | - Jay A Hamm
- Midtown Community Mental Health Center/Eskenazi Health, Indianapolis, IN, USA
| | - Marina Kukla
- Roudebush VA Med Center (116H), Roudebush VA Medical Center, 1481 West 10th St, Indianapolis, IN 46202, USA
| | - Kyle S Minor
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Steven de Jong
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands; Department of Clinical and Experimental Psychopathology, Rijksuniversiteit Groningen, The Netherlands
| | - Rozanne van Donkersgoed
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Marieke H M Pijnenborg
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands; Department of Clinical and Experimental Psychopathology, Rijksuniversiteit Groningen, The Netherlands
| | - Jerillyn S Kent
- Indiana University, Department of Psychological and Brain Sciences, Bloomington, IN, USA
| | - Sean C Matthews
- Indiana University, Department of Psychological and Brain Sciences, Bloomington, IN, USA
| | - Jamie M Ringer
- Roudebush VA Med Center (116H), Roudebush VA Medical Center, 1481 West 10th St, Indianapolis, IN 46202, USA
| | - Bethany L Leonhardt
- University of Indianapolis, School of Psychological Science, Indianapolis, IN, USA
| | - Michael M Francis
- Midtown Community Mental Health Center/Eskenazi Health, Indianapolis, IN, USA; Indiana University School of Medicine Indianapolis, IN, USA
| | - Kelly D Buck
- Roudebush VA Med Center (116H), Roudebush VA Medical Center, 1481 West 10th St, Indianapolis, IN 46202, USA
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