- Adams, T. (2010). The Applicability of A Recovery Approach to Nursing People with Dementia. International Journal of Nursing Studies, 47 (5): 626-634.» 摘要
Abstract: Objectives: Recent developments in nursing to people with mental health conditions of working age have been underpinned by the recovery approach. This paper critically reviews the idea of recovery in relationship to people with dementia and examines its applicability to dementia care nursing. Design: The paper critically reviews literature relating to the use recovery approach and the people with dementia, particularly their nursing care. The paper identifies common ideas within two approaches and suggests how the recovery approach may underpin nursing care to people with dementia. Data sources: A search of CINAHL, Medline and PsycINFO was undertaken from 1987 onwards using keywords 'recovery', 'nursing' and 'dementia'. Results: The paper found that the recovery approach shares many ideas with person-centred approaches to dementia care and illustrates this in relationship to well-being, social inclusion, self-management, and hope. Conclusion: The paper concludes by suggesting that dementia care nursing should draw on ideas taken from the recovery approach and identifies each approach drawing on ideas that have come together in postpsychiatry.
- Aitken, LM., Chaboyer, W., Kendall, E.& Burmeister, E.(2012). Health status after traumatic injury. Journal of trauma and acute care surgery, 72(6), 1702-1708.» 摘要
Abstract:BACKGROUND: This study explored the relationships between health-related quality of life and postacute factors such as patients' perceived access to information and support, perceptions of illness and ability to provide self-care after traumatic injury.METHODS: Adults (18 years or older) admitted to hospital for >= 24 hours for the acute treatment of trauma in two hospitals in Queensland, Australia, were enrolled in a prospective cohort study. Questionnaires completed at hospital discharge and 3 months and 6 months incorporated the following: demographic data; psychological factors (Revised Illness Perception Questionnaire, Information, Autonomy and Support Scale, and Therapeutic Self-Care Scale); and outcome data (medical short form-36). Data on injury and hospital stay were obtained from health care records and the Queensland Trauma Registry.RESULTS: One hundred ninety-four patients with a median Injury Severity Score 9 (interquartile range, 5-14) were enrolled, with 125 (64%) completing questionnaires at 6 months. More than half the cohort reported symptoms of pain, fatigue, stiff joints, sleep difficulties, and loss of strength. All subscale scores on the short form-36 were below Australian norms 6 months after injury. Predictors of poor physical health included older age, lower extremity injury, and increased perceived consequences of their injuries, whereas predictors of poor mental health included younger age, female gender, and lower perceived control over their environment. CONCLUSIONS: Patients with minor to moderate injury based on anatomic injury scoring systems have ongoing challenges with recovery including problematic symptoms and low quality of life. Interventions aimed toward assisting recovery should not be limited to trauma patients with major injury.
- Allen, J., Burbach, F., Reibstein, J.(2013). "A Different World' Individuals' experience of an integrated family intervention for psychosis and its contribution to recovery. Psychology and Psychotherapy-Theory Research and Practice, 86(2), 212-228.» 摘要
Abstract:Objectives. The aim of this study is to explore the meaning and significance of family interventions (FI) for the individual who experiences psychosis, and its significance for recovery. Design. A qualitative in-depth interview design was used to explore individuals' experience of FI and its meaning to them. Methods. Seven individuals recovering from psychosis attending integrated FI sessions were interviewed using a semi-structured interview schedule developed with service user input. Interviews were recorded, transcribed verbatim, and explored using Interpretative Phenomenological Analysis. Results. Three central themes highlighted the participants' experience: (1) They welcomed the shared experience with their families and felt contained and valued by the therapists; (2) They felt the sessions contributed to changed patterns of relating within the family and the creation of new meaning through the validation of multiple perspectives; and (3) They described how the family sessions supported a new positioning in the world, a sense of their own empowerment and personal responsibility, greater self-acceptance, an increased ability to manage emotions, and hope for the future. Conclusions. Conditions in the family sessions provided an environment for changes in patterns of relating, personal meaning, and emotions to take place. Recovery, for these individuals, appeared to be about repositioning themselves in the world. The shared experience of sessions and the recognition of multiple perspectives within a containing environment may be related to recovery via the development of new perspectives and a more robust sense of self. This has clinical implications for the focus of FI sessions. Practitioner Points center dot This study supports the use of various elements of integrated family interventions. center dot Understanding service-users' experience of family interventions and recovery processes can support the development of responsive clinicians and produce therapies that best support recovery processes.
- Alvarez-Jimenez, M., Gleeson, J.F., Henry, L.P., Harrigan, S.M., Harris,M.G., Killackey,E., Bendall,S., Amminger,G.P., Yung,A.R., Herrman,H.,Jackson,H.J.,&McGoorry,P.D.(2012). Road to full recovery: longitudinal relationship between symptomatic remission and psychosocial recovery in first-episode psychosis over 7.5 years. PSYCHOLOGICAL MEDICINE, 42(3), 595-606.» 摘要
Abstract:Background. In recent years there has been increasing interest in functional recovery in the early phase of schizophrenia. Concurrently, new remission criteria have been proposed and several studies have examined their clinical relevance for prediction of functional outcome in first-episode psychosis (FEP). However, the longitudinal interrelationship between full functional recovery (FFR) and symptom remission has not yet been investigated. This study sought to : (1) examine the relationships between FFR and symptom remission in FEP over 7.5 years; (2) test two different models of the interaction between both variables.
Method. Altogether, 209 FEP patients treated at a specialized early psychosis service were assessed at baseline, 8 months, 14 months and 7.5 years to determine their remission of positive and negative symptoms and functional recovery. Multivariate logistic regression and path analysis were employed to test the hypothesized relationships between symptom remission and FFR.
Results. Remission of both positive and negative symptoms at 8-month follow-up predicted functional recovery at 14-month follow-up, but had limited value for the prediction of FFR at 7.5 years. Functional recovery at 14-month follow-up significantly predicted both FFR and remission of negative symptoms at 7.5 years, irrespective of whether remission criteria were simultaneously met. The association remained significant after controlling for baseline prognostic indicators.
Conclusions. These findings provided support for the hypothesis that early functional and vocational recovery plays a pivotal role in preventing the development of chronic negative symptoms and disability. This underlines the need for interventions that specifically address early psychosocial recovery. - Amital D., Amital H., Shohat G., Soffer Y.& Bar-Dayan Y.(2012). Resilience Emotions and Acute Stress Reactions in the Population of Dimona and the General Population of Israel Two Days after the First Suicide Bombing Attack in Dimona. Israel Medical Association Journal, 14(5), 281-285.» 摘要
Abstract:Background: On 4 February 2008, two terrorists armed with suicide bombs arrived at the open market in the southern Israeli city of Dimona. One detonated his bomb at approximately 10:30 a.m. causing multiple casualties. Short-term emotional effects and acute stress reactions usually appear among survivors after such incidents.
Objectives: To compare the differences in emotions and in disturbances of daily life activities that emerge a couple of days following such an event and to identify patterns of stress development among resilient and low-resilient members of the population in Dimona and in the general population of Israel.
Methods: A telephone survey of two randomly selected representative samples of adults (428 Israeli residents and 250 Dimona residents) was conducted 2 days after the event.
Results: A higher prevalence of stress and fear and a lower prevalence of joy were reported among the population of Dimona compared to the general population in Israel (P < 0.05). Differences were also recorded when the population of Dimona was categorized by its personal degree of resilience (P < 0.05). A higher prevalence of disturbances in daily life activities and changes in leisure activity was found in the low-resilient population in Dimona (P < 0.01).
Conclusions: This study demonstrates that following a public terror event, self-reported low-resilient subjects have a higher prevalence of disturbances in daily life activities, as well as adverse emotional responses. These differences must be addressed by the relevant social service agencies for immediate public intervention. - Anna, M. S., Mimi, M. K., Jeffrey, W. S., Marvin, S. S. (2007) . Psychiatric Advance Directives: A Tool for Consumer Empowerment and Recovery. Psychiatric Rehabilitation Journal. 31(1), p70-75.» 摘譯
Psychiatric advance directives: a tool for consumer empowerment and recovery.
對於精神失能的疾病患者而言，抉擇能力與自我指揮管理能力是復原的核心要素，人們在罹患精神疾病的期間抉擇能力與自我管理能力是缺乏的，而這可能造成他們一些傷害。精神進階管理（PADs）是一個被合法的創造的文件工具，讓缺乏自主與抉擇的人能夠去溝通交談。此篇文章去調查PADs的支持方法，並且PADs可做為復原的一個工作，更進一步的去討論未來復原力取向在PAD的研究與處遇發展方向。 - Anonymous (2007). A Story of Recovery. Tennessee Bar Journal, 43(9), p12-15.» 摘譯
- Anthony, E. B., Valory, N. W.,Ross, S., Simon, N. W., Lois, C. F., Romero, C., George, C. D., Irina, C., Thomas, R. K., Robert, R. K. (2007). Association of spirituality and Sobriety during a behaveioral spirituality intervenetion for twelve step(TS) recovery. American Journal of Drug & Alcohol Abuse, 33(4), p611-617.» 摘譯
Association of spirituality and Sobriety during a behaveioral spirituality intervenetion for twelve step(TS) recovery.
此篇文章描述十二個復原的步驟利用了靈性去促進行為上的冷靜，且過去沒有這樣的方案著重在靈性的運用。其發展了一套七週的行為上的靈性處遇，名為『認識你自己的高能量（Knowing Your Higher Power）』，並依循著十二復原步驟來執行。有二十六位復原中心的參與者參與了此方案，七週去評估他們行為的基準線，12週之中確實的執行。參與者在 12週過後，在靈性與信念的測量上確實有顯著性的增加，且在行為冷靜的分數上相較於過去確實有所增加。這樣的發現能夠有助於在處遇物質濫用的個案。 - Anthony, EK ; Stone, SI (2010). Individual and Contextual Correlates of Adolescent Health and Well-Being. FAMILIES IN SOCIETY-THE JOURNAL OF CONTEMPORARY SOCIAL SERVICES, 91 (3): 225-233 . » 摘要
Abstract: Assessing a broad positive outcome such as well-being presents numerous challenges and empirical investigations are limited. This study used an eco-interactional-developmental perspective based on risk and protective factors to examine individual and contextual correlates of health and well-being in a sample of 20,749 ethnically diverse middle and high school students. School fixed-effects regression analyses modeling a composite measure of well-being as a function of youth, peer, family, school, and neighborhood characteristics indicated that the measure was most stable when modeled as a global (vs. domain specific) composite. Relational (vs. expectation and behavioral) characteristics of parental and peer involvement were more influential in predicting adolescent well-being. The implications for interventions striving to enhance well-being across developmental transitions are discussed.
- Bardone-Cone, A.M., Harney, M.B., Maldonado, C.R., Lawson, M.A., Robinson, D.P., Smith, R., Tosh, A. (2010). Defining Recovery from an Eating Disorder: Conceptualization, Validation, and Examination of Psychosocial Functioning and Psychiatric Comorbidity. Behaviour Research and Therapy, 48 (3): 194-202. » 摘要
Abstract: Conceptually, eating disorder recovery should include physical, behavioral, and psychological components, but such a comprehensive approach has not been consistently employed. Guided by theory and recent recovery research, we identified a "fully recovered" group (n = 20) based on physical (body mass index), behavioral (absence of eating disorder behaviors), and psychological (Eating Disorder Examination-Questionnaire) indices, and compared them with groups of partially recovered (n = 15), active eating disorder (n = 53), and healthy controls (n = 67). The fully recovered group was indistinguishable from controls on all eating disorder-related measures used, while the partially recovered group was less disordered than the active eating disorder group on some measures, but not on body image. Regarding psychosocial functioning, both the fully and partially recovered groups had psychosocial functioning similar to the controls, but there was a pattern of more of the partially recovered group reporting eating disorder aspects interfering with functioning. Regarding other psychopathology, the fully recovered group was no more likely than the controls to experience current Axis I pathology, but they did have elevated rates of current anxiety disorder. Results suggest that a stringent definition of recovery from an eating disorder is meaningful. Clinical implications and future directions regarding defining eating disorder recovery are discussed.
- Bayrakli, H. & Kaner, S. (2012).Investigating the Factors Affecting Resiliency in Mothers of Children with and without Intellectual Disability. Kuram Ve Uygulamada Egitim Bilimleri ,12(2), 936-943.» 摘要
Abstract:In this study, the effect of quantity and duality of social support and problem-focused coping style on mothers' resilience was examined by conducting a structure; equation. modeling. The sample of the research consisted of 257 mothers of children with intellectual. disability, and 234 mothers of typically-developing children. The data were gathered through the Mother Resiliency Scale, the Coping Style Scale, and the Revised Parental Social Support Scale Path analysis with latent variables was conducted to investigate the relationship between the constructs after testing the measurement models. Both groups of mothers confirmed the model showing that quantity and quality of the social support affected the problem-focused coping in a positive and moderate way and affects the resiliency in a tow hut positive direction. Also, the problem-focused cooing style influenced resiliency in a high and positive way.
- Bellin, M. H., Kovacs, P. J., & Sawin, K. J. (2008). Risk and Protective Influences in The Lives of Siblings of Youths with Spina Bifida. Health & Social work, 33(3), p 199-209. » 摘譯
- Bensimon, M. (2012).Elaboration on the association between trauma, PTSD and posttraumatic growth: The role of trait resilience. Personality and Individual Differences, 52(7), 782-787.» 摘要
- Bergmans, Y., Langley, J., Links, P., Lavery, J.V.(2009). The Perspectives of Young Adults on Recovery from Repeated Suicide-Related Behavior. Crisis-the Journal Of Crisis Intervention and Suicide Prevention, 30(3), 120-127.» 摘要
- Berk, M., Berk, L., Udina, M., Moylan, S., Stafford, L., Hallam, K., Goldstone, S., & McGorry, P.D. (2012). Palliative models of care for later stages of mental disorder: maximizing recovery, maintaining hope, and building morale. AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY, 46(2), 92-99.» 摘要
- Betancourt T.S., Williams T.P., Kellner S.E., Gebre-Medhin J., Hann K.& Kayiteshonga Y.(2012).Interrelatedness of child health, protection and well-being: An application of the SAFE model in Rwanda. Social Science& Medicine, 74(10), 1504-1511.» 摘要
- Bjerge, B., Nielsen, B. (2014). Empowered and self-managing users in methadone treatment. European Journal of Social Work, 17(1), 74-87.» 摘要
- Brindle, R.C. & Conklin, S.M.(2012). Daytime Sleep Accelerates Cardiovascular Recovery after Psychological Stress.INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE , 19(1), 111-114.» 摘要
- Bromand Z., Temur-Erman S., Yesil R., Heredia M. A., Aichberger MC., Kleiber D., Schouler-Ocak M., Heinz A., Kastrup MC.& Rapp MA.(2012). Mental health of Turkish women in Germany: resilience and risk factors. European Psychiatry, 27(2), S17-S21.» 摘要
- Brooks, E., Early, S.R., Gundersen, D.C., Shore, J.H.& Gendel, M.H.(2012). Comparing Substance Use Monitoring and Treatment Variations among Physician Health Programs. American journal of addictions, 21(4), 327-334.» 摘要
- Brown, N.R., Kallivayalil, D., Mendelsohn, M., & Harvey, M.R. (2012). Working the Double Edge: Unbraiding Pathology and Resiliency in the Narratives of Early-Recovery Trauma Survivors. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY, 4(1), 102-111.» 摘要
- Buck, KD., Roe, D., Yanos, P., Buck, B., Fogley, RL., Grant, M., Lubin, F., Lysaker, PH. (2013). Challenges to assisting with the recovery of personal identity and wellness for persons with serious mental illness: Considerations for mental health professionals. Psychosis-Psychological Social and Integrative Approaches, 5(2), 134-143.» 摘要
- Buckley-Walker, K., Crowe, TP., Caputi, P. (2013). Measuring Identity Processes in Family Relational Empowerment. INTERNATIONAL JOURNAL OF MENTAL HEALTH AND ADDICTION, 11(3), 358-368.» 摘要
- Burt, K. B. & Paysnick, A. A.(2012).Resilience in the transition to adulthood. Development and Psychopathology, 24(2), 493-505.» 摘要
- Cabral, L. ; Muhr, K. ; Savageau, J. (2013). Perspectives of People Who Are Deaf and Hard of Hearing on Mental Health, Recovery, and Peer Support. Community Mental Health Journal. 49(6), 649-657.» 摘要
- Cacioppo, John T., Reis, Harry T., Zautra, Alex J. (2011). Social Resilience. American Psychologist. 66(1), 43-51.» 摘要
- Cairns J. M., Curtis S. E. & Bambra C. (2012). Defying deprivation: A cross-sectional analysis of area level health resilience in England. Health &Place, 18(4), 928-933.» 摘要
- Cameron, D., McGowan, P. (2012). The mental health social worker as a transitional participant: actively listening to "voices' and getting into the recovery position. Journal of Social Work Practice, 27(1), 21-32.» 摘要
- Carp, Joel M. (2010).Resiliency: The Essence of Survival in Chaos. Families in Society, 91(3), 266-271.» 摘要
- Carpenter-Song, E., Hipolito, MMS., Whitley, R. (2012)."Right Here Is an Oasis": How "Recovery Communities" Contribute to Recovery for People With Serious Mental Illnesses. Psychiatric Rehabilitation Journal, 35(6), 435-440.» 摘要
- Casale, Marisa (2011) .‘I am living a peaceful life with my grandchildren. Nothing else.’ Stories of adversity and ‘resilience’ of older women caring for children in the context of HIV/AIDS and other stressors .Ageing & Society, 31 (8), 1265-1288.» 摘要
- Cavelti, M., Beck, E.M., Kvrgic, S., Kossowsky, J.& Vauth, R.(2012). The Role of Subjective Illness Beliefs and Attitude Toward Recovery Within the Relationship of Insight and Depressive Symptoms Among People With Schizophrenia Spectrum Disorders. Journal of clinical psychology, 68(4), 462-476.» 摘要
- Cavelti, M., Kvrgic, S., Beck, E.M., Kossowsky, J., Vauth, R.(2012). Assessing recovery from schizophrenia as an individual process. A review of self-report instruments. European Psychiatry. 27(1),19-32. » 摘要
- Chan, C. K. P., & Ho, R. T. H. (2017). Discrepancy in Spirituality among Patients with Schizophrenia and Family Care-Givers and Its Impacts on Illness Recovery: A Dyadic Investigation. The British Journal of Social Work, 47(1), 28-47.» 摘要
- Chang, W.C., Tang, J.Y., Hui, C.L., Lam,M.M.,Chan, S.K., Wong, G.H., Chiu, C.P., & Chen, E.Y. (2012). Prediction of remission and recovery in young people presenting with first-episode psychosis in Hong Kong: A 3-year follow-up study. AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY, 46(2), 100-108.» 摘要
- Chiba, R., Miyamoto, Y., Kawakami, N. (2010). Reliability and Validity of the Japanese Version of The Recovery Assessment Scale (RAS) for People with Chronic Mental Illness: Scale Development. International Journal of Nursing Studies, 47 (3): 314-322.»摘要
Abstract: Background: Recovery is defined as a complex process of developing new meaning and purpose in life as one grows beyond the catastrophic effects of mental illness. To promote this process, the necessity of recovery assessment using psychometric measures has been emphasized; however, no measure to assess the individual recovery process is available in Japan. Objective: To develop a Japanese version of the Recovery Assessment Scale (RAS) and to examine its reliability and validity. Design: The study was a cross-sectional questionnaire survey. Settings: Participants came from 1 daycare, 1 outpatient clinic of a psychiatric hospital, 5 sheltered workshops used for social rehabilitation, 3 peer support groups, and 6 inpatient wards of 2 psychiatric hospitals. Participants: The Survey included 237 participants who had chronic mental illness and were aged 20 or older. For analysis, we used data from 209 participants who had no missing values on the RAS, with 58.9% male and a mean age of 48.3 years. Methods: The questionnaire consisted of the Japanese version of the 24-item RAS, developed by the authors with focus group cognitive interviews and the translation-back-translation procedure. Also included were the Herth Hope Index, Empowerment scale, Resilience scale, SF-8, and BASIS-32. Internal consistency reliability was assessed by Cronbach's alpha coefficients, and test-retest reliability was assessed by the intraclass correlation coefficient (ICC) and weighted kappa in a randomly selected subsample (n = 24). Exploratory and confirmatory factor analyses and correlations with other scales were used to examine the factor-based validity, concurrent and construct validity of the RAS. Results: Cronbach's alpha coefficient was 0.89 for the overall RAS. ICC and weighted kappa generally indicated good test-retest reliability. Factor analysis of the RAS items yielded five factors: (a) goal/success orientation and hope, (b) reliance on others, (c) personal confidence, (d) no domination by symptoms, and (e) willingness to ask for help. The item "Coping with mental illness is no longer the main focus of my life" showed an inverse factor loading. The overall RAS score significantly and positively correlated with the Herth Hope Index, Empowerment scale, Resilience scale, and SF-8 mental component summary; there was a significant negative correlation with BASIS-32 psychiatric symptoms and functional impairment (p, < 0.01). Conclusion: This study confirmed the reliability and validity of the Japanese version of the 24-item RAS among people with chronic mental illness currently living in communities and inpatient ward settings in Japan.
- Chiu, C.C., Frangou, S., Chang, C.J., Chiu, W.C., Liu, H.C., Sun, I.W., Liu, S.I., Lu, M.L., Chen, C.H., Huang, S.Y., Dewey, M.E., & Stewart, R. (2012). Associations between n-3 PUFA concentrations and cognitive function after recovery from late-life depression. AMERICAN JOURNAL OF CLINICAL NUTRITION, 95(2), 420-427.» 摘要
- Christens, BD ; Collura, JJ ; Tahir, F(2013). Critical Hopefulness: A Person-Centered Analysis of the Intersection of Cognitive and Emotional Empowerment. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY, 52(1-2), 170-184.» 摘要
- Clarke, S., Oades, L.G., Crowe, T.P.(2012). Recovery in Mental Health: A Movement Towards Well-Being and Meaning in Contrast to an Avoidance of Symptoms. Psychiatric rehabilitation journal, 35(4), 297-304.» 摘要
- Cleary, A., Dowling, M.(2009). Knowledge and Attitudes of Mental Health Professionals in Ireland to The Concept of Recovery in Mental Health: A Questionnaire Survey. Journal of Psychiatric And Mental Health Nursing, 16(6), 539-545.» 摘要
- Conradi, HJ., Ormel, J.& de Jonge P.(2012). Symptom profiles of Dsm-iv-defined remission, recovery, relapse, and recurrence of depression: the role of the core symptoms. Depression and anxiety, 29(7), 638-645.» 摘要
- Cook, J.A., Copeland, M.E., Jonikas, J.A., Hamilton, M.M., Razzano, L.A., Grey, D.D., Floyd, C.B., Hudson, W.B., Macfarlane, R.T., Carter, T.M.& Boyd, S.(2012). Results of a Randomized Controlled Trial of Mental Illness Self-management Using Wellness Recovery Action Planning. Schizophrenia bulletin, 38(4), 881-891.» 摘要
- Coyle, J.P., Nochajski, T., Maguin, E., Safyer, A., DeWit, D., Macdonald, S. (2009). An Exploratory Study of the Nature of Family Resilience in Families Affected by Parental Alcohol Abuse. Journal of Family Issues, 30(12), 1606-1623.» 摘要
- Daley, S., Newton, D., Slade, M., Murray, J., Banerjee, S.(2012). Development of a framework for recovery in older people with mental disorder.International Journal of Geriatric Psychiatry, 28(5), 522-529. » 摘要
Abstract:Objective To evaluate whether a conceptual framework of recovery developed for working age adults holds value for users of older people's mental health services, including those with dementia. Method Thirty-eight qualitative interviews were undertaken with service users and carers from an older people's mental health service in South London and were analysed using grounded theory methods. Results Components of recovery, which appear to be meaningful to older people with mental disorder include the following: (i) the impact of illness, (ii) the significance of personal responsibility, and (iii) specific coping strategies. Unlike their younger peers, older people did not aspire to a new and revised sense of identity, nor did they seek peer support from others with lived experience of mental illness. Three components of recovery were identified as being distinct to older people: the significance of an established and enduring sense of identity; coping strategies, which provide continuity and reinforce identity; and the associated impact of physical illness. Finally, two additional components of recovery were identified for people with dementia: (i) the changing experience over time and (ii) support from others. Conclusion Mental health policy is increasingly framed in terms of recovery'. This paper provides empirical evidence of how it applies to users of older people's mental health services. Practice implications include the need to focus on the maintenance of identity, and embed the values of empowerment, agency and self-management within service delivery.
- Dalrymple , K.A .,Birmingham, E. , Bischof , W.F. ,Barton, J.J.S. , Kingstone , A (2011). Opening a window on attention: Documenting and simulating recovery from simultanagnosia.Cortex, 47(7), 787-799. » 摘要
Abstract: Simultanagnosia is a disorder of visual attention: the inability to see more than one object at one time. Some hypothesize that this is due to a constriction of the visual "window" of attention. Little is known about how simultanagnosics explore complex stimuli and how their behaviour changes with recovery. We monitored the eye movements of simultanagnosic patient SL to see how she scans social scenes shortly after onset of simultanagnosia (Time 1) and after some recovery(Time 2). At Time 1 SL had an abnormally low proportion of fixations to the eyes of the people in the scenes. She made a significantly larger proportion of fixations to the eyes at Time 2. We hypothesized that this change was related to an expansion of her restricted window of attention. Previously we simulated SL's behaviour in healthy subjects by having them view stimuli through a restricted viewing window. We used this simulation paradigm here to test our expanding window hypothesis. Subjects viewing social scenes through a larger window allocated more fixations to the eyes of people in the scenes than subjects viewing scenes through a smaller window, supporting our hypothesis. Recovery in simultanagnosia may be related to the expansion of the restricted attentional window that characterizes the disorder.
- Daniel F.K., W.（2008）. Differential Impacts of Stressful Life Events and Social Support on The Mental Health of Mainland Chinese Immigrant and Local Youth in Hong Kong: A Resilience Perspective. Journal of socialwork ,38（2）, 236-252.» 摘譯
- Daniels, J.K., Hegadoren, K.M., Coupland, N.J., Rowe, B.H., Densmore, M., Neufeld, R.W.& Lanius, R.A. (2012).Neural Correlates and Predictive Power of Trait Resilience in an Acutely Traumatized Sample: A Pilot Investigation. Journal of Clinical Psychiatry, 73(3), 327-332.» 摘要
Abstract:Objective: Resilience refers to the ability to thrive despite adversity and is defined as a multidimensional phenomenon, spanning internal locus of control, sense of meaning, social problem-solving skills, and self-esteem. We aimed to investigate the predictive value of resilience for the development of posttraumatic stress disorder (PTSD) and to examine the neural correlates mediating the relationship between resilience and recovery from a traumatic event in acutely traumatized subjects. We hypothesized that resilience would mediate the relationship between childhood trauma and posttraumatic recovery.
Method: We conducted a prospective study with 70 acutely traumatized subjects with DSM-IV PTSD recruited at the emergency department, assessing PTSD symptom severity at 3 time points within the first 3 months posttrauma. Scores for childhood trauma as assessed with the Childhood Trauma Questionnaire and trait resilience as assessed with the Connor-Davidson Resilience Scale were used as predictors of symptom severity. A subsample of 12 subjects additionally underwent a functional 4 Tesla magnetic resonance imaging scan 2 to 4 months posttrauma. We employed the traumatic script-driven imagery paradigm to assess the correlations between trait resilience and blood oxygen level-dependent (BOLD) response. The study was conducted from 2003 to 2007.
Results: Resilience predicted PTSD symptom severity at 5 to 6 weeks (beta=-0.326, P=.01) as well as at 3 months (beta=-0.423, P=.003) posttrauma better than childhood trauma. Resilience essentially mediated the relationship between childhood trauma and posttraumatic adjustment. Resilience scores were positively correlated with BOLD signal strength in the right thalamus as well as the inferior and middle frontal gyri (Brodmann area 47). Conclusions:This pilot investigation revealed a significant relationship between resilience and emotion regulation areas during trauma recall in an acutely traumatized sample. Resilience was established as a significant predictor of PTSD symptom severity and mediated the influence of childhood trauma on posttraumatic adjustment. - Davidson J., Stein D.J., Rothbaum B.O., Pedersen R., Szumski A.& Baldwin D.S.(2012). Resilience as a predictor of treatment response in patients with posttraumatic stress disorder treated with venlafaxine extended release or placebo. Journal of Psychopharmacology, 26(6), 778-783.» 摘要
Abstract:This post-hoc analysis evaluated resilience as a predictor of treatment response in patients with posttraumatic stress disorder (PTSD). Data were pooled from two randomized, double-blind studies conducted with adult outpatients treated with flexible doses of venlafaxine extended release (ER) 37.5 to 300 mg/day or placebo. The 17-item Clinician-Administered Posttraumatic Stress Disorder Scale (CAPS-SX17) was the primary outcome measure. Baseline Connor-Davidson Resilience Scale (CD-RISC) scores for the 25-, 10-, and 2-item versions were used to predict changes in PTSD symptom severity at week 12 and symptomatic remission (CAPS-SX17 <= 20). Analyses were conducted for the overall population and separately for the individual treatment groups. In total, pretreatment resilience predicted a positive treatment response. For the overall population, all versions of the CD-RISC predicted CAPS-SX17 change scores and remission after controlling for variables such as treatment group and baseline symptom severity. For venlafaxine ER-treated patients, all versions of the CD-RISC were predictive of remission, but only the 10-item version was predictive of CAPS-SX17 change score. Our results suggest that higher pretreatment resilience is generally associated with a positive treatment response. Future research may be warranted to explore the relationship between response to active treatment and the spectrum of resiliency.
- Depauw, J., & Driessens, K. (2017). Taking the measure: a participatory approach to measuring and monitoring psychological empowerment in social work practices. European Journal of Social Work, 20(4), 522-535.» 摘要
Abstract: For years, the professional field has been searching for methods that could be used to chart the effectiveness of social services. Social workers report that their current systems for registration and measurement do not provide an accurate reflection of their practice. The measurement of client empowerment might offer an alternative method that could improve the evaluation of social services. This method links the need for measuring instruments to the paradigm of empowerment, which has shaped contemporary social work. A scale for measuring psychological empowerment was developed in consultation with social workers and people in poverty, based on validated and reliable measurement scales. It was subsequently tested in two Public Centres for Social Welfare in Flanders (Belgium). Results of confirmatory factor analysis indicate that the measurement model provides a good fit for the data and that the various latent factors are reliable and valid. We conclude that the factors emerging from the factor analysis reflect the three dimensions that form the concept of psychological empowerment: the intrapsychic, interpsychic and behavioural components. Results from the post-test survey indicate that this measurement instrument is promising, and that it could offer a response to current needs, although additional efforts are needed in order to improve the instrument’s handling.
- Dilks, S., Tasker, F., Wren, B. (2010).Managing the Impact of Psychosis: A Qrounded Theory Exploration of Recovery Processes in Psychosis. British Journal of Clinical Psychology, 49, 87-107.» 摘要
Abstract: Objectives. There has been little conceptual bridge building between what individuals report as helpful in recovery and how psychological therapy might impact on recovery in psychosis. This study explores the links between therapy and recovery in psychosis. Design. Grounded theory was chosen as an appropriate methodology to distil an explanatory account across the qualitative data collected. Methods. An initial sample of 19 therapy session tapes and 23 interviews with psychologists and clients engaged in psychological therapy in psychosis was collected and analysed using grounded theory. This data set was extended through the additional sampling and analysis of 31 published personal accounts of the experience of psychosis. Results. The study reports on specific elements of a larger grounded theory study that particularly relate to recovery processes in psychosis. Specific categories of activity were conceptualised to theorise the key activities involved in managing the impact of psychosis. Conclusions. Therapy in psychosis appeared to be aimed at enhancing clients' functioning in the social world. In an effort to achieve this, it seemed that clients engaged in an ongoing effort to manage the impact of psychosis on both their subjective experience and on day to day life. The conceptualisation of this effort as an active, ongoing, and individually-directed process was consistent with other examinations of service user accounts.
- Dipietro, L., Krebs, H.I., Volpe, B.T., Stein, J., Bever, C., Mernoff, S.T., Fasoli, S.E., & Hogan, N. (2012). Learning, Not Adaptation, Characterizes Stroke Motor Recovery: Evidence From Kinematic Changes Induced by Robot-Assisted Therapy in Trained and Untrained Task in the Same Workspace. IEEE TRANSACTIONS ON NEURAL SYSTEMS AND REHABILITATION ENGINEERING, 20(1), 48-57.» 摘要
Abstract:Both the American Heart Association and the VA/DoD endorse upper-extremity robot-mediated rehabilitation therapy for stroke care. However, we do not know yet how to optimize therapy for a particular patient's needs. Here, we explore whether we must train patients for each functional task that they must perform during their activities of daily living or alternatively capacitate patients to perform a class of tasks and have therapists assist them later in translating the observed gains into activities of daily living. The former implies that motor adaptation is a better model for motor recovery. The latter implies that motor learning (which allows for generalization) is a better model for motor recovery. We quantified trained and untrained movements performed by 158 recovering stroke patients via 13 metrics, including movement smoothness and submovements. Improvements were observed both in trained and untrained movements suggesting that generalization occurred. Our findings suggest that, as motor recovery progresses, an internal representation of the task is rebuilt by the brain in a process that better resembles motor learning than motor adaptation. Our findings highlight possible improvements for therapeutic algorithms design, suggesting sparse-activity-set training should suffice over exhaustive sets of task specific training.
- Donahue, EG., Forest, J., Vallerand, RJ., Lemyre, PN ., Crevier-Braud, L., Bergeron, E.(2012).Passion for Work and Emotional Exhaustion: The Mediating Role of Rumination and Recovery. Applied Psychology-Health and Well Being, 4(3), 341-368. » 摘要
Abstract: The purpose of the present research is to present a model pertaining to the mediating roles of rumination and recovery experiences in the relationship between a harmonious and an obsessive passion (Vallerand et al., 2003) for work and workers' emotional exhaustion. Two populations were measured in the present research: namely elite coaches and nurses. Study 1's model posits that obsessive passion positively predicts rumination about one's work when being physically away from work, while harmonious passion negatively predicts ruminative thoughts. In turn, rumination is expected to positively contribute to emotional exhaustion. The results of Study 1 were replicated in Study 2. In addition, in the model of Study 2, obsessive passion was expected to undermine recovery experiences, while harmonious passion was expected to predict recovery experiences. In turn, recovery experiences were expected to protect workers from emotional exhaustion. Results of both studies provided support for the proposed model. The present findings demonstrate that passion for work may lead to some adaptive and maladaptive psychological processes depending on the type of passion that is prevalent.
- Donoghue, B.O., Lyne, J. ,Hill, M., O'Rourke, L. ,Daly, S., Larkin, C., Feeney, L. ,O'Callaghan, E. (2011).Perceptions of involuntary admission and risk of subsequent readmission at one-year follow-up: The influence of insight and recovery style. Journal of Mental Health, 20 (3), 249-259. » 摘要
Abstract: Background. Involuntary admission is one of the most ethically challenging practices in medicine, yet we are only beginning to learn more about the patient's perspective. Aims：To investigate (i) peoples' perception of the necessity of their involuntary admission at one year after discharge (ii) readmission rates to hospital and the influence of insight and recovery style. Methods：We interviewed individuals admitted involuntarily at one year following discharge using the Mac Arthur Admission Experience Interview, Birchwood Insight Scale, the Drug Attitude Inventory, Global Assessment of Functioning and the Recovery Style Questionnaire. Results：Sixty-eight people (84%) were re-interviewed at one year and fewer (60%) reported that their involuntary admission had been necessary when compared to inception (72%). Of the 33% that changed their views, most reflected negatively on their involuntary admission. We found that insight was moderately associated with the acknowledgement that the involuntary admission was necessary. Within a year, 43% were readmitted to hospital and half of these admissions were involuntary. Individuals with a sealing over recovery style were at four times the risk of involuntary readmission. Conclusions： Peoples' perception of the necessity of their involuntary admissions is not stable over time and risk of involuntary readmission is associated withrecovery style.
- Doukas, N., Cullen, J. (2009). Recovered, in Recovery or Recovering From Substance Abuse? A Question of Identity. Journal of Psychoactive Drugs, 41 (4): 391-394.» 摘要
Abstract: There has always been widespread debate on how people with past substance abuse problems choose to identify themselves with regards to their recovery and the terms used to associate with that identity. Most of the disagreement over these terms is rooted on whether recovery is seen as an ongoing process ("recovering" or "in recovery") or a life event that can be mastered ("recovered"). This article discusses these three controversial terms and attempts to make them available as terms that one can use or identify with by presenting different perspectives on the topic of recovery. Some of these perspectives may be unconventional when compared to traditional views of the recovery process, but they are the realities of many individuals who have had a past experience with substance abuse and may be confronted with prejudice when voicing their recovery in a past tense. The article makes comparisons between the DSM IV and the Big Book of AA and discusses identity vs labels and the influence of the medical community on this controversial topic.
- Doyle,M., Logan, C., Ludlow, A., & Holloway, J. (2012). Milestones to recovery: Preliminary validation of a framework to promote recovery and map progress through the medium secure inpatient pathway. CRIMINAL BEHAVIOUR AND MENTAL HEALTH, 22(1), 53-64. » 摘要
Abstract:Background Forensic mental health care in the UK has undergone a rapid expansion since the late 1990s. In medium secure units (MSUs), there is growing emphasis on developing care pathways without much theoretical underpinning. We developed a concept of 'Milestones to Recovery' (MTR) to measure progress through the MSU pathway. Aims Our aim was to validate the MTR framework. Our hypotheses were that patients scoring higher on the MTR Scale would be more likely to be aggressive to others in the following 6 months and resident in the acute areas of the unit and that those scoring lower would be more likely to be discharged within 6 months of the assessment. Methods An MTR scale was developed to enable the investigation of the validity of the MTR framework and evaluated with staff evaluations of 80 resident patients using a prospective, longitudinal and naturalistic design. Results The results suggest that the MTR framework is valid in discriminating between different stages on the MSU pathway. Therapeutic engagement was particularly important in terms of progress through the MSU, whereas current behaviour was important in predicting future aggression. Conclusions Further research is required to test the MTR framework across different levels of security, with larger samples and within different populations. Implications for practice Provides a framework to map progress through the service. Identifies key factors that influence recovery and rehabilitation. Potential to promote dialogue between patients and staff, and enhance motivation.
- Drake, RE. , Whitley, R. (2012). Recovery and Severe Mental Illness: Description and Analysis. Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie,59(5), 236-242.» 摘要
Abstract:The notion of recovery has been embraced by key stakeholders across Canada and elsewhere. This has led to a proliferation of definitions, models, and research on recovery, making it vitally important to examine the data to disentangle the evidence from the rhetoric. In this paper, first we ask, what do people living with severe mental illness (SMI) say about recovery in autobiographical accounts? Second, what do they say about recovery in qualitative studies? Third, from what we have uncovered about recovery, can we learn anything from quantitative studies about proportions of people leading lives of recovery? Finally, can we identify interventions and approaches that may be consistent or inconsistent with the grounded notions of recovery unearthed in this paper? We found that people with mental illness frequently state that recovery is a journey, characterized by a growing sense of agency and autonomy, as well as greater participation in normative activities, such as employment, education, and community life. However, the evidence suggests that most people with SMI still live in a manner inconsistent with recovery; for example, their unemployment rate is over 80%, and they are disproportionately vulnerable to homelessness, stigma, and victimization. Research stemming from rehabilitation science suggests that recovery can be enhanced by various evidence-based services, such as supported employment, as well as by clinical approaches, such as shared decision making and peer support. But these are not routinely available. As such, significant systemic changes are necessary to truly create a recovery-oriented mental health system.
- Dresler, T. Schecklmann, M., Ernst, L.H., Pohla, C., Warrings, B., Fischer, M., Polak, T., & Fallgatter, A.J. (2012). Recovery of cortical functioning in abstinent alcohol-dependent patients: Prefrontal brain oxygenation during verbal fluency at different phases during withdrawal. WORLD JOURNAL OF BIOLOGICAL PSYCHIATRY, 13(2), 135-145.» 摘要
Abstract:Objectives. Neurotoxic effects of alcohol consumption are well-known. There is plenty of literature on frontal lobe impairment on the behavioural and structural brain imaging level. However, only few functional imaging studies investigated altered neural patterns and even less abstinence-related neural recovery. Methods. In a cross-sectional design three patient groups (acute withdrawal, detoxified, abstinent) and healthy controls (each n = 20) performed a phonological and semantic verbal fluency task (VFT) while brain activity was measured with near-infrared spectroscopy (NIRS). Results. First, for the phonological condition withdrawal patients and detoxified patients showed less fluency-related frontal lobe activation compared to controls despite equal performance. Second, significant linear trend effects from withdrawal patients over detoxified and abstinent patients up to healthy controls indicated more normal activation patterns in the abstinent group that did not differ significantly from the controls. In the detoxified group brain activation increased with time since detoxification. Conclusions. Our results are compatible with an increase in frontal brain activity from alcohol dependence over abstinence up to normal functioning. However, as cross-sectional designs do not allow to assess causal relations, results have to be considered preliminary and longitudinal studies are needed to further elucidate recovery processes in alcohol dependence.
- Elbogen, E.B., Tiegreen, J., Vaughan, C., Bradford, D.W.(2011). Money Management, Mental Health, and Psychiatric Disability: A Recovery-Oriented Model for Improving Financial Skills. Psychiatric Rehabilitation Journal, 34(3), 223-231. » 摘要
Abstract: Topic: Although money management skills are essential for independent functioning in the community, when viewed from the framework of psychosocial rehabilitation, there have been few systematic models for teaching money management skills to consumers with psychiatric disabilities based on a recoveryorientation. Purpose: For those diagnosed with psychiatric disabilities, better money management has consistently been shown to be associated with superior quality of life, fewer hospitalizations, and greater self-efficacy. Consumers frequently indicate that learning how to budget and staying out of debt are among their top goals for recovery with mental illness. The current paper reviews the issues of money management and mental health among people with psychiatric disabilities and proposes a recovery-oriented approach to increasing money management skills to increase community functioning among consumers. Sources Used: Published literature, clinical cases, and financial literacy resources . Conclusions and Implications for Practice: Improving money management can lead to a number of benefits by helping consumers with psychiatric disabilities: 1) gain more knowledge about disability benefits, 2) improve basic financial skills, and 3) reduce vulnerability to financial exploitation. Future work on incorporating this model into psychiatric rehabilitation programs would address skills consumers can use in living, working, and social environments in a way that enhances consumer choice and promotes recovery.
- Elfeddali, I., Bolman, C., Candel, M.J.J.M., Wiers, R.W., & De Vries, H. (2012). The role of self-efficacy, recovery self-efficacy, and preparatory planning in predicting short-term smoking relapse. BRITISH JOURNAL OF HEALTH PSYCHOLOGY, 17(1), 185-201.» 摘要
Abstract:Objectives. This study aims to identify the role of self-efficacy, recovery self-efficacy, and preparatory planning with regard to short-term smoking relapse. We also assessed whether the importance of these variables differed for smokers quitting individually and without help (self-quitters) and smokers quitting with the help of a smoking cessation course (group quitters). Design. A longitudinal quasi-experimental study with follow-ups at 1 and 3 months after the quit attempt was conducted in order to assess the role of baseline self-efficacy, recovery self-efficacy, and preparatory planning on short-term relapse. Methods. The recruitment included adult daily smokers (N = 121), quitting in a smoking cessation course (N = 57) and self-quitters (N = 64). Respondents received internet-based questionnaires 2 weeks before quitting (baseline) and 1 and 3 months after the quit attempt. Predictors of relapse were analysed using logistic regression analyses. Results. Relapse at 1 and 3 months after the quit attempt was predicted by low levels of baseline self-efficacy. Simple slope analyses revealed that less preparatory planning significantly predicted relapse at 1 month after the quit attempt among group quitters, but not among self-quitters. Recovery self-efficacy was only predictive of relapse after 1 month when self-efficacy was excluded from the analyses. Moreover, among group quitters, the results indicated a borderline significant curved relation between recovery self-efficacy and relapse after 1 month. Conclusions. Our results suggest that more research is needed on the role of preparatory planning and recovery self-efficacy. Moreover, we recommend incorporating self-efficacy increasing techniques in relapse-prevention interventions.
- El-Guebaly, N.(2012). The Meanings of Recovery From Addiction Evolution and Promises. Journal of addicyion medicine, 6(1), 1-9.» 摘要
Abstract: Objective: To review the evolution of the paradigm of recovery in addiction and its implications. Method: A systematic literature review was conducted using the MEDLINE and PsychInfo databases over the past 10 years and key references from the retrieved literature. Findings: The historical evolution of the concept of recovery has been shaped by several driving forces, including consumer experience, the need to better define our treatment outcome and parallel elaboration of the concepts of health, quality of life, and chronic disorders. Similarities and differences with the concept of "recovery" in mental health and other biomedical fields are identified. The empirical basis is growing in support of various proposed attributions and features of recovery along with the temporal benchmarks involved. The various forms of recovery, such as "natural," "transformational," or "medication-assisted," describe a choice of pathways to a common goal. The management implications are far-reaching and call for system shifts from acute stabilization to sustained recovery, including the growth of alternative institutions, and roles complementary to mutual help. Tools for the sustenance of recovery, including educational kits, recovery workbooks, and e-recovery initiatives, are developing. Conclusions: Although first-person accounts of recovery abound, a more systematic empirical investigation of the concept has just begun, including demographic and cultural differences. Management implications are derived from the experience with other "mainstream" chronic disorders with treatment providing stabilization and initiation of recovery and a range of long-term resources becoming available to sustain it.
- Estacio, EV.(2013). Health literacy and community empowerment: It is more than just reading, writing and counting. Journal of Health Psychology, 18(8), 1056-1068.» 摘要
Abstract: The concept of health literacy is evolving. The re-emergence of Freireian-inspired health literacy projects moves the conceptualisation of health literacy from merely the ability to apply functional literacy skills in a health-care context to a wider ability to exert control over the determinants of health. This article presents an example of a community-based project that adopts an empowerment education model in health literacy. Based within a small indigenous community in the Philippines, participants were engaged in critical reflection to gain a better understanding of how health is conceptualised within their socio-economic and political environment and its implications for practice, power relations and subjective experiences. The article concludes with the assertion that although developing health literacy skills is important, we must never lose sight of unbalanced power relations and unfair structures that hinder positive social change.
- Faber, G., Smid , HGOM ,Van Goo l , A.R. , Wunderink , L. ,Wiersma, D.,van den Bosch, R.J.(2011).Neurocognition and recovery in first episode psychosis. Psychiatry Research, 188(1), 1-6. » 摘要
Abstract: Cognitive functioning has been found to be a predictor of functional outcome of schizophrenia. It is unclear, however, whether clinical recovery can be predicted by scores on specific cognitive domains. The predictive value of specific neurocognitive domains and other clinical variables for symptomatic and functional outcome and clinical recovery after a 2-year follow-up is explored in a group of 51 patients with non-affective first-episode psychosis. A comprehensive neurocognitive battery was administered 18 and 41 weeks after inclusion. Other patient characteristics, which were expected to independently predict clinical recovery, were assessed at baseline. Several neurocognitive tests, especially tests measuring speed of processing, and among others, Duration of Untreated Psychosis (DUP), were significant predictors of clinical recovery. Poor neuropsychological performance accurately predicted non-recovery, but improved neuropsychological performance did not accurately predict recovery. This study confirms previous findings of an association between neurocognition and outcome, but the results also suggest that in order to accurately predict recovery, the role of other factors needs to be investigated.
- Fellner, M.(2013).ADHD in Educational Counselling - Perspectives of Discourse Theory and Empowerment at the Interface Between Youth Welfare, Health Care System and School System. Praxis Der KinderpsychologieI Und Kinderpsychiat,62(1), 61-76. » 摘要
Abstract: ADHD in Educational Counselling - Perspectives of Discourse Theory and Empowerment at the Interface Between Youth Welfare, Health Care System and School System ADHD is a controversial concept, which provokes educational counselling to position in an explosive stress field of school system, health care system and youth welfare. This positioning could be sharpened by a discourse theoretical perspective and used for counselling in the sense of empowerment. Based on the clinical controversy of ADHD the institutional coherence of school system, youth welfare and health care system gets reconstructed as the societal basis of this clinical discourse, this for showing how the clinification of infantine experience and behaviour, connected with the ADHD-diagnosis, on the one hand is following the constriction of normality and on the other hand is aiming to assure equal opportunities.
- Ferrari, J.R., Aase, D.M., Mueller, D.G., Jason, L.A. (2010). Landlords of Self-Governed Recovery Homes: An Initial Exploration of Attitudes, Opinions, and Motivation to Serve Others. Journal of Psychoactive Drugs, 41 (4): 349-354.» 摘要
Abstract: Landlords of community-based recovery homes are an under-researched group. The few existing studies available suggest that landlords might be more open to renting to vulnerable populations if certain conditions are met or communication is more open between all parties involved. The present exploratory study surveyed landlords (n = 30) of self-governed recovery homes across the United States regarding their attitudes and opinions about renting to these homes, and motivations for community service. Results indicated that landlords generally had positive perceptions of renting to self-governed recovery environments, and even perceived benefits of renting to these homes compared to more traditional tenants. Implications of these findings for future research are discussed in the context of existing research and limitations of the present study.
- Fisher, D.G., Pilon, D., Hershberger, S.L., Reynolds, G.L., LaMaster, S.C., Davis, M. (2009). Psychometric Properties of an Assessment for Mental Health Recovery Programs. Community Mental Health Journal, 45(4), 246-250.»摘要
- Fitzgerald, M.M.(2010). Comparison of Recovery Style and Insight of Patients with Severe Mental Illness in Secure Services with Those in Community Services. Journal of Psychiatric and Mental Health Nursing, 17 (3): 229-235.» 摘要
Abstract: Accessible summary People experiencing serious mental illness often adopt either a 'sealing over' or 'integrating' recovery style. 'Integration' is characterized with being aware and of trying to make sense of ones illness and of being engaged with health services. 'Sealing over' is characterized with the individual viewing their illness as alien and they can therefore become avoidant of services. Recovery styles are related to the individual's insight into their illness, how they feel about themselves and how they cope with the experience of having an illness. People who cope well with their illness are often considered to be more suitable for treatment in the community while those who have difficultly coping are more often seen in secure services. This study wishes to examine the idea that there is a relationship between recovery style and insight and where a person receives treatment. In particular, whether they receive treatment in the community or in a secure service. This study is relevant because it connects recovery style and insight with a person's ability to cope. Impairment resulting from illness can continue throughout life despite adequate and appropriate medication. This impairment has been linked to depression and the experience of stigma. By better understanding the relationship between recovery style, insight and coping, services may be able to provide, in addition to medication progressive treatments, that over time improve long-term impairment. Abstract Insight and recovery style have long been associated with Severe Mental Illness (SMI) but there remains little understanding of the relationship between how individuals comprehend and react to their illness and whether this reaction has a subsequent impact on where they receive treatment. Patients receiving treatment for SMI in two different locations, community services and long-term secure services were compared on their Recovery Style and Insight. This study hypothesizes that patients with SMI who receive treatment in secure services do so because they have poor insight into their illness and adopt a 'sealing over' recovery style. A significant difference in insight was found. The community group recorded higher insight than those in the secure group. Recovery style was found to relate to insight but not to service provision. This difference may provide an explanation of how insight and recovery style contributes to the recovery process and why some people do not respond well to the traditional medical approach to their illness. Further research is required to explore these possibilities but early indications are that services could benefit from the assessment of insight and recovery style at the baseline assessment stage to support early treatment formulation.
- Fogger, S.A., McGuinness, T.M.(2012).The Relationship Between Addictions and Bariatric Surgery for Nurses in Recovery. Perspectives in Psychiatric Care. 48(1),10-15.» 摘要
Abstract:PURPOSE: Determinants of morbid obesity are complex and numerous, yet understanding the neurobiological underpinnings improves our knowledge of this serious issue. Emerging science supports a comparison of disordered eating with other addictive substances. DESIGN AND METHODS: The study used a sub-analysis of a cross-sectional study of nurses in a state-monitoring program. FINDINGS: A study of 173 participants in a state-monitoring program for impaired nurses revealed that 14% (n = 25) had undergone bariatric surgery. Of these, 17 developed an addiction after surgery. PRACTICE IMPLICATIONS: Evidence suggests that some individuals may require additional treatment, similar to those with pharmacological addictions
- Francis, A. (2014). Strengths-based assessments and recovery in mental health: reflections from practice. International Journal of Social Work and Human Services Practice, 2, 264-271.» 摘要
Abstract:Social workers in the mental health sector are required to undertake assessments to determine the needs of their clients and to use appropriate strategies of interventions in a very demanding and compelling environment. One of the critical questions being asked in this context is- What do social workers really do in an assessment? And how do they do the assessment? Is a strengths based assessment model feasible in a predominantly biomedical model of practice? What is recovery? How can these concepts be applied in practice? How can the invisible nature of social work intervention be made more explicit and thus develop a sense of professional leadership? These are some of the questions that prompted this paper. Hence, in this paper the author discusses the relevance of strengths based philosophy and addresses how these ideas can be employed in adopting strengths- based assessment practice, and a recovery practice frame work in the mental health field with a special focus on social work. This is further illustrated with two case studies, which helps the readers to form questions and provides some practice tips for social workers to become an effective recovery oriented practitioner in the field.
- Fukui,S. , Starnino, V.R. ,Susana, M. , Davidson, L.J. , Cook, K., Rapp, C.A. , Gowdy, E.A. (2011). Effect of Wellness Recovery Action Plan (WRAP) Participation on Psychiatric Symptoms, Sense of Hope, and Recovery. Psychiatric Rehabilitation Journal , 34 (3), 214-222. » 摘要
Abstract: Objective: Self-management of psychiatric illness is a central tenet of consumer-directed mental health treatment. While several manualized self-management programs have been developed in recent years, the most widely disseminated is the Wellness Recovery Action Plan (WRAP). This study examined the effects of WRAP participation on psychiatric symptoms, hope, and recovery outcomes for people with severe and persistent mental illness. Methods: A quasi-experimental study, with an experimental (n=58) and a comparison (n=56) group was conducted. WRAP sessions (8-12 week) were facilitated by one staff person and one peer worker at five community mental health centers in a Midwestern state. The Modified Colorado Symptom Index, the State Hope Scale, and the RecoveryMarkers Questionnaire (RMQ) were employed at the first and last WRAP sessions, as well as six months following the intervention. Repeated measures analysis of covariance and planned comparisons before and after the intervention were conducted. Results: Findings revealed statistically significant group intervention effects for symptoms and hope, but not for RMQ. Planned comparisons showed statistically significant improvements for the experimental group in psychiatric symptoms and hope after the intervention, while non-significant changes occurred in the comparison group. Conclusions and Implications for Practice: The study results offer promising evidence that WRAP participation has a positive effect on psychiatric symptoms and feelings of hopefulness. If recovery is the guiding vision for mental health system reform, the study results provide evidence that WRAP programming may warrant a place in the current array of services offered through the publicly funded mental health system.
- Gale, C., Skegg, K., Mullen, R., Patterson, T.& Gray, A. (2012). Thoughts of suicide and stage of recovery in patients with schizophrenia in community mental health care. Australasian psychiatry, 20(4), 313-317.» 摘要
Abstract: Objective: Suicidality among patients with schizophrenia remains a major concern. The consumer-oriented concept of recovery has been recognised as important in recent years. We aimed to assess whether there was any relationship between stages of recovery and suicidality among people with schizophrenia in community care. Method: In a community mental health service, 85 patients with schizophrenia consented to an interview during which their stages of recovery were assessed using the Stages of Recovery Instrument. They were asked about suicidality and screened for depression using the Revised Clinical Interview Schedule. Insight was assessed via the Insight and Treatment Attitudes Questionnaire. Data analysis involved logistic regression. Results: In the past year 14% of the patients reported having wanted to die and 13% had considered suicide. Scores indicating the highest stage of recovery were associated with lower odds of suicidal thoughts. In contrast, suicidality was not significantly associated with depression or stage of insight. Conclusion: The link found between suicidality and stages of recovery has practical implications for suicide prevention among those with schizophrenia in community care. Approaches that facilitate the recovery process may reduce suicidal thoughts in this population.
- Gehart ,D.R.(2012). The Mental Health Recovery Movement and Family Therapy, Part I: Consumer-Led Reform of Services to Persons Diagnosed with Severe Mental Illness. Journal of marital and family therapy, 38(3), 429-442.» 摘要
Abstract: In 2004, the U.S. Department of Health and Human Services issued a consensus statement on mental health recovery based on the New Freedom Commissions recommendation that public mental health organizations adopt a recovery approach to severe and persistent mental illness, including services to those dually diagnosed with mental health and substance abuse issues. By formally adopting and promoting a recovery orientation to severe mental illness, the United States followed suit with other first-world nations that have also adopted this approach based on two decades of research by the World Health Organization. This movement represents a significant paradigm shift in the treatment of severe mental health, a shift that is more closely aligned with the nonpathologizing and strength-based traditions in marriage and family therapy. Furthermore, the recovery movement is the first consumer-led movement to have a transformational effect on professional practice, thus a watershed moment for the field. Part I of this article introduces family therapists to the concept of mental health recovery, providing an overview of its history, key concepts, and practice implications. Part II of this article outlines a collaborative, appreciative approach for working in recovery-oriented contexts.
- Gehart, D.R.(2012). The Mental Health Recovery Movement and Family Therapy, Part II: A Collaborative, Appreciative Approach for Supporting Mental Health Recovery. Journal of marital and family therapy, 38(3), 443-457.» 摘要
Abstract: A continuation of Part I, which introduced mental health recovery concepts to family therapists, Part II of this article outlines a collaborative, appreciative approach for working in recovery-oriented contexts. This approach draws primarily upon postmodern therapies, which have numerous social justice and strength-based practices that are easily adapted in recovery-oriented contexts. The model outlined in this article includes an overview of the recovery partnership (i.e., therapeutic relationship), mapping recovery (i.e., assessment and case conceptualization), recovery planning (i.e., treatment planning), facilitating recovery (i.e., intervention), accessing resources (i.e., case management), recovery maintenance, and service contexts as well as a case study.
- Gibson, R.W., D'Amico, M., Jaffe, L., Arbesman, M.(2011).Occupational Therapy Interventions for Recovery in the Areas of Community Integration and Normative Life Roles for Adults With Serious Mental Illness: A Systematic Review. American Journal of Occupational Therapy , 65(3), 247-256. » 摘要
Abstract: This systematic review investigated research literature evaluating the effectiveness of occupational therapy interventions focusing on recovery in the areas of community integration and normative life roles for people with serious mental illness. The review included occupation- and activity-based interventions and interventions addressing performance skills and performance patterns, aspects of context and environment, activity demands, and client factors. The results indicated that the evidence of the effectiveness of social skills training is moderate to strong. The evidence for the effectiveness of life skills and instrumental activities of daily living (IADLs) training to improve performance is moderate, as is the evidence for neurocognitive training paired with skills training in the areas of work, social participation, and IADLs. The evidence for client-centered intervention and increased intensity and duration of treatment is limited but positive, and the evidence that providing intervention in the natural context is more beneficial than in the clinic setting is inconclusive.
- Gillespie, C.F., Phifer, J., Bradley, B., Ressler, K.J. (2009). Risk And Resilience: Genetic And Environment Influences on Development of The Stress Response. Depression and Anxiety, 26(11), 984-992.» 摘要
- Gonzales, R., Anglin, M.D., Beattie, R., Ong, C.A.& Glik, DC.(2012). Perceptions of Chronicity and Recovery Among Youth in Treatment for Substance Use Problems. Journal of adolescent health, 51(2), 144-149.» 摘要
Abstract:
Purpose: To explore how youth contextualize substance use problems and recovery, in general and for themselves, in relation to the commonly accepted chronicity framework.
Conclusions: Findings highlight the importance of considering youth perceptions about substance use chronicity and recovery in making improvements and promoting new developments in clinical and recovery support approaches to better meet the needs of youth with substance use problems. Findings are discussed under a theoretical context of behavior change to provide insights for the treatment and recovery communities. Published by Elsevier Inc. on behalf of Society for Adolescent Health and Medicine.
Methods: Fourteen focus groups were conducted with 118 youth in substance abuse treatment settings (aged 12-24 years; 78.3% male; 66.1% Latino) located throughout diverse areas of Los Angeles County. Transcribed qualitative focus group data were analyzed for major substance use and recovery themes.
Results: Most (80%) youth do not accept a chronicity framework that conceptualizes substance use problems as recurring and constituting a lifelong illness. Most (65%) view substance use problems as a function of poor behavioral choices or a developmental/ social lifestyle phase. Youth perceptions of recovery tend to parallel this view, as most define recovery to mean having an improved or changed lifestyle that is achieved through making better behavioral choices (67%) and exerting personal control over one's behavior (57%) through willpower, confidence, or discipline. Other recovery themes identified by youth were substance use related (47%), wellness or well-being related (43%), and therapeutic or treatment related (14%). - Goodkind, J.R., Hess, J.M., Gorman, B. & Parker, D.P. (2012). "We're Still in a Struggle": Dine Resilience, Survival, Historical Trauma, and Healing. Qualitative Health Research, 22(8), 1019-1036.» 摘要
Abstract:As part of a community/university collaborative effort to promote the mental health and well-being of Dine (Navajo) youth, we explored the relevance of addressing historical trauma and current structural stressors, and of building on individual and community strengths through healing and social transformation at multiple levels. Qualitative analyses of 74 ethnographic interviews with 37 Dine youth, parents, and grandparents suggested that a focus on historical trauma as a conceptual frame for behavioral health inequities, understood within the context of resilience and survival, is appropriate. Our findings also highlight the salience of current stressors such as poverty and violence exposure. We explore the fit of an historical trauma healing framework and present implications for intervention and transformation through revitalization of traditional knowledge, culturally based healing practices, intergenerational education, and social change strategies designed to eliminate social inequities.
- Gratz, K.L., Rosenthal, M.Z., Tull, M.T., Lejuez, C.W., Gunderson, J.G. (2010). An Experimental Investigation of Emotional Reactivity and Delayed Emotional Recovery in Borderline Personality Disorder: The Role of Shame. Comprehensive Psychiatry, 51 (3): 275-285.» 摘要
Abstract: Despite the emphasis on emotional reactivity and delayed emotional recovery in prominent theoretical accounts of borderline personality disorder (BPD), research in this area remains limited This study sought to extend extant research by examining emotional reactivity (and recovery following emotional arousal) to 2 laboratory stressors (one general, and the other involving negative evaluation) and exploring the impact of these stressors on subjective responding across the specific emotions of anxiety, in-liability, hostility, and shame. We hypothesized that outpatients with BPD (compared to outpatients without a personality disorder, non-PD) would demonstrate heightened subjective emotional reactivity to both stressors, as well as a delayed return to baseline levels of emotional arousal Results provide evidence for context- and emotion-specific reactivity in BPD Specifically, BPD participants (compared to non-PD participants) evidenced heightened reactivity to the negative evaluation but not the general stressor Furthermore, results provide support for shame-specific reactivity in BPD, with BPD participants (vs non-PD participants) evidencing a significantly different pattern of change in shame (but not in reported anxiety, irritability, or hostility) across the course of the study. Specifically, not only did BPD participants report higher levels of shame in response to the negative evaluation, their levels of shame remained elevated following this stressor (through the post-recovery period at the end of the study). Findings suggest the importance of continuing to examine emotional reactivity in BPD within specific contexts and across distinct emotions, rather than at the general trait level.
- Grealish, A., Tai, S., Hunter, A., Morrison, AP. (2013). Qualitative Exploration of Empowerment from the Perspective of Young People with Psychosis. CLINICAL PSYCHOLOGY & PSYCHOTHERAPY, 20 (2): 136-148.» 摘要
Abstract: Evidence suggests that empowerment is central to improving the effectiveness and quality of mental health care. Empowerment includes increased involvement, choice and access to health information for service users. Within the process of empowerment, individuals may better understand their health needs and accordingly improve their prognoses. Despite the widespread use of the term empowerment' within mental health, there have been no studies examining how young people with psychosis understand and conceptualize the term empowerment or which factors are conductive to them developing a sense of empowerment. This study aims to qualitatively conceptualize empowerment from the perspective of young people aged 1418years experiencing psychosis. Individual interviews were conducted with nine young people with a diagnosis of a psychotic disorder regarding their understanding and experience of empowerment. The interviews were audiotaped, transcribed verbatim and analysed using interpretative phenomenological analysis. Results indicated that young people who have experienced psychosis conceptualized empowerment as being listened to, being understood, taking control and making decisions for themselves. Young people place high importance on experiencing personal empowerment in relation to being users of mental health services and regard being empowered as the most important factor for determining their own recovery. Results also revealed that young people view mental health workers as very variable in their ability and willingness to address and help facilitate empowerment. They also identified daily routine, structure and avoidance of inactivity as additional means of increasing empowerment. The implications for research and practice are discussed. Copyright (c) 2011 John Wiley & Sons, Ltd. Key Practitioner Message The way practitioners interact with young people impacts upon their experience of empowerment. Young people with psychosis equate being listened to with being empowered. Young people with psychosis, especially when hospitalized, want to develop and use their own coping styles. Clinicians who give choices and have a sense of humour are valued by young people with psychosis. Clinicians must consider whose needs are being met when decisions are made for young people with psychosis.
- Green, CA. ; Perrin, NA. ; Leo, MC. ; Janoff, SL. ; Yarborough, BJH. ;Paulson, RI.(2013) Recovery From Serious Mental Illness: Trajectories, Characteristics, and the Role of Mental Health Care. Psychiatric Services, 64 (12): 1203-1210.» 摘要
Abstract: The objective was to identify trajectories of recovery from serious mental illnesses. Methods: A total of 177 members (92 women; 85 men) of a not-for-profit integrated health plan participated in a two-year mixed-methods study of recovery (STARS, the Study of Transitions and Recovery Strategies). Diagnoses included schizophrenia, schizoaffective disorder, bipolar disorder, and affective psychosis. Data sources included self-reported standardized measures, interviewer ratings, qualitative interviews, and health plan data. Recovery was conceptualized as a latent construct, and factor analyses and factor scores were used to calculate recovery trajectories. Individuals with similar trajectories were identified through cluster analyses. Results: Four trajectories were identified two stable (high and low levels of recovery) and two fluctuating (higher and lower). Few demographic or diagnostic factors differentiated clusters at baseline. Discriminant analyses for trajectories found differences in psychiatric symptoms, physical health, satisfaction with mental health clinicians, resources and strains, satisfaction with medications, and mental health service use. Those with higher scores on recovery factors had fewer psychiatric symptoms, better physical health, greater satisfaction with mental health clinicians, fewer strains and greater resources, less service use, better quality of care, and greater satisfaction with medication. Consistent predictors of trajectories included psychiatric symptoms, physical health, resources and strains, and use of psychiatric medications. Conclusions: Having access to good-quality mental health care defined as including satisfying relationships with clinicians, responsiveness to needs, satisfaction with psychiatric medications, receipt of services at needed levels, support in managing deficits in resources and strains, and care for general medical conditions may facilitate recovery. Providing such care may improve recovery trajectories.
- Greene, G. J., Kondrat, D. C., Lee, M. Y., Clement, J., Siebert, H., Mentzer, R. A., & Pinnel, S. R. (2006). A Solution Focused Approach to Case Management and Recovery with Consumers Who Have a Severe Mental Disability. Families in Society, 87(3), 339-350. »摘譯
A solution focused approach to case management and recovery with consumers who have a severe mental disability
社區心理衛生體系越來越強調須對嚴重精神障礙者提供服務以協助其復元，文獻中已呈現優點個案管理有助於精神障礙者經歷復元。雖然優點個案管理以六個原則為基礎及發揮五項功能，但在微視系統─個管員與心理衛生服務接受者之間的互動中，上述原則及功能尚未完全操作化。本篇文章?述在焦點解決治療當中，如何將優勢觀點實際運用於直接且個別的互動中，以促進案主復元。 - Greer, T.L., Kurian, B.T., Trivedi, M.H. (2010). Defining and Measuring Functional Recovery from Depression. Cns Drugs, 24 (4): 267-284.» 摘要
Abstract: Depression is associated with significant functional impairment and reduced quality of life. Disruptions occur both globally as well as in specific functional areas such as work, interpersonal relationships and cognitive function. From both a clinical and research perspective, much focus has been given to the resolution of symptoms associated with depression, while relatively little attention has been given to functional improvements. Definitions of remission in depression are most frequently based on achieving a cut-off score on clinical rating scales of depressive symptoms. Research in this area has sparsely included psychosocial function or health-related quality of life as a primary outcome measure in clinical trials. However, the need to fully understand the impact of depression and its treatments on functioning is great, given the existing evidence of the profound effect that depression has on function. Even mild depressive symptoms and subsyndromal depression result in functional impairment and reduced quality of life, and untreated residual depressive symptomatology can result in an increased likelihood for relapse of the fully symptomatic disorder (i.e. major depressive disorder). Therefore, clinicians and researchers alike need to broaden the focus of treatment to encompass not only the specific symptoms of depression, but the functional consequences as well. Many tools have been developed to assess function and quality of life, both globally as well as within specific domains. In addition, the effect of residual symptoms associated with functional impairment (i.e. insomnia, fatigue, pain [somatic] symptoms and cognition) in depression, even independently of depressive symptoms, warrants evaluation and monitoring. Recommendations for evaluating functional outcomes include: (i) adequately assessing functional impairment; (ii) identifying and/or developing treatment plans that will target symptoms associated with functional impairments; and (iii) monitoring functional impairments and associated symptoms throughout the course of treatment. The development of treatments that specifically target improvements in functional impairments is needed, and may require the use of novel treatment strategies.
- Guinn, B., Vincent, V,. Dugas, D. (2009). Stress Resilience Among Border Mexican American Women. Hispanic Journal of Behavioral Sciences, 31(2), 228-243.» 摘要
- Gutierrez, M., Romero, I. (2014). Resilience, subjective well-being and adolescents' attitudes toward drug use in Angola. Anales De Psicologia, 30 (2): 608-619.» 摘要
Abstract: The aim of this study was to analyse the relationship among self-esteem, emotional intelligence, social support, resilience, satisfaction with life and adolescents' attitudes toward drug use. Participants were 2506 adolescents (1231 males and 1275 females) aged from 14 to 18 years old (M = 16.40; SD = 1.40). Structural Equation Modeling was carried out to examine de effects of self-esteem, social support and emotional intelligence on resilience, and the effect of resilience on adolescents' satisfaction with life and attitudes toward drug use. Results showed positive effects of self-esteem, family support and regulation of emotion on adolescents' satisfaction with life; and a positive effect of use of emotion on family influence to avoid adolescents' drug use. Additionally, the effects of school support, self-emotion appraisal and others' emotion appraisal on resilience were negative; as well as the effects of resilience on adolescents' satisfaction with life and drug use pleasure. Results are discussed in the positive psychology framework.
- Hacking, S., Secker, J., Spandler, H., Kent, L.＆ Shenton, J. (2008). Evaluating the Impact of Participatory art Projects for People with Mental Health Needs. Health & Social Care in the Community, 16（6）,638-648.» 摘譯
Evaluating the impact of participatory art projects for people with mental health needs
有心理健康需求的人參與藝術方案通常被要求展現成果，例如在自信、自尊、社會參與和心理健康的進步。然而，這樣的要求很少有強而有力的成果研究支持。這份報告乃是一個全國性評估方案的一部分，展現了英國44位女性和18位男性參與了22個藝術方案的成果。透過自填問卷來量化第一次參與方案的成果，從2006的1月到3月，和6個月之後。問卷包括三種測量指標：充權、心理健康（臨床日常評估成果，Clinical Outcomes in Routine Evaluation (CORE)）和社會包容。使用雙尾t檢定來比較整體的改變，和混合模型重複測量變異數的分析來與次團體比較，包括年齡、性別、教育程度和參與的程度。結果顯示充權(P = 0.01)、心理健康 (P = 0.03)社會包容 (P = 0.01)有顯著的進步。在CORE得到較高分數的參與者，在三次的測量中，他們的生活中沒有新的壓力和他們生活中對於藝術的影響有正面的印象，獲益最多。對藝術影響的正面印象與充權、心理健康和社會包容等三項測量指標皆有顯著相關，其中最大的效益是充權(P= 0.002)。本研究顯示藝術參與有益於有心理健康困難的人。藝術參與可增進充權的程度，以及對於心理健康和社會包容有潛在的影響。 - Hamilton, R.H. , Chrysikou , E.G.. , Coslett , B.(2011). Mechanisms of aphasia recovery after stroke and the role of noninvasive brain stimulation. Brain and Language, 118 (1-2), 40-50. » 摘要
Abstract: One of the most frequent symptoms of unilateral stroke is aphasia, the impairment or loss of language functions. Over the past few years, behavioral and neuroimaging studies have shown that rehabilitation interventions can promote neuroplastic changes in aphasic patients that may be associated with the improvement of language functions. Following left hemisphere strokes, the functional reorganization of language in aphasic patients has been proposed to involve both intrahemispheric interactions between damaged left hemisphere and perilesional sites and transcallosal interhemispheric interactions between the lesioned left hemisphere language areas and homotopic regions in the right hemisphere. A growing body of evidence for such reorganization comes from studies using transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), two safe and noninvasive procedures that can be applied clinically to modulate cortical excitability during post-stroke language recovery. We discuss a hierarchical model for the plastic changes in language representation that occur in the setting of dominant hemisphere stroke and aphasia. We further argue that TMS and tDCS are potentially promising tools for enhancing functional recovery of language and for further elucidating mechanisms of plasticity in patients with aphasia.
- Hammersley R. (2011). Pathways through drugs and crime: Desistance, trauma and resilience. Journal of Criminal Justice, 39(3), 268-272. » 摘要
Abstract: Purpose: To develop theoretical understandings of pathways through drugs and crime.Method: Critical and theoretical review.Content: Discourse about drugs and crime tends to focus either on delinquency, nowadays including some drug use, or on drug dependence. There are other pathways through drugs and crime, which deserve further exploration, not forgetting that most people desist from offending, or that drug dependence is a relatively rare outcome of drug use. A notable pathway involves a temporary period of intense substance use and offending which often remits without intervention. It is hypothesised that such periods are often caused by traumatic life events, or the persisting effects of earlier trauma, and that intense use converts to more protracted drug dependence when trauma and/or its effects continue. One way that this can happen is that drug use itself causes or perpetuates trauma and, then, use continues to cope with the negative psychological effects of trauma, in a vicious circle.Conclusions: There is need to assess and treat trauma amongst substance users and to avoid over treating intense substance use that might remit untreated. Normative adult substance use outcomes need to be researched and theorised.
- Harrow, M., Hansford, B.G., Astrachan-Fletcher, E.B.,(2009). Locus of control: Relation to Schizophrenia, to Recovery, and to Depression and Psychosis - A 15-Year Longitudinal Study. Psychiatry Research, 168(3), 186-192.» 摘要
- Harvey, P.D., Bellack, A.S., (2009). Toward a Terminology for Functional Recovery in Schizophrenia: Is Functional Remission a Viable Concept? Schizophrenia Bulletin, 35(2), 300-306.» 摘要
- Helen Herrman, Donna E Stewart, Natalia Diaz-Granados, Elena L Berger , Beth Jackson, Tracy Yuen(2011).What Is Resilience? Canadian Journal of Psychiatry, 56(5),258-265.» 摘要
Abstract:Objective: While everyone-including front-line clinicians-should strive to prevent the maltreatment and other severe stresses experienced by many children and adults in everyday life, psychiatrists and other health professionals also need to consider how best to support, throughout the lifespan, those people affected by severe adversity. The first step in achieving this is a clear understanding of the definitions and concepts in the rapidly growing study of resilience. Our paper reviews the definitions of resilience and the range of factors understood as contributing to it, and considers some of the implications for clinical care and public health. Method: This narrative review took a major Canadian report published in 2006 as its starting point. The databases, MEDLINE and PsycINFO, were searched for new relevant citations from 2006 up to July 2010 to identify key papers considering the definitions of resilience and related concepts. Results: Definitions have evolved over time but fundamentally resilience is understood as referring to positive adaptation, or the ability to maintain or regain mental health, despite experiencing adversity. The personal, biological, and environmental or systemic sources of resilience and their interaction are considered. An interactive model of resilience illustrates the factors that enhance or reduce homeostasis or resilience. Conclusions: The 2 key concepts for clinical and public health work are: the dynamic nature of resilience throughout the lifespan; and the interaction of resilience in different ways with major domains of life function, including intimate relationships and attachments.
- Hertz, P., Addad, M., Ronel, N.(2012).Attachment Styles and Changes among Women Members of Overeaters Anonymous Who Have Recovered from Binge-Eating Disorder.Health & Social Work, 37(2), 110-122.» 摘要
Abstract:In Overeaters Anonymous (OA), the 12-step self-help program for compulsive overeaters, binge eating is regarded as a physical, spiritual, and emotional disorder. Consequently, the program proposes recovery through the adoption of a lifestyle that leads to physical, spiritual, and emotional well-being. A qualitative phenomenological study that focused on the emotional recovery of OA members was conducted. Personal narratives were obtained through semistructured in-depth interviews. It was found that the tools used for spiritual and emotional work at OA are essential to recovery. Furthermore, the experience of secure attachment is likely to occur within OA when safe ground is provided and positive attachment figures are accessible. These safe ground and positive attachment figures facilitate a corrective emotional experience that compensates for a childhood recollected in terms of rejection and time spent with a caregiver who lacked the emotional availability required for the creation of a secure attachment. Theoretical, clinical, and future research implications are discussed.
- Henley, Robert.(2010).Resilience enhancing psychosocial programmes for youth in different cultural contexts: Evaluation and research.Progress in Development Studies, 10(4), 295-307.» 摘要
Abstract:This article takes a first step towards developing a resilience assessment scale for use by development organisations offering services to youth and young adults in different cultural contexts. The purpose of a resilience assessment scale would be to assess effectiveness of services in enhancing competencies of youth in managing and adapting to adversities they experience. An in-depth conceptualisation of individual resilience and how this interacts with multi-layered social resilience is explored: Organisations provide psychosocial services to help strengthen competencies of vulnerable young people, who in turn can help enhance resilience in the family, neighbourhood and community.
- Hicks, A.L., Deane, F.P.& Crowe, TP.(2012). Change in working alliance and recovery in severe mental illness: An exploratory study. Journal of Mental Health, 21(2), 128-135.» 摘要
Abstract: Background: Consumer-defined recovery from schizophrenia spectrum disorders and other recurring psychotic illnesses ("serious mental illness", "SMI") emphasize re-establishment of a personally meaningful life. The working alliance ("the alliance") is highlighted as important in facilitating recovery, however there is little empirical evidence concerning the relationship between the alliance and recovery in populations with SMI. Aims: The aim is to explore the relationship between the alliance and recovery over time in a sample with SMI. Method: Sixty-one individuals with SMI receiving case management support from mental health services in Australia were recruited by their mental health workers and completed measures of working alliance and recovery. Measures were collected by the workers during regular counselling sessions on two separate occasions.The average time between measurement times was 6 months apart. Results: Multiple regression analyses indicated that changes in the alliance predicted recovery, but changes in recovery also predicted the alliance. No definitive conclusions regarding the causal direction of the relationship between the alliance and recovery could be drawn. Conclusions: The results provide preliminary evidence that improvement in the alliance positively influences gains in recovery and that gains in recovery also facilitate stronger alliance in SMI. These findings support an emphasis on the alliance.
- Hiller, SP., Syvertsen, JL., Lozada, R., Ojeda, VD.(2013). Social support and recovery among Mexican female sex workers who inject drugs. Journal of Substance Abuse Treatment, 45(1), 44-54.» 摘要
Abstract: This qualitative study describes social support that female sex workers who inject drugs (FSW-IDUs) receive and recovery efforts in the context of relationships with family and intimate partners. We conducted thematic analysis of in-depth interviews with 47 FSW-IDUs enrolled in an intervention study to reduce injection/sexual risk behaviors in Tijuana, Mexico. FSW-IDUs received instrumental and emotional social support, which positively and negatively influenced recovery efforts. Participants reported how some intimate partners provided conflicting positive and negative support during recovery attempts. Problematic support (i.e., well-intended support with unintended consequences) occurred in strained family relationships, limiting the positive effects of support. Mexican drug treatment programs should consider addressing social support in recovery curricula through evidence-based interventions that engage intimate partners, children and family to better reflect socio-cultural and contextual determinants of substance abuse. (c) 2013 Elsevier Inc. All rights reserved..
- Ho, W.W.N., Chiu, M.Y.L., Lo, W.T.L., Yiu, M.G.C. (2010). Recovery Components as Determinants of The Health-Related Quality of Life Among Patients with Schizophrenia: Structural Equation Modelling Analysis. Australian and New Zealand Journal of Psychiatry, 44 (1): 71-84.» 摘要
Abstract: Objective: The Substance Abuse and Mental Health Services Administration (SAMHSA) National Consensus Statement on Mental Health Recovery proposed 10 recovery components as guiding principles for fostering recovery among people with severe mental illness. Although researchers have recognized a close association between patient-oriented recovery and health-related quality of life (HRQOL), the relation between the recovery components and patients' self-reported HRQOL is still unknown. The purpose of the present study was therefore to use structural equation modelling to predict HRQOL of schizophrenia outpatients from the recovery components proposed by SAMHSA.Methods: The recovery status of 201 outpatients with schizophrenia, schizophreniform, or schizoaffective disorder was measured using 12 variables that indicate the outcome of 10 recovery components. Canonical correlation analysis was applied to screen variables that are highly correlated with HRQOL. Valid variables were then used to build a structural model that predicted individuals' HRQOL as indicated by the World Health Organization Quality of Life Measure Abbreviated (WHOQOL-BREF (HK)). Results: The best-fit model was able to explain 80.7% of the variance in WHOQOL-BREF outcome. The model demonstrated significant direct and indirect effects of five recovery components on HRQOL. The effect of psychosocial symptoms on HRQOL was highest (total beta = -0.64), followed by sense of personal agency (total beta = 0.58), sense of optimism (total beta = 0.54), perceived support (total beta = 0.47), and internal stigma (total beta = -0.42). Conclusion: The recovery components proposed by the SAMHSA consensus statement provided a useful framework to explain HRQOL of outpatients with schizophrenia. The present model indicated a moderate to large effect of five major recovery components on HRQOL. It showed that patients' perceptions of support, optimism, and personal agency were influenced by psychosocial symptoms and internal stigma. This empirical study supported the use of recovery principles, such as resilience building or mastery-based intervention to improve the QOL of community dwellers with schizophrenia.
- Hou, W.K., Ng, S.M. (2014). Emotion-focused positive rumination and relationship satisfaction as the underlying mechanisms between resilience and psychiatric symptoms. Personality and Individual Differences, 71: 159-164.» 摘要
Abstract: More empirical investigation is needed to understand the mechanisms through which psychological resilience impacts psychiatric symptoms. This study aimed to examine the mediating role of emotion-focused positive rumination and relationship satisfaction in the inverse associations between trait resilience and anxiety and depressive symptoms. A sample of 284 Chinese college students were recruited and asked to self-administer questionnaires measuring trait resilience, emotion-focused positive rumination, relationship satisfaction, and anxiety and depressive symptoms. Structural equation modeling revealed that emotion-focused positive rumination and relationship satisfaction independently and jointly mediated the inverse association between trait resilience and anxiety symptoms (data-model fit: CFI = 1.000; TLI = 1.022; IFI = 1.004; RMSEA =.000; SRMR =.014). Relationship satisfaction, alone, mediated the inverse association between trait resilience and depressive symptoms (data-model fit: CFI = 1.000; TLI = 1.021; IFI = 1.003; RMSEA =.000; SRMR =.014). The results suggested possible underlying mechanisms of the psychological benefit of trait resilience. Feasible directions for fostering resilience among college populations were discussed. (C) 2014 Elsevier Ltd. All rights reserved.
- Hourani L, Bender R.H., Weimer B., Peeler R., Bradshaw M., Lane M.& Larson G.(2012). Longitudinal study of resilience and mental health in marines leaving military service. Journal of Affective Disorders, 139(2),154-165.» 摘要
Abstract: Background: Despite a growing emphasis on psychological outcomes following military combat, few longitudinal studies have examined the combined role of risk and protective factors in the mental health of combat-exposed military personnel. This study characterizes the impact of resilience scale scores and combat exposure on mental health outcomes among Marines after separating from military service, along with intra-individual changes in mental health status.
- Howell, A. (2012). The Demise of PTSD: From Governing through Trauma to Governing Resilience. Alternatives, 37(3), 214-226.» 摘要
Abstract:This article raises questions about the possible waning of the authority of the diagnosis of posttraumatic stress disorder (PTSD). While avoiding predictions, it points to signs that the authority of PTSD is now being challenged by both the rise of resilience-based models and the increasing authority of biomedical and neurological approaches in the governance of trauma. It explores these challenges in various empirical sites, including humanitarian interventions, Western military settings (especially involving the US Army and North Atlantic Treaty Organization [NATO]), as well as civilian contexts, including national health services, emergency preparedness, schools, universities, and other sectors. The article concludes by stressing some of the troubling politics that surround these new developments, which, like the diagnosis of PTSD, may individualize and govern the experience of traumatic events, including war, in a broad context of social and economic austerity.
- Hue, Ming-Tak(2011).Developing resiliency in students with behavioural problems in Hong Kong secondary schools: teachers’ narratives from a school guidance perspective. Pastoral Care in Education, 29(4), 261-272.» 摘要
Abstract:Hong Kong schools are concerned about how students with behavioural problems could be supported. This article reports the findings of a study investigating teachers’ constructs of students’ resilience. Specifically it examines how it could be promoted through school guidance and factors affecting the development of students’ resilient capability. Twenty-four teachers from four secondary schools were interviewed. Their constructs of resiliency were explored from the perspective of social constructivism and the narrative approach was also employed. The study identifies the challenges school guidance faced in developing resiliency are identified. Also four means through which school guidance could be made more resilient are suggested, including helping students explore the natural tendencies of students’ inner-strength, developing a resilient approach to behaviour management, including the resiliency into whole-school guidance curriculum, and building connections between school, home and community. The findings also show that the construct of resiliency was culturally grounded upon Confucianism. The direction for future research is given.
- Ireland, R., Weisbart, C., Dubowitz, H., Rowe, J., Stein, M.T. (2009). When Family Drawings Reveal Vulnerabilities and Resilience. Journal of Development and Behavioral Pediatrics, 30(5), 474-477.» 摘要
- Isaac R. Galatzer-Levy, Charles L. Burton,&George A. Bonanno (2012). Coping Flexibility, Potentially Traumatic Life Events, and Resilience: A Prospective Study of College Student Adjustment.Journal of Social and Clinical Psychology, 31(6),542-567.» 摘要
Abstract: College has been shown to be a particularly stressful time both due to unique emergent stressors and because of increased vulnerability for exposure to potentially traumatic events (PTEs). Both of these conditions are associated with heightened risk for the development of stress-related pathology. However, while this period may be particularly challenging, previous work shows most students adapt in a number of heterogeneous ways that result in little or no stress-related symptomatology over the four years of college. There is indication from the coping literature that the ability to flexibly move between multiple coping behaviors may foster resilient outcomes. In this study, we examined trajectories of distress, using Latent Growth Mixture Modeling, and whether flexible coping aids in adaption. Results showed that trajectories were not influenced by exposure to a PTE and that the common outcome was little or no distress over the four years of college. Flexible coping was strongly associated with a resilient outcome.
- Jacob, K. (2015). Recovery Model of Mental Illness: A Complementary Approach to Psychiatric Care. Indian Journal of Psychological Medicine, 37(2), 117.» 摘要
Abstract:
Medicine, in keeping with its status in society, always had a paternalistic culture. Doctors listened to patients' concerns, examined them, ordered laboratory investigations, diagnosed disease, prescribed medication and prognosticated about course and outcome. While they did explain the issues to their patients, medical perspectives and opinions guided their decisions. Patients were expected to follow their advice. The prevalent paternalistic culture within the medical profession often dismissed patient perspectives and did not take kindly to objections or different points of view.
Psychiatry with its focus on symptoms and functioning developed elaborate assessments, standardized interviews and rating scales to document and monitor psychopathology. These appraisals measured positive and negative psychotic symptoms, depression and anxiety, cognitive deficits, as well as functioning. The early success of psychotropic medication in reducing symptoms of psychosis and ameliorating anxiety and depression led to optimism among mental health professionals that people with these conditions will recover from their mental illness and lead normal lives. Five decades later, mental health professionals accept that a significant proportion of people with mental disorders continue to have persistent and disabling symptoms and are unable to get back to their previous occupations and social roles. However, the quest for newer psychotropic medication also meant a continued focus on residual symptoms and deficits. - Janssen, M. B., Tineke, A. A. & Van Regenmortel, T. (2012). Maintaining mastery despite age related losses. The resilience narratives of two older women in need of long-term community care. Journal of Aging Studies, 26(3), 343-354.» 摘要
Abstract: The aim of this article is to examine how older people mobilise sources of strength, often denoted under the concept of resilience, to maintain mastery over their lives in the context of significant threats to their function. Departing from a relational approach to resilience, we focus on how they cooperate and interact with significant others to achieve their personal goals. This is illustrated by the narratives of two older women. The concept of resilience helps us to reflect on their stories and to gain an in-depth understanding of the mediating sources of strength older people rely on when encountering the losses associated with old age. The narratives of the women show that what on the surface appears to be a similar burden to a life or function, turned out to be interpreted and responded to in a different way. Maintaining mastery in old age is a symbolic and interactional process, and a shared responsibility for older persons and their social environment. Important mediating sources of strength that turn out to influence positively one's sense of mastery include a positive perception of one's situation, openness about one's vulnerability and responsiveness to help. In order to promote older people's sense of mastery, significant others need to approach them in a positive way, by being aware of the way support is offered, by believing in their potential and strength and by allowing reciprocity in the relationship. When these conditions are fulfilled, it becomes possible to enter into a constructive dialogue and recommendations can be developed - in terms of treatment - that are consistent with the older persons' values and expectations.
- Jeras, S. O., Shepherd, J. B., Britton, P. J. (2003). Counseling Older Adults with HIV/AIDS: A Strength-Based Model of Treatment. Journal of Mental Health Counseling, 25( 3), 233-244.» 摘譯
Counseling Older Adults with HIV/AIDS: A Strength-Based Model of Treatment
這篇文章概述一種以優勢為基礎的評估及處遇模式，可應用於因為HIV而老化的人的心理健康諮商。藉由聚焦案主可以有效運用的生活特定領域，這種模式不僅減少他們對病狀及污名的關注，反之，更能增強案主的權能，使其專注於他們可以控制的生活領域。 - Johnson, J., Gooding, P.A., Wood, A.M., Tarrier, N. (2010) .Resilience as Positive Coping Appraisals: Testing the Schematic Appraisals Model of Suicide (SAMS). Behaviour Research and Therapy, 48 (3): 179-186.» 摘要
Abstract: Aims: The Schematic Appraisals Model of Suicide (SAMS) suggests that positive self-appraisals may be important for buffering suicidal thoughts and behaviours, potentially providing a key source of resilience. The current study aimed to explore whether positive self-appraisals buffered individuals from suicidality in the face of stressful life events. Method: 78 participants who reported experiencing some degree of suicidality were recruited from a student population. They completed a battery of questionnaires including measures of suicidality, stressful life events and positive self-appraisals. Results: Positive self-appraisals moderated the association between stressful life events and suicidality. For those reporting moderate or high levels of positive self-appraisals, raised incidence of stressful life events did not lead to increases in suicidality. Discussion: These results support the SAMS framework, and suggest that positive self-appraisals may confer resilience to suicide. Positive self-appraisals may be a promising avenue for further resilience research, and an important area to target for suicide interventions.
- Joice, S., Johnston, M., Bonetti,D., Morrison, V., & MacWalter, R. (2012). Stroke survivors' evaluations of a stroke workbook-based intervention designed to increase perceived control over recovery. HEALTH EDUCATION JOURNAL, 71(1), 17-29.» 摘要
Abstract:Objective: To report stroke survivors' experiences and perceived usefulness of an effective self-help workbook-based intervention.
Design: A cross-sectional study involving the intervention group of an earlier randomized controlled trial.
Setting: At the participants' homes approximately seven weeks post-hospital discharge.
Method: Following the five-week implementation period of the intervention, stroke survivors (n = 59) completed a structured exercise designed to assess and prioritize perceived usefulness of the intervention components. Demographic, clinical and psychological measures from the original study were included.
Results: Ninety per cent (n = 53) of respondents rated the stroke workbook intervention as being better than slightly useful. A factor analysis of the completed responses derived three components, which were labelled information, support and behavioural activities. Repeated measures analysis of variance (ANOVA) showed information and support to be significantly more useful than the behavioural activities (F (2, 116) = 60.79, p = .001). Behavioural activities were more highly rated by women than men (p = .02) and by those without a caregiver than those with (p = .02). Participants with high desire rated all three components of the intervention more useful than those with low desire (p = .01).
Conclusions: Those who used the intervention generally found it useful, with information and social support being perceived as being more useful than behavioural activities. Perceiving the behavioural activities as least useful may impede the uptake of recovery-promoting activities, which may have consequences for the effect of rehabilitation, and recovery. - Jonker, L., Greeff, A.P.(2009). Resilience Factors in Families Living With Mental Illnesses. Journal of Community Psychology, 37(7), 859-873.» 摘要
- Kaplan, K., Salzer, M.S., & Brusilovskiy, E. (2012). Community Participation as a Predictor of Recovery-Oriented Outcomes Among Emerging and Mature Adults with Mental Illnesses. PSYCHIATRIC REHABILITATION JOURNAL, 35(3), 219-229.» 摘要
Abstract:Objective: The promotion of recovery and quality of life is a major focus of national and local mental health system transformation efforts. There has been simultaneous interest in enhancing community participation as a facilitator of recovery. This study examines the community participation experiences of emerging adults and mature adults with serious mental illnesses and the relationship between various types of participation and recovery, quality of life, and meaning of life. Methods: Baseline data from the Consumer-Operated Service Program multisite study were utilized. The sample was recruited from traditional mental health services and consisted of 233 emerging adults and 1,594 mature adults. Ten areas of participation were examined: parenting, employment, volunteering, college student, group membership, civic engagement, peer support, friendships, intimate relationships, and engagement in religious/spiritual activities. Results: Emerging and mature adults differed in developmentally appropriate ways. Emerging adults and those who participated more had higher scores on the recovery, quality of life and meaning of life measures. Conclusions and Implications for Practice: The higher scores on the dependent variables may be explained by younger adults having greater hope and higher expectations that are typical for those at that stage of life and that living longer with a serious mental illness and being exposed longer to the mental health system may dampen hope. Participation in general, and specific areas of participation, were predictive of recovery-oriented outcomes. These results should inspire future developmentally-oriented research examining factors that facilitate recovery and provide direction to providers about participation areas that may be most beneficial in facilitating recovery.
- Kasmel, A., Tanggaard, P. (2011). Evaluation of Changes in Individual Community-Related Empowerment in Community Health Promotion Interventions in Estonia. International Journal of Environmental Research and Public Health, 8(6), 1772-1791. » 摘要
Abstract: This study assessed changes in community members' ratings of the dimensions of individual community related empowerment (ICRE) before and two years after the implementation of an empowerment expansion framework in three community health promotion initiatives within the Estonian context. We employed a self-administered questionnaire, the adapted mobilisation scale-individual. As the first step, we investigated the multidimensional nature of the ICRE construct and explored the validity and reliability (internal consistency) of the ICRE scale. Two datasets were used. The first dataset comprised a cross-sectional random sample of 1,000 inhabitants of Rapla County selected in 2003 from the National Population Register, which was used to confirm the composition of the dimensions of the scale and to examine the reliability of the dimensions. The second dataset comprised two waves of data: 120 participants from three health promotion programs in 2003 (pre-test) and 115 participants in 2005 (post-test), and the dataset was used to compare participants' pre-test and post-test ratings of their levels of empowerment. The content validity ratio, determined using Lawshe's formula, was high (0.98). Five dimensions of ICRE, self-efficacy, intention, participation, motivation and critical awareness, emerged from the factor analysis. The internal consistency (a) of the total empowerment scale was 0.86 (subscales self-efficacy alpha = 0.88, intention alpha = 0.83, participation alpha = 0.81 and motivation alpha = 0.69; critical awareness comprised only one item). The levels of ICRE dimensions measured after the application of the empowerment expansion framework were significantly more favourable for the dimensions self-efficacy, participation, intention and motivation to participate. We conclude that for Rapla community workgroups and networks, their ICRE was rendered more favourable after the implementation of theempowerment expansion framework.
- Kelly, J., Wellman, N., Sin, J.(2009). HEART - the Hounslow Early Active Recovery Team: Implementing an Inclusive Strength-Based Model of Care for People with Early Psychosis. Journal of Psychiatric And Mental Health Nursing, 16(6), 569-577.» 摘要
- Kern, R.S., Glynn, S.M., Horan, W.P.,Marder, S.R., (2009). Psychosocial Treatments to Promote Functional Recovery in Schizophrenia. Schizophrenia Bulletin, 35(2), 347-361. » 摘要
- Kerstin, R., Migliardi, P., Mignone, J. (2012). HIV, social support, and care among vulnerable women. Journal of Community Psychology, 40(5), 487-500.» 摘要
Abstract: Little research has been conducted on women living with HIV with a focus on caregiving. This paper explores data that emerged in a study examining caregiving networks among people living with HIV in the Prairies in Canada. Photovoice provided a methodology for data collection. The narratives presented suggest that while these women's lives are riddled with risk and violence, there are clear features to which they turn to in order to gain support and strength. Recommendations for future social support conclude the paper.
- Kidd, A.& Steinglass, J.(2012). What can Cognitive Neuroscience Teach us about Anorexia Nervosa? Current psychiatry reports, 14(4), 415-420.» 摘要
Abstract: Anorexia nervosa (AN) is a complex illness and highly challenging to treat. One promising approach to significantly advance our understanding of the underlying pathophysiology of AN involves developing a cognitive neuroscience model of illness. Cognitive neuroscience uses probes such as neuropsychological tasks and neuroimaging techniques to identify the neural underpinnings of behavior. With this approach, advances have been made in identifying higher-order cognitive processes that likely mediate symptom expression in AN. Identification of related neuropathology is beginning. Such findings led to the development of complex neurobehavioral models that aim to explain the etiology and persistence of AN. Future research will use these advanced tools to test and refine hypotheses about the underlying mechanisms of AN.
- Killaspy, H., Whit,e S., Taylor, TL.& King, M.(2012). Psychometric properties of the Mental Health Recovery Star. British journal of psychiatry, 201(1), 65-70.» 摘要
Abstract: The Mental Health Recovery Star (MHRS) is a popular outcome measure rated collaboratively by staff and service users, but its psychometric properties are unknown. Aims：To assess the MHRS's acceptability, reliability and convergent validity. Method：A total of 172 services users and 120 staff from in-patient and community services participated. Interrater reliability of staff-only ratings and test-retest reliability of staff-only and collaborative ratings were assessed using intraclass correlation coefficients (ICCs). Convergent validity between MHRS ratings and standardised measures of social functioning and recovery was assessed using Pearson correlation. The influence of collaboration on ratings was assessed using descriptive statistics and ICCs. Results：The MHRS was relatively quick and easy to use and had good test-retest reliability, but interrater reliability was inadequate.Collaborative ratings were slightly higher than staff-only ratings. Convergent validity suggests it assesses social function more than recovery. Conclusions：The MHRS cannot be recommended as a routine clinical outcome tool but may facilitate collaborative care planning.
- Kimhi, S., Eshel, Y., Zysberg, L.,Hantman, S (2009). Getting a Life: Gender Differences in Postwar Recovery. Sex Roles, 61(7-8), 554-565. » 摘要
- King, R., Neilsen, P., White, E. (2013). Creative writing in recovery from severe mental illness. International Journal of Mental Health Nursing, 22(5), 444-452. » 摘要
- Kirmayer, Laurence J.,Dandeneau, Stéphane4、Marshall, Elizabeth,Phillips, Morgan Kahentonni , Williamson , Karla Jessen(2011).Rethinking Resilience From Indigenous Perspectives. Canadian Journal of Psychiatry, 56(2),84-91.» 摘要
Abstract:The notions of resilience that have emerged in developmental psychology and psychiatry in recent years require systematic rethinking to address the distinctive cultures, geographic and social settings, and histories of adversity of indigenous peoples. In Canada, the overriding social realities of indigenous peoples include their historical rootedness to a specific place (with traditional lands, communities, and transactions with the environment) and the profound displacements caused by colonization and subsequent loss of autonomy, political oppression, and bureaucratic control. We report observations from an ongoing collaborative project on resilience in Inuit, Métis, Mi'kmaq, and Mohawk communities that suggests the value of incorporating indigenous constructs in resilience research. These constructs are expressed through specific stories and metaphors grounded in local culture and language; however, they can be framed more generally in terms of processes that include: regulating emotion and supporting adaptation through relational, ecocentric, and cosmocentric concepts of self and personhood; revisioning collective history in ways that valorize collective identity; revitalizing language and culture as resources for narrative self-fashioning, social positioning, and healing; and renewing individual and collective agency through political activism, empowerment, and reconciliation. Each of these sources of resilience can be understood in dynamic terms as emerging from interactions between individuals, their communities, and the larger regional, national, and global systems that locate and sustain indigenous agency and identity. This social-ecological view of resilience has important implications for mental health promotion, policy, and clinical practice.
- Kleiman, E. M., Beaver, J. K.(2013). A meaningful life is worth living: Meaning in life as a suicide resiliency factor. Psychiatry Research, 210(3), 934-939.» 摘要
Abstract: Given the high rate of suicide worldwide, it is imperative to find factors that can confer resiliency to suicide. The goal of the present study was to examine the search for and the presence of meaning in life as possible resilience factors. We hypothesized that the presence of, but not the search for, meaning in life would predict decreased suicidal ideation over an eight-week time period and decreased lifetime odds of a suicide attempt. We also examined a subsidiary hypothesis that the presence of, but not the search for, meaning in life would mediate the relationship between the two variables associated with the interpersonal psychological theory of suicide (i.e., perceived burdensomeness and thwarted belongingness) and suicidal ideation. Our results were generally in support of our hypothesis: presence of meaning in life predicted decreased suicidal ideation over time and lower lifetime odds of a suicide attempt. Surprisingly, search for meaning in life also predicted decreased suicidal ideation over time. Finally, the search for, but not presence of, meaning in life mediated the relationship between the interpersonal psychological theory variables and suicidal ideation. These findings suggest that interventions that target meaning in life may be useful to attenuate suicide risk in individuals. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
- Klingemann, J.I.(2012). Mapping the Maintenance Stage of Recovery: A Qualitative Study among Treated and Non-treated Former Alcohol Dependents in Poland. Alcohol and Alcoholism, 47(3), 296-303.» 摘要
Abstract: Aims: The study provides an in-depth qualitative understanding of the maintenance stage when recovering from alcohol dependence with a focus on the broader social context of change of addictive behaviour. It explores the recovery as a subjective process within the abstinence-oriented Polish treatment system organized on the basis of the Minnesota model and is probes for group differences between treated and non-treated populations. Methods: The study is based on qualitative data from a media-recruited sample of 29 treated and non-treated former alcohol dependents (ICD-10) in Warsaw/Poland 2006/2007. They reported a recovery time of at least 2 years (M-recovery = 11, SD = 9). In-depth, semi-structured interviews were analysed according to the problem-centred interview method using ATLAS.ti software. Results: A wide range of maintenance strategies potentially contributing to the stabilization of recovery from alcohol dependence was identified. However, from the respondents' point of view, the change process is contingent upon the subjective weighing of specific maintenance factors and the importance attributed to their interplay. This includes time management as well as one's ability to invest available resources and strengths in shaping and pursuing personal goals. Conclusion: More commonalities than differences can be observed between groups during the maintenance stage, regardless of respondents' type of the pathway out of addiction. However, when confronting professional concepts of recovery with subjective accounts, only a subgroup conforms to the invasive, potentially normative definitions of recovery, while others do not link their recovery with identity transformation.
- Klockmo, C., Marnetoft, S.U., Nordenmark, & M., Dalin, R. (2012). Knowledge and attitude regarding recovery among mental health practitioners in Sweden. INTERNATIONAL JOURNAL OF REHABILITATION RESEARCH, 35(1), 62-68.» 摘要
Abstract:The aim was to investigate the knowledge and the attitude regarding recovery among practitioners working in the Swedish mental health system, Personligt Ombud (PO), Supported Housing Team (SHT) and Psychiatric Out Patient Service (POPS), to determine whether and how knowledge and attitude regarding recovery differ between the three services. A web-based questionnaire based on the Recovery Knowledge Inventory was sent to the participants. Participant selection ensured that different parts of Sweden were represented. A multiple linear regression was used to examine the result under control of Sex, Age, Educational Level, Further Education, Relevant Work Experience and Training in Recovery. The result of the regression showed that POs had higher scores than both SHT and POPS on the subscales, even under control of other variables. The SHT differed significantly from POs on two of the subscales and POPS differed significantly from POs on all subscales. Personnel with university education, more work experience or specific training in recovery also had a higher mean score. Swedish practitioners need to learn more about certain aspects of the recovery process. The differences between the services may possibly be due to the services' organization, assignment and role. Other important aspects were the level of education and having specific training in recovery; the combination of these elements could facilitate the development of a recovery-oriented mental health system.
- Krentzman, AR. (2012). Review of the Application of Positive Psychology to Substance Use, Addiction, and Recovery Research. Psychology of Addictive Behaviors, 27(1), 151-165.» 摘要
Abstract:Advances in positive psychology have grown exponentially over the past decade. The addictions field has experienced its own growth in a positive direction, embodied by the recovery movement. Despite parallel developments, and great momentum on both sides, there has been little crosspollination. This article introduces positive psychology and the recovery movement, describes the research on positive psychology in the addictions, and discusses future avenues of theory, research, and intervention based on a positive-psychology framework. A systematic review of positive psychology applied to substance use, addiction, and recovery found nine studies which are discussed according to the following themes: theoretical propositions, character strengths and drinking, positive psychology and recovery, positive interventions, and addiction: feeling good and feeling bad. The current scholarship is scant, but diverse, covering a wide range of populations (adults, adolescents, those in and out of treatment), topics (character strengths, recovery, positive affect), and addictive behaviors (work addiction, cigarette smoking, and alcohol use disorders). There is diversity, too, in country of origin, with work originating in the U.S., U.K., Poland, and Spain. The rigorous application of the lens, tools, and approaches of positive psychology to addiction research generally, and to the aims of the recovery movement specifically, has potential for the development of theory and innovation in prevention and intervention. Further, because the work in positive psychology has primarily focused on microsystems, it may be primed to make contributions to the predominantly macrosystems focus of the recovery movement.
- Kukla, M., Lysaker, PH., Roe, D. (2014). Strong subjective recovery as a protective factor against the effects of positive symptoms on quality of life outcomes in schizophrenia. Comprehensive Psychiatry, 55 (6),1363-1368 . » 摘要
Abstract: Background: Interest in recovery from schizophrenia has been growing steadily, with much of the focus on remission from psychotic symptoms and a return to functioning. Less is known about the experience of subjective recovery and its relationships with other important outcomes, such as quality of life and the formation and sustenance of social connections. This study sought to address this gap in knowledge by examining the links between self perceived recovery, symptoms, and the social components of quality of life. Methods: Sixty eight veterans with schizophrenia-spectrum disorders who were participating in a study of cognitive remediation and work were concurrently administered the Recovery Assessment Scale, Positive and Negative Syndrome Scale, and the Heinrichs-Carpenter Quality of Life Scale (QLS). Results: Linear regression analyses demonstrated that subjective recovery moderated the relationship between positive symptoms and both QLS intrapsychic foundations scores and QLS instrumental role functioning after controlling for negative symptoms. Further examination of this interaction revealed that for individuals with substantial positive symptoms, higher levels of subjective recovery were associated with better instrumental role functioning and intrapsychic foundational abilities. Conclusion: Greater self perceived recovery is linked with stronger quality of life, both in regards to the cognitive and affective bases for socialization and active community involvement, even in the presence of substantial psychotic symptoms. Clinical implications of these findings are discussed. Published by Elsevier Inc.
- Kvrgic, S., Cavelti, M., Beck, EM., Rusch, N., Vauth, R. (2013). Therapeutic alliance in schizophrenia: The role of recovery orientation, self-stigma, and insight. Psychiatry Research, 209 (1),15-20 . » 摘要
Abstract: The present study examined variables related to the quality of the therapeutic alliance in out-patients with schizophrenia. We expected recovery orientation and insight to be positively, and self-stigma to be negatively associated with a good therapeutic alliance. We expected these associations to be independent from age, clinical symptoms (i.e. positive and negative symptoms, depression), and more general aspects of relationship building like avoidant attachment style and the duration of treatment by the current therapist. The study included 156 participants with DSM-IV diagnoses of schizophrenia or schizoaffective disorder in the maintenance phase of treatment. Therapeutic alliance, recovery orientation, self-stigma, insight, adult attachment style, and depression were assessed by self-report. Symptoms were rated by interviewers. Hierarchical multiple regressions revealed that more recovery orientation, less self-stigma, and more insight independently were associated with a better quality of the therapeutic alliance. Clinical symptoms, adult attachment style, age, and the duration of treatment by current therapist were unrelated to the quality of the therapeutic alliance. Low recovery orientation and increased self-stigma might undermine the therapeutic alliance in schizophrenia beyond the detrimental effect of poor insight. Therefore in clinical settings, besides enhancing insight, recovery orientation, and self-stigma should be addressed. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
- Kymalainen, J.A., Henze, K.T., DeLuca, M., Mitton, T.A., Walton, H.M., Duffy, P., Kapungu, C ., Lefebvre, T., Alexander, W.H., Pinsky, J. (2009). Are We There Yet? The Four-Year Impact of a VA Fellowship Program on the Recovery Orientation of Rehabilitation Programs. Psychiatric Rehabilitation Journal, 33 (4): 320-327 Sp. Iss. » 摘要
Abstract: Objective: This study represents the first program evaluation of the impact of a Psychosocial Rehabilitation (PSR) fellowship program within the Veterans Health Administration (VHA). Specifically, it examines the recovery orientation of five mental health rehabilitation programs at the Edith Nourse Rogers Memorial VA Medical Center (ENRM VAMC) in Bedford, MA by comparing program stakeholder rating of the "recovery orientation" between the initial data and the four-year follow-up during which the PSR fellowship was in operation. The goal of this fellowship program is to increase the VHA's fidelity to recovery-oriented best practice recommendations. Method: Participants were mental health consumers and staff members within five key psychiatric rehabilitation programs at the ENRM VAMC. Perception of programs' recovery orientation was measured at the start of the fellowship (Time 1) and after the fellowship was in place for four years (Time 2). Results: Results demonstrate that across the entire sample of stakeholders, perceptions of recovery orientation significantly improved from Time 1 to Time 2. Results also reveal a significant overall increase in program recovery orientation over time in three out of the five rehabilitation programs, with years of fellow involvement in particular programs significantly and positively correlating with increases in ratings of program recovery-orientation gains. Discussion: Implications for using fellowships as agents of program change, and specifically, recovery-oriented change, are discussed.
- Laffaye, C., Rosen, C. S., Schnurr, P. P. & Friedman, M. J. (2007). Dose Compensation Status Influence Treatment Participation and Course of Recovery from Post-Traumatic Stress Disorder? Military Medicine, 172(10), p1039-1045.»摘譯
Dose compensation status influence treatment participation and course of recovery from post-traumatic stress disorder?
作者們檢閱了實證文獻，以調查在精神健康處遇和復元的課程上，如何去找出補償或彌補「後創傷壓力相關能力失調」症狀。此篇文章指出已經有一些資深的工作者，相較於沒有使用補償性措施在處遇上的，在處遇上給予補償的已經有很高的比例了。然而在資深者的處遇研究結果上，研究產生的不是無效用，就是混亂無章的發現，沒有一致性的證據資料，在運用補償(compensation-seeking)上也預測出了一些錯誤的結果。而在交通意外倖存者研究上，發現補償性的措施和復元的課程是沒有相關的。在未來研究進一步的建議上，主要是在不同的補償性的情境上要使用清楚且一致的定義。 - Lang, C.E., Bland, M.D., Connor, L.T., Fucetola, R., Whitson, M., Edmiaston, J., Karr, C., Sturmoski, A., Baty, J., & Corbetta, M. (2011). The Brain Recovery Core: Building a System of Organized Stroke Rehabilitation and Outcomes Assessment Across the Continuum of Care. JOURNAL OF NEUROLOGIC PHYSICAL THERAPY, 35(4), 194-201.» 摘要
Abstract:This Special Interest article describes a multidisciplinary, interinstitutional effort to build an organized system of stroke rehabilitation and outcomes measurement across the continuum of care. This system is focused on a cohort of patients who are admitted with the diagnosis of stroke to our acute facility, are discharged to inpatient and/or outpatient rehabilitation at our free-standing facility, and are then discharged to the community. This article first briefly explains the justification, goals, and purpose of the Brain Recovery Core system. The next sections describe its development and implementation, with details on the aspects related to physical therapy. The article concludes with an assessment of how the Brain Recovery Core system has changed and improved delivery of rehabilitation services. It is hoped that the contents of this article will be useful in initiating discussions and potentially facilitating similar efforts among other centers.
- Laudet, AB., Humphreys, K.(2013). Promoting recovery in an evolving policy context: What do we know and what do we need to know about recovery support services?. Journal of Substance Abuse Treatment, 45(1), 126-133.» 摘要
Abstract: As both a concept and a movement, "recovery" is increasingly guiding substance use disorder (SUD) services and policy. One sign of this change is the emergence of recovery support services that attempt to help addicted individuals using a comprehensive continuing care model. This paper reviews the policy environment surrounding recovery support services, the needs to which they should respond, and the status of current recovery support models. We conclude that recovery support services (RSS) should be further assessed for effectiveness and cost-effectiveness, that greater efforts must be made to develop the RSS delivery workforce, and that RSS should capitalize on ongoing efforts to create a comprehensive, integrated and patient-centered health care system. As the SUD treatment system undergoes its most important transformation in at least 40 years, recovery research and the lived experience of recovery from addiction should be central to reform.
- Law, FM., Guo, GJ.(2012). Hope and Recovery From Substance Abuse for Female Drug Offenders in Taiwan. International Journal of Offender Therapy and Comparative Criminology, 56(8), 1258-1282.» 摘要
Abstract: This study was designed to fulfill a twofold purpose. First, based on the hope theory framework and previous research, a 16-session hope-based substance abuse treatment program to help female drug abusers achieve a better recovery was developed. Second, ANCOVA was used to test the effectiveness of this treatment model. The participants were 40 female drug offenders who were randomly assigned into experimental and control groups. The 20 experimental group participants received 16 sessions of hope-based substance abuse treatment whereas the 20 control group members were put on the waiting list for another term of treatment. The results indicated that the members of the two groups had significant differences in their posttest scores for recovery goal setting and pursuing, pathway controlling, adequate energy, knowledge of the changing process, ability to cope, adequate cognition, emotion regulation, and self-esteem.
- Law, H., Morrison, A., Byrne, R.& Hodson, E.(2012). Recovery from psychosis: a user informed review of self-report instruments for measuring recovery. Journal of Mental Health, 21(2), 193-208.» 摘要
Abstract: Background: Mental health services are being encouraged to adopt a recovery approach, creating a requirement for standardised measures of recovery to be developed and embedded within services. Measurement of this unique concept is inherently difficult, but it is feasible and valid provided that service users and clinicians work collaboratively. Aims: To evaluate which measures of recovery have clinical utility and are acceptable to service users. Method: Instruments included in this review are (1) quantitative self-report measures, (2) published in a peer reviewed English language journal and (3) designed to measure personal recovery. The review team included two service-user researchers to allow evaluation of acceptability to service users. Results: Twenty-five measures of recovery were identified; six of these met the inclusion criteria. A summary table of the measures is included to enable readers to make an informed choice of measure for their specific needs, along with an overview of each measure. Conclusions: The Recovery Assessment Scale appears to be the most acceptable and valid measure currently available. No "gold-standard" measure of recovery has been developed to date. Further research is required to examine the longitudinal reliability of existing tools, and their utility within clinical services and as outcome measures.
- Laws, J.(2013). 'Recovery work' and 'magic' among long-term mental health service-users. Sociological Review, 61(2), 344-362.» 摘要
Abstract: Based on an extended period of qualitative research with mental health service-users in north-east England, this article considers the various forms of magical work' and recovery work' that emerge in the lives of people living with severe mental health problems. Given the now sizeable body of literature which seeks to problematize traditional conceptual boundaries of work, the article asks to what extent these hidden and unusual work-forms might also be considered legitimate members of the category. Rather than argue for the expansion of the construct to accommodate these activities, the paper attempts simply to problematize the extent to which so-called mad' forms of work are irresolvably different to more conventional forms of occupation. In challenging notions of the psychiatric patient as inevitably inactive, new vocabularies for service-user work are explored. Concluding remarks are also directed to recent policy debates concerning back-to-work' welfare reform for long-term out of work service-users.
- Lee, H., Williams, RA.(2012). Effects of Parental Alcoholism, Sense of Belonging, and Resilience on Depressive Symptoms: A Path Model. Substance Use & Misuse, 48(3), 265-273.» 摘要
Abstract: This paper explored the relationships between parental alcoholism, sense of belonging, resilience, and depressive symptoms among Koreans in the U. S. Data from 206 Koreans (Mean age = 28.4 years; 59.8% females) living in a Midwestern state were collected in 2009, using a web-based survey, which included Children of Alcoholic Screening Test, Sense of Belonging Instrument, Connor-Davidson Resilience Scale, and Beck Depression Inventory-II. Path analysis results revealed sense of belonging as the most powerful, and resilience as the second important factor, resisting depressive symptoms associated with parental alcoholism. Implications for practice and research and study limitations are discussed. The study's limitations are noted.
- Lee, Jennifer E. C,Sudom, Kerry A.,McCreary, Donald R.(2011)Higher-Order Model of Resilience in the Canadian Forces.Canadian Journal of Behavioural Science, 43 (3), 222-234.»摘要
Abstract:Psychological resilience is an important construct for those who work in high-stress, potentially traumatic occupations. Using data collected as part of the Canadian Forces (CF) Recruit Health Questionnaire (RHQ), structural equation modelling analyses were performed to test the fit of a model of resilience comprised of several intrapersonal resilience factors (i.e., Big Five personality traits, dispositional affect, dispositional optimism, hardiness, mastery, self-esteem) and one interpersonal resilience factor (i.e., social support). An initial model showed that all lower-order intrapersonal variables loaded significantly onto a higher-order intrapersonal resilience latent factor, and that this factor was significantly correlated with social support. However, the strong intercorrelations between a few of the intrapersonal variables pointed to some redundancy. Based on empirical data and on a conceptual analysis, an alternative, more parsimonious model of resilience was developed. This model consisted of the Big Five personality traits, positive affect, and mastery as lower-order factors of dispositional resilience, which was hypothesised to be correlated with social support. This analysis is an important first step to developing an approach to conceptualise and measure resilience. One benefit of being able to assess resilience is that doing so can inform the development of programs to enhance mental health, readiness and recovery. However, more research is needed to understand the processes through which these psychological factors influence occupational as well as health outcomes before relevant policies may be developed.
- Lei, M., Li, C., Xiao, X., Qiu, J., Dai, Y.& Zhang, Q.(2012).Evaluation of the psychometric properties of the Chinese version of the Resilience Scale in Wenchuan earthquake survivors. Comprehensive Psychiatry, 53(5), 616-622. » 摘要
Abstract: Objectives: Resilience refers to the ability to effectively cope and positively adapt after adversity or trauma. This study investigated the factor structure and psychometric properties of the Chinese version of the Resilience Scale (RS) for college students with Wenchuan earthquake exposure.
Methods: A total of 888 Chinese college students with Wenchuan earthquake exposure completed a set of scales, including the RS, the Posttraumatic Stress Disorder Self-rating Scale, the Zung Self-rating Depression Scale, the Zung Self-rating Anxiety Scale, and the Eysenck Personality Questionnaire Short Scale for Chinese. The internal consistency and concurrent validity were investigated. Sex and regional differences were also examined.
Results: The results of exploratory factor analysis and confirmatory factor analysis showed that the 4-factor structure was suitable for both Chinese samples 1 and 2. The Cronbach a coefficient was .94 (P < .01), split-half reliability coefficient was .92 (P < .01), and the test-retest reliability coefficient was .82 (P < .01). The total resilience score was correlated negatively with posttraumatic stress disorder (r = 0.21; P < .01), depression (r = 0.45; P < .01), anxiety(r = 0.34; P < .01), and neuroticism (r = 0.23; P < .01), and correlated positively with extraversion (r = 0.23; P < .01). Men showed higher resilience scores than women, and people living in the high earthquake-exposure areas reported higher level of resilience than those from low earthquake-exposure areas.
Conclusions: The Chinese version of the RS was demonstrated to be a reliable and valid measurement in assessing resilience for Wenchuan earthquake survivors. - Leipold, B., Greve, W.,(2009). Resilience A Conceptual Bridge Between Coping and Development. European Psychologist,14(1), 40-50.» 摘要
- Lepage, J. G. & Lefebvre, H. (2012). Resilience In Families Of Adolescents With Severe Traumatic Brain Injuries: Development of a Support Intervention. Brain Injury, 6(4-5), 315-316.
- Leung, J. T. (2015). The strengths model: a recovery-oriented approach to mental health services. China Journal of Social Work, 8(1), 84-86.
- Levine, S.Z., Laufer, A., Stein, E., Hamama-Raz, Y. Solomon, Z. (2009). Examining the Relationship Between Resilience and Posttraumatic Growth. Journal of Traumatic Stress, 22(4), 282-286.» 摘要
- Li, M., Xu, J., He, Y.& Wu, Z. (2012).The analysis of the resilience of adults one year after the 2008 wenchu an earthquake. Journal of Community Psychology, 40(7),860-870.» 摘要
Abstract: Resilience, the ability to spring back from adversity and successfully adapt to it, is becoming an increasingly popular focus in research on the intervention and prevention of mental breakdown. This article aims to assess the resilience of adults exposed to the 2008 Wenchuan earthquake 1 year after the occurrence of the earthquake, to explore the relationship between demographic factors (such as gender, age, ethnic group, education level, and monthly income) and resilience via the Resilience Scale for Adults, and to identify the significant predictors of resilience. Using variance analysis and multiple regression analysis of all demographic factors above we further elaborate the findings.
- Liossis, P.L., Shochet, I.M., Millear, P.M., Biggs, H.(2009). The Promoting Adult Resilience (PAR) Program: The Effectiveness of the Second, Shorter Pilot of a Workplace Prevention Program. Behaviour Change, 26(2), 97-112.» 摘要
- Little, M., Sandler, I.N., Wolchik, S.A., Tein, J.Y., Ayers, T.S.(2009). Comparing Cognitive, Relational and Stress Mechanisms Underlying Gender Differences in Recovery from Bereavement-Related Internalizing Problems. Journal of Clinical Child And Adolescent Psychology, 38(4), 486-500.» 摘要
- Lim, C., Barrio, C., Hernandez, M., Barragán, A., & Brekke, J. S. (2017). Recovery from schizophrenia in community-based psychosocial rehabilitation settings: rates and predictors. Research on Social Work Practice, 27(5), 538-551.» 摘要
Abstract: We assessed the rate of recovery from schizophrenia in community-based psychosocial rehabilitation and whether psychosocial attributes predicted the achievement of recovery beyond demographic and clinical characteristics. We used data from 246 individuals with schizophrenia spectrum disorder collected at baseline and at 6 and 12 months after admission to psychosocial rehabilitation. The proportion of participants who showed recovery during either 6-month period and the full 1-year period was 19.86% and 7.53%, respectively. Although predictors of recovery for the 1-year period could not be reliably estimated due to its low rate, higher levels of intrinsic motivation and more positive family relationships at baseline predicted recovery for either 6-month period after controlling for initial functioning capacity. One in five individuals with schizophrenia who engage in intensive community-based psychosocial rehabilitation can achieve periods of recovery during treatment. Psychosocial attributes at the start of treatment are important contributors to subsequent recovery.
- Liu, Y., Wang, ZH., Zhou, CJ., Li, T. (2014). Affect and self-esteem as mediators between trait resilience and psychological adjustment. Personality and Individual Differences, 66, 92-97.» 摘要
Abstract:The primary purpose of the current study was to examine the potential sequential mediation effects of affect and self-esteem on the association between trait resilience and psychological adjustment, as indexed by life satisfaction and psychological distress. A total of 412 undergraduate students completed a packet of questionnaires that assessed trait resilience, positive and negative affect, self-esteem, life satisfaction and psychological distress. Mediation analyses showed that self-esteem mediated the relation between trait resilience and life satisfaction. In addition, positive affect, negative affect, and self-esteem were found to intervene between trait resilience and psychological distress. Furthermore, the sequential mediation effects of affect-self-esteem on the relations between trait resilience and life satisfaction as well as psychological distress were confirmed. Results are discussed in light of previous findings. Limitations of the study and suggestions for future research are briefly discussed. (C) 2014 Elsevier Ltd. All rights reserved.
- Lo Sasso, A.T., Byro, E., Jason, L.A., Ferrari, J.R., & Olson, B. (2012). Benefits and costs associated with mutual-help community-based recovery homes: The Oxford House model. EVALUATION AND PROGRAM PLANNING, 35(1), 47-53.» 摘要
Abstract:We used data from a randomized controlled study of Oxford House (OH), a self-run, self-supporting recovery home, to conduct a cost-benefit analysis of the program. Following substance abuse treatment, individuals that were assigned to an OH condition (n = 68) were compared to individuals assigned to a usual care condition (n = 61). Economic cost measures were derived from length of stay at an Oxford House residence, and derived from self-reported measures of inpatient and outpatient treatment utilization. Economic benefit measures were derived from self-reported information on monthly income, days participating in illegal activities, binary responses of alcohol and drug use, and incarceration. Results suggest that OH compared quite favorably to usual care: the net benefit of an OH stay was estimated to be roughly $29,000 per person on average. Bootstrapped standard errors suggested that the net benefit was statistically significant. Costs were incrementally higher under OH, but the benefits in terms of reduced illegal activity, incarceration and substance use substantially outweighed the costs. The positive net benefit for Oxford House is primarily driven by a large difference in illegal activity between OH and usual care participants. Using sensitivity analyses, under more conservative assumptions we still arrived at a net benefit favorable to OH of $17,830 per person.
- Loh, J. M. I., Schutte, N. S., Thorsteinsson, E. B. (2014). Be Happy: The Role of Resilience Between Characteristic Affect and Symptoms of Depression. Journal of Happiness Studies, 15(5), 1125-1138.» 摘要
Abstract:Characteristic affect may influence the development of resilience. Higher levels of resilience may in turn decrease the likelihood of individuals developing symptoms of depression. All first year psychology students (N = 217) were recruited in this longitudinal study to examine whether resilience mediates the relationship between characteristic affect and symptoms of depression. One hundred and seven students completed survey measures at the start of a semester and again 3 months later. Results indicated that greater negative affect predicted worsening of depressive symptoms over 3 months, while greater positive affect predicted a lessening of depressive symptoms over 3 months. Resilience fully mediated the effects of positive affect on change in depression and partly mediated the effects of negative affect on change in depression. These results are interpreted in the context of a hierarchical model of affect and the Broaden and Build Theory, which may explain how resilience arises from positive affect and mediates between affect and symptoms of depression over time.
- Lopez, J.E,, Orrell, M., Morgan, L., Warner, J. (2010).Empowerment in Older Psychiatric Inpatients: Development of the Empowerment Questionnaire for Inpatients (EQuIP).American Journal of Geriatric Psychiatry, 18 (1), 21-32.» 摘要
Abstract: Objective: To develop a questionnaire that measures levels of empowerment experienced by older adults admitted to a psychiatric ward. Design: Diverse views were sought to inform the questionnaire through a triangulation method; opinions of researchers were collected through a Delphi survey, clinical staff from different disciplines completed questionnaires, and patients participated in two focus group sessions. Once the questionnaire was developed, the authors asked patients to complete it alongside other instruments. Settings: Eight psychiatric wards of seven hospitals in and around London for people aged more than 65 years with a range of organic and functional mental health problems. Participants: Eighty-seven patients with a functional psychiatric diagnosis participated in the psychometric evaluation of the instrument; 28 completed the scale twice for test-retest reliability. Measures: Measures of quality of life (World Health Organisation Quality of Life - Abbreviated Version), degree of dependency (Care Dependency Scale), satisfaction with care (Psychiatric Care Satisfaction Questionnaire [PCSQ]), and psychosocial functioning (GAF) were used to evaluate psychometric properties of the empowerment questionnaire for inpatients (EQuIP). Results: The EQuIP is a measure of empowerment, which computes the subjective importance of the different aspects of psychiatric care for the individual patient. It had high internal consistency (Cronbach's alpha = 0.88) and reasonable concurrent validity (correlation with PCSQ as a measure of satisfaction with care, r(85) = 0.65, p = 0.01). High test-retest variability may signify fluidity of the construct of empowerment. Conclusion: The EQuIP may be used to assess empowerment in older psychiatric inpatients.
- Lundberg, B., Hansson, L., Wentz, E., Bjorkman, T.(2009). Are Stigma Experiences Among Persons with Mental Illness, Related to Perceptions of Self-esteem, Empowerment and Sense of Coherence? Journal of Psychiatric and Mental Health Nursing, 16(6), 516-522.» 摘要
- Lysaker, P.H., Roe, D., Ringer, J., Gilmore, E.M.& Yanos, P.T. (2012). Change in Self-Stigma Among Persons With Schizophrenia Enrolled in Rehabilitation: Associations With Self-Esteem and Positive and Emotional Discomfort Symptoms. Psychological services, 9(3), 240-247.» 摘要
Abstract: Self-stigma is a barrier to the recovery of persons with schizophrenia. Little is known about whether participation in rehabilitation is naturalistically linked to declines in self-stigma, and if so, what is correlated with changes in self-stigma. The current study examined in a quasi-experimental design the rate of change of self-stigma and whether changes were correlated with self-esteem, positive symptoms, and emotional distress for persons enrolled in rehabilitation. Symptoms were measured using the Positive and Negative Syndrome Scale (Kay, Fizsbein, & Opler, 1987), self-esteem was measured with the Multidimensional Self-Esteem Inventory (Lysaker, Ringer, & Davis, 2008), and self-stigma was assessed using the Internalized Stigma of Mental Illness Scale (Ritsher, Otilingam, & Grajales, 2003). Seventy persons with schizophrenia who worked at least one month in a vocational rehabilitation program were assessed on all measures at baseline and five months later. Results indicated a 25% decrease in self-stigma for 38% of the sample; these individuals tended to have less emotional distress both at baseline and follow-up, and had higher levels of self-esteem at follow-up. No differences in positive symptoms were found for groups whose stigma did or did not decrease. Results suggest that decreases in self-stigma may be correlated with increased self-esteem, while higher levels of emotional distress may be a barrier to stigma reduction.
- MacAteer, A., Manktelow, R., & Fitzsimons, L. (2015). Mental Health Workers' Perception of Role Self-Efficacy and the Organisational Climate Regarding the Ethos of Recovery. The British Journal of Social Work, 46(3), 737-755.» 摘要
Abstract: The recent organisational changes in mental health service delivery with their increasing emphasis on implementing and evaluating recovery-oriented practice have implications for ongoing professional development. This study examined the relationship between work-related self-efficacy, organisational climate in terms of perceived service resilience, and the organisational conditions of role conflict and role ambiguity. A survey of members of community and hospital mental health multidisciplinary teams in a Northern Ireland Health and Social Care integrated Trust was conducted. Sixty-seven of a sample of one hundred and ten mental health staff, including social workers, nurses, occupational therapists and day-care workers, in three service settings including hospital, community and day-care completed a thirty-eight-item questionnaire. The questionnaire contained four scales measuring organisational change, self-efficacy, and role conflict and role ambiguity. Results showed that there were strong negative correlations between organisational climate and role stressors, and a negative correlation of moderate significance between self-efficacy and role ambiguity. The researchers suggest that task-specific, self-efficacy measures could be used routinely with increased reflective practice to promote a reduction in role ambiguity. The continued use of personal and professional recovery-enhancing measures as part of service evaluation is also advocated.
- Macpherson, H., Hart, A., & Heaver, B. (2016). Building resilience through group visual arts activities: Findings from a scoping study with young people who experience mental health complexities and/or learning difficulties. Journal of Social Work, 16(5), 541-560.» 摘要
Abstract: This article reports research that aimed to identify and evaluate potential resilience benefits of visual arts interventions for young people with complex needs. The study involved a review of the ‘arts for resilience’ literature and a case study of 10 weekly resilience-building arts workshops for 10 young people experiencing mental health complexities and/or learning difficulties. We found a significant existing evidence-base linking visual arts practice to individual and community resilience, across disciplinary fields including art therapy, social work, community health, visual arts practice and geographies of health. Visual art activities were utilised to both educate young people about resilience and enhance young people’s overall resilience. Qualitative research material developed from the case study shows that even short-term visual arts interventions can impact on young people’s resilience – crucially, participation was extremely beneficial to young people’s sense of belonging and ability to cope with difficult feelings (topics which arose repeatedly during interview, focus group discussion and observation). Our review and findings from this small case study provide some initial insights into the resilience benefits of participation in visual arts activities. This, combined with the resilience-based practice framework presented here, could aid the effective targeting of interventions for social workers and others working with young people with complex needs. Alongside this research paper, an arts for resilience practice guide has been produced by the project team (including young people). It contains instructions on how to conduct a range of practical visual arts activities that we identified as being resilience-promoting.
- Manzano Garcia, G. & Ayala Calvo, J. C.(2012). Emotional exhaustion of nursing staff: influence of emotional annoyance and resilience. International Nursing Review, 59(1), 101-107.» 摘要
Abstract: Aim: This paper aimed to study the influence of emotional annoyance and resilience on the emotional exhaustion levels of nursing staff.
Background: Emotional exhaustion is one of the key factors in understanding both the performance and the quality of care that nurses give to their patients. There is a considerable body of knowledge that has focused on the study of emotional exhaustion in relation to cynicism and professional efficiency. More recently emotional annoyance and resilience have been identified as variables that could help explain levels of emotional exhaustion.
Methods: Nine hundred eighty-three nurses who work in five hospitals in the north of Spain were invited to participate in the study. Five hundred questionnaires were distributed, of which 200 were fully completed. The average response rate was 40%. A personal information form, and a questionnaire concerning nurses' emotional annoyance, resilience, professional efficiency and cynicism were used as data collection instruments. To estimate a path model with latent variables, partial least squares was used.
Findings: Emotional annoyance and resilience contribute to a better understanding of emotional exhaustion levels of nursing staff. There was a significant association between emotional annoyance and emotional exhaustion (beta = 0.26, P = 0.020), while resilience appeared to be protective against emotional exhaustion (beta = -0.22, P = 0.004).
Conclusion: A more complete explanation and understanding of emotional exhaustion in nursing is achieved when emotional annoyance and resilience is measured in addition elements of burnout, which include professional efficiency and cynicism. - Marchinko , S. , Clarke, D.(2011).The Wellness Planner: Empowerment, Quality of Life, and Continuity of Care in Mental Illness. Archives of Psychiatric Nursing, 25(4), 284-293. » 摘要
Abstract: Coordination of mental health services has often been a challenge from the user's point of view. Resulting gaps in care can lead to increased use of crisis services, more frequent hospitalization, and impaired quality of life. This study examined an innovative approach to building an individual's self-care capacities by testing the use of a wellness intervention: an adaptation of a client-held medical record/crisis plan in booklet form. Fifty individuals using community mental health services were recruited. Using a pretestposttest design, participants completed measures of empowerment, continuity of care, quality of life, and satisfaction with services at the start of and again following 3 months of using the booklet. The booklet, referred to as the Wellness Planner, included components that have been empirically demonstrated as effective, such as crisis planning, goal setting, and resource planning. For the 42 individuals who completed the study, statistically significant increases were seen in empowerment, continuity of care, and satisfaction with services after 3 months of using the Wellness Planner. Qualitative data further demonstrated positive acceptance of the booklet by the users. Findings of the study suggest that the use of such a booklet could not only have a positive impact on the recovery of individuals but could also have utility within the mental health system. Since the completion of this study, the Winnipeg Regional Health Authority has adopted the booklet for use within all its adult mental health programs. Future research will focus on the impact of the booklet on system-wide indicators such as service utilization and readmission rates.
- Marioni, R.E., Van den Hout, A., Valenzuela, M.J., Brayne, C., & Matthews, F.E. (2012). Active Cognitive Lifestyle Associates with Cognitive Recovery and a Reduced Risk of Cognitive Decline. JOURNAL OF ALZHEIMERS DISEASE, 28(1), 223-230.» 摘要
Abstract:Education and lifestyle factors linked with complex mental activity are thought to affect the progression of cognitive decline. Collectively, these factors can be combined to create a cognitive reserve or cognitive lifestyle score. This study tested the association between cognitive lifestyle score and cognitive change in a population-based cohort of older persons from five sites across England and Wales. Data came from 13,004 participants of the Medical Research Council Cognitive Function and Ageing Study who were aged 65 years and over. Cognition was assessed at multiple waves over 16 years using the Mini-Mental State Examination. Subjects were grouped into four cognitive states (no impairment, slight impairment, moderate impairment, severe impairment) and cognitive lifestyle score was assessed as a composite measure of education, mid-life occupation, and current social engagement. A multi-state model was used to test the effect of cognitive lifestyle score on cognitive transitions. Hazard ratios for cognitive lifestyle score showed significant differences between those in the upper compared to the lower tertile with a more active cognitive lifestyle associating with: a decreased risk of moving from no to slight impairment (0.58, 95% CI (0.45, 0.74)); recovery from a slightly impaired state back to a non-impaired state (2.93 (1.35, 6.38)); but an increased mortality risk from a severely impaired state (1.28 (1.12, 1.45)). An active cognitive lifestyle is associated with a more favorable cognitive trajectory in older persons. Future studies would ideally incorporate neuroradiological and neuropathological data to determine if there is causal evidence for these associations.
- Markowitz, F.E. , Angell, B. ,Greenberg, J.S. (2011).Stigma, Reflected Appraisals, and Recovery Outcomes in Mental Illness .Social Psychology Quarterly ,74(2), 144-165. » 摘要
Abstract: Drawing on modified labeling theory and the reflected appraisals process and using longitudinal data from 129 mothers and their adult children with schizophrenia, we estimate models of the effects of mothers' stigmatized identity appraisals of their mentally ill children on reflected and self-appraisals, and how appraisals affect outcomes (symptoms, self-efficacy, life satisfaction). Results indicate that initial symptoms and functioning are related to how significant others think about their ill family members, how persons with mental illness think others perceive them, and how they perceive themselves. Part of the effects of initial symptoms and functioning on reflected appraisals are due to mothers' appraisals. A small part of the effects of outcomes on self-appraisals are due to others' and reflected appraisals. Stigmatized self-appraisals are related to outcomes, but reflected appraisals do not affect outcomes directly. Implications for modified labeling theory and social psychological processes in recovery from mental illness are discussed.
- Martin, G. (2009). Recovery Approach to The Care of People with Dementia: Decision Making and 'Best Interests' Concerns. Journal of Psychiatric and Mental Health Nursing, 16(7), 654-660.» 摘要
- Maunu, A; Stein, CH (2010).Cping With The Personal Loss of Having A Parent With Mental Illness: Young Adults' Narritive Accounts of Spiritual Struggle And Strength. Schizophrenia Bulletin, 35, 307-318.» 摘要
- Mausbach, B.T., Moore, R., Bowie, C., Cardenas, V., Patterson, T.L.(2009). A Review of Instruments for Measuring Functional Recovery in Those Diagnosed With Psychosis. Schizophrenia Bulletin, 35, 307-318.» 摘要
- McLaren, S., Challis, C. (2009). Resilience Among Men Farmers: The Protective Roles of Social Support and Sense of Belonging in the Depression-Suicidal Ideation Relation. Death Studies, 33(3), 262-276.» 摘要
- McMahon, R.C., Enders, C.(2009). Personality Disorder Factors Predict Recovery of Employment Functioning Among Treated Cocaine Abusers. American Journal of Drug and Alcohol Abuse, 35(3), 138-144.» 摘要
- McNally, J. R. (2012).Are We Winning the War Against Posttraumatic Stress Disorder? Science, 336(6083), 872-874.» 摘要
Abstract: The most methodologically rigorous epidemiological study on American military personnel deployed to Iraq and Afghanistan found that 4.3% of troops developed posttraumatic stress disorder (PTSD). Among deployed combatants, 7.6% developed PTSD, whereas 1.4% of deployed noncombatants did so. The U.S. Department of Veterans Affairs has launched a program ensuring that all veterans with PTSD will receive evidence-based cognitive-behavioral therapy, and the Army has developed Battlemind postdeployment early interventions that reduce risk for the disorder.
- Mealer, M., Jones, J. & Moss, M.(2012). A qualitative study of resilience and posttraumatic stress disorder in United States ICU nurses. Intensive Care Medicine, 38(9),1445-1451.» 摘要
Abstract: Intensive care unit (ICU) nurses are at increased risk of developing psychological problems including posttraumatic stress disorder (PTSD). However, there are resilient individuals who thrive and remain employed as ICU nurses for many years. The purpose of this study was to identify mechanisms employed by highly resilient ICU nurses to develop preventative therapies to obviate the development of PTSD in ICU nurses.Qualitative study using semi-structured telephone interviews with randomly selected ICU nurses in the USA. Purposive sampling was used to identify ICU nurses who were highly resilient, based on the Connor-Davidson Resilience Scale and those with a diagnosis of PTSD, based on the posttraumatic diagnostic scale. New interviews were conducted until we reached thematic saturation.Thirteen highly resilient nurses and fourteen nurses with PTSD were interviewed (n = 27). A constructivist epistemological framework was used for data analysis. Differences were identified in four major domains: worldview, social network, cognitive flexibility, and self-care/balance. Highly resilient nurses identified spirituality, a supportive social network, optimism, and having a resilient role model as characteristics used to cope with stress in their work environment. ICU nurses with a diagnosis of PTSD possessed several unhealthy characteristics including a poor social network, lack of identification with a role model, disruptive thoughts, regret, and lost optimism.Highly resilient ICU nurses utilize positive coping skills and psychological characteristics that allow them to continue working in the stressful ICU environment. These characteristics and skills may be used to develop target therapies to prevent PTSD in ICU nurses.
- Merecz D., Waszkowska, M.,& Wezyk, A.(2012).Psychological consequences of trauma in MVA perpetrators - Relationship between post-traumatic growth, PTSD symptoms and individual characteristics. Transportation Research Part f-traffic Psychology and Behaviour , 15(5),565-574.» 摘要
Abstract: The study explores two problems rarely discussed in literature. Firstly, it presents the psychological consequences of traumatic stress in perpetrators of motor vehicle accidents (MVAs). The attention of both clinicians and researchers is very seldom focused on this group of MVA participants, as in the natural way, people have a tendency to empathise with victims and distancing from those who make harm to others. MVA perpetrators usually feel no right to complain about experienced symptoms of poor well-being, and guilt prevent them against searching for any help. Such a situation may lead to further problems related to traffic safety, as persistent and untreated symptoms of PTSD or other anxiety disorders may negatively affect driving behaviour. Secondly, apart from post-traumatic psychopathology, the symptoms of post-traumatic growth (PTG) in MVA perpetrators together with factors related to them are analysed in the study. The examination results from the comprehensive sample of MVA perpetrators (n = 236) referred to Occupational Medicine Centres in the catchment area of Mazowieckie Voivodship, Poland, indicate that both PTSD and PTG symptoms are experienced by MVA perpetrators. The key predictors of PIG are neuroticism, conscientiousness, agreeableness and intensity of PTSD symptoms. Moreover, sex and perpetrators' injuries during the accident seem to play a vital role in the process of post-traumatic growth. Those of subjects who were women or were injured generally declared more positive changes in their life as a consequences of the accident they caused.
- Michael, W. D. (2007). Diagnosing Reading Disability: Reading Recovery as a Component of a Response-to-Intervention Assessment Method. Learning Disabilities - A Contemporary Journal , 5(2), p31-47.» 摘譯
Diagnosing reading disability: reading recovery as a component of a response-to-intervention assessment method.
此篇文章在探查閱讀能力復原方案的評量組成，做為未來處遇模式的參考。文中發現閱讀復原力的評量要素是一年級學生的重要預測項目（預測其有閱讀失能），文中最後會呈現最大的預測項目，並分類學生是否有無閱讀失能。 - Min, J.A., Lee, N.B., Lee, C.U., Lee, C.& Chae, J.H.(2012). Low trait anxiety, high resilience, and their interaction as possible predictors for treatment response in patients with depression. Journal of Affective Disorders, 137(1-3), 61-69.» 摘要
Abstract: Background: Although many demographic and clinical characteristics have been suggested to predict treatment outcome of depression, they provide only a weak prediction for clinical response. Based on the predictive values of trauma and biological markers involved in stress response, we investigated the roles of baseline trait anxiety and resilience, which were assumed as vulnerability and resilience factors, respectively, in predicting treatment response in naturalistically treated outpatients with depressive disorders.
Methods: A total of 178 outpatients with depressive disorders were consecutively recruited and completed measures of trauma experiences, psychological symptoms, and resilience at baseline. Response was defined by Clinical Global Impression (CGI)-Improvement score <= 2 at last visit during a 6 month-treatment period. Univariate analyses and multiple logistic regression analysis were performed to determine predictors of treatment response.
Results: Among demographic and clinical variables, treatment response was associated with increased age, longer treatment duration, higher resilience, and lower trait anxiety. in logistic regression analysis, resilience, trait anxiety, and their interaction significantly predicted treatment response after adjusting for age and treatment duration. Interaction between resilience and trait anxiety remained significant in the final model. Examining the interaction between the two, patients with low trait anxiety were only significantly affected by the level of resilience in response rate.
Conclusions: Low trait anxiety, high resilience, and their interaction might contribute to better treatment response in depressed patients. Our result suggested that individual differences in responding to stress might be important in predicting treatment outcome of depression in addition to other demographic and clinical factors. - Mitrani, V.B., Weiss-Laxer, N.S., Feaster, D.J. (2009).Factors Related to Loss of Child Custody in HIV plus Women in Drug Abuse Recovery. American Journal of Drug and Alcohol Abuse, 35 (5), 320-324.» 摘要
Abstract: Background: Mothers who are dually-diagnosed with HIV/AIDS and drug abuse are particularly burdened and vulnerable to loss of child custody. Objectives: This study explores factors associated with child custody loss among HIV+ women in drug abuse recovery, and compares mothers who have custody of their children to mothers who do not have custody of all of their children. Methods: Descriptive analyses were conducted on 68 HIV+ mothers in drug recovery, 46% who had custody of all of their children, and 54% who did not. Results: The lost-custody group was less likely to be employed and had more history of violent impulses and arrest, particularly on drug charges. The groups reported similar recent and lifetime drug use patterns, but the custody group had received more drug treatment. Post-hoc analyses found the lost-custody group had lower rates of participation in the interventions offered in the parent clinical trial and higher avoidant coping. Conclusions: The sample in the current study supports that HIV+ women in drug recovery are at high risk of loss of child custody. Non-adherence to available treatment seems to be associated with loss of child custody. Scientific significance: Results suggest the need for further research and active treatment outreach for this population.
- Molinero, O., Salguero, A., & Marquez, S. (2012). Stress and recovery in athletes and their relationship to mood state disturbances and coping strategies. REVISTA DE PSICOLOGIA DEL DEPORTE, 21(1), 163-170.» 摘要
Abstract:The aim of this study was to assess situations related to overtraining within the context of sport (RESTQ-Sport, Kellmann and Kallus, 2001; Gonzalez-Boto et al., 2008c) and identify its temporal relationship with mood state disturbances (POMS, McNair et al., 1971; Balaguer et al., 1993) and its possible influence on the appearance of imbalances between stress and recovery according to the coping strategies used to deal with stress (ISCCS, Gaudreau and Blondin, 2002; Molinero et al., 2006, 2008, 2009). A total of 167 athletes (62.5% men, and 36.9% women) ranging in age from 18 to 28 years old in 11 sport modalities participated in the study.
The results showed that modifications took place during the three measurements made of the levels of general stress (p = .027*), conflict/pressure (p = .000**), fatigue (p = .000**), general wellbeing (p = .022*), burnout/emotional fatigue (p = .009**), physical fitness/injuries (p = .000**), burnout/personal accomplishment (p = .000**), self-regulation (p = .000**), non-sport stress (p = .006**), sport stress (p = .001**), sport recovery (p = .000**) and total stress (p = .001**), which had changed compared with the main indices assessed by the RESTQ Sport. At the emotional level, we observed changes in the levels of depression (p = .040*), anger, (p = .006**), confusion (p = 036*) and total mood disturbance (p = .041*). We did not find any changes in the coping strategies used.
According to these results, it is necessary to pay more attention to temporal changes during recovery, because they may lead to positive adaptations after overtraining periods and their relationship to athletes' mood states, which have usually been used as fatigue indicators (Gonzalez-Boto et al., 2009; Kellmann et al., 2001; Rietjens et al., 2005). Athletes use a number of coping strategies that may lead in different ways to the balance between stress and recovery and therefore, the possible triggering of overtraining (Marquez, 2006; Gonzalez Boto et al., 2006, 2008a, 2009). This research project was supported by the Ministry of Science and Innovation (R+D Plan 008-2011) (Spain). - Moore, BA., Fazzino, T., Barry, DT., Fiellin, DA., Cutter, CJ., Schottenfeld, RS., Ball, SA (2013). The Recovery Line: A pilot trial of automated, telephone-based treatment for continued drug use in methadone maintenance. Journal of Substance Abuse Treatment, 45(1), 63-69.» 摘要
Abstract:The current pilot study evaluated feasibility, acceptability, and initial efficacy of a therapeutic Interactive Voice Response (IVR) system ("the Recovery Line") for patients receiving methadone maintenance who continue to use illicit drugs. Patients were randomized (N = 36) to 4 weeks of treatment-as-usual (TAU) or Recovery Line plus TAU. Ratings of the Recovery Line were high and remained stable throughout the study. However, despite instructions and reminders, patients used substantially less than the recommended daily use (< 10 days of 28). Patients were more likely to report abstinence from opioids and cocaine on days they used the Recovery Line (p = .01) than those they did not. Conditions did not differ significantly on patient satisfaction, urine screen outcomes, or coping efficacy. As with other computer-based treatments, findings suggest the Recovery Line is acceptable and feasible. However, additional methods to increase patient utilization of automated systems and larger clinical trials are needed.
- Moran, G., Mashiach-Eizenberg, M., Roe, D., Berman, Y., Shalev, A., Kaplan, Z ., Epstein, PG. (2014). Investigating the anatomy of the helping relationship in the context of psychiatric rehabilitation: The relation between working alliance, providers' recovery competencies and personal recovery. Psychiatry Research, 220(1-2), 592-597.» 摘要
Abstract:Professional helping relationships established with mental health consumers are vital in mental health recovery processes. However, little is known about how the constructs of alliance building and providers' recovery promoting strategies relate to each other and play a role in supporting recovery. To this end, we examined associations between consumer-reported working alliance, perceived providers' recovery competencies, and personal recovery. In a cross-sectional study design, 72 mental health consumers who established relationships with providers through a psycho-educational intervention over a period of 10 months in hourly weekly sessions were examined as part of a larger study conducted in mental health community settings in Israel. Participants filled in the Working Alliance Inventory (Tracey and Kokotovic, 1989), the Recovery Promoting Relationships Scale (Russinova et al., 2013), and Recovery Assessment Scale (Corrigan et al., 2004). Pearson correlations and linear regression analysis showed positive correlations between relational variables and recovery. A mediating model was identified whereby providers' recovery strategies positively impact the working alliance, which, in turn, positively impact consumers' recovery. Implications of the current study for future research and clinical practice are discussed, emphasizing the importance of examining recovery strategies and the working alliance with regard to the process of mental health recovery. (c) 2014 Elsevier Ireland Ltd. All rights reserved.
- Moran, G.S., Russinova, Z., Gidugu, V., Yim, J.Y., & Sprague, C. (2012). Benefits and Mechanisms of Recovery Among Peer Providers With Psychiatric Illnesses. QUALITATIVE HEALTH RESEARCH, 22(3), 304-319.» 摘要
Abstract:Providing peer support to individuals with psychiatric disabilities has emerged as a promising modality of mental health services. These services are delivered by individuals who experience mental illnesses themselves. The purpose of this study was to explore how working as a peer provider can enhance personal recovery. The study was conducted with 31 peer providers employed in a variety of mental health agencies. Data were collected through face-to-face semistructured interviews and analyzed using a grounded theory approach. Qualitative analysis revealed a wide range of recovery benefits for the peer providers. The benefits span across five wellness domains: foundational, emotional, spiritual, social, and occupational. In addition, analysis revealed five role-related and five work-environment-related mechanisms of beneficial impact. The role of sharing one's personal story is highlighted as contributing to positively reauthoring one's self-narrative. Implications for peer training, job development, and workplace supports are discussed.
- Morton, A., Fairhurst, A., Ryan, R. (2010). Promoting Recovery: Service User and Staff Perceptions of Resilience Provided by a New Early Intervention in Psychosis Service. Early Intervention in Psychiatry, 4 (1): 89-92.» 摘要
Abstract: Aim: The principles and practice of recovery are guiding many changes in mental health service provision. As a new Early Intervention in Psychosis (EIP) service, we were interested in finding out if both staff and users perceive the service as promoting resilience and in turn, recovery. Methods: A naturalistic sample of service users and staff completed the Organizational Climate questionnaire to assess the degree to which the service promotes resilience in overcoming a first episode psychosis.Results: The results indicated that both staff and service users similarly perceive the service as positively supporting resilience. The one exception was the staff rated the 'available resources to meet people's needs' as less than service users.Conclusions: The positive rating of resilience indicated that the service is working in a manner consistent with a recovery orientation. The results will act as a benchmark to compare with both other EIP services and future performance.
- Motti-Stefanidi, Fr., Asendorpf, J. B. & Masten, A. S.(2012). The adaptation and well-being of adolescent immigrants in Greek schools: A multilevel, longitudinal study of risks and resources. Development and Psychopathology, 24(2), 451-473.» 摘要
Abstract: This study examined growth patterns in adaptation of immigrant youth from a risk and resilience perspective. Students from first-and second-generation immigrant families living in Greece and their nonimmigrant classmates (N = 1,057) were assessed over the first 3 years of secondary school (ages 13-15). Three-level hierarchical linear models were used to disentangle individual and classroom-level effects on initial level and change in academic achievement, conduct, peer popularity, and psychological well-being. At the individual level, adaptation was more related to self-efficacy and parental school involvement (resources) than immigrant status and social adversity (risks). Only for academic achievement did risks explain variance when resources were controlled. Parental school involvement moderated the effect of immigrant status for initial level and growth in achievement. For all students, achievement and conduct worsened over time. At the classroom level, socioeconomic and ethnic composition of the classroom moderated the effects of self-efficacy and immigrant status on academic achievement and peer popularity, respectively. Second-generation immigrants were more popular than first-generation immigrants, but showed a larger decrease over time in school achievement. Results support a developmental, differentiated, and contextualized approach to the study of immigrant youth adaptation.
- Morton, MH., Montgomery, P.(2013). Youth Empowerment Programs for Improving Adolescents' Self-Efficacy and Self-Esteem: A Systematic Review. Research on Social Work Practice, 23(21), 22-33.» 摘要
Abstract: Objectives: Assess the state of evidence regarding impacts of youth empowerment programs (YEPs) on adolescents' (ages 10-19) self-efficacy and self-esteem, as well as other social, emotional, and behavioral outcomes. Method: Systematic searches of databases combined with an international outreach to identify experimental or quasi-experimental trials of community interventions that regularly involved youths in decision making. Results: Of the 8,789 citations identified, 3 studies met the inclusion criteria. None reported significant effects on the review's primary outcomes. Data from only two studies on self-efficacy could be meta-analyzed (combined N = 167). Results found no significant intervention effect on self-efficacy (z = 1.21; 95% confidence interval [CI]: [-0.12, 0.49]). Significant effects were found for some secondary outcomes, but these were inconsistent across studies. Conclusions: The review reveals insufficient evidence of YEPs' impacts. Further research is needed using well-implemented models with clear theories of change, larger samples, and rigorous impact study designs complemented by mixed-methods process evaluation.
- Mulder, R.T., Frampton, C.M.A., Luty, S.E., Joyce, P.R. (2009). Eighteen Months of Drug Treatment for Depression: Predicting Relapse and Recovery. Journal of Affective Disorders, 114(1-3), 263-270.» 摘要
- Muraven, M., Baumeister, R. F., Tice, D. M. (1999). Longitudinal Improvement of Self-Regulation Through Practice: Building Self-Control Strength Through Repeated Exercise. The Journal of Social Psychology, 139 (4), 446-457.» 摘譯
Longitudinal Improvement of Self-Regulation Through Practice: Building Self-Control Strength Through Repeated Exercise
這個研究檢測了關於自律力量的不斷自我控制測試結果已超過一段時間。研究中針對69名美國大學生的樣本進行兩週自我控制測驗的其中一項：監控並且改善姿勢、調整心情或是監控及紀錄飲食。和一個沒有做測試的控制組做比較，這些執行自我控制測試的參與者根據測量上的結果在自我調整的能力上有明顯的改善。 - Neal, JW, Neal, ZP (2011).Power as a Structural Phenomenon. American Journal of Community Psychology, 48(3-4), 157-167.» 摘要
Abstract:In an effort to inform empowerment theory and research, this paper provides a structural conception of power. First, we examine the essential features present in three dominant conceptions of power in community psychology: social power, psychopolitical power, and relational power. Next, commonalities in the key features of power identified by these conceptions are explored and pared down to yield a more parsimonious conception of power that is grounded only in the structural pattern of relationships through which resources are exchanged. Drawing on social exchange theory, we offer a method for measuring this streamlined, structural conception of power that allows for its more precise examination. Finally, we discuss the implications of a structural conception and measurement of power for targeting and facilitating empowering processes and evaluating empowered outcomes.
- Neocleous M. (2012)."Don't Be Scared, Be Prepared": Trauma-Anxiety-Resilience. Alternatives, 37(3), 188-198.» 摘要
Abstract: Rather than concerning ourselves with "governing trauma" we should instead be concerned with how trauma has come to govern us. Trauma talk now comes naturally, and the article explores what all this trauma talk might be doing, ideologically and politically, especially in the context of the relationship between security and anxiety. The management of trauma and anxiety has become a way of mediating the demands of an endless security war: a war of security, a war for security, a war through security. The article therefore seeks to understand the concept of trauma and the proliferation of discourses of anxiety as ideological mechanisms deployed for the security crisis of endless war; deployed, that is, as a training in resilience. Trauma is less an issue of memory or the past and more a question of building resilience for the future. The language of trauma and anxiety, and the training in resilience that is associated with these terms, weds us to a deeply conservative mode of thinking.
- Nussbaum, L., Ogodescu, A., Hogea, L., Nussbaum, L., & Zetu, I. (2017). Risk factors and resilience in the offspring of psychotic parents. Revista de Cercetare si Interventie Sociala, 56, 114-122.» 摘要
Abstract: We approach an integrated research-action model of the interactions between the psychosis of the parent, parenting, family relations, the child’s development, risk and resilience factors. The research objectives are: identifying the resilience factors, the research of the interaction between the risk and resilience mechanisms, predicting or not the development of psychopathology in children of psychotic parents, the dynamic evaluation of the resilience. The longitudinal study was conducted in the period 2003-2013 on a group of 75 children with a schizophrenic parent and 70 children with a parent with bipolar disorder. We applied the scales: CBCL, Vth Axis ICD 10, PANSS and CD-RISC (Connor-Davidson Resilience Scale). Through PANSS for the psychotic parents, we correlated the scores for specific items with those obtained by the children through CD-RISC. Through MANOVA and the Pearson test we correlated the dependent variables with the predictive influence factors. The high PANSS scores for specific items were correlated negatively with the resilience scores of the children with psychotic parents. The maximum frequency of positive codifications on the Vth Axis, found for: rejection behavior from one parent (76, 4%), family disharmony (73, 52%), distorted family communication (70, 58%), was significantly correlated (p<0.001) with low scores of the child’s resilience for personal competency, negative effects tolerance, safe interpersonal relations, high performance. The social, family support and social connectedness proved to be relevant variables. Resilience can be modified and improved through targeted interventions, so that the understanding of the resilience process and of the concurrent factors is needed.
- Nilsson, K., Engstrom, I., & Hagglof, B. (2012). Family Climate and Recovery in Adolescent Onset Eating Disorders: A Prospective Study. EUROPEAN EATING DISORDERS REVIEW, 20(1), 96-102.»摘要
Abstract:Objective: This prospective study investigated the self-assessed family climate of adolescent patients and their parents during treatment of and recovery from eating disorders. Method: One hundred two girls aged 13-17 years with eating disorders, answered the self-report Family Climate Scale (FCS) and Eating Disorders Inventory for Children at initial assessment and after 18 and 36 months. The FCS was also answered by their parents at the same time points. Results: Self-assessed family climate and eating disorder symptoms were similar for recovered (R) and nonrecovered (NR) adolescents at initial assessment and at 18 months. At 36 months, FCS Closeness was higher for R, and FCS Distance was lower for R compared with NR. Parents of R adolescents had higher scores on FCS Closeness and lower scores on FCS Chaos compared with parents of NR adolescents at the 36-month follow-up. Conclusion: Self-reported family climate was associated with recovery. Changes in eating disorder symptoms preceded changes in family climate.
- Nordby, K ., Kjonsberg, K., Hummelvoll, J.K. (2010). Relatives of Persons with Recently Discovered Serious Mental Illness: In Need of Support to Become Resource Persons in Treatment and Recovery. Journal of Psychiatric and Mental Health Nursing, 17 (4): 304-311. »摘要
Abstract: Accessible summary Relatives want the health workers to regard the patient not only as sick but also regard him/her as a person. Parents want to get involved at an early stage and find it important that their opinions and experiences are heard. The staff also express that relatives possess knowledge that should be important for them to receive. The relatives underline the importance of an opening for hope to be present at all time, else you do not have the strength to cope with the situation. No matter how pessimistic the staff are, hope must be expressed. The relatives want to know what happens after discharge. They do not always know what questions to ask before discharge as challenges are discovered gradually. They want to know how to behave and what to say to their family member with a psychiatric illness. When parents can impart their concerns and receive adjusted counselling their level of stress is reduced. It is important to consider relatives as resource persons. The staff consider themselves as experts on psychosis and the parents as experts on their own children. Abstract A considerable amount of research on the treatment of young people suffering from serious mental illnesses states that good collaboration with relatives is essential for reducing relapse, improving recovery and enhancing quality of life for patients and relatives. The aim of this study was to explore and describe what facilitates active involvement for relatives in the treatment and rehabilitation of their family member. The present study is a part of a larger cooperative inquiry project carried out in a mental hospital in southern Norway focusing on improving practices for collaboration with relatives. This sub-study presents results from eight focus group interviews with relatives and staff members. Data were analysed by means of qualitative content analysis. The results showed that the relatives had mostly positive experiences from their encounters with the staff, although some negative experiences were articulated. Both relatives and staff underlined the importance of developing a good encounter characterized by sharing information, giving guidance and support according to the relatives' needs as well as addressing existential issues. This was perceived as a necessary basis for the relatives to become active participants in the treatment and rehabilitation process. To activate this basis, the relatives are dependent on the staff members' ability to convey and nurture hope related to the patient's recovery and quality of life.
- Norris, F.H., Tracy, M., Galea, S. (2009). Looking for resilience: Understanding the Longitudinal Trajectories of Responses to Stress. Social Science & Medicine, 68(12), 2190-2198.» 摘要
- Nrugham, L., Holen, A., Sund, A.M. (2010). Associations Between Attempted Suicide, Violent Life Events, Depressive Symptoms, and Resilience in Adolescents and Young Adults. Journal of Nervous and Mental Disease, 198 (2): 131-136.» 摘要
Abstract: Were violent/nonviolent traumatic life events and victimization by/witnessing violence associates of attempted suicide among depressed adolescents who were also less resilient at early adulthood? The present study examined a subset of mainly depressed, age-and gender-matched, adolescents derived from a representative sample of 2464 students (T1, mean age = 13.7 years) followed up after 1 year (T2Q) and reassessed 5 years later (T3, n = 252, mean age = 20.0 years, 73% participation), with a questionnaire, including the Connor-Davidson Resilience Scale and The Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version psychiatric interviews, which also tapped traumatic life events. Logistic regression analyses revealed that attempters were victims, not witnesses of violence, more depressed, and less resilient than nonattempters, and that resilience was a moderator of lifetime violent events and attempted suicide, even in the presence of antecedent depression.
- Obradovic, J. (2012).How can the study of physiological reactivity contribute to our understanding of adversity and resilience processes in development? Development and Psychopathology, 24(2), 371-387.» 摘要
Abstract:The focus of this article is to present current progress in understanding the interplay among adversity, physiological sensitivity to context, and adaptive functioning, with an emphasis on implications and future directions for resilience researchers. It includes a review of current literature that demonstrates (a) links between various levels of adversity exposure and variability in physiological reactivity, (b) how the interplay between children's physiological reactivity and different sources of risk and adversity relates to variability in adaptive functioning, and (c) various approaches for capturing a more dynamic nature of physiological reactivity and related processes. Throughout, important conceptual and empirical issues are highlighted.
- O'Grady, C.P.& Skinner, W. J. W.(2012). Journey as Destination: A Recovery Model for Families Affected by Concurrent Disorders. Qualitative health research, 22(8), 1047-1062.» 摘要
Abstract: We conducted a study offering peer support and education to members of families affected by concurrent disorders (CD). This article is an analysis of the qualitative data from a mixed methods study. Using constructivist grounded theory, we analyzed semistructured interviews with participants, with half attending a 12-week support group and reading weekly workbook assignments, and the others receiving the workbook only and being interviewed 3 months later. We developed a model that describes family journeys into, through, and beyond CD, involving three phases connected by two transitional constructs. Preoccupation with the unresolved CD of an ill family member characterized the journey into and through illness, the first two phases, whereas renewal characterized the passage from illness to journeying on toward recovery. Participants had strong comments about health care providers and the service system, and spoke of the need for self-care, empowerment, support, and inclusion.
- Oksanen, A.(2012).To Hell and Back: Excessive Drug Use, Addiction, and the Process of Recovery in Mainstream Rock Autobiographies. Substance Use& Misuse. 47(2),143-154.» 摘要
Abstract:Rock autobiographies have become increasingly popular since the 1990s. This article analyzes 31 mainstream rock autobiographies describing a wide variety of legal and illegal substances used and reckless behavior. Narrative analysis shows that books concentrate on recovering from addiction. The majority of writers have participated in some kind of treatment. Rock autobiographies use therapeutic vocabulary and borrow discursive elements from culturally familiar Alcoholics Anonymous texts recounting recovery stories. The analysis shows that drugs and alcohol are not associated with rebellion and authenticity as they once were in rock music. Surviving addiction has become a key theme of rock culture.
- Onken, S., Craig, M., Ridgway, P., Ralph, R., Cook, J. (2007). An Analysis of The Definitions and Elements of Recovery: a Review of the Literature. Psychiatric Rehabilitation Jounal, 31(1), p9-22.» 摘譯
An analysis of the definitions and elements of recovery: a review of the literature.
在精神健康的復原上獲得了一個引領，許多人已經下了多樣化的定義。一些人也試圖在關於復原力文獻上創造一些特點分析，以評估關於復原力概念的進步，或者甚麼樣的定義是必須的。此篇文章是將生態的架構融入了個人的生活脈絡，並強調個人精神健康的重建以及透過一個大社區協助減輕與緩和來自外在情境的壓力與障礙，期望藉此讓人們能夠經歷社會的整合與社區融入。 - Orbach, Y., Lamb, M.E., La Rooy, D., Pipe, M.E.(2012). A Case Study of Witness Consistency and Memory Recovery Across Multiple Investigative Interviews. Applied Cognitive Psychology. 26(1),118-129.» 摘要
Abstract:Access to audio recordings of five interviews (Interviews 26), and to the interviewer's contemporaneous notes during an initial unrecorded interview, made it possible to assess consistency across repeated attempts by a 9-year-old to describe her older sister's abduction from their shared bedroom. Information provided in each of the interviews was systematically analysed to determine whether each unit of information was new, consistent (repeated) or contradictory in relation to earlier reported information and whether any informative detail provided in the witness' initial interview was subsequently omitted. In addition, the witness' accounts were compared with details provided by the victim upon her rescue. This case analysis is particularly informative in light of widespread professional concerns about the effects of repeated interviewing on the quality and accuracy of children's accounts of experienced events.
- Oser, C.B., Harp, K.L.H., O'Connell, D.J., Martin , S.S., Leukefeld, C.G.(2012).Correlates of participation in peer recovery support groups as well as voluntary and mandated substance abuse treatment among rural and urban probationers. Journal Substance Abuse Treatment. 42(1),95-101.» 摘要
Abstract:This study explores the correlates of probationers' participation in 12-step programs, voluntary treatment, and mandated treatment, with respect to the geographic location of where the services are being provided as the primary covariate of interest. Data were derived from face-to-face interviews with rural and urban probationers (N=1,464). Results of the three logistic regression models suggested that even when all the covariates are taken into account, urban probationers were significantly more likely to have been involved in 12-step programs, voluntary treatment, and mandated treatment over their lifespan. Despite high levels of self-reported substance use among all participants, treatment services were underused by rural probationers. These data suggest that individuals residing in rural communities may face additional barriers to receiving treatment services and that criminal involvement is associated with participation in peer recovery support groups and treatment. Future studies can investigate criminal involvement as an avenue to enhance recovery and how to overcome treatment barriers in rural areas.
- Ostacher, M.J., Perlis, R.H., Nierenberg, A.A., Calabrese, J.,Stange, J.P., Salloum, I., Weiss, R.D., Sachs, G.S. (2010). Impact of Substance Use Disorders on Recovery From Episodes of Depression in Bipolar Disorder Patients: Prospective Data From the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). American Journal of Psychiatry, 167 (3): 289-297.» 摘要
Abstract: Objective: Bipolar disorder is highly comorbid with substance use disorders, and this comorbidity may be associated with a more severe course of illness, but the impact of comorbid substance abuse on recovery from major depressive episodes in these patients has not been adequately examined. The authors hypothesized that comorbid drug and alcohol use disorders would be associated with longer time to recovery in patients with bipolar disorder. Method: Subjects (N=3,750) with bipolar I or bipolar II disorder enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) were followed prospectively for up to 2 years. Prospectively observed depressive episodes were identified for this analysis. Subjects with a past or current drug or alcohol use disorder were compared with those with no history of drug or alcohol use disorders on time to recovery from depression and time until switch to a manic, hypomanic, or mixed episode. Results: During follow up, 2,154 subjects developed a new-onset major depressive episode; of these, 457 subjects switched to a manic, hypomanic, or mixed episode prior to recovery. Past or current substance use disorder did not predict time to recovery from a depressive episode relative to no substance use comorbidity. However, those with current or past substance use disorder were more likely to experience switch from depression directly to a manic, hypomanic, or mixed state. Conclusions: Current or past substance use disorders were not associated with longer time to recovery from depression but may contribute to greater risk of switch into manic, mixed, or hypomanic states. The mechanism conferring this increased risk merits further study.
- Padgett, D.K.,; Henwood, B., Abrams, C., Drake, R.E. (2008). Social Relationships Among Persons Who Have Experienced Serious Mental Illness, Substance Abuse, and Homelessness: Implications for Recovery. American Journal of Orthopsychiatry, 78(3), 333-339.»摘要
- Padgett, D. K., Henwood, B. F. (2009). Obtaining Large-Scale Funding for Empowerment-Oriented Qualitative Research: A Report From Personal Experience. Qualitative Health Research, 19(6), 868-874.»摘要
- Pan, J.Y., Wong, D.F.K., Chan, C.L.W., Joubert, L.(2008). Meaning of Life as a Protective Factor of Positive Affect in Acculturation: A Resilience Framework and a Cross-Cultural Comparison. International Journal of Intercultural Relations, 32(6), 505-514.»摘要
- Park, SA., Sung, KM.(2013).The Effects on Helplessness and Recovery of An Empowerment Program for Hospitalized Persons With Schizophrenia. PERSPECTIVES IN PSYCHIATRIC CARE ,49(2), 110-117.»摘要
- Peebles, S.A., Mabe, P.A., Fenley, G., Buckley, P.F., Bruce, T.O., Narasimhan, M., Frinks, L., Williams, E. (2009). Immersing Practitioners in the Recovery Model: An Educational Program Evaluation. Community Mental Health Journal, 45(4), 239-245.»摘要
- Peng, L., Zhang, J., Li, M., Li, P., Zhang, Y., Zuo, X., Miao, Y.& Xu Y.. (2012).Negative life events and mental health of Chinese medical students: The effect of resilience, personality and social support. Psychiatry Research, 196(1), 138-141.» 摘要
Abstract: The present study was conducted on a large sample of Chinese medical students to test the moderating effect of resilience between negative life events and mental health problems, and investigate the factors that affect the mental health problems of the students. The Adolescent Self-Rating Life Events Check List, Eysenck Adult Personality Questionnaire-Revised, Social Support Rating Scale, Connor-Davidson Resilience Scale, and Symptom Check List were adopted for a survey with 1,998 Chinese medical students as respondents. Mental health problems had a positive correlation with negative life events and neuroticism. On the other hand, mental health problems had a negative correlation with social support, extraversion, and resilience. Regression analysis showed that resilience moderated negative life events and mental health problems. Promoting resilience may be helpful for the adjustment of college students.
- Pfefferbaum, B., Flynn, B.W., Schonfeld, D., Brown, L.M., Jacobs, G.A., Dodgen, D., Donato, D., Kaul, R.E.,Stone, B., Norwood, A.E., Reissman, D.B., Herrmann, J., Hobfoll, S.E., Jones, R.T., Ruzek, JI., Ursano, R.J., Taylor, R.J.& Lindley, D., (2012). The Integration of Mental and Behavioral Health Into Disaster Preparedness, Response, and Recovery. Disaster medicine and public health preparedness, 6(1), 60-66.» 摘要
Abstract: The close interplay between mental health and physical health makes it critical to integrate mental and behavioral health considerations into all aspects of public health and medical disaster management. Therefore, the National Biodefense Science Board (NBSB) convened the Disaster Mental Health Subcommittee to assess the progress of the US Department of Health and Human Services (HHS) in integrating mental and behavioral health into disaster and emergency preparedness and response activities. One vital opportunity to improve integration is the development of clear and directive national policy to firmly establish the role of mental and behavioral health as part of a unified public health and medical response to disasters. Integration of mental and behavioral health into disaster preparedness, response, and recovery requires it to be incorporated in assessments and services, addressed in education and training, and founded on and advanced through research. Integration must be supported in underlying policies and administration with clear lines of responsibility for formulating and implementing policy and practice. (Disaster Med Public Health Preparedness. 2012;6:60-66)
- Philippe F.L., Laventure S., Beaulieu-Pelletier G., Lecours S., Lekes N. (2011). Ego-Resiliency as a Mediator Between Childhood Trauma and Psychological Symptoms. Journal of Social and Clinical Psychology, 30(6) , 583-598. » 摘要
Abstract: Clinical research has firmly established that individuals who experience psychological trauma during their childhood are likely to display psychological or functional disorders in adulthood. However, a significant number of adults with a history of trauma remain psychologically healthy. These individuals have been described as resilient. Although there has been much research on resilience in the past decades, the psychological processes involved are still debated. An important issue is whether resiliencedevelops as a consequence of trauma (resilience as an outcome) or if resilience is a relatively common characteristic of many people that can emerge with or without traumatic experiences (resilience as a trait or ego-resiliency). In the present research, we propose an integration of these two perspectives by showing that ego-resiliency can play an important mediating role in the relationship between childhood trauma and psychological symptoms. A total of 118 outpatients at a psychology clinic completed questionnaires measuring their level of childhood trauma, ego-resiliency, anxiety, depression, and self-harm behaviors. Results revealed that ego-resiliency was a significant mediator of the relationship between childhood trauma and these three types of symptoms. Implications for the conceptualization of resilience as a trait are discussed.
- Piat, M., Sabetti, J., Bloom, D. (2010). The Transformation of Mental Health Services to a Recovery-Orientated System of Care: Canadian Decision Maker Perspectives. International Journal of Social Psychiatry, 56 (2): 168-177.» 摘要
Abstract: Background: Recovery is emerging as a worldwide paradigm in mental health. There is increasing recognition that the transformation of mental health systems to a recovery perspective requires collaboration among all stakeholders. Research to date has focused on the perspectives of service users and providers. The role and influence of organizational decision makers in the transformation process has been less studied. Materials: This study reports findings from semi-structured interviews with decision makers on the implementation of recovery in Canada. Discussion: Decision makers view community-based services as most open to recovery-based approaches, and front-line providers as pivotal in implementing system change. Decision makers described their own role as limited to providing overall orientation and funding.
- Pietrzak, R.H., Johnson, D.C., Goldstein, M.B., Malley, J.C., Rivers, A.J., Morgan, C.A., Southwick, S.M. (2010). Psychosocial buffers of traumatic stress, depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom and Iraqi Freedom: The role of resilience, unit support, and postdeployment social support. Journal of Affective Disorders, 120 (1-3): 188-192.» 摘要
Abstract: Background: Little research has examined the role of protective factors such as psychological resilience, unit support, and postdeployment social Support in buffering against PTSD and depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF). Materials and methods: A total of 272 OEF/OIF veterans completed a survey containing PTSD and depression screening measures, and questionnaires assessing resilience, social support, and psychosocial functioning. Results: Lower unit support and postdeployment social support were associated with increased PTSD and depressive symptoms, and decreased resilience and psychosocial functioning. Path analyses suggested that resilience fully mediated the association between unit support and PTSD and depressive symptoms, and that postdeployment social support partially mediated the association between PTSD and depressive symptoms and psychosocial functioning. Limitations: Generalizability of results is limited by the relatively low response rate and predominantly older and reserve/National Guard sample. Conclusions: These results suggest that interventions designed to bolster unit support, resilience, and postdeployment support may help protect against traumatic stress and depressive symptoms, and improve psychosocial functioning in veterans.
- Pietrzak, R.H., Johnson, D.C., Goldstein, M.B., Malley, J.C., Southwick, S.M. (2009). Psychological Resilience and Postdeployment Social Support Protect Against Traumatic Stress and Depressive Symptoms in Soldiers Returning From Operations Enduring Freedom and Iraqi Freedom. Depression and Anxiety, 26(8), 745-751.»摘要
- Pitschel-Walz, G., Rummel-Kluge, C., Frobose, T., Beitinger, R., Stiegler, M., Bauml, J.& Kissling, W.(2012). Enhancing empowerment for relatives of patients with schizophrenia. Results of a psychoeducational group program under naturalistic conditions. Psychotherapeut, 57(4), 313-318.» 摘要
Abstract: Enhancing empowerment is one of the aims of psychoeducational family interventions but it has never been examined in psychoeducational groups for relatives led by professionals. This study investigated the knowledge gain and the increase of empowerment of psychoeducational group programs for relatives in a naturalistic setting. A total of 54 relatives of persons with schizophrenia or schizoaffective disorders took part in a psychoeducational group program of 8 sessions. A short questionnaire was used to assess the empowerment before and after the group programs. Knowledge gain was measured with the knowledge of illness about schizophrenia questionnaire (WFB). Among the participants of the psychoeducational groups the level of empowerment was significantly enhanced and the knowledge was significantly increased (p < 0.01). The improvement of empowerment was independent of the knowledge gain and did not correlate with gender, age, education or group attendance. Psychoeducational groups for family members not only reduce the rehospitalization rates of the ill relatives but also have additional positive effects on the family members themselves: better knowledge of the illness and enhanced empowerment. The findings emphasize the importance of psychoeducational groups for the relatives of persons with schizophrenia.
- Polcin, D.L., Galloway, G.P., Bond, J., Korcha, R., Greenfield, T.K. (2010). How do Residents of Recovery Houses Experience Confrontation Between Entry and 12-Month Follow-Up? Journal of Psychoactive Drugs, 42 (1): 49-62.» 摘要
Abstract: The role of confrontation in recovery has been vigorously debated. Proponents suggest confrontation can break down denial and increase motivation. Critics point to counseling studies showing confrontation harms the therapeutic alliance and increases resistance. Frequently missing in these debates is an operational definition of confrontation that can be reliably measured. The Alcohol and Drug Confrontation Scale (ADCS) is a new 72-item measure that defines confrontation as "warnings about potential harm" that might result from substance use (e.g., arrests, loss of job, loss of relationships, etc.). Previous psychometric work indicated the ADCS had acceptable reliability and validity when administered to 323 individuals entering recovery houses. Confrontation from different sources (e.g., family, friends and professionals) was generally experienced as supportive and helpful. The goals of the current study were twofold: (1) to see if the psychometric properties of the ADCS among the same sample were maintained at six and 12 month follow-up, and (2) to see if experiences and perceptions of confrontation changed over time. Despite minor variations in the factor structure between baseline and follow-up, the ADCS generally maintained good reliability and validity. At follow-up, the amount of confrontation participants received declined, but it continued to be generally experienced as supportive and helpful.
- Pompei F., Dima D., Rubia K., Kumari V., Frangou S. (2011). Dissociable functional connectivity changes during the Stroop task relating to risk, resilience and disease expression in bipolar disorder. Neuroimage , 57(2), 576-582. » 摘要
Abstract: Reduced cognitive control is considered a core feature of bipolar disorder (BD). Abnormalities in ventrolateral prefrontal cortex (VLPFC) and other functionally linked regions that underpin cognitive control during the Stroop Colour Word Task (SCWT) have been reported in patients with BD and their relatives. In this functional magnetic resonance study we used psychophysiological interaction analysis to examine functional connectivity during the SCWT in 39 euthymic BD patients, 39 of their first-degree relatives (25 with no Axis I disorders and 14 with major depressive disorder) and 48 healthy controls. The aim of this study was to identify potential diagnosis-specific functional connectivity changes differentiating patients with BD from their relatives with MDD, as well as functional connectivity correlates of resilience in relatives of BD patients who remain well. Psychophysiological interactions in healthy controls revealed a negative functional connectivity between the VLPFC and the ventral anterior cingulate cortex and insula and a positive connectivity between the VLPFC and the caudate and parietal cortices. Abnormalities in fronto-insular connectivity emerged as a key correlate of predisposition and disease expression for BD. Reduced fronto-cingulate connectivity was also observed in association with predisposition to BD irrespective of clinical outcome. BD patients and their MOD relatives showed additional abnormalities in frontal-basal ganglia connectivity while increased coupling between the ventral and dorsal lateral PFC was observed in relatives without any Axis I disorder. These findings suggest that during the SCWT the VLPFC and subcortical regions are involved in a dynamic interplay. Breakdown in these interactions is associated with risk and disease expression for mood disorders while increased functional coupling between dorsal and ventral prefrontal regions may reflect adaptive functional changes associated with resilience.
- Poole, J. C., Dobson, K. S., & Pusch, D. (2017). Childhood adversity and adult depression: the protective role of psychological resilience. Child abuse & neglect, 64, 89-100.»摘要
- Power, J., Goodyear, M., Maybery, D., Reupert, A., O’Hanlon, B., Cuff, R., & Perlesz, A. (2016). Family resilience in families where a parent has a mental illness. Journal of Social Work, 16(1), 66-82.»摘要
- Probst, B (2009). Contextual Meanings of the Strengths Perspective for Social Work Practice in Mental Health. Families in Society-The Journal of Contemporary Social Services, 90(2), 162-166.»摘要
- Queri, S. K. (2016). Factors Associated with Employee Stress in Psychiatric Rehabilitation: Identifying Vulnerability and Resilience. Journal of Social Service Research, 42(3), 386-401.» 摘要
Abstract: Use of sick days related to mental stress and burnout is a growing problem in Germany. Since stress is related to work demands, there is a substantial need for suitable workplace health promotion programs. This study identifies several organizational and personal stress predictors and presents a predictive model for workers in the field of psychiatric rehabilitation. A cross-sectional design was utilized to collect the self-ratings of employees (n = 243) who typically work with patients. Univariate analyses show, overall, above average stress scores, below average scores in occupational self-efficacy, and a much higher proportion of a gratification crisis (that is, insufficient reward for work performance) compared to other people employed in health care. A multivariate model for predicting the heightened stress indicates the supposed pathogenetic and salutogenetic main effects for organizational variables, such as gratification crisis, and personal variables, such as occupational self-efficacy as well as an interaction of both types of variables. High occupational self-efficacy can attenuate the effect of an existing gratification crisis. Workplace health promotion programs in this field should address organizational and personal variables, in particular occupational self-efficacy and gratification crisis. Future research should focus on interaction effects based on a person-environment-interaction model.
- Radin, SM., Banta-Green, CJ.; Thomas, LR., Kutz SH.& Donovan DM.(2012). Substance Use, Treatment Admissions, and Recovery Trends in Diverse Washington State Tribal Communities. American journal of drug and alcohol abuse, 38(5), 511-517» 摘要
Abstract: Background: Qualitative and quantitative data and participatory research approaches might be most valid and effective for assessing substance use/abuse and related trends in American Indian and Alaska Native (AIAN) communities. Method: Twenty-nine federally recognized AIAN tribes in Washington (WA) State were invited to participate in Health Directors (HD) interviews and State treatment admissions data analyses. Ten Tribal HD(or designees) from acrossWA participated in 30-60-minute qualitative interviews. State treatment admissions data from 2002 to 2008 were analyzed for those who identified with one of 11 participating AIAN communities to explore admission rates by primary drug compared to non-AIANs. Those who entered treatment and belonged to one of the 11 participating tribes (n = 4851) represented 16% of admissions for those who reported a tribal affiliation. Results: Interviewees reported that prescription drugs, alcohol, and marijuana are primary community concerns, each presenting similar and distinct challenges. Additionally, community health is tied to access to resources, services, and culturally appropriate and effective interventions. Treatment data results were consistent with interviewee-reported substance use/abuse trends, with alcohol as the primary drug for 56% of AIAN adults compared to 46% of non-AIAN, and other opiates as second most common for AIAN adults in 2008 with 15% of admissions. Limitations: Findings are limited to those tribal communities/community members who agreed to participate. Conclusion: Analyses suggest that some diverse AIAN communities in WA State share similar substance use/abuse, treatment, and recovery trends and continuing needs. Scientific Significance: Appropriate and effective research with AIAN communities requires respectful and flexible approaches.
- Rani, U. (2015). The strengths model: A recovery-oriented approach to management of people suffering with severe mental illness. Indian Journal of Health and Wellbeing, 6(4), 445.» 摘要
Abstract:The idea of promoting strength-based practice in community care organizations often creates an unexpected dilemma. Intuitively, the idea of focusing on the strengths of people is warmly embraced and considered to be a respectful and meaningful starting point in supporting positive change. However, the actual practice of identifying, acknowledging and working with strengths as a starting point for change is rarely experienced by those receiving the service of the community or health care service. Many practitioners from different professional backgrounds will claim to be working from strength's perspective; it is rare to see practitioners or organizations seriously working from an underlying set of values, principles and philosophy of strength-based practice.
- Rolfe, A(2010).Women and Depression: Recovery and Resistance. Feminism & Psychology, 20 (1), 136-138.
- Rotegard, A.K., Fagermoen, M.S., Ruland, C.M.(2012).Cancer Patients' Experiences of Their Personal Strengths Through Illness and Recovery. Cancer Nursing. 35(1), E8-E17.» 摘要
Abstract:Background: Cancer patients' strengths and capabilities have received little attention from healthcare providers whose primary focus is on patients' problems. Thus, providers miss an important opportunity to build on cancer patients' strengths. New care approaches are needed that nourish patients' strengths and encourage them to take an active role in their care. Focusing on health assets is 1 such approach. However, so far, little is known about the strengths cancer patients use and experience during their illness and recovery. Objective: The objective of the study was to explore and describe cancer patients' experiences and perception of their strengths, needed or used by themselves or supported by their care providers. Methods: In this qualitative, exploratory study, we collected data from 26 participants in 4 focus group interviews. We conducted a qualitative, thematic analysis with an inductive approach to analyze the interview transcripts. Results: Cancer patients described a large repertoire of strengths they used or wished for during illness and recovery including good mood, mindfulness, willpower, positive relationships, hopes and beliefs, protection, and taking action and control. Patients also reported that healthcare providers rarely focused on patients' strengths, something they fervently wished for. Conclusion: Patients want their strengths to be more appreciated and encouraged by care providers, to become active partners in care and feeling in control. Implications for Practice: Our findings support that patients' own strengths are a crucial factor to get through their illness. Nurses should therefore have a greater focus on eliciting and nourishing patients' personal strengths in their care.
- Ruggiero, K.J., Gros, K., McCauley, J.L., Resnick, H.S., Morgan, M., Kilpatrick, D.G., Muzzy, W.& Acierno, R. (2012).Mental Health Outcomes Among Adults in Galveston and Chambers Counties After Hurricane Ike. Disaster Medicine and Public Health Preparedness, 6(1), 26-32.» 摘要
Abstract: Objective: To examine the mental health effects of Hurricane Ike, the third costliest hurricane in US history, which devastated the upper Texas coast in September 2008.
Method: Structured telephone interviews assessing immediate effects of Hurricane Ike (damage, loss, displacement) and mental health diagnoses were administered via random digit-dial methods to a household probability sample of 255 Hurricane Ike-affected adults in Galveston and Chambers counties.
Results: Three-fourths of respondents evacuated the area because of Hurricane Ike and nearly 40% were displaced for at least one week. Postdisaster mental health prevalence estimates were 5.9% for posttraumatic stress disorder, 4.5% for major depressive episode, and 9.3% for generalized anxiety disorder. Bivariate analyses suggested that peritraumatic indicators of hurricane exposure severity-such as lack of adequate clean clothing, electricity, food, money, transportation, or water for at least one week-were most consistently associated with mental health problems.
Conclusions: The significant contribution of factors such as loss of housing, financial means, clothing, food, and water to the development and/or maintenance of negative mental health consequences highlights the importance of systemic postdisaster intervention resources targeted to meet basic needs in the postdisaster period. - Russinova, Z., Rogers, E.S., Ellison, M.L., Lyass, A. (2011). Recovery-Promoting Professional Competencies: Perspectives of Mental Health Consumers, Consumer-Providers and Providers. Psychiatric Rehabilitation Journal, 34(3), 177-185. » 摘要
Abstract: Objectives: The purpose of this study was to empirically validate a set of conceptually derived recovery-promoting competencies from the perspectives of mental health consumers, consumer-providers and providers. Methods: A national sample of 603 consumers, 153 consumer-providers and 239 providers completed an anonymous survey via the Internet. The survey evaluated respondents' perceptions about a set of 37 competencies hypothesized to enhance clients' hope and empowerment and inquired about interactions with providers that enhanced clients' recovery process. We used descriptive statistics and ranking to establish the relevance of each competency and generalized linear models and post-hoc tests to examine differences in the consumers', consumer-providers' and providers' assessments of these competencies. Results: Analyses confirmed the recovery relevance of several competencies and their relative importance within each group of study participants. They also revealed that while most competencies tended to have universal significance, others depended more strongly on the client's preferences. Finally, differences in the perceptions of consumers, consumer-providers and providers about the recovery relevance of these competencies were established. Conclusions and Implications for Practice: The study highlighted the crucial role practitioners play in enhancing recovery from serious mental illnesses through specific strategies and attitudes that acknowledge clients' personhood and foster their hopefulness, empowerment and illness management. It informed the development of a new instrument measuring providers' recovery-promoting competence and provides guidelines for sharpening the recovery focus of a wide range of mental health and rehabilitation services.
- Saavedra, J., Cubero, M.&Crawford, P.(2012). Everyday Life, Culture, and Recovery: Carer Experiences in Care Homes for Individuals with Severe Mental Illness. Culture medicine and psychiatry, 36(3), 422-441.» 摘要
Abstract: Supported homes or Care Homes (CHs) have become in-services that play a fundamental role in social-health systems, particularly in mental health systems in Europe and the United States. They provide settings where residents' day-to-day routines are supervised by in-house non-clinician professional carers. Ten semi-structured in-depth interviews were conducted by expert professional carers of persons with schizophrenia to explore interactions and activities between carers and users living in special "Care Homes". Analysis focused primarily on the functions of everyday life and daily routines in the recovery process. Social positioning analysis was used to investigate meanings and subjective experiences of professionals. The analysis revealed the importance of personal interactions in daily routines for recovery. We identified two main concerns guiding professionals' interactions with users: "Bring [users] to the here and now" and "give them the initiative to start actions". We suggest that CHs promote the construction of privileged identity in western urban societies, forming part of the process towards recovery and better social integration.
- Sadler, E., Sarre, S., Tinker, A., Bhalla, A., & McKevitt, C. (2017). Developing a novel peer support intervention to promote resilience after stroke. Health & social care in the community, 25(5), 1590-1600.»摘要
- Sankaran, L., Muralidhar, D., Benegal, V.(2008). Strengthening Resilience within Families in Addiction Treatment. Indian Journal of Social Work, 69(1), 45-53.»摘要
- Savvidou, I., Lazuras, L., Tsorbatzoudis, H.(2012).Social Cognitive Predictors of Exercise Intentions Among Substance Users in Recovery. Journal of Applied Sport Psychology. 24(1), 48-58.» 摘要
Abstract:The present study examined the social-cognitive predictors of exercise intention among substance abusers in recovery. An extended version of the theory of planned behavior was used, accounting for past exercise behavior and self-esteem. Members of self-help groups in Melbourne, Australia (N = 201) completed an anonymous questionnaire. Hierarchical regression, multiple mediation, and moderation analysis were used. The findings showed that attitudes and perceived behavioral control were the strongest predictors of exercise intentions, and mediated the effects of past behavior and self-esteem. Psychological interventions to promote exercise among substance abusers should target attitudinal beliefs and build self-control skills.
- Scali, J., Gandubert, C., Ritchie, K., Soulier, M., Ancelin, M. & Chaudieu I. (2012). Measuring Resilience in Adult Women Using the 10-Items Connor-Davidson Resilience Scale (CD-RISC). Role of Trauma Exposure and Anxiety Disorders. Plos One, 7(6), e39879.» 摘要
Abstract: Purpose: Resilience is the ability of individuals to adapt positively in the face of trauma. Little is known, however, about lifetime factors affecting resilience.
Methods: We assessed the effects of psychiatric disorder and lifetime trauma history on the resilience self-evaluation using the Connor-Davidson Resilience Scale (CD-RISC-10) in a high-risk-women sample. Two hundred and thirty eight community-dwelling women, including 122 participants in a study of breast cancer survivors and 116 participants without previous history of cancer completed the CD-RISC-10. Lifetime psychiatric symptoms were assessed retrospectively using two standardized psychiatric examinations (Mini International Neuropsychiatric Interview and Watson's Post-Traumatic Stress Disorder Inventory).
Results: Multivariate logistic regression adjusted for age, education, trauma history, cancer, current psychiatric diagnoses, and psychoactive treatment indicated a negative association between current psychiatric disorder and high resilience compared to low resilience level (OR = 0.44, 95% CI [0.21-0.93]). This was related to anxiety and not mood disorder. A positive and independent association with a trauma history was also observed (OR = 3.18, 95% CI [1.44-7.01])..
Conclusion: Self-evaluation of resilience is influenced by both current anxiety disorder and trauma history. The independent positive association between resilience and trauma exposure may indicate a "vaccination" effect. This finding need to be taken into account in future studies evaluating resilience in general or clinical populations. - Schutt, R.K. ,Rogers, E.S.(2009). Empowerment and Peer Support : Structure and Process of Self-Help in a Consumer-Run Center for Individuals with Mental Illness. Journal of Community Psychology, 37(6), 697-710.»摘要
- Schulz, PJ., Nakamoto, K (2013). Patient behavior and the benefits of artificial intelligence: The perils of "dangerous" literacy and illusory patient empowerment. PATIENT EDUCATION AND COUNSELING, 92(2), 223-228.»摘要
- Scotti, P.(2009). Recovery as Discovery. Schizophrenia Bulletin, 35(5), 844-846.»摘要
- Seale, G.S., Berges, I.M., Ottenbacher, K.J., Ostir, G.V. (2010). Change in Positive Emotion and Recovery of Functional Status Following Stroke. Rehabilitation Psychology, 55 (1): 33-39.» 摘要
- Segal, D.L. (2009). Self-Reported History of Sexual Coercion and Rape Negatively Impacts Resilience to Suicide Among Women Students. Death Studies, 33(9), 848-855.» 摘要
- Sexton, M.B., Flynn, H.A., Lancaster, C., Marcus, S.M., McDonough, S.C., Volling, B.L., Lopez, J.F., Kaciroti, N., & Vazquez, D.M. (2012).Predictors of Recovery from Prenatal Depressive Symptoms from Pregnancy Through Postpartum. JOURNAL OF WOMENS HEALTH, 21(1), 43-49.» 摘要
Abstract:Background: Identifying predictors of the course of depressive symptoms from pregnancy through postpartum is important to inform clinical interventions. Methods: This longitudinal study investigated predictors of recovery from prenatal elevated depressive symptoms in the postpartum period. Forty-one pregnant women completed demographic, interpersonal, and psychosocial self-report assessment measures at 32 weeks of gestation and again 12 weeks postpartum. Results: Of those with elevated depressive symptoms, defined as a Beck Depression Inventory-II (BDI-II) score >= 10, at the prenatal baseline, 39% (n = 16) recovered to nonelevated symptom levels postpartum, whereas 61% (n = 25) experienced sustained elevated symptoms. Women who recovered evidenced significantly lower baseline depression severity and more frequent engagement in physical activity and cohabitated with a romantic partner. In multiparous women (n = 25), history of past postpartum depression (PPD) differentiated between those with transient and those with persisting symptoms, although history of lifetime depression did not. None of the additional demographic, interpersonal, or psychosocial variables investigated differentiated between groups. Logistic regression analysis showed prenatal depression severity and exercise frequency as predictors of recovery postpartum. Conclusions: Results suggest most women will not experience spontaneous recovery. Women with prenatal heightened symptom severity and previous experiences with PPD are acutely vulnerable to experience sustained symptoms. In contrast, having a cohabitating partner and engagement in prenatal exercise predicted symptom improvement. Physical exercise may be an important clinical recommendation, as it may improve mood. Given the small sample size, these results are preliminary. Implications and future research recommendations are discussed.
- Shahar, G.(2012). A social-clinical psychological statement on resilience: introduction to the special issue. Journal of social and clinical psychology, 31(6), 535-541.» 摘要
Abstract: Psychological resilience is a relatively young field of empirical inquiry that is currently drawing increasing attention on the part of investigators, theoreticians, and clinicians. It raises questions regarding why some people succumb to life circumstances-acute or chronic-while others survive, and even thrive, under dire circumstances; whether the ability to transcend human stress is an individual quality or the product of benevolent environmental conditions; whether it is a transient or stable trait; and what are the relationships between resilience and risk/vulnerability. This special issue addresses these issues via contributions from authors from diverse backgrounds whose work reflects a variety of research interests and methods. At the basis of all the papers lies a social-clinical psychological perspective which stresses the centrality of person-context exchanges in the stress process.
- Shiers, D., Rosen, A., Shiers, A.(2009). Beyond Early Intervention: Can We Adopt Alternative Narratives Like 'Woodshedding' as Pathways to Recovery in Schizophrenia? Early Intervention In Psychiatry, 3(3), 163-171.» 摘要
- Siegmann, Karin Astrid (2010).Strengthening whom? the role of international migration for women and men in Northwest Pakistan.Progress in Development Studies,10(4),345-361.» 摘要
Abstract:This article investigates the role of international labour migration from Pakistan's Northwest for the sending communities' social resilience. It focuses on the implications of male out-migration for the women who stay behind. This article refers to Bourdieu's Theory of Practice to shed light on the gendered nature of vulnerability and resilience. Contradictions identified between heightened vulnerability at the level of individual women and strengthened resilience of the household underline the social construction of scale in the analysis of resilience. With his emphasis on material as well as symbolic resources determining opportunities and well-being, Bourdieu provides an analytical key for the identification of such 'uncomfortable layers of resilience'.
- Skarsater, I. Rayens, M.K., Peden, A., Hall, L., Zhang, M., Agren, H., Prochazka, H.(2009). Sense of Coherence and Recovery From Major Depression: A 4-Year Follow-up. Archives of Psychiatric Nursing, 23(2), 119-127.»摘要
- Slutske, W.S., Blaszczynski, A., Martin, N.G. (2009). Sex Differences in the Rates of Recovery, Treatment-Seeking, and Natural Recovery in Pathological Gambling: Results From an Australian Community-Based Twin Survey. Twin Research and Human Genetics,12(5), 425-432.» 摘要
- Song, L .& Hsu, S. (2011).The Development of the Stages of Recovery Scale for Persons with Persistent Mental Illness. Research on Social Work Practice, 21(5), 572-581.» 摘要
Abstract:This study aimed to develop a scale which could be used as a valid way to show the evidence of recovery-oriented services. A 51-item scale was developed to assess both the component processes and outcomes of recovery. A sample of 471 participants administered the questionnaire. The factor analysis yielded a 45-item scale with six subscales, including three components of process and three outcomes. The construct validity was confirmed. Each subscale has very good internal consistency (α = .80—.95), and the 3—5 weeks test—retest reliability was .72. The scale could significantly differentiate the rehabilitation sample and the better functioning sample. The results indicated four stages of recovery. The external construct validity was also ensured. The results supported the psychometric property of the Stages of Recovery Scale (SRS). It could be utilized for both assessment and evaluation to document the evidence of a recovery-oriented program, collectively or individually.
- Song,L. & Shih,C.(2009).Factors, Process, and Outcomes of Recovery from Psychiatric Disability -The Unity Model. International Journal of Social Psychiatry, 55(4), 348-360.» 摘要
Abstract:Background: Despite the fruitful findings on related issues of recovery in the West, some researchers have called for more studies on the factors that facilitate recovery and international literature on recovery to be made available. Moreover, to date, a united model that integrates outcome, component process and contextual factors of recovery has not yet been developed. Thus, this study explored the recovery experiences of persons with psychiatric disabilities (hereinafter called consumers) in Taiwan and extracted the key facilitators for developing a preliminary unity theory of recovery.Material: In-depth qualitative interviews of 15 consumers in recovery and their caregivers were held. Over a research period of two years, consumers were interviewed twice. The dialogue of each interview was transcribed into text and a narrative summary of the storyline for each participant was also prepared.Discussion: For most consumers, the journey of recovery was an incremental process of progress, yet few of them mentioned a turning point and its significant change on their life. Regaining social roles seemed to be a necessary but not sufficient outcome indicator for recovery. While symptom remission, mental strength and parental support were the cornerstones for recovery, the treatment model and professionals got the credit for it too.Conclusion: The recovery process occurs within a complex context of various stages and multi-facilitators. The forces of three cornerstones, essential components and contextual facilitators all influx into the river of recovery and emerge as one united mechanism that supports the consumer's spiral progress through the journey of striving for autonomy.
- Sperling, W., Kreil, S.& Biermann, T.(2012).Somatic Diseases in Child Survivors of the Holocaust With Posttraumatic Stress Disorder A Comparative Study. Journal of Nervous and Mental Disease,200(5), 423-428.» 摘要
Abstract: The incidence of mental and somatic sequelae has been shown to be very high in people who survived the Holocaust. In the current study, 80 Holocaust survivors with posttraumatic stress disorder were examined based on evaluation of their complete record (medical reports, clinical history, medical statements, and handwritten declarations of patients under oath). These survivors were compared with subjects with posttraumatic stress disorder caused by traumata other than the Holocaust. The data were analyzed for the presence of cardiovascular, gastrointestinal, and orthopedic diseases that developed in the time between the earliest medical report (expert opinion) and the latest expert opinion. Analysis revealed an increase in myocardial infarction, chronic degenerative diseases, and cancerous changes in the second expert opinion. No differences between the groups were seen with regard to sex, age at traumatization, or age at examination. Several implications of the data are discussed, including the implication that the survivors examined in this study may comprise a highly resilient group, inasmuch as they had reached an advanced age.
- Stacey, G.& Stickley T.(2012). Recovery as a threshold concept in mental health nurse education. Nurse education today, 32(5), 534-539.» 摘要
Abstract: This theoretical review discusses the complexities of understanding and applying the concept of recovery for pre-registration mental health nursing. It is suggested that reframing recovering as a threshold concept in mental health nurse education will illuminate the issues and challenges that students and educators appear to encounter. This is attributed to the transformative nature of learning in this area which requires the student to reassess beliefs and prejudices and enter into an uncertain territory where knowledge and values are questioned. Educational approaches are proposed which aim to facilitate the depth of learning required to engage with the concept of recovery at this level whilst responding sensitively to the students' potential reluctance, discomfort and in some cases resistance. Teaching recovery in mental health nursing therefore challenges educators to use any and every approach that stimulates emotional and transformational learning. As such, recovery in mental health is a threshold concept, that once learned, may transform not only the learner in the classroom but their practice in the future.
- Stajduhar K.I., Funk L., Shaw A.L., Bottorff J.L. & Johnson J.（2009）. Resilience From the Perspective of the Illicit Injection Drug User: An Exploratory Descriptive Study. International journal of drug policy, 20（4）, 309-316.» 摘譯
Resilience from the perspective of the illicit injection drug user: An exploratory descriptive study
背景：非法注射毒品之後伴隨而來的傷害乃是一個重要的健康和社會關注點。以復原力為基礎的策略擁有補充現存方法的潛力，但是目前缺乏關於復原力的研究。本研究確認和探索非法藥物使用者（IDUs）間復原力的實證，包括在關鍵轉捩點的認知轉換指標和與增強復原力有關的保護性因素。
方法：從有41位注射毒癮者和45個服務提供者與社區領導人參與的較大型之量化研究中所蒐集的資料來進行次級資料分析。復原力的概念型定義為在關鍵轉捩點所展現的相關和動態過程，提供一個分析的架構，其也在Garmezy和Werner and Smith的復原模型中被提出。認知轉換的例子也同時被確認。本文使用比較的分析技術和開放編碼。
結果：關鍵轉捩點反應出復原力可由兩個主題取得，第一：參與者描述如何「達到改變的點」，包含特定的認知和情緒運作機制，這些技巧包括此主題：「認清它（毒品）不值得」，「變得害怕」，和「認清內心想要戒掉的想望」。第二個復原力的體現關注在設定目標時所制定的想望和承擔「展望更好的未來」。相比之下，需要減輕過去和現在的絕望與痛苦的敘述會抑制復原力。希望和控制感為復原力的特別體現。其它因素（生理或是心理的痛苦，令人恐懼的經驗，目睹或是經歷負面的代價）對某些人來說是具有保護性的，但是對某些人來說是抑制復原力的因素。
結論：本文的研究結果支持復原力概念運用於瞭解非法藥物使用者間的認知和行為改變的實用性，以及提供未來研究的方向。 - Stanard, R. P. (1999). The Effect of Training in a Strengths Model of Case Management on Client Outcomes in a Community Mental Health Center. Community Mental Health Journal, 35 (2), 169-179.» 摘譯The Effect of Training in a Strengths Model of Case Management on Client Outcomes in a Community Mental Health Center
這項研究的目的是在確定個案管理者將優勢觀點模式運用於個案管理時對其個案影響之結果。這些結果包括：個案的生活品質、才能／訓練、居住的生活、住院治療的比例、看診天數與症狀等，並從中比較經由一般模式與優勢觀點模式二種處遇模式之結果。個案管理者在實驗組以優勢觀點模式訓練；在控制組則以未接受優勢觀點模式訓練，分別在兩組訓練前與訓練後3個月後進行資料收集。研究結果發現，實驗組(優勢觀點模式)在生活品質、症狀、才能／訓練出現改善，且實驗組(優勢觀點模式)的生活品質、才能／訓練結果是明顯優於控制組(非優勢觀點模式)。 - Steenkamp, M.M., Dickstein, B.D., Salters-Pedneault, K., Hofmann, S.G. & Litz, B.T.(2012).Trajectories of PTSD symptoms following sexual assault: Is resilience the modal outcome? Journal of Traumatic Stress, 25(4), 469-474.» 摘要
Abstract: Theoretical frameworks positing qualitatively distinct trajectories of posttrauma outcome have received initial empirical support, but have not been investigated in cases of severe interpersonal trauma. To address this limitation, we conducted latent class growth analysis with longitudinal data collected from 119 female sexual assault survivors at 1-, 2-, 3-, and 4-months postassault. Participants' mean age was 33 years; 63% were White. We hypothesized that given the severity of exposure associated with sexual assault, resilience would not be the modal course of adaptation. Four distinct PTSD growth trajectories, representing unique latent classes of participants, best fit the data: a high chronic trajectory, a moderate chronic trajectory, a moderate recovery trajectory, and a marked recovery trajectory. Contrary to previous studies and recent theoretical models, resilience and resistance trajectories were not observed, as high levels of distress were evident in nearly all participants at 1-month postassault. These results suggest that theoretical models of posttrauma response positing resilience as the modal outcome may not generalize to cases of sexual assault.
- Stewart, D.E., Yuen T. (2011). A Systematic Review of Resilience in the Physically Ill. Psychosomatics,52(3), 199-209 . » 摘要
Abstract: Background: Resilience is the capacity of individuals to maintain, or regain, their mental health in the face of significant adversity, including physical illness. Objective: We conducted a systematic review of resilience and related concepts in the physically ill to determine factors associated with predicting or promoting resilience. Methods: An electronic search of PsychInfo, Medline, and CINAHL databases between 1950 and May 2009 was performed using the terms resilience, and various types of physical illnesses. Inclusion criteria were broad and exclusion criteria were not published in English or not focused on resilience in physical illness. Results: A total of 475 articles were retrieved and 52 articles met inclusion/exclusion criteria. Psychological factors associated with resilience were self efficacy, self-esteem, internal locus of control, optimism, mastery, hardiness, hope, self-empowerment, acceptance of illness, and determination. Social support was highly predictive of and associated with, resilience. Coping strategies such as positive cognitive appraisal, spirituality, active coping, and mastery were also associated with resilience. Resilience factors directly salient to physical illness such as self-care, adherence to treatment, health related quality of life, illness perception, pain perception, exercise adherence, and physical outcomes were also found. Discussion: These findings need to be considered and when appropriate incorporated into the psychological and psychiatric care of physically ill individuals.
- Stotland, N.L.(2012). Recovery from Depression. Psychiatric clinics of north America, 35(1), 37+-.» 摘要
Abstract: In the past, persistent or chronic symptoms of depression have often been labeled depressive personality. Full recovery from depression is a relatively new concept and therapeutic goal and is difficult to define; however, pursuit is underway for new treatment options for full recovery. These options include more standardized and aggressive treatment with antidepressants; matching patients to specific medications at the outset of treatment using pharmacogenetics, electroencephalography, or other tools; cognitive interventions; treatment of cooccurring disorders including substance abuse; better doctor-patient relationships and active involvement of patients in selecting and carrying out treatment modalities; and combining of psychopharmacologic and psychotherapeutic treatments.
- Stuber, J., Rocha, A., Christian, A., Johnson, D. (2014). Predictors of Recovery-Oriented Competencies Among Mental Health Professionals in One Community Mental Health Syste. Community Mental Health Journal, 50(8), 909-914 . » 摘要
Abstract:A survey of 813 mental health professionals serving adults with severe mental illness clustered in 25 community mental health centers assessed the extent to which mental health professionals possess clinical competencies that support recovery and the predictors of these competencies. The results suggest there is room for improvement in recovery-oriented competencies. In-depth professional training in recovery, greater job variety, more years practicing in mental health, participation on an intensive case management team, and perceptions of workplace recovery culture were predictors of recovery-oriented competencies. Prioritization of on-going professional, worker retention, and management strategies that incorporate a team approach to treatment and improvements in workplace recovery culture may potentially increase recovery-oriented clinical practice.
- Subbaraman, MS., Witbrodt, J. (2013).Differences between abstinent and non-abstinent individuals in recovery from alcohol use disorders. Addictive Behaviors,39(12), 1730-1735. » 摘要
Abstract: Non-abstinent goals can improve quality of life (QOL) among individuals with alcohol use disorders (AUDs). However, prior studies have defined "recovery" based on DSM criteria, and thus may have excluded individuals using non-abstinent techniques that do not involve reduced drinking. Furthermore, no prior study has considered length of time in recovery when comparing QOL between abstinent and non-abstinent individuals. The current aims are to identify correlates of non-abstinent recovery and examine differences in QOL between abstainers and non-abstainers accounting for length of time in recovery. Sample: A large (N = 5380) national sample of individuals who self-describe as "in recovery" from alcohol problems recruited in the context of the What Is Recovery? (WIR) study. Method: Multivariate stepwise regressions estimating the probability of non-abstinent recovery and average quality of life. Results: Younger age (OR = 0.72), no prior treatment (OR = 0.63) or AA (OR = 032), fewer dependence symptoms (OR = 0.17) and less time in recovery all significantly (P < 0.05) related to non-abstinent recovery. Abstainers reported significantly (P < 0.05) higher QOL than non-abstainers (B = 039 for abstinence vs. non-abstinence), and abstinence was one of the strongest correlates of QOL, even beyond sociodemographic variables like education. Conclusions: Non-abstainers are younger with less time in recovery and less problem severity but worse QOL than abstainers. Clinically, individuals considering non-abstinent goals should be aware that abstinence may be best for optimal QOL in the long run. Furthermore, time in recovery should be accounted for when examining correlates of recovery. (C) 2014 Elsevier Ltd. All rights reserved.
- Sun, FK., Long, A. (2013). A suicidal recovery theory to guide individuals on their healing and recovering process following a suicide attempt. Journal of Advance Nursing,69(9), 2030-2040. » 摘要
Abstract: Abstract: Aim. To develop a theory to guide the recovery process of a recent suicide attempt. Background. Suicide is one of the 10 leading causes of death in many countries. Many nations have set targets to reduce the high incidence of suicide by aiming to prevent people from taking their own lives and also providing care to promote the healing of those who attempt suicide. Design. A qualitative grounded theory approach was used. Methods. Data were collected in 2011-2012 in a Taiwanese hospital until data saturation occurred. Twenty participants were interviewed, comprising patients who recovered from suicide attempts (N=14) and their caregivers (N=6). Data were analysed using open, axial, and selective coding and using the constant comparison technique. Findings. A substantive theory was formulated to guide the recovery process of people who have recently attempted suicide. The core category that emerged from the data collected was Striving to accept the value of self-in-existence'. Other key categories linked to and embraced in this core category were: becoming flexible and open-minded, re-building a positive sense of self, and endeavouring to live a peaceful and contented life. Conclusion. Nurses could use this theory as a theoretical framework to guide people who are recovering from a suicide attempt by affording them the opportunity to grow and heal, and facilitating the re-building a positive sense of self, acknowledging the uncertainties of life, and inspiring hope.
- Sutherland, J.A., Cook, L., Stetina, P., Hernandez, C. (2009). Women in Substance Abuse Recovery Measures of Resilience and Self-Differentiation. Western Journal of Nursing Research, 31(7), 905-922. » 摘要
- Sutton, D.J., Hocking, C.S.& Smythe, L.A.(2012). A phenomenological study of occupational engagement in recovery from mental illness.Canadian journal of occupational therapy-revue canadienned er ergotherapie, 79(3), 142-150.» 摘要
Abstract: Background. Recovery from mental illness has been described as a process involving personal growth and a search for meaning. Occupation is a primary medium for human development as well as the creation of life meaning, suggesting the exploration of recovery from an occupational perspective is warranted. Purpose. To explore the experience and meaning of occupation for 13 people who self-identified as being in recovery from mental illness. Methods. Recovery narratives were collected from participants in conversational interviews that were recorded and transcribed. The transcripts were analysed using hermeneutic phenomenology. Findings. A range of experiences were evident in the recovery narratives, from complete disengagement to full engagement in occupations. Insights into the experience and meaning of different states of occupation were revealed. Implications. All forms of occupational engagement, including disengagement, can be meaningful in the recovery process. Increased understanding of different modes of occupational engagement will assist therapists to support recovery more effectively.
- Taddeo, PD., Gomes, KWL., Caprara, A., Gomes, AMD., de Oliveira, GC., Moreira, TMM.(2012). Access, educational practice and empowerment of patients with chronic diseases.Cienci & Saude Coletiva, 17(11), 2923-2930.» 摘要
Abstract: Empowerment is a process whereby people achieve mastery over their lives, acquiring knowledge to make decisions about their health. Chronic diseases are increasingly common in the health service, requiring the attention of health professionals and empowering those affected by them. The scope of this study was to analyze the perceptions of users with chronic diseases and monitored by the Family Health Program with respect to empowerment. This was a qualitative study in which open interviews and systematic observations were conducted and NVIVO software was used for data analysis. Users indicate the existence of some geographical barriers in access to health, which caused fatigue, discouragement and low continuity of care. It was noted that adherence and practices of care were linked to differentiated service, based on trust and respect for the wishes of users. This includes healthcare guidance and education as key elements to encourage the practice of self-care. It is necessary to restructure the conduct of health professionals involved in the Family Health Strategy because its function is to promote health in a logical intersectoral and interdisciplinary manner.
- Tanya, N. A., Adriana F., Ruth, E. G. & Yanping W., et al.(2008). Trauma, Resilience, and Recovery in a High-Risk African-American Population. American Journal of Psychiatry, 165（12）, 1566-1576.» 摘譯Trauma, Resilience, and Recovery in a High-Risk African-American Population
儘管暴露在創傷之後的精神疾病會提高風險，很多人能夠適應最低限度的生活分裂，其他人在症狀期之後最終能夠康復。本研究檢視社會心理因素與復原力和從精神疾病復原的相關性，其樣本來源為曝露在一連串嚴重創傷的非裔美國成人的高風險樣本，以結構式的診斷訪談為資料蒐集方式。樣本包括259位至少有一次曝露在嚴重創傷事件的病患，從Howard大學的初級保健辦公處和管理DSM-IV 組織臨床會診量表（Structured Clinical Interview for DSM-IV）招募而來。採用多類別對數比率回歸(multinomial logistic regression)來確認潛在的社會心理因素與復原力和復元（包括生活目標、掌控感和因應策略）的相關性。47個參與者沒有終身的精神疾病（具復原力），85個至少一項符合過去DSM-IV疾病的標準，但是目前沒有疾病（復元）和127位至少有一項符合目前DSM-IV疾病的標準（目前有疾病）。復原的團體的特徵為明顯地有較低的終身創傷負荷。性別是女性乃是目前有疾病的狀態的預測因素。在最後的模型，主要的因素之一生活目標與復原力和復元兩者有顯著相關，掌控感也顯著地與復元有相關。確認心理社會因素與抗拒嚴重創傷的相關性可以提供資訊給未來的高風險人口群預防和處遇之研究。哪一種社會心理因素是持續地與復原有關連，以及在整個臨床干預中它們可以被修正的範圍都需要進一步研究來釐清。 - Terrion, JL.(2012). The experience of post-secondary education for students in recovery from addiction to drugs or alcohol: Relationships and recovery capital.Journal of Social and Personal Relationships, 30(1), 3-23.» 摘要
Abstract: Given the drug and alcohol-friendly nature of most college and university campuses, young people who have struggled with addiction to substances - and who are overcoming these struggles - face many challenges in maintaining their recovery and achieving academic success. Using recovery capital as a theoretical framework, this study explored aspects of the academic experience of students in recovery, including the identity formation process, development of relationships, and use of support services. Thematic analysis of in-depth semi-structured interviews showed the development and mobilization of personal, family/social, and community recovery capital and highlighted areas of difficulty in building these resources. The article points to the importance of social and personal relationships to both abstinence and academic success for students in recovery and discusses the role of policy in facilitating the mobilization of recovery capital.
- Tew, J .(2012). Recovery capital: what enables a sustainable recovery from mental health difficulties?European Journal of Social Work, 16(3), 360-374.» 摘要
Abstract: Abstract: There is increasing international interest in recovery approaches in mental healthand this connects with an emerging focus within European social work around promoting capability and sustainability. Research at a population level would suggest that social factors rather than medical interventions are the main determinants of recovery from mental health difficultiesbut this is not yet reflected in social work practice, which can still be dominated by biomedical perspectives and a focus on risk management. Drawing upon and extending analyses of social and other forms of capital, this paper outlines the basis for a new paradigm for mental health social work that is specifically oriented towards enabling the development of personal efficacy and social capabilityan approach that is explicitly focused on achieving longer-term sustainability rather than shorter-term problem solving.
- Thomas, K. A., & Rickwood, D. J. (2016). One woman’s journey of recovery from mental illness—Hopes, back-up plans, rebuilding self and service support. Qualitative Social Work, 15(4), 501-517.» 摘要
Abstract: Recovery from mental illness is a personal experience, unique to each individual. The purpose of this study was to explore the changing focus of one woman’s continuing recovery from mental illness, exploring the domains of hope, self-identity, a meaningful life, and responsibility. A case study was conducted using semi-structured interviews with a woman during three separate admissions to a residential mental health unit, and analyzed using a theory-driven approach. Aspects of the service that were instrumental in the woman’s recovery journey were analyzed, using a content analysis of the transcripts. The analysis demonstrated changes over time in the hopes the woman expressed; redefining self-identity was an ongoing objective; seeking a meaningful life involved overcoming addictions as a priority over pursuing hobbies and work; and there were indications she was taking more responsibility for her own recovery. Features of the residential service that were instrumental in her recovery progress were the therapeutic groups, tailored clinical support, support towards self-management, instrumental support, and social interaction. Repeat admissions to the residential unit assisted this woman to progress in her recovery. Her story demonstrates how personal responsibility can be increasingly achieved with the support of a recovery-oriented service.
- Till, U. (2007). The Values of Recovery within Mental Health Nursing. Mental Health Practice, 11(3), p32-36.» 摘譯
The values of recovery within mental health nursing.
此篇文章為探索在大不列顛的精神照顧領域上有關復元的價值。作者指出精神健康的護士需要去思考到他們在實務上的角色與關注焦點，他們應該要去強化一些額外的技術與技能。作者強調復元取向是一個以價值為基處的服務取向，此應該能夠在精神間康照顧實務上，提供不同面向的支持。 - Todd, N.J., Jones, S.H.& Lobban, F.A.(2012). "Recovery" in bipolar disorder: How can service users be supported through a self-management intervention? A qualitative focus group study. Journal of mental health, 21(2), 115-127.» 摘要
Abstract: Background: Bipolar disorder (BD) is a chronic and recurrent affective disorder. Recovery is defined as the process by which people can live fulfilling lives despite experiencing symptoms. Aims: To explore how an opportunistically recruited group of service users with BD experience recovery and self-management to understand more about how a service users' recovery may be supported. Method: Twelve service users with BD took part in a series of focus groups. Service users' responses to questions about their personal experiences of self-management and recovery were analysed. Focus groups were transcribed verbatim and thematic analysis ([Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101]) was employed to identify common themes in the data. Results: Four key themes were identified: (1) Recovery is not about being symptom free; (2) Recovery requires taking responsibility for your own wellness; (3) Self-management: building on existing techniques; (4) Overcoming barriers to recovery: negativity, stigma and taboo. Conclusion: Service users with BD have provided further support for the concept of recovery and have suggested a number of ways recovery can be supported. A self-management approach informed by the recovery literature has been proposed as a way to support service users' recovery.
- Torgalsboen, A.K., Rund, B.R. (2010). Maintenance of Recovery From Schizophrenia at 20-Year Follow-Up: What Happened? Psychiatry-Interpersonal and Biological Processes, 73 (1): 70-83. » 摘要
Abstract: The present Study reports longitudinal data on individuals who 20-years ago were fully recovered from previously diagnosed schizophrenia. Four subjects from the original sample consented and were interviewed at the present follow-up; data on two more subjects were secured elsewhere. A semistructured interview, the Positive and Negative Symptom Scale (PANSS) and Connor and Davidsons Resilience Scale (CD-RISC) were used to examine the psychosocial functioning and resilience of the subjects in the follow-up period. Out of the six subjects with a confirmed diagnosis of schizophrenia, two subjects were still fully recovered, one was recovered, one was in remission, one had a deteriorating course of illness, and one was deceased. The results indicate that full recovery was maintained for nearly half of the reexamined Subjects when a criterion-based definition of full recovery is used. Good personality and attitudinal approaches (resilience) seem to play a role in sustaining recovery.
- Treeby, M., Bruno, R.(2012). Shame and guilt-proneness: Divergent implications for problematic alcohol use and drinking to cope with anxiety and depression symptomatology. Personality and individual differences, 53(5), 613-617.» 摘要
Abstract: Shame and guilt are closely related emotions of negative affect that give rise to considerably divergent motivational and self-regulatory behaviors. While shame-proneness has demonstrated replicable relationships with increased alcohol use disorder symptomatology, guilt-proneness appears to protect an individual against development of problematic alcohol use. One prominent but untested hypothesis is that shame-prone individuals are motivated to consume alcohol in order to down-regulate experiences of negative affect. The present study aimed to test this hypothesis by exploring relationships between shame and guilt-proneness with motivations for consuming alcohol. University students (N = 281) completed measures of shame and guilt-proneness, measures of alcohol use disorder symptomatology, and a measure assessing five motivational domains for consuming alcohol. Shame-proneness was positively associated with problematic alcohol use and drinking as a means of coping with anxiety and depression-related symptomatology. In contrast, guilt-proneness was inversely related to alcohol problems and drinking to cope with depression. This study provides initial support for the hypothesis that shame-prone individuals are inclined to consume alcohol in order to cope with negative affect states. These findings may help explain the inverse relationship between guilt-proneness and alcohol problems and the apparent positive relationship between shame-proneness and problematic alcohol use.
- Truitt M., Biesecker B., Capone G., Bailey T.& Erby L.(2012). The role of hope in adaptation to uncertainty: The experience of caregivers of children with Down syndrome. Patient Education and Counseling, 87(2), 233-238. » 摘要
Abstract: Objective: The goal of this study was to investigate the relationships between perceived uncertainty, hope, and adaptation in caregivers of children with Down syndrome (DS).
Methods: A total of 546 caregivers were recruited from local and national DS groups and from a DS clinic list. A cross-sectional survey examined caregivers' levels of perceived uncertainty, hope, and adaptation. The hope that caregivers had for their child was also measured.
Results: Uncertainty, hope and adaptation were all significantly correlated, with uncertainty and hope independently predicting caregiver adaptation. Caregivers' motivation to reach goals for their child was higher than their ability to think of ways to meet those goals, and their lessened ability to think of ways to reach goals was significantly related to decreased adaptation levels.
Conclusion: Findings from this study suggest that having hope in the face of uncertainty is important in adaptation but that caregivers struggle with having hope related to thinking of ways to reach goals for their child.Practice implications: The results of this study indicate that perceived uncertainty and hope may be important targets for improving psychological well-being. Interventions that assist caregivers in setting and attaining appropriate goals may be of particular interest. - Tsai J., Salyers , M.P., McGuire , A.B. (2011). A Cross-Sectional Study of Recovery Training and Staff Attitudes in Four Community Mental Health Centers. Psychiatric Rehabilitation Journal , 34(3), 186-193. » 摘要
Abstract: Objective: Recovery has become a concept often incorporated in mental health staff trainings. However, little research has investigated the influence of training on recovery attitudes. The current study examined whether recovery-related trainings in community mental health centers is associated with differences in staff attitudes and reported organizational practices. Methods: A total of 318 staff members at four community mental health centers completed questionnaires about their recovery attitudes and trainings they had received in the past year. Results: Compared to staff who had no recovery-related training in the past year, staff who had at least one recovery-related training reported significantly higher consumer optimism and a greater agency recovery orientation towards consumers' life goals. The number of recovery-related trainings was significantly correlated with scores on personal optimism, consumer optimism, and agency recovery orientation towards consumers' life goals. Conclusions and Implications for Practice: The findings suggest recovery training is positively related to staff recovery attitudes and agency practices. Community mental health centers may benefit from a systematic approach to recovery training. Further research is needed to determine directionality of these relationships and to parse the mechanisms of action.
- Tschopp, M.K., Frain, M.P., Bishop, M.(2009). Empowerment Variables for Rehabilitation Clients on Perceived Beliefs Concerning Work Quality of Life Domains. Work a Journal of Prevention Assessment & Rehabilitation, 33(1), 59-65.» 摘要
- Tsemberis, S., Kent, D., Respress, C.(2012).Housing Stability and Recovery Among Chronically Homeless Persons With Co-Occuring Disorders in Washington, DC. American Journal of Public Health. 102(1),13-16.» 摘要
Abstract:Pathways Housing First provides access to housing, support, and treatment services to clients having the most complex needs persons who have been homeless for at least 5 years and have both a psychiatric disability and substance dependency. In a 2-year Housing and Urban Development-funded demonstration project in Washington, DC, in 2007 and 2008, we observed promising outcomes in housing retention and reductions in psychiatric symptoms, alcohol use, and demand for intensive support services. The program is designed to be fiscally self-sustaining through extant public disability benefits for housing, treatment, and support services. This approach shows strong support for first providing a permanently supported housing solution for chronically homeless and severely disabled individuals in need of housing and treatment of co-occurring disorders.
- Tsoi, W. S. E., Tse, S., Fukui, S., & Jones, S. (2015). Study protocol for a controlled trial of Strengths Model Case Management in mental health services in Hong Kong. BMJ open, 5(10).» 摘要
Abstract:Although strengths-based models are popular within recovery-oriented approaches, there is still a lack of conclusive research to guide how they should be implemented. A recent meta-analysis confirmed the lack of clarity in how this perspective is operationalised and that fidelity monitoring during the implementation process is lacking. Hence, there is a clear need to evaluate the feasibility of delivering and evaluating a clearly operationalised strengths-based intervention that incorporates fidelity checks to inform more definitive research. This protocol therefore describes a controlled trial of Strengths Model Case Management (SMCM), a complex intervention, for people with severe mental illnesses in Hong Kong. This trial follows the guidelines of the Medical Research Council as a phase 2 trial. Hence, it is a pilot study that tests the feasibility and effectiveness of the model.
- Tural, U., Onder, E.& Aker, T.(2012). Effect of Depression on Recovery from PTSD. Community mental health journal, 48(2), 161-166.» 摘要
Abstract: It has been suggested that the treatment strategy needs to be reviewed and changed if depression occurs in patients with posttraumatic stress disorder (PTSD). We analyzed data extracted from the Marmara Epidemiological Survey (MES) which had examined 683 survivors at 3 years after a devastating earthquake. Fifty three cases (40.5%) out of the 131 cases with PTSD had also been diagnosed with MDD. Comorbid PTSD and MDD group has significantly lower rates of recovery from PTSD in comparison to PTSD without MDD (26.4% vs. 47.4% respectively). Rates of past psychiatric disorder and past traumatic experience were significantly more frequent among the comorbid group. Moreover, comorbidity of PTSD and MDD was clearly associated with greater psychological distress, more severe PTSD, and diminished perceived social support. Past psychiatric disorder, General Health Questionnaire (GHQ-12) and Multidimensional Scale of Perceived Social Scale (MSPSS) total scores succeeded in predicting the comorbidity of PTSD and MDD significantly.
- Van Breda, Adrian D.(2011).Resilient Workplaces: An Initial Conceptualization. Families in Society,92(1), 33-40.»摘要
Abstract:Resilience has become a mainstream concept in social work theory and practice. While resilience has been well applied to individuals and families, there has been virtually no application to the workplace, a social system that is central to the lives of employed people and their families. This article extrapolates the literature on the resilience of the family system to the workplace system. A provisional model of workplace resilience is proposed, incorporating the dimensions of stressor, risk factors, protective factors, and outcomes. Implications for occupational social work practice and research are detailed.
- Van Gestel-Timmermans J.A., Brouwers E.P., Bongers I.L., Van Assen M.A.& Van Nieuwenhuizen Ch.(2012). Profiles of individually defined recovery of people with major psychiatric problems. International journal of social psychiatry, 58(5), 521-531.» 摘要
Abstract: Background: Research on factors associated with individually defined recovery is limited. Several phases of recovery have been described in the literature. Individuals in these distinct phases have different characteristics and problems. Aims: To identify classes of people with major psychiatric problems who have comparable profiles of individually defined recovery, to relate these classes to the phases of recovery as described by Spaniol, Wewiorsky, Gagne, and Anthony (2002), and to associate the classes to demographic and psychiatric characteristics, and health-related variables. Methods: Data of 333 participants with major psychiatric problems were used. A latent class analysis was conducted on the mean scores of four proxy measures of recovery. Results: Three well-defined classes were found that differed on the recovery measures. The classes differed significantly on variables corresponding to Spaniol's phases of recovery (Spaniol et al., 2002) and on health care utilization, health care needs and anxiety disorder, but not on demographic variables. Conclusions: It is possible to identify classes of people with major psychiatric problems who have comparable profiles of individually defined recovery that seem to correspond to phases of recovery. More knowledge of the characteristics of people in different phases of recovery will contribute to more fine-tuned and recovery-oriented health care.
- Veselska, Z., Geckova, A.M., Orosova, O., Gajdosova, B., van Dijk, J.P., Reijneveld, S.A. (2009). Self-esteem and Resilience: The Connection with Risky Behavior among Adolescents. Addictive Behaviors, 34(3), 287-291.» 摘要
- Veseth, M., Binder, P., Borg, M., & Davidson, L. (2012). Toward Caring for Oneself in a Life of Intense Ups and Downs: A Reflexive-Collaborative Exploration of Recovery in Bipolar Disorder. QUALITATIVE HEALTH RESEARCH, 22(1), 119-133. » 摘要
Abstract:In this article, we discuss processes of recovery in bipolar disorder. We utilized a hermeneutical-phenomenological approach developed within a reflexive-collaborative framework to examine what individuals do to promote improvement and positive change in their own lives. The study was designed and carried out in collaboration with an expert-by-experience group of 12 coresearchers with firsthand experiences of mental distress and recovery. In-depth interviews were conducted with 13 participants who acknowledged having lived and dealt with a bipolar disorder. Four core themes were drawn from our analysis: (a) handling ambivalence about letting go of manic states; (b) finding something to hang on to when the world is spinning around; (c) becoming aware of signals from self and others; and (d) finding ways of caring for oneself. Interrelationships between the four themes, along with limitations, strengths, and implications of the study are discussed.
- Viniol A., Jegan N., Leonhardt C., Strauch K., Brugger M., Barth J., Baum E.& Becker A.(2012).Study protocol: Transition from localized low back pain to chronic widespread pain in general practice: Identification of risk factors, preventive factors and key elements for treatment - A cohort study. BMC Musculoskeletal Disorders, 13, 77. » 摘要
Abstract: Background: Chronic localized pain syndromes, especially chronic low back pain (CLBP), are common reasons for consultation in general practice. In some cases chronic localized pain syndromes can appear in combination with chronic widespread pain (CWP). Numerous studies have shown a strong association between CWP and several physical and psychological factors. These studies are population-based cross-sectional and do not allow for assessing chronology. There are very few prospective studies that explore the predictors for the onset of CWP, where the main focus is identifying risk factors for the CWP incidence. Until now there have been no studies focusing on preventive factors keeping patients from developing CWP.
Our aim is to perform a cross sectional study on the epidemiology of CLBP and CWP in general practice and to look for distinctive features regarding resources like resilience, self-efficacy and coping strategies. A subsequent cohort study is designed to identify the risk and protective factors of pain generalization (development of CWP) in primary care for CLBP patients.
Methods/Design: Fifty-nine general practitioners recruit consecutively, during a 5 month period, all patients who are consulting their family doctor because of chronic low back pain (where the pain is lasted for 3 months). Patients are asked to fill out a questionnaire on pain anamnesis, pain-perception, co-morbidities, therapy course, medication, socio demographic data and psychosomatic symptoms. We assess resilience, coping resources, stress management and self-efficacy as potential protective factors for pain generalization. Furthermore, we raise risk factors for pain generalization like anxiety, depression, trauma and critical life events. During a twelve months follow up period a cohort of CLBP patients without CWP will be screened on a regular basis (3 monthly) for pain generalization (outcome: incident CWP).
Discussion: This cohort study will be the largest study which prospectively analyzes predictors for transition from CLBP to CWP in primary care setting. In contrast to the typically researched risk factors, which increase the probability of pain generalization, this study also focus intensively on protective factors, which decrease the probability of pain generalization. - Wahl, O.F. (2012). Stigma as a barrier to recovery from mental illness. TRENDS IN COGNITIVE SCIENCES, 16(1), 9-10.» 摘要
Abstract:Advances in neuroscience, technology and research sophistication have greatly increased understanding of mental illnesses and improved the treatment of these disorders. However, there are also important psychosocial aspects of mental illness that play a significant role in recovery from these conditions. One set of these factors involves the prejudice and discrimination, often referred to as 'stigma', faced by people when others learn that they have been diagnosed with, and/or treated for, a mental disorder.
- Wahlin, I., Ek, A.C., Idvall, E. (2009).Empowerment from The Perspective of Next of Kin in Intensive Care.. Journal of Clinical Nursing, 18(18), 2580-2587.» 摘要
- Walsh, J.(2009). Children's Understanding of Mental Ill Health: Implications for Risk and Resilience in Relationships. Child & Family Social Work, 14（1）, 115-122.» 摘譯
Children's understanding of mental ill health: implications for risk and resilience in relationships.
研究顯示在心理健康有問題的父母對小孩有相關的風險，但是一些家庭看起來非常有復原力和沒有總是承受這些困境。為了讓社會工作者能夠支持那些有風險的家庭復原力的發展，我們需要瞭解什麼因素可能改善這些風險。研究似乎提出可以概念化他們父母的心理健康問題為代表父母「之外」的事情的兒童，比起把心理健康問題視為代表父母一部分的兒童在依附對象有較好的成果。然而，為了要發展對於這樣的概念化如何影響依附關係和成果之瞭解，我們需要知道兒童對於心理疾病健康有什麼樣的瞭解。我們也需要考量這樣的概念化可能如何被改變，而父母、其它依附對象和支持對象顯然在此扮演主要的角色。本篇研究提供在研究範圍做選擇性的瀏覽和討論可能影響這個複雜過程的機制。本文的結論提供未來研究和實務的建議。 - Warner, R. (2009). Recovery From Schizophrenia and The Recovery Model. Current Opinion in Psychiatry, 22(4), 374-380.» 摘要
- Warner, R.(2010). Recovery in Mental Health: Reshaping Scientific and Clinical Responsibilities. American Journal of Psychiatry, 167 (4): 478-479.
- Wciórka, J., Świtaj, P., & Anczewska, M. (2014). The sense of empowerment in the early stage of recovery from psychosis. Psychosis, (ahead-of-print), 1-12.» 摘要
Abstract:
Objective: To assess the characteristics, correlates and prediction model of empowerment among patients recovering from psychosis.
Method: Rogers’s Empowerment Scale (ES) was used to assess the sense of empowerment among 110 patients at the early stage of recovery from a psychotic episode. Its correlation with social–demographic, clinical, and personal characteristics are analysed.
Results: The mean score and profile of ES in this Polish study is close to the original ES results. Empowerment correlates positively with the male sex, self-esteem, self-efficacy, resilience, social support, hope, and quality of life; and negatively with depression, loneliness and internalised stigma. The second-order factor analysis of the ES proves the suitability of Corrigan, Faber, Rashid and Leary (1999) model of two superordinate factors/dimensions (individual versus social) of empowerment. The regression model demonstrates that self-esteem and self-efficacy are the main positive predictors while stigma and depression the main negative predictors of empowerment.
Conclusion: The results obtained with a Polish version of the ES proves its comparable suitability. The regression model suggests some priorities in terms of how to enhance empowerment in the early stage of recovery from psychosis illness. The two-dimensional model of empowerment and its clinical application deserves further attention and study. - Weiller, C., Bormann, T., Saur, D., Musso , M., Rijntjes, M. (2011). How the ventral pathway got lost - And what its recovery might mean. Brain and Language, 118(1-2), 29-39. » 摘要
Abstract: Textbooks dealing with the anatomical representation of language in the human brain display two language-related zones, Broca's area and Wernicke's area, connected by a single dorsal fiber tract, the arcuate fascicle. This classical model is incomplete. Modern imaging techniques have identified a second long association tract between the temporal and prefrontal language zones, taking a ventral course along the extreme capsule. This newly identified ventral tract connects brain regions needed for language comprehension, while the well-known arcuate fascicle is used for "sensorimotor mapping" during speech production. More than 130 years ago, Carl Wernicke already described a ventral connection for language, almost identical to the present results, but during scientific debate in the following decades either its function or its existence were rejected. This article tells the story of how this knowledge was lost and how the ventral connection, and in consequence the dual system, fits into current hypotheses and how language relates to other systems.
- White, W.L. (2009). The Mobilization of Community Resources to Support Long-Term Addiction Recovery. Journal of Substance Abuse Treatment, 36(2), 146-158.» 摘要
- Wickizer, T.A., Mancuso, D., Campbell, K., Lucenko, B.(2009). Evaluation of the Washington State Access to Recovery project: Effects on Medicaid costs for working age disabled clients. Journal of Substance Abuse Treatment, 37(3), 240-246.» 摘要
- Wideman, T.H., Sullivan, M.J.L.(2012). Development of a Cumulative Psychosocial Factor Index for Problematic Recovery Following Work-Related Musculoskeletal Injuries. Physical Therapy. 92(1),58-68.» 摘要
Abstract: Background. Psychosocial variables such as fear of movement, depression, and pain catastrophizing have been shown to be important prognostic factors for a wide range of pain-related outcomes. The potential for a cumulative relationship between different elevated psychosocial factors and problematic recovery following physical therapy has not been fully explored.
Objective. The purpose of this study was to determine whether the level of risk for problematic recovery following work-related injuries is associated with the number of elevated psychosocial factors.
Design. This was a prospective cohort study.
Methods. Two hundred two individuals with subacute, work-related musculoskeletal injuries completed a 7-week physical therapy intervention and participated in testing at treatment onset and 1 year later. An index of psychosocial risk was created from measures of fear of movement, depression, and pain catastrophizing. This index was used to predict the likelihood of experiencing problematic recovery in reference to pain intensity and return-to-work status at the 1-year follow-up.
Results. Logistic regression analysis revealed that the number of prognostic factors was a significant predictor of persistent pain and work disability at the 1-year follow-up. Chi-square analysis revealed that the risk for problematic recovery increased for patients with elevated levels on at least 1 psychosocial factor and was highest when patients had elevated scores on all 3 psychosocial factors.
Limitations. The physical therapy interventions used in this study were not standardized. This study did not include a specific measure for physical function.
Conclusions. The number of elevated psychosocial factors present in the subacute phase of recovery has a cumulative effect on the level of risk for problematic recovery 1 year later. This research suggests that a cumulative prognostic factor index could be used in clinical settings to improve prognostic accuracy and to facilitate clinical decision making. - Wilrycx, G., Croon, M.A., van den Broek A.& van Nieuwenhuizen C.(2012). Psychometric properties of three instruments to measure recovery. Scandinavian journal of caring sciences, 26(3), 607-614.» 摘要
Abstract: Scand J Caring Sci; 2012; 26; 607614 Psychometric properties of three instruments to measure recovery Background: The process of recovery is gaining more and more attention within health care for patients with severe mental illness. Therefore, instruments to measure recovery can be useful for clinical and research purposes. Aims: This study evaluates the psychometric properties of three instruments pertaining to recovery for possible application in the Netherlands. The Recovery Attitude Questionnaire and the Recovery Knowledge Inventory were investigated among 210 mental health professionals, and the Recovery Promoting Relationship Scale was administered to 142 mental health consumers. Methods: The factor structure, reliability and internal consistency were examined using the same analysis strategy. First, each questionnaire was submitted to a confirmatory factor analysis based on the factorial structure proposed by the original developers of the questionnaire. In case of a bad fit, an exploratory factor analysis was conducted. Based on factor analyses, subscales were formed for each questionnaire and the internal consistency (Cronbachs alpha) was assessed. In all three cases the final principal axes solution was obliquely rotated by means of the OBLIMIN rotation procedure. Results: The originally proposed factor structure did not yield an acceptable fit in any of the Dutch samples. After analyses, three instruments are proposed that are suitable for research on recovery-oriented competencies and the recovery-promoting relationship for professionals working with people with serious mental illness in the Netherlands. Conclusions: The results in this study may be a step forward and give a new impulse to stimulate research in mental health recovery.
- Windell, D., Norman, R.& Malla, A.K.(2012). The Personal Meaning of Recovery Among Individuals Treated for a First Episode of Psychosis. Psychiatric services, 63(6), 548-553.» 摘要
Abstract: Objective: There is little understanding of service users' conceptions of recovery in the early phase of psychotic disorders. An enhanced understanding of personal notions of recovery may help with the development and evaluation of interventions that address the concerns of service users. This study examined personal definitions of recovery among individuals recently treated in a specialized early-intervention service in Canada. Methods: Semistructured interviews were carried out with 30 individuals three to five years after initial treatment of a first episode of psychosis. Interpretative phenomenological analysis was used to examine participants' personal meanings of recovery. A typology of recovery definitions was constructed. Results: A majority of individuals considered themselves to be recovered. Responses indicated that recovery is a multidimensional experience and is often a personalized and achievable goal at this early stage in treatment. Individuals described recovery as improvement in one or more of three domains: illness recovery, psychological and personal recovery, and social and functional recovery. There was variation in the extent to which individuals perceived that recovery involved alleviation of symptoms and elimination of underlying vulnerability to illness. Conclusions: There were several components of the personal meanings of recovery from a first episode of psychosis and variations in the emphasis that individuals placed on each component. An overall positive outlook may be a function of younger age, shorter duration of illness, and receipt of client-centered comprehensive and phase-specific treatment. Improved understanding of personal notions of recovery can guide clinical practices to address service users' recovery goals.
- Windell, D., Norman, RMG.(2013). A qualitative analysis of influences on recovery following a first episode of psychosis. International Journal of Social Psychiatry, 59(5), 493-500.» 摘要
Abstract: Abstract: Background: Understanding perceived influences on recovery following a first episode of psychosis could help improve services. Material: Thematic analysis was used to examine important influences on early recovery identified by 30 individuals receiving services in an early intervention programme. Discussion: Social support, medication, meaningful activities and lifestyle modification were identified as helpful, and stigma, substance abuse and medication side effects as harmful. Perceptions of benefits of social support and the negative effects of stigma were particularly prominent. Conclusions: Results suggest the importance of assistance with engagement in valued activities and relationships, and provision of messages of worth and hope for recovery.
- Wisdom, J.P., Saedi, G.A., Green, C.A. (2009). Another Breed of "Service" Animals: STARS Study Findings About Pet Ownership and Recovery From Serious Mental Illness. American Journal of Orthopsychiatry, 79(3), 430-436.» 摘要
- Wolmer L., Hamiel D., Barchas J.D., Slone M., Laor N. (2011). Teacher-Delivered Resilience-Focused Intervention in Schools With Traumatized Children Following the Second Lebanon War. Journal of Traumatic Stress,24(3), 309-316. » 摘要
Abstract: The 2006 Lebanon War exposed children in the north of Israel to daily rocket attacks. To cope with the massive psychological needs, a teacher-delivered protocol focusing on enhancing personal resilience was implemented. Children were assessed for risk factors, symptoms, and adaptation before the 16-week program (Time 1; n = 983) and after its completion (Time 2; n = 563). At a 3-month follow-up (Time 3; n = 754) children were assessed together with a waiting-list comparison group (n = 1,152). Participating children showed a significant symptom decrease at Time 2 and significantly fewer symptoms than the control group at Time 3. Six or more risk factors were associated with greater symptoms and parental concern about the child's adaptive functioning. Teachers are valuable cost-effective providers for clinically informed interventions after mass trauma and disaster.
- Woodside, H., Krupa, T. & Pocock, K. (2007). Early Psychosis, Activity Performance and Social Participation: A Conceptual Model to Guide Rehabilitation and Recovery. Psychiatric Rehabilitation Journal, 31(2), p125-130.» 摘譯Early psychosis, activity performance and social participation: A conceptual model to guide rehabilitation and recovery.
此篇文章在描述一個概念模式，焦點乃是精神病患者在第一次劇烈發病之前，社會參與以及活動結果的狀況。此理論的發展乃是採用了結構主義的背景理論與方法。資料的來源主要是訪談25位參與者以及有關他們的文件檔案。訪談的對象尚包括了15位參與者的支持網絡成員，以及 6位精神疾病復元的專家。此模式說明了活動結果以及社會參與的核心結構，是受到以下三個狀況的影響：個人能力的衰退、成功的協商或談判、風險因子。此模式被建議用於復元與恢復的早期處遇上。 - Wunderink, L., Sytema, S., Nienhuis, F.J., Wiersma, D. (2009). Clinical Recovery in First-Episode Psychosis. Schizophrenia Bulletin, 35(2), 362-369.» 摘要
- Wyder, M., Bland, R.(2014). The Recovery Framework as a Way of Understanding Families' Responses to Mental Illness: Balancing Different Needs and Recovery Journeys. Australian Social Work, 67(2), 179-196.» 摘要
Abstract: Personal recovery is a guiding principle in mental health and suggests that consumers own and are responsible for their own recovery. An exclusive focus on the recovery of those living with mental illness challenges the relevance of recovery concepts to families' experiences. This paper extends these recovery principles to consider if the recovery framework is helpful in understanding families' experiences. We distinguished the family's recovery task by recovery-oriented support and the family's own recovery journey. By applying recovery frameworks developed by Davidson et al. and Leamy et al. to these two tasks, we were able to highlight similarities and points of tension between consumer and family recovery tasks. The tasks for families include: (1) maintaining hope; (2) reconnecting; (3) overcoming secondary trauma; and (4) journeying from carer to family. Family response to mental illness is a dynamic, multilayered process rather than a static and enduring role of caregiving. The recovery framework offers an alternative way to understand a family's response to mental illness and suggests possibilities for social work practice with families.
- Yates, I., Holmes, G.& Priest, H.(2012). Recovery, place and community mental health services. Journal of mental health, 21(2), 105-114.» 摘要
Abstract: Background: While some studies have examined recovery in relation to specific contexts (e.g. housing and work), few have looked in detail at the social and environmental conditions in which recovery occurs. Aims: To explore the relationship between the recovery of people receiving community mental health services and the places in which they live; to generate knowledge concerning aspects of locality which impact on recovery. Method: Grounded theory methodology was employed as a framework for collecting and analysing qualitative data. The study incorporated aspects of Photovoice (Lopez et al., 2005) and ethnography. Results: Four overlapping theoretical accounts are presented. These are: housing, space and agency; representations of social identity; natural environments; and replacement communities. Conclusions: Recovery can be understood as a variety of interacting ecological processes occurring in the context of the social, economic and physical environment. This offers new ways of thinking about recovery-orientated services
- Yan, N. (2016). Children's resilience in the presence of mothers' depressive symptoms: Examining regulatory processes related to active agency. Children and Youth Services Review, 61, 90-100.» 摘要
Abstract: The current study examined the proposal that children's processes related to their active and controlled engagement with the environment, their active agency, are critical in promoting their resilience at first grade in the presence of mothers' cumulative depressive symptoms. Using a large sample from the NICHD Study of Early Child Care, the current study demonstrated that: (1) previously found associations between children's individual (i.e., intelligence, low difficult temperament) and environmental (i.e., maternal sensitivity, child care quality) characteristics and their resilience in the presence of mothers' depressive symptoms are partially attributed to their competent functioning in effortful control, self-assertion, and mastery motivation. Effortful control was the most consistent independent predictor of resilience across four developmental outcomes. (2) These agentic processes promoted these children's resilience via additive main effects rather than interactive effects. Findings from both the mediating and moderating analytic approaches converged in terms of underscoring the importance of the agentic system in promoting child resilience in the presence of mothers' depressive symptoms.
- Yeung E. W., Arewasikporn A. & Zautra A. J.(2012). Resilience and Chronic Pain. Journal of Social and Clinical Psychology , 31(6), 593-617.» 摘要
Abstract: This paper presents a two-factor model to classify biological elements, affective and cognitive characteristics, and social determinants of successful adaptation to chronic pain. The two factors, vulnerability and resilience, identify variables that are further differentiated into stable and modifiable indicators that influence adaptation to chronic pain. Examples of stable and modifiable constructs are presented and used to examine different pathways to resilient responding. The paper concludes with implications of this Stable-Modifiable Model of Vulnerability and Resilience Processes for clinical intervention and suggestions for areas of future research.
- Yip, K. S. (2005). A Strengths Perspective in Working with an Adolescent with Depression. Psychiatric Rehabilitation Journal, 28(4), 362-370.» 摘譯
TA strengths perspective in working with an adolescent with depression
憂鬱問題長存於社會中，在這篇文章中作者嘗試對照病理取向與優勢觀點取向在協助有憂鬱問題的青少年之差異。優勢觀點提倡在案主的症狀與缺陷之外能夠找出個體的需求與能力、培養個體的正向態度及邁向復元的希望、建立具啟發性的工作員與案主間的互動、以及發展正向的因應方法。 - Yu, M.Y., Shim, W.,(2009). Couples with Schizophrenia "Becoming like Others'' in South Korea: Marriage as Part of a Recovery Process. Family Process, 48(3), 429-440.» 摘要
- Zahran S., Peek L.,Snodgrass J.G., Weiler S.,Hempel L.(2011). Economics of Disaster Risk, Social Vulnerability, and Mental Health Resilience. Risk Analysis, 31(7), 1107-1119. » 摘要
Abstract: We investigate the relationship between exposure to Hurricanes Katrina and/or Rita and mental health resilience by vulnerability status, with particular focus on the mental health outcomes of single mothers versus the general public. We advance a measurable notion of mental health resilience to disaster events. We also calculate the economic costs of poor mental health days added by natural disaster exposure. Negative binomial analyses show that hurricane exposure increases the expected count of poor mental health days for all persons by 18.7% (95% confidence interval [CI], 7.44-31.14%), and by 71.88% (95% CI, 39.48-211.82%) for single females with children. Monthly time-series show that single mothers have lower event resilience, experiencing higher added mental stress. Results also show that the count of poor mental health days is sensitive to hurricane intensity, increasing by a factor of 1.06 (95% CI, 1.02-1.10) for every billion (U.S.$) dollars of damage added for all exposed persons, and by a factor of 1.08 (95% CI, 1.03-1.14) for single mothers. We estimate that single mothers, as a group, suffered over $130 million in productivity loss from added postdisaster stress and disability. Results illustrate the measurability of mental health resilience as a two-dimensional concept of resistance capacity and recovery time. Overall, we show that natural disasters regressively tax disadvantaged population strata.
- Zauszniewski, J.A., Bekhet, A.K., Suresky, M.J. (2010). Effects on Resilience of Women Family Caregivers of Adults With Serious Mental Illness: The Role of Positive Cognitions. Archives of Psychiatric Nursing, 23 (6): 412-422.» 摘要
Abstract: This study examined the effects of risk and protective factors on resilience in 60 women family members of adults with serious mental illness. Both the risk factors constituting caregiver burden (strain, stigma, client dependence, and family disruption) and protective factors, including eight positive cognitions were found to predict two indicators of resilience: resourcefulness and sense of coherence. The effects of caregiver burden on resourcefulness and sense of coherence were mediated by positive cognitions, lending support to resilience theory and suggesting the need to develop interventions to encourage positive thinking among women caregivers of adults with mental illness.
- Zhang, R., Mak, W. W., & Chan, R. C. (2017). Perceived primal threat of mental illness and recovery: The mediating role of self-stigma and self-empowerment. American Journal of Orthopsychiatry, 87(1), 44.» 摘要
Abstract: Although people in recovery from mental illness can continue to live a personally meaningful life despite their mental illness, their perception of mental illness as being a threat to their basic needs may influence the way they view themselves as a person with mental illness and their sense of mastery over their condition. The present study explored the effects of perceived primal threat on the recovery of people with mental illness, considering the mediating roles of self-stigma and self-empowerment. Latent variable structural equation modeling was conducted among 376 individuals with mental illness in Hong Kong. The model had excellent fit to the data (χ2 = 123.96, df = 60, χ2/df = 2.07, comparative fit index [CFI] = .98, Tucker–Lewis index [TLI] = .97, root mean square error of approximation [RMSEA] = .05, standardized root mean squared residual [SRMR] = .04). The influence of perceived primal threat on recovery was mediated by self-stigma and self-empowerment. Specifically, perceived primal threat was associated positively with self-stigma, which was negatively related to recovery; in contrast, it was negatively related to self-empowerment, which was positively related to recovery. This study adds to the understanding of the mechanism underlying the influence of perceived primal threat on recovery and suggests that perceived primal threat should be considered in the recovery process among people with mental illness.
A story of recovery
此篇文章探討了有關作者如何克服酒藥癮的經驗，作者自陳過去由於他的錯誤，使他和妻子分離，也沒有盡到有關法律上公民責任。某天，他的妻子和他的合夥人建議他去接受處遇治療，他花了六十天的時間在田納西洲的處遇中心，使用與經歷了『12個復原步驟』方案，當他離開處遇中心，他已經回歸到正常生活。
此篇文章探討了有關作者如何克服酒藥癮的經驗，作者自陳過去由於他的錯誤，使他和妻子分離，也沒有盡到有關法律上公民責任。某天，他的妻子和他的合夥人建議他去接受處遇治療，他花了六十天的時間在田納西洲的處遇中心，使用與經歷了『12個復原步驟』方案，當他離開處遇中心，他已經回歸到正常生活。
Risk and protective influences in the lives of siblings of youths with spina bifida
兒童慢性健康狀況如脊柱裂（SB）的影響，是一種共同的家庭經驗。然而，罹患SB的手足之經驗則不為人知。一百五十五名的罹患此疾病的手足回答郵寄的匿名開放性問題，旨在提高大眾對於SB青少年手足對此疾病之經驗的認識。跨學科的作者們進行內容分析後指出四個面向：脊柱裂的獎勵和後果，對脊柱裂的接受過程，手足的情緒氣氛，和社會環境的品質；這些面向描繪了罹患SB手足在回應生活中各種風險和保護因子的複雜情緒。透過加強SB手足的優勢和資源，有助於他們的因應機制,靈性，有凝聚力的家庭關係，和支持同儕的友誼，社會工作者和其他衛生保健專業人員可以幫助他們成功地駕馭緊張和混亂的情緒，進而可能自SB相關的挑戰和機會中躍升。
兒童慢性健康狀況如脊柱裂（SB）的影響，是一種共同的家庭經驗。然而，罹患SB的手足之經驗則不為人知。一百五十五名的罹患此疾病的手足回答郵寄的匿名開放性問題，旨在提高大眾對於SB青少年手足對此疾病之經驗的認識。跨學科的作者們進行內容分析後指出四個面向：脊柱裂的獎勵和後果，對脊柱裂的接受過程，手足的情緒氣氛，和社會環境的品質；這些面向描繪了罹患SB手足在回應生活中各種風險和保護因子的複雜情緒。透過加強SB手足的優勢和資源，有助於他們的因應機制,靈性，有凝聚力的家庭關係，和支持同儕的友誼，社會工作者和其他衛生保健專業人員可以幫助他們成功地駕馭緊張和混亂的情緒，進而可能自SB相關的挑戰和機會中躍升。
Abstract: Research divides and reports negative associations between negative (pathogenic; e.g., posttraumatic stress disorder; PTSD) and positive (salutogenic; e.g., posttraumatic growth, resilience) psychological responses to trauma. This study elaborates prior research by casting resilience as a trait rather than state. Participants with varied exposure levels (n = 500) completed measures of resilience, trauma history, PTSD, and posttraumatic growth. Results of structural equation modeling with LISREL showed that trauma increased PTSD and growth levels, whereas resilience was associated positively with growth and negatively with PTSD. It is concluded that salutogenic and pathological responses to trauma show differential associations with trait resilience.
Abstract: Background: This qualitative study sought to develop an understanding of how young adults between the ages of 18-25 years, who have a history of two or more suicide attempts, transition away from high-risk suicide-related behaviors. Aims: To understand the transition to safer behaviors and to provide clinical suggestions for those who provide care to this population. Methods: Sixteen young adults under the age of 25 years, who had completed at least one cycle of intervention for people with repeated suicide attempts, participated in this qualitative, grounded theory study. Results: The young adults described a pathway that included three major elements: (a) "living to die", (b) ambivalence and tipping/turning points, and (c) a process of recovery that included small steps or phases (pockets of recovery) toward life. The journey was not always experienced as steady movement forward, and the potential for relapse either in the young people's behavior or their wish to engage in their relationship with death could ebb and flow. Conclusions: Clinicians need to be aware that the struggle to live is a process involving a fluid pathway moving between three key elements.
Abstract:Background: The concept of staging of disease in psychiatry has developed over the past years. A neglected component of this model pertains to people in the advanced stages of a mental illness, who remain symptomatic and functionally impaired despite treatment. These patients are often high service utilizers, receiving complex multimodal treatments where the balance of risk and benefit shifts perceptibly. In this paper, we argue the need to adopt 'palliative' models of care for some individuals, and consider changing the therapeutic goals to follow care pathways similar to those used in other chronic and refractory medical illnesses.
Method: Data was sourced by a literature search using Medline and a hand search of scientific journals. Relevant articles were selected. Results: Clinical staging can help us better define subgroups of patients who will benefit from different goals and treatment. In the most advanced stage group, we find patients with persistent symptoms and treatment resistance. In these situations, it may be preferable to follow some of the principles of palliative care, which include the setting of attainable goals, reduction of side-effects, limited symptom control, targeting identified psychological and social problems, and attempting to attain the best quality of life for these patients and their families. Conclusions: It is in the interest of those in the advanced phases of a disorder that clinicians acknowledge the limitations of treatment and actively attempt to plan treatment utilizing alternate models. It is essential to be clear that such approaches do not equate to the abandonment of care, but rather to the reconceptualizing of feasible and personalized treatment goals, a rebalancing of the risks and benefits of intervention, the management of illness behaviour, and the approaches that allow the patient to live gainfully within their limitations.
Method: Data was sourced by a literature search using Medline and a hand search of scientific journals. Relevant articles were selected. Results: Clinical staging can help us better define subgroups of patients who will benefit from different goals and treatment. In the most advanced stage group, we find patients with persistent symptoms and treatment resistance. In these situations, it may be preferable to follow some of the principles of palliative care, which include the setting of attainable goals, reduction of side-effects, limited symptom control, targeting identified psychological and social problems, and attempting to attain the best quality of life for these patients and their families. Conclusions: It is in the interest of those in the advanced phases of a disorder that clinicians acknowledge the limitations of treatment and actively attempt to plan treatment utilizing alternate models. It is essential to be clear that such approaches do not equate to the abandonment of care, but rather to the reconceptualizing of feasible and personalized treatment goals, a rebalancing of the risks and benefits of intervention, the management of illness behaviour, and the approaches that allow the patient to live gainfully within their limitations.
Abstract: This study examines the core components of children's basic security and well-being in order to examine issues central to improving child protection in Rwanda. Sources of data included 15 focus groups with adults, 7 focus groups with children ages 10-17, and 11 key informant interviews with child protection stakeholders, including representatives from international NGOs, community-based groups, and the Rwandan Government, all of which took place in April and May of 2010. Participants painted a complex picture of threats to children's basic security in Rwanda. Three key themes were pervasive across all interviews: (1) deterioration of social and community cohesion in post-genocide Rwanda; (2) the cascading effects of poverty; and (3) the impact of caregiver illness and death on the caregiving environment. Consistent with the SAFE (Safety/freedom from harm; Access to basic physiological needs and healthcare; Family and connection to others; Education and economic security) model of child protection, participants rarely elaborated on a child protection threat independent of other basic security needs and rights. Findings suggest a need for integrated approaches to child protection that recognize this interrelatedness and extend beyond issue-specific child protection responses. This study contributes to a growing body of work highlighting the interrelated nature of child protection threats and the implications of adaptive and dangerous survival strategies that children and families engage in to meet their basic security needs. Analysis of this interrelatedness provides a roadmap for improving policies and implementing integrated and robust child protection strategies in Rwanda and other settings.
Abstract: Empowerment is a keyword in treatment. Users should have the means and possibilities to influence their treatment and become self-managing. Drawing on ethnographic fieldwork in a Danish methadone treatment project, we find that the practices of users and staff are often not carried out in accordance with governmental intentions. We identify a gap between the official notions of treatment and practices. We analyse the notions and practices of empowerment by applying two analytical perspectives. First, we apply a constructionist perspective in which empowerment is analysed as wanting to set users free' but also as ways to govern. We elaborate the analysis by applying a more practice-oriented focus. Drawing on this perspective, we analyse the ways in which staff and users constantly produce, construct and negotiate institutional practices that differ from the governmental intentions for treatment.
Abstract: Sleep restriction and poor sleep quality is linked with cardiovascular morbidity. The present study aimed to explore the influence of daytime sleep supplementation on cardiovascular reactivity. Participants (N = 85) were generally healthy young adults and were randomized to a 60-min polysomnographically-monitored sleep condition or to a no-sleep condition. Participants then completed a standard three-phase mental stress reactivity task. Significantly lower mean arterial pressure means were found in the recovery phase of the stress reactivity task among participants that accrued more than 45 min of daytime sleep. These findings suggest daytime sleep may offer cardiovascular benefit in the form of greater cardiovascular recovery from psychological stress. Further research should assess daytime sleep characteristics (time of day, length, and architecture) on cardiovascular response, in an effort to better understand its role as a possible recuperative agent against suboptimal nocturnal sleep patterns.
Abstract:Background.- The purpose of the present study was to examine the protective and risk factors of mental distress among Turkish women living in Germany.Method.- 105 Turkish immigrant women living in Berlin were investigated with measures of extraversion/neuroticism (NEO-FFI), general self-efficacy (GSE), social support (BSSS), social strain (F-SOZU) and mental distress (GHQ-28). Interrelations between psychosocial variables were assessed using simple Pearson correlations.Results.- In all subjects, social strain (Pearson's r=.26**, p=.008) and neuroticism (r=.34**, p<.001) were positively associated with mental distress. In contrast, perceived self-efficacy (r= -.38**, p<.001) and extraversion (r= -.36**, p<.001) were negatively associated with mental distress.
Conclusion.- Protective factors such as extraversion and self-efficacy seem to have a buffering effect on the process of migration. However, in addition to neuroticism, social strain seems to be positively associated with mental distress.
Abstract: There is growing evidence that physician health programs (PHPs) are an important component in physicians' recovery from substance disorders, although we do not know how variations in treatment and monitoring affect physician recovery. This study was designed to understand how programmatic differences impact clients' overall program completion. This study was part of a larger investigation, the Blueprint Project, which evaluated outcomes for clients enrolled in PHPs nationally. Here we compared physicians presenting to a Colorado-based PHP for substance use to a nationally based referent, contrasting treatment, monitoring, and outcomes (Colorado n = 72, National n = 730). The samples were similar demographically although more Colorado physicians were poly-substance users. We found variations in treatment and monitoring patterns with Colorado physicians participating in more types of primary treatment and monitoring services and were allowed to work more at some point during monitoring. There was greater relapse among Colorado physicians, but these differences disappeared when we controlled for prior treatment. The great majority of clients in both samples showed successful recovery. This data provides a foundation on which to understand population characteristics, contractual differences, and outcome variations among PHPs and serves to inform internal PHP programmatic structures and regulatory agencies.
Abstract: The purposes of this article are to (a) document salient characteristics and dilemmas of early recovery from complex trauma as evidenced in the narratives of 20 trauma survivors in treatment; (b) identify sources and expressions of resiliency that may coexist, and indeed be intertwined, with severe psychopathology; and (c) consider what the narratives tell us that therapists might need to know as they approach the task of offering help to traumatized patients in the relational context of psychotherapy. Using a grounded theory analysis of interview transcripts of survivors, preludes to vulnerability (i.e., experiences and circumstances that portend of harm and set the stage for recurrent and extreme abuse) are discussed. The ways in which self-experience and identity development can become corrupted by recurrent trauma are presented. Narrative analysis reveals that adaptations to trauma are typically both pathogenic and suggestive of resilient capacities that may be mined in the service of functionality, and recovery.
Abstract: With the expectation that many can recover from schizophrenia, the implications for the roles of practitioners to assist them are critical. Although much has been written about how to empower a recovering person to develop a more positive identity, an important area which seems relatively underdeveloped in the literature pertains to the challenges and suffering borne from the process of recovery itself. The current paper will suggest that there are four related, though independent, challenges associated with the recovery process that practitioners should be prepared to address: (1) the discomfort elicited by the loss of, or threats to, a previous sense of identity, (2) the loss of previous ways of making meaning of the world, (3) awareness of concrete losses in one's life which have occurred, and (4) accepting oneself as an ordinary, though agentic, person. For each we will review experimental, clinical, and first-person literature and refer to an illustrative vignette. Through recognition of these potentially painful challenges, practitioners may be even more effective in supporting recovery.
Abstract: This paper outlines a procedure for measuring personal identity that uses self-characterisations to elicit and integrate ideographic data for fixed construct repertory grid nomothetic applications. There is a focus on how family members view their personal identities when they are recovering from the impacts of having a 'loved one' with a mental illness and/or substance used disorder. The unique nature of personal and relational empowerment journeys necessitates the use of an ideographic approach to capture changes in personal identity. A significant research implication for this procedure is that the consistent meaning generated through this initially ideographic approach can then be used to explore changes in identity across larger populations. The clinical implications include having a phenomenological framework upon which care plans that include a focus on identity processes can be individually tailored.
Abstract: The emerging adulthood years, commonly defined as the late teens and twenties, represent a period of significant variability and change for much of the population. Thus, it is important for the field to consider pathways of at-risk youth as they move through this key window of development. We review research on positive outcomes in the transition to adulthood following a history of experienced adversity, including both investigations focused on resilience in diverse specific populations as well as broader longitudinal studies. There is compelling evidence for major protective and promotive factors identified in younger age periods continuing to exert an influence at this stage of development, along with evidence for new factors unique to this developmental time and/or to specific populations. We conclude by noting recommendations for future work in this area, emphasizing Garmezy's call for the testing of competing models.
Abstract: This qualitative study sought to better understand the experiences of deaf and hard of hearing individuals with accessing recovery-oriented mental health services and peer support via a focus group and interviews. Cultural brokers were used to facilitate culturally-sensitive communication with study participants. Findings indicate that access to adequate mental health services, not just recovery-oriented and peer support services, is not widely available for this population, largely due to communication barriers. Feelings of isolation and stigma are high among this population. Public mental health systems need to adapt and expand services for various cultural groups to insure recovery.
Abstract: Resilience has been regarded narrowly as a quintessential individual property by most investigators. Social resilience, however, is inherently a multilevel construct, revealed by capacities of individuals, but also groups, to foster, engage in, and sustain positive social relationships and to endure and recover fro,n stressors and social isolation. Emergent levels of organization, ranging from dyads, families, and groups to cities, civilizations, and international alliances have long been apparent in human existence, but identifying the features of individuals, relationships, and group structures and norms that promote social resilience-and determnining effective interventions to build social resilience-represent some of the mmiost unportant challenges facing the mnilitamy as well as contemporary behavioral science. We identify nine personal resources that foster social resilience, and we describe an educational, comnputer-hased program that builds on these resources in an effort to improve the social resilience among troops in the U.S. Army. Data from this program should provide valuable evidence regarding the challenge of building social resilience.
Abstract:Previous research has found evidence that some economically deprived areas in England exhibit 'health resilience' in terms of lower than expected mortality rates. Consistent with earlier research we analysed area 'resilience' for parliamentary constituencies and our work extends previous research by including measures of morbidity. Standardised Morbidity Ratios (SMRs) of self-reported general health, limiting long-term illness, emergency hospital admissions, and CHD hospital admissions were derived from the 2001 UK Census and 2001 Hospital Episodes Statistics, and combined into a Composite Morbidity Index (CMI). Area variation in the CMI was compared with previous findings about mortality rates. Multiple Correspondence Analysis (MCA) was used to test the associations between area level 'health resilience' and ethnic composition, residential mobility, employment type, housing tenure, and an indicator of social cohesion. Nine areas were 'resilient' in terms of morbidity. Only four areas of England exhibited 'health resilience' in terms of both mortality and morbidity. MCA revealed that there may be several factors associated with greater 'health resilience'.
Abstract:The voice of each individual is a unique and self-defining characteristic, a way of freely expressing the essence of our very being and a basic human right protected under international law. However, for so-called psychiatric voice hearers (PVHs; The term PVH' as used in the present context, is not meant to demean or denigrate the experience but to distinguish between those who hear voices and those whose voice hearing experience is synonymous with being labelled mentally ill.) whose voice hearing experiences are synonymous with a diagnosis of mental illness this principle has added and far reaching consequences. This collaborative paper draws on and integrates the dual and respective inside out and outside in perspectives and subjectivities of a PVH and a mental health practitioner arguing that while recovery is very much in vogue if it is defined predominantly by psychiatric contexts, illness saturated environments founded on professional disciplinary power, it misses the point. Rather recovery is considered as an essentially contested concept which must be self-defined and self-directed by the ideographic narratives of those who own and are living with the experience. In what has become an increasingly risk adverse culture of the care management system, the mental health social worker as a transitional participant is strategically placed to bridge and integrate the disparate but interrelated internal and external worlds of the psychiatric client living in the community. Managing and validating the totality of their experience to establish a radical, collaborative and life sustaining relationship which promotes real and meaningful recovery.
Abstract: Disaster mental health work requires additional skills and an enlarged vision of the human condition that values the resiliency and strengths that people have. Using models post social workers are trained to apply in clinical work is a potentially dangerous trap People are likely to be perceived by professionals as victims or broken people and lacking needed strength and resilience if that clinical lens is automatically or universally applied to people who experience traumatic incidents (terrorism natural disasters or the unexpected or violent death of a family member peer or significant other). Focusing only on the individual in these situations can cause professionals to lose the ability to focus equally upon the institutional and communal social systems that have also, been thrown into chaos.
Abstract: Objective: "Creating Communities" is a study that examines the influence of stable housing on recovery within intentional communities of people living with severe mental illnesses in Washington, DC. We label these configurations "recovery communities" (RCs). The authors aim to identify features of the contextual environment of RCs that contribute to recovery from the perspective of RC residents. Method: Focus groups were conducted with RC residents at 4-month intervals to inquire into day-to-day life in the communities. Focus group transcripts were reviewed and thematic analysis was conducted to identify prominent and emergent themes relating to the RC and recovery. Results: Thematic analysis yielded three contextual domains through which study participants articulate the RC contributing to their recovery: (a) service environment, (b) physical environment, and (c) social environment. RCs are embedded in a complementary service system; the physical environment provides a refuge from homelessness, drug activity, and violence; and the social environment offers a place to "belong" amid peer-support for mental health and sobriety. Conclusions and Implications for Practice: Findings suggest the need for recovery-oriented services to be holistic and prepared to address multiple, complex needs that include, but go beyond, clinical efforts to reduce psychiatric symptomatology, substance use, and the impact of trauma. People with serious mental illnesses living in RCs express the need for support that ranges from the very concrete to the less tangible, fundamental need for connection and belonging. As a rehabilitative strategy, RCs offer support for the mitigation of psychiatric challenges as well as a refuge from poverty and homelessness.
Abstract: While the adverse effects of HIV and AIDS on female care-givers in southern Africa have been well documented, there are too few examples of more nuanced analyses, which reflect not only adversity and challenges, but also positive responses, perspectives and experiences. By discussing findings of qualitative research conducted with nine female carers of children in South Africa's Kwazulu-Natal province, one of the world's most HIV-affected regions, this paper explores two themes, focusing mainly on older (grandmother) carers: (a) their strength and resourcefulness in responding to adversity to ensure their families' survival and (b) their leadership role in affronting HIV and related stigma within their own families. These two themes unfold through insights provided by the stories of two study participants, which are discussed in the context of the broader study findings and literature. The aim of this research is both to add to experiential data on the much-debated notion of ‘resilience’ and further challenge the stereotype of older carers or ‘rural African grandmothers’ as passive victims of a changing world, rather than key agents of change. While terms such as ‘coping strategies’ and ‘resilience’ should be used cautiously, it is important to consider carers' short-term responses to the many challenges faced, with a view to constructively informing interventions.
Abstract: Objective: Low levels of insight are a risk factor for treatment nonadherence in schizophrenia, which can contribute to poor clinical outcome. On the other hand, high levels of insight have been associated with negative outcome, such as depression, hopelessness, and lowered quality of life. The present study investigates mechanisms underlying the association of insight and depressive symptoms and protective factors as potential therapeutic targets. Methods: One hundred and forty-two outpatients with schizophrenia or schizoaffective disorder (35.2% women, mean age of 44.83 years) were studied using questionnaires and interviews to assess insight, depressive symptoms, recovery attitude, and illness appraisals with regard to course, functional impairments, and controllability. Psychotic and negative symptoms were assessed as control variables. The cross-sectional data were analyzed using structural equation models and multiple linear regression analyses with latent variables. Results: Higher levels of insight and psychotic symptoms were associated with more depressive symptoms. The association of negative symptoms with depressive symptoms was not significant. The relationship between insight and depressive symptoms was mediated by the participants' perception of their illness as being chronic and disabling, as well as suppressed by their expectation of symptom control due to treatment. Finally, the association of insight and depressive symptoms was less pronounced in the patients with a positive recovery attitude than in those without this protective factor. Conclusions: To achieve recovery, which includes symptom reduction, functional improvement, and subjective well-being, it is necessary to prevent depressive symptoms as indicators of a demoralization process, which may arise as a consequence of growing insight. Possible treatment strategies focusing on changes of dysfunctional beliefs about the illness and the self and inducing a positive recovery attitude are discussed.
Abstract: Objective. - Studies investigating indicators of recovery from schizophrenia yielded two concepts of recovery. The first is the reduction of psychiatric symptoms and functional disabilities ('clinical recovery'), while the second describes the individual adaptation process to the threat posed to the individual sense of self by the disorder and its negative consequences ('personal recovery'). Evidence suggests that both perceptions contribute substantially to the understanding of recovery and require specific assessment and therapy. While current reviews of measures of clinical recovery exist, measures of personal recovery have yet to be investigated. Considering the steadily growing literature on recovery, this article gives an update about existing measures assessing personal recovery. Method. - A literature search for instruments was performed using Medline, Embase, PsycINFO&P-SYNDEXPlus, ISI Web of Knowledge, and Cochrane Library. Inclusion criteria were: (1) quantitative self-report measures; (2) specifically developed for adults with schizophrenia or schizoaffective disorder or at least applied to individuals suffering from severe mental illness; (3) empirically tested psychometric properties and/or published in a peer-reviewed, English-language journal. Instruments were evaluated with regard to psychometric properties (validity and reliability) and issues of application (user and administrator friendliness, translations). Results. - Thirteen instruments met the inclusion criteria. They were individually described and finally summarized in a table reflecting the pros and cons of each instrument. This may enable the reader to make an evidence-based choice for a questionnaire for a specific application. Conclusion. - The Recovery Assessment Scale is possibly the best currently available measure of personal recovery when all evaluation criteria are included. However, the ratings listed in the current paper depended on the availability of information and the quality of available reports of previous assessment of the measurement properties. Considering the significant amount of information lacking and inconsistent findings, further research on the reviewed measures is perhaps more important than the development of new measures of personal recovery.
Abstract: Family is one of the primary sources of spiritual care for people with schizophrenia. Gaps in perspectives between family care-givers and patients not only result in improper spiritual care, but also lead to family conflicts and hamper recovery. Yet, the mutual understanding of spirituality among both parties is often neglected. We here reported part of a larger study that explored the meaning and the role of spirituality in schizophrenia rehabilitation from the perspectives of patients, mental-health professionals and family care-givers. The result suggests that discrepancies in conceptions of spirituality between patients and their care-givers may affect patients’ family dynamic and their recovery. A qualitative approach based on grounded-theory principles was used. Six patient–care-giver dyads and one triad of two patients with schizophrenia and one care-giver (N = 15) were recruited from an outpatient clinic of a hospital in Hong Kong. The findings revealed that patients usually tried to fit in with their care-giver’s spiritual perspective, in order to preserve family harmony and supports. They would then experience further psychological distress that impeded their recovery. Meanwhile, among the dyads, the mutual understanding and respect on spirituality helped facilitate patients’ recovery. Care-givers should be more attentive and open to patients’ spiritual needs. Implications for clinical practice were discussed.
Abstract: Objective: The aim of the current study was to investigate the rates and predictors of symptomatic remission and recovery in patients presenting with first-episode psychosis 3 years after treatment initiation. Methods: Seven hundred participants aged 15-25 years consecutively enrolled in a territory-wide early intervention programme in Hong Kong from July 2001 to August 2003 fulfilled study inclusion criteria, with 539 completing 3-year follow-up. Baseline and follow-up variables were collected via systematic medical file review. The operational criteria for recovery were based on clinical definition incorporating both symptom and functional dimensions. Results: By the end of 3-year follow-up, 58.8% (n = 317) and 17.4% (n = 94) of participants met criteria for symptomatic remission and recovery, respectively. Around half (51.2%, n = 276) were not remitted either symptomatically or functionally in the last 12 months of follow-up. Of those who achieved sustained symptomatic remission, only 43.1% were also in functional remission. Patients in symptomatic remission had lower rate of admissions, shorter duration of hospitalisations and more favourable psychosocial functioning than non-remitted counterparts. Logistic regression analysis revealed that female sex, older age of onset of psychosis, shorter duration of untreated psychosis (DUP) and early symptom resolution predicted symptomatic remission at the end of follow-up. Higher educational attainment, superior baseline occupational status and shorter DUP were found to be predictive of recovery. Conclusion: In a large representative cohort of Chinese young people presenting with first-episode psychosis, although more than half achieved symptomatic remission 3 years after service entry, the rates of functional remission and recovery were low. More intensive psychosocial interventions may be required to further improve patients' functional outcome.
Abstract:Background: Lower concentrations of n-3 PUFAs have been reported to be associated with cognitive impairment and dementia, but also with depression-itself a potential risk factor for cognitive decline.
Objective: The aims of this study were to investigate associations between n-3 PUFA concentrations in erythrocyte membrane or plasma and cognitive function in an at-risk sample of older people with previous major depression and to explore specificity with respect to cognitive domains. Design: A cross-sectional sample of 132 eligible participants who had recovered from major depression (mean +/- SD age: 67.8 +/- 6.6 y) were enrolled from outpatient psychiatric services. A series of cognitive tests and a structured questionnaire were administered. Fasting blood samples were collected for n-3 PUFA measurements. Results: Higher EPA and total n-3 PUFA concentrations and a lower ratio of arachidonic acid to EPA in erythrocyte membranes were associated with a higher cognitive composite score: independent of age and sex, but no longer significant after adjustment for education. No associations were found with plasma concentrations of any fatty acid. Considering individual cognitive tests, the strongest and most consistent correlations were found between immediate recall and concentrations of total n-3 PUFAs and alpha-linolenic acid (ALA) in erythrocytes, which were observed only in participants with recurrent depression. Conclusions: Total erythrocyte n-3 PUFA concentrations are positively associated with cognitive function, particularly immediate recall, in older people with previous depression. Lower concentrations of n-3 PUFAs or ALA in erythrocyte membranes may be good predictors for cognitive impairment in older people with previous recurrent depression.
Objective: The aims of this study were to investigate associations between n-3 PUFA concentrations in erythrocyte membrane or plasma and cognitive function in an at-risk sample of older people with previous major depression and to explore specificity with respect to cognitive domains. Design: A cross-sectional sample of 132 eligible participants who had recovered from major depression (mean +/- SD age: 67.8 +/- 6.6 y) were enrolled from outpatient psychiatric services. A series of cognitive tests and a structured questionnaire were administered. Fasting blood samples were collected for n-3 PUFA measurements. Results: Higher EPA and total n-3 PUFA concentrations and a lower ratio of arachidonic acid to EPA in erythrocyte membranes were associated with a higher cognitive composite score: independent of age and sex, but no longer significant after adjustment for education. No associations were found with plasma concentrations of any fatty acid. Considering individual cognitive tests, the strongest and most consistent correlations were found between immediate recall and concentrations of total n-3 PUFAs and alpha-linolenic acid (ALA) in erythrocytes, which were observed only in participants with recurrent depression. Conclusions: Total erythrocyte n-3 PUFA concentrations are positively associated with cognitive function, particularly immediate recall, in older people with previous depression. Lower concentrations of n-3 PUFAs or ALA in erythrocyte membranes may be good predictors for cognitive impairment in older people with previous recurrent depression.
Abstract:Leaders in struggles for social justice agree on the importance and the difficulty of maintaining hopefulness while developing critical awareness of social issues. Research has indicated that the analogous components of psychological empowerment (emotional and cognitive) often do not co-vary across populations. This study used a person-centered analytic approach, latent class analysis, to identify subpopulations of participants (n = 1,322) according to the cognitive and emotional components of psychological empowerment. Four distinct sub-groups emerged: those who were relatively (1) critical but alienated, (2) uncritical but hopeful, (3) uncritical and alienated, or (4) critical and hopeful. These clusters were then examined for demographic differences and relationships with a set of conceptually relevant variables including social capital, psychological sense of community, openness, organizational participation and mental wellbeing. Results shed light on the complexity of empowerment processes and yield implications for ongoing community research and action.
Abstract:Objective: This paper examines the types of goals being set by individuals in the context of Australian mental health services and whether goal type differs across the stages of recovery. Methods: Goal records of 144 individuals accessing services were reviewed to examine goal content, ratio of approach and avoidance oriented goals and changes across stages of psychological recovery. Results: Individuals further along in their recovery set significantly more approach goals and types of goals set appeared to reflect broader life roles. Conclusions and Implications for Practice: Setting approach goals and goals that reflect broader life roles tends to support the definition of psychological recovery as being "the movement towards" greater meaning and enhanced sense of self.
Abstract: Recovery is the model of care presently advocated for mental health services internationally. The aim of this study was to examine the knowledge and attitudes of mental health professionals to the concept of recovery in mental health. A descriptive survey approach was adopted, and 153 health care professionals (nurses, doctors, social workers, occupational therapists and psychologists) completed an adapted version of the Recovery Knowledge Inventory. The respondents indicated their positive approach to the adoption of recovery as an approach to care in the delivery of mental health services. However, respondents were less comfortable in encouraging healthy risk taking with service users. This finding is important because therapeutic risk taking and hope are essential aspects in the creation of a care environment that promotes recovery. Respondents were also less familiar with the non-linearity of the recovery process and placed greater emphasis on symptom management and compliance with treatment. Multidisciplinary mental health care teams need to examine their attitudes and approach to a recovery model of care. The challenge for the present and into the future is to strive to equip professionals with the necessary skills in the form of information and training.
Abstract:Background Depression outcomes in research and clinical practice are commonly defined by the concepts of remission, recovery, relapse, and recurrence. Despite their widespread use, there has been little empirical examination of these concepts. Therefore, we investigated profiles of individual symptoms during each of these phases of depression. Methods In a 3-year prospective study of 267 depressed primary care patients, we established the presence or absence of the individual DSM-IV depressive symptoms week-by-week during DSM-IV-defined remissions, recoveries, relapses, and recurrences. We measured symptoms in 12 quarterly assessments using the Composite International Diagnostic Interview. Results Remissions were characterized by double the proportion of time that the core symptoms were present compared to the initial phase of recoveries after a major depressive episode (MDE; 59 versus 32%; Z = 3.03; P = .002). Before a relapse, remissions again showed elevated levels of core symptoms in comparison to the final phase of recoveries before a recurrence (58 versus 26%; Z = 2.99; P = .003). Conclusions Compared with the initial and final phases of recoveries, remissions showed a consistently higher level of core symptoms. Clinically, this means that unresolved core symptoms in the direct aftermath of a MDE seem to constitute a risk for relapse and should be the target of preventive or augmented interventions.
Abstract:The purpose of this study was to determine the efficacy of a peer-led illness self-management intervention called Wellness Recovery Action Planning (WRAP) by comparing it with usual care. The primary outcome was reduction of psychiatric symptoms, with secondary outcomes of increased hopefulness, and enhanced quality of life (QOL). A total of 519 adults with severe and persistent mental illness were recruited from outpatient community mental health settings in 6 Ohio communities and randomly assigned to the 8-week intervention or a wait-list control condition. Outcomes were assessed at end of treatment and at 6-month follow-up using an intent-to-treat mixed-effects random regression analysis. Compared to controls, at immediate postintervention and at 6-month follow-up, WRAP participants reported: (1) significantly greater reduction over time in Brief Symptom Inventory Global Symptom Severity and Positive Symptom Total, (2) significantly greater improvement over time in hopefulness as assessed by the Hope Scale total score and subscale for goal directed hopefulness, and (3) enhanced improvement over time in QOL as assessed by the World Health Organization Quality of Life-BREF environment subscale. These results indicate that peer-delivered mental illness self-management training reduces psychiatric symptoms, enhances participants' hopefulness, and improves their QOL over time. This confirms the importance of peer-led wellness management interventions, such as WRAP, as part of a group of evidence-based recovery-oriented services.
Abstract: Resilient families are able to adapt to adversities, but the nature of family resilience is not well understood. This study examines patterns of family functioning that may protect families from the negative impact of alcohol abuse. Naturally occurring patterns of family functioning are identified and associations between these patterns and parenting, current parental alcohol use, recent family stressful events, supportive relationships outside the family, and demographic characteristics are assessed. Cross-sectional data are analyzed from racially diverse American and Canadian families (N = 674) who have at least one parent with an alcohol abuse problem and a child between ages 9 and 12 years. Cluster analyses derived from family functioning indicators are used to identify naturally occurring family patterns. Multivariate assessments evaluated relationships between family functioning clusters and potentially influencing factors. The study results reveal a continuum of family functioning associated with parenting, child's perception of teacher caring, and race.
Differential impacts of stressful life events and social support on the mental health of Mainland Chinese immigrant and local youth in Hong Kong: A resilience perspective
以復原觀點為基礎，本研究企圖去探索影響香港的移民者和當地青少年心理健康的風險與保護因素。本研究使用結構性問卷，內容包括華人青少年生活事件勾選單（The Chinese Adolescents Life Events Checklist）、感受的社會支持滿意度量表（Perceived Satisfaction of Social Support Scale）和簡明症狀量表（The Brief Symptoms Inventory）。210位年齡介於15到20歲的當地和移民青少年由受過訓練的訪員個別訪問。與我們的假設相反，結果顯示移民青少年有較好的心理健康和與當地青少年有相同程度的壓力。此外，發現同儕支持在移民青少年的心理健康發揮強大的影響力。雖然人際關係困難被認定為當地和移民青少年所面臨的一般風險因素，移民青少年面臨了有關變換新學校和父母的衝突等額外的風險因素。另一方面，困境的忍耐力，社交能力和同儕支持被認為是保護性因素，其可能與移民青少年有更好的心理健康有關。本篇研究的意涵包括採用復原力的觀點來瞭解增強移民青少年心理健康之保護方法，發展全國的策略來建立青少年在社會中的人際關係技巧，和組織特定的方案來加強移民青少年的同儕系統和處理父母衝突。
以復原觀點為基礎，本研究企圖去探索影響香港的移民者和當地青少年心理健康的風險與保護因素。本研究使用結構性問卷，內容包括華人青少年生活事件勾選單（The Chinese Adolescents Life Events Checklist）、感受的社會支持滿意度量表（Perceived Satisfaction of Social Support Scale）和簡明症狀量表（The Brief Symptoms Inventory）。210位年齡介於15到20歲的當地和移民青少年由受過訓練的訪員個別訪問。與我們的假設相反，結果顯示移民青少年有較好的心理健康和與當地青少年有相同程度的壓力。此外，發現同儕支持在移民青少年的心理健康發揮強大的影響力。雖然人際關係困難被認定為當地和移民青少年所面臨的一般風險因素，移民青少年面臨了有關變換新學校和父母的衝突等額外的風險因素。另一方面，困境的忍耐力，社交能力和同儕支持被認為是保護性因素，其可能與移民青少年有更好的心理健康有關。本篇研究的意涵包括採用復原力的觀點來瞭解增強移民青少年心理健康之保護方法，發展全國的策略來建立青少年在社會中的人際關係技巧，和組織特定的方案來加強移民青少年的同儕系統和處理父母衝突。
Abstract: The concept of recovery can be operationalized from either the point of view of the consumer, or from the perspective of the agency providing services. The Milestones of Recovery Scale (MORS) was created to capture aspects of recovery from the agency perspective. Evidence establishing the psychometric properties of the MORS was obtained in three efforts: Inter-rater reliability using staff at The Village, a multi-service organization serving the homeless mentally ill in Long Beach, California; inter-rater reliability was also obtained from Vinfen Corporation, a large provider of housing services to mentally ill persons in Boston, Massachusetts. A test-retest reliability study was conducted using staff rating of clients at The Village, and evidence for validity was obtained using the Level of Care Utilization System (LOCUS) as a validity measure. The intra-class correlation coefficient for the inter-rater reliability study was r = .85 (CI .81, .89) for The Village and r = .86 (CI .80, .90) for Vinfen Corporation; test-retest reliability was r = .85 (CI .81, .87); and validity coefficients for the LOCUS were at or above r = .49 for all subscales except one. There is sufficient evidence for the reliability and validity of the MORS.
Abstract: Exposure to stressful events during development has consistently been shown to produce long-lasting alterations in the hypothalamic-pituitary-adrenal (HPA) axis, which may increase vulnerability to disease, including posttraumatic stress disorder and other mood and anxiety disorders. Recently reported genetic association studies indicate that these effects may be mediated, in part, by gene x environment interactions involving polymorphisms within two key genes, CRHR1 and FKBP5. Data suggest that these genes regulate HPA axis function in conjunction with exposure to child maltreatment or abuse. In addition, a large and growing body of preclinical research suggests that increased activity of the amygdala-HPA axis induced by experimental manipulation of the amygdala mimics several of the physiological and behavioral symptoms of stress-related psychiatric illness in humans. Notably, interactions between the developing amygdala and HPA axis underlie critical periods for emotional learning, which are modulated by developmental support and maternal care. These translational findings lead to an integrated hypothesis: high levels of early life trauma lead to disease through the developmental interaction of genetic variants with neural circuits that regulate emotion, together mediating risk and resilience in adults.
Abstract: The purpose of this study was to identify factors distinguishing Mexican American women living near the U. S.-Mexican border who are resilient to the experience of stress from those who are not. The study sample consisted of 418 participants ranging in age from 20 to 61 years. Data were gathered through a self-report survey instrument composed of items assessing stress vulnerability, acculturation, health, physical activity, education, and marital status. Descriptive discriminant analysis was used to determine which variables made the greatest contribution in discerning between stress-resistant and stress-susceptible women. The results indicated that higher educational attainment, greater acculturation, better health status, and marriage differentiated between those women reporting themselves resilient to the effects of stress and those reporting being vulnerable. These results have implications for stress resilience promotion among this population group.
Abstract: The present prospectively designed 15-year longitudinal research was conducted to study whether locus of control is linked to diagnosis, to major symptoms, to functioning and recovery, and to personality for schizophrenia patients. depressive patients, and patients with other major disorders. The research studied 128 patients from the Chicago Follow-up Study at the acute phase and reassessed them 5 times over a 15-year period, Patients were evaluated on locus of control, global outcome, recovery, premorbid developmental achievements, psychosis, diagnosis, depression, and personality variables. 1) After the acute phase. schizophrenia patients were not more external than other diagnostic groups. 2) Internality is significantly associated with increased recovery in schizophrenia. 3) A more external locus of control was significantly related to depression. 4) The relationship between externality and psychosis was significant. In severe psychiatric disorders a more external locus of control is not specific to schizophrenia and after the acute phase is not associated with one particular diagnostic group. A more external locus of control is significantly related to fewer periods of recovery, to both depressed mood and psychosis, and to various aspects of personality.
Abstract: Recovery in schizophrenia is receiving increasing attention. Part of the increased focus is based on the recent working criteria for clinical remission in schizophrenia and the realization that many people with schizophrenia meet these criteria for remission. In this article, we consider whether functional disability can also be evaluated in a "remission" model. In so doing, we evaluate the concept of clinical remission, evaluate the possibility of remission of other generally stable features of schizophrenia such as negative symptoms, and make some heuristic terminological recommendations. We also propose a "level and breadth" model for the definition of functional remission and examine some of the alternate influences that could produce suboptimal everyday functioning, including effort, motivation, and societal barriers toward functional achievement.
Abstract: CASE: Sonia's mother was concerned about her 9-year old daughter's aggression, defiant behavior, and distractibility. When she was 4-years, she kicked her bother and he lost a tooth as a result of the trauma. At this time, her pediatrician was concerned about hyperactivity, impulsivity, and defiance of authority and recommended a psychological evaluation. Sonia's father refused an evaluation and responded by physically abusing his wife while demanding a transfer to a new physician. Sonia's mother left her husband at this time and moved away with Sonia. Spousal abuse occurred frequently before the separation, and Sonia may have been physically abused as well.
Currently, Sonia is in third grade where she is underperforming in many areas. She enjoys drawing and reading, but struggles to sit quietly and stay on task. Her teacher reports frequent vocal and physical disruptions. Homework takes an inordinate amount of time to complete. She does not have a sustained friendship; her mother feels that this is because other kids do not like being bossed by Sonia. Her mother is concerned about Sonia's behavior especially the unremorseful disruptive behavior toward her younger brother and grandmother.
Sonia was born after an uneventful full-term pregnancy without evidence of maternal smoking, drugs, alcohol, or medications. Motor and social developmental milestones were achieved at the appropriate time. Language milestones were achieved early; her mother recalls that Sonia learned to read at the age of 3 years.
Sonia's medical history is significant for obesity, seasonal allergic rhinitis, and delayed sleep onset with prolonged awakenings associated with nightmares. Her mother reports that Sonia "worries about everything," including thoughts that her brother will turn into a monster. When an argument occurs at home, she "gets scared," bites her nails, and cries. Sonia currently lives with her mother, 2 younger brothers, step-father, and grandparents. Family history is significant for drug abuse by her father and mental illness in the father's family.
While conducting an interview with her mother, Sonia was asked to draw a picture of her family. instead, she illustrated a book detailing her past experience in words accompanying each drawing. She described how she watched her father physically abuse her mother and her persistent fear of danger when conflict occurred at home. Although spelling was poor, her vocabulary, sequencing, and illustrations demonstrated above age-level skills for written expression and drawing. Examples of the writing that accompanied the drawings include: "I hate when my parents fight. I get scared and feel sick to my tummy like I want to throw up. I just hate that feeling!" "My mom told me she had a 'boyfriend.' These words were the most horrible I ever heard. Soon a nightmare began. Nightmares make me very, very scared."
Currently, Sonia is in third grade where she is underperforming in many areas. She enjoys drawing and reading, but struggles to sit quietly and stay on task. Her teacher reports frequent vocal and physical disruptions. Homework takes an inordinate amount of time to complete. She does not have a sustained friendship; her mother feels that this is because other kids do not like being bossed by Sonia. Her mother is concerned about Sonia's behavior especially the unremorseful disruptive behavior toward her younger brother and grandmother.
Sonia was born after an uneventful full-term pregnancy without evidence of maternal smoking, drugs, alcohol, or medications. Motor and social developmental milestones were achieved at the appropriate time. Language milestones were achieved early; her mother recalls that Sonia learned to read at the age of 3 years.
Sonia's medical history is significant for obesity, seasonal allergic rhinitis, and delayed sleep onset with prolonged awakenings associated with nightmares. Her mother reports that Sonia "worries about everything," including thoughts that her brother will turn into a monster. When an argument occurs at home, she "gets scared," bites her nails, and cries. Sonia currently lives with her mother, 2 younger brothers, step-father, and grandparents. Family history is significant for drug abuse by her father and mental illness in the father's family.
While conducting an interview with her mother, Sonia was asked to draw a picture of her family. instead, she illustrated a book detailing her past experience in words accompanying each drawing. She described how she watched her father physically abuse her mother and her persistent fear of danger when conflict occurred at home. Although spelling was poor, her vocabulary, sequencing, and illustrations demonstrated above age-level skills for written expression and drawing. Examples of the writing that accompanied the drawings include: "I hate when my parents fight. I get scared and feel sick to my tummy like I want to throw up. I just hate that feeling!" "My mom told me she had a 'boyfriend.' These words were the most horrible I ever heard. Soon a nightmare began. Nightmares make me very, very scared."
Abstract: In South Africa, a substantial burden is placed on families living with people with mental illnesses. The aim of this study was to identify resilience factors in families living in an underprivileged area, caring for people with mental illnesses. Data was obtained from family representatives (N = 34) using semistructured interviews and a set Of seven self-report, quantitative questionnaires during the course of a once-off interview. The results of the qualitative analysis show that the most commonly cited resilience factors are religion and spirituality, and personal characteristics of individual family members. Both these factors were cited by 67.6% of the Participants. The results of the Spearman correlations showed that the factor that displayed the strongest relationship with family adaptation was the quality of communication in the family unit.
Abstract: In recent years in the UK, the National Health Service has made policy commitments to delivering mental health services based on recovery principles. In general though, the UK mental health service providers are in the early stages of implementing recovery principles and approaches in front-line services. This paper describes the work of the Hounslow Early Active Recovery Team (HEART), which has made substantial progress in placing recovery principles and approaches at the heart of the work of an early intervention for psychosis team working in an ethnically diverse area of West London. As evidence of the success of the HEART, in its first year and half, the team has achieved high levels of customer satisfaction with its work and a recent audit has revealed that 57% of respondents were in employment or education contrasting with the extremely high unemployment rates reported in several UK studies of people with serious mental health problems.
Abstract: A number of psychosocial treatments are available for persons with schizophrenia that include social skills training, cognitive behavioral therapy, cognitive remediation, and social cognition training. These treatments are reviewed and discussed in terms of how they address key components of functional recovery such as symptom stability, independent living, work functioning, and social functioning. We also review findings on the interaction between pharmacological and psychosocial treatments and discuss future directions in pharmacological treatment of schizophrenia. Overall, these treatments provide a range of promising approaches to helping patients achieve better outcomes far beyond symptom stabilization.
Abstract: This study examined gender differences in stress symptoms and recovery one year after the end of war, among two Israeli samples (adults n = 870 and adolescents n = 810). MANOVA analysis indicated that females reported higher levels of stress symptoms and lower levels of postwar recovery compared to males. Adolescents reported lower levels of stress and higher levels of recovery compared to adults. Path analysis supported the following: Gender associated negatively with family support and sense of danger. Sense of danger associated positively with symptoms and negatively with recovery, while family support associated with these variables in the opposite direction. Mediation test indicated that family support and sense of danger served as mediators between gender and recovery and between gender and stress symptoms.
Abstract: There is evidence that creative writing forms an important part of the recovery experience of people affected by severe mental illness. In this paper, we consider theoretical models that explain how creative writing might contribute to recovery, and we discuss the potential for creative writing in psychosocial rehabilitation. We argue that the rehabilitation benefits of creative writing might be optimized through focus on process and technique in writing, rather than content, and that consequently, the involvement of professional writers might be important. We describe a pilot workshop that deployed these principles and was well-received by participants. Finally, we make recommendations regarding the role of creative writing in psychosocial rehabilitation for people recovering from severe mental illness and suggest that the development of an evidence base regarding the effectiveness of creative writing is a priority.
Abstract: Traditionally resilience is viewed as an important way of coping: Through resilience, an individual recovers from or avoids negative outcomes from burdensome conditions. In this paper, we argue that individual stability under significant adverse conditions (i. e., resilience) results, to a large degree, from coping processes (e. g., assimilation and accommodation) influenced by personal and situational conditions. Moreover, we propose that resilience, viewed as a stabilizing constellation, should be considered an important part of the conceptual bridge between coping and development. Resilience, however, requires a definition of successful development. Here, we argue that the potential and possibility for further development may be used as a common denominator of current proposals. The aim is to outline an integrative model of coping, resilience, and development as a theoretical access to successful aging. Some empirical results illustrate the developmental conditions for assimilative and accommodative processes.
Abstract: To extend the literature the present study aims to examine the interrelationships between resilience (defined by a lack of posttraumatic stress disorder following trauma) and posttraumatic growth. Two studies were conducted of Israeli: (a) adolescents exposed to terror (N = 2908), and (b) citizens and army personnel following the second Lebanon War (N = 588). Across studies the results showed that high levels of resilience were associated with the lowest posttraumatic growth scores. The results imply that although growth and resilience are both salutogenic constructs they are inversely related. The theoretical and clinical implications of these findings are discussed.
Abstract: The Promoting Adult Resilience (PAR) program is a strengths-based resilience building program that integrates Interpersonal and CBT perspectives. The second, successful pilot of the PAR program in the human-service departments of a local government organisation used a 7-week format. At posttest, PAR participants reported greater self-efficacy, more family satisfaction, greater work-life fit and balance and less negative family-work spillover than the comparison group. At the 6-month follow tip, these gains were maintained, although to a lesser degree, with work-life balance being considerably strengthened, and negative spillover in both directions reduced. Participants also reported greater optimism, greater work satisfaction, less stress and promisingly for human service workers, exhaustion was reduced and work vigour was increased. This is important for human service professions as exhaustion, a component of burnout, is associated with higher employee turnover and poorer employee outcomes. Participants reported that they could easily incorporate the new skills into their lives and at follow up, they continued to use the skills to manage the demands of their work and family lives.
Abstract: Four putative mediators underlying gender differences in youths' recovery from bereavement-related internalizing problems were examined in a sample (N = 109; age range = 8-16 years at the initial assessment) of parentally bereaved youth: intrusive thoughts about grief, postdeath stressors, negative appraisals of postdeath stressors, and fear of abandonment. A three-wave parallel process longitudinal growth model design was employed. Changes in internalizing problems and mediators were measured as a function of months since the death. Girls showed stability in depression symptoms and a slight rise in anxiety symptoms; boys' trajectories of symptoms of anxiety and depression declined. Girls' higher initial levels of postdeath stressors, threat appraisals and fear of abandonment mediated their higher level of internalizing problems 14 months later. Girls' higher initial fear of abandonment also mediated additional growth in anxiety relative to boys.
Abstract: The aim of the study was to explore the relationship between stigmatizing rejection experiences and self-related variables. Our hypothesis was that rejection experiences would be negatively associated with perceptions of self-esteem, empowerment and sense of coherence. A cross-sectional study assessing rejection experiences, empowerment, sense of coherence and self-esteem was performed, including 200 persons in current or earlier contact with mental health services. The results showed that experiences of rejection were negatively associated with sense of coherence, empowerment and self-esteem. This exploratory investigation suggests that experiences of rejection might be a target for coping interventions. Mental health nurses are in a key position to identify patients' experiences of stigma and by that to understand what consequences of devaluation/discrimination can have for the afflicted.
Abstract
The concept of 'recovery' has been central to the discussion of the care of people with mental health problems in recent years, in this paper these ideas will be applied to the care of people with dementia in an attempt to focus nursing practice on the notion that it is possible to involve this group of patients in their own decision-making processes. It is acknowledged that this is not always possible without support and advocacy by nurses and other carers who must take on board the need to arrive at solutions to problems or change that are in the person's best interests. The provisions of the Mental Capacity Act in 2005 are key to this discussion, and ways forward are recommended, which include a nursing model for change, in an effort to bring together the concepts addressed in this paper. The conclusion reached is that the recovery approach has some difficulties when applied to people with dementia but it remains an essential aspect of the care process which, together with the provisions of the Mental Capacity Act, could bring about radical improvements to the lives of this group of vulnerable people.
The concept of 'recovery' has been central to the discussion of the care of people with mental health problems in recent years, in this paper these ideas will be applied to the care of people with dementia in an attempt to focus nursing practice on the notion that it is possible to involve this group of patients in their own decision-making processes. It is acknowledged that this is not always possible without support and advocacy by nurses and other carers who must take on board the need to arrive at solutions to problems or change that are in the person's best interests. The provisions of the Mental Capacity Act in 2005 are key to this discussion, and ways forward are recommended, which include a nursing model for change, in an effort to bring together the concepts addressed in this paper. The conclusion reached is that the recovery approach has some difficulties when applied to people with dementia but it remains an essential aspect of the care process which, together with the provisions of the Mental Capacity Act, could bring about radical improvements to the lives of this group of vulnerable people.
Abstract: The present study examines the personal accounts of nine young adults who have parents living with mental illness. Adults' experience of personal loss due to their parents' mental illness and perceptions of their religious faith journey and spiritual struggles are described. Overall, young adults who reported experiencing more personal loss due to their parents' mental illness also reported feeling more confused on their faith journey, and reported experiencing more spiritual struggle relative to participants who reported experiencing less personal loss. Regardless of level of personal loss, all participants identified positive personal attributes that resulted from coping with their parents' illness, including a greater sense of independence, personal strength, and compassion. (C) 2010 Wiley Periodicals, Inc.
Abstract: The task of judging an individual's functional recovery is not an easy one for healthcare professionals. Indeed, increasing one's accuracy in predicting one's ability to self-maintain would be of great value for determining if functional recovery has or is occurring. The purpose of this review is to examine existing measures for assessing remission/normalization of functional status among people with psychosis. Our review evaluates 8 measures of functional ability encompassing self-report, clinical, and performance-based measures. We elected to utilize a grading system to aid readers in understanding the merit of a scale for use in assessing functional recovery. In this approach, a letter grade (A, B, or C) was assigned to each of 4 domains we deemed important to professionals in electing to use specific assessments: (1) Ease of Administration, (2) Reliability, (3) Validity/Relationship to Real-World Outcomes, and (4) Sensitivity to Change/Use in Clinical Trials. Results indicated that no "gold standard" measure has been developed to date, but performance-based measures appear to have the most evidence for predicting concurrent self-maintenance abilities (eg, residing independently or maintaining work). More research on existing measures is needed, and greater funding for developing new measures of functional recovery is strongly recommended.
Abstract: This study investigated the applicability of 3 models of resiliency for the prediction of suicidal ideation from depression (the risk factor) and social support and sense of belonging (the protective factors). A sample of 99 Australian men farmers completed measures of depression, suicidal ideas, social support, and sense of belonging. Sense of belonging compensated for high levels of depression, and social support, sense of belonging, and an increasing number of protective factors each weakened the depression-suicidal ideation relation. The findings are limited because of the small sample and reliance on self-report measures, but suggest that increasing social support and sense of belonging may benefit the mental health of men farmers.
Abstract: Background: Identifying treatments that produce specific benefits in nondrug psychosocial functioning areas such as employment functioning has been illusive. Examination of dimensions of clinical status that moderate such effects may be useful in planning more effective interventions. Objectives: The purpose of this study is to determine if life stress and four dimensions of personality and psychopathology previously found to predict early post-treatment relapse in diverse groups of substance abusers, predict less recovery in employment functioning among 240 cocaine dependent males after completion of residential treatment. Methods: Latent growth curve analysis was used to determine if antisocial, avoidant, dependent, paranoid-delusional personality dimensions, and life event stress predict employment problem severity evident at drug treatment discharge and change in employment problems over three 3-month follow-up intervals. Results: Individuals with higher employment severity at intake and those who spent less time in treatment tended to have greater employment problems at the predischarge. Two covariates were significant predictors of the linear growth component, and the set of covariates explained approximately 18% of the variation in the linear growth rates. Individuals with higher paranoid/delusional scores and lower educational attainment experienced less improvement in their employment status over follow-up. Conclusions: Current findings appear consistent with those of McLellan and colleagues who found that greater psychiatric severity predicts poor response to treatment across multiple psychosocial outcomes including employment status. Clinical Significance: More intensive and long-term psychiatric treatment and vocational-educational rehabilitative services may be required for improvement in employment functioning among those with relatively severe psychopathology.
Abstract: Background: The clinically relevant outcomes in treating depression are persistent recovery, relapse, and treatment resistance.
Method: 175 outpatients treated with antidepressants for 6 months were assessed for major depression. Those who had recovered were prospectively monitored for one year to study rates of relapse (at least two weeks of major depression). Those who were depressed at 6 months were monitored for rates of recovery (at least 8 weeks of no major depression).
Results: 94%, of the sample was monitored for one year. Of the 123 patients who were not depressed at 6 months 57 (46%) relapsed. Patients who relapsed were more likely to have a history of recurrent depression, to have residual depressive symptoms, to have a less sustained response to initial treatment, to have avoidant. personality disorder symptoms, schizotypal personality disorder symptoms, higher harm avoidance (HA) scores and lower self directedness (SD) scores. Of the 38 patients who were depressed at 6 months 13 (34%) recovered. There were no patient characteristics associated with recovery.
Limitations: The findings apply to moderately depressed outpatients. There was no placebo control.
Conclusion: Most patients with depression will recover but many become unwell again within a year. Clinically long term monitoring and sustained efforts to treat patients with major depression seem warranted.
Method: 175 outpatients treated with antidepressants for 6 months were assessed for major depression. Those who had recovered were prospectively monitored for one year to study rates of relapse (at least two weeks of major depression). Those who were depressed at 6 months were monitored for rates of recovery (at least 8 weeks of no major depression).
Results: 94%, of the sample was monitored for one year. Of the 123 patients who were not depressed at 6 months 57 (46%) relapsed. Patients who relapsed were more likely to have a history of recurrent depression, to have residual depressive symptoms, to have a less sustained response to initial treatment, to have avoidant. personality disorder symptoms, schizotypal personality disorder symptoms, higher harm avoidance (HA) scores and lower self directedness (SD) scores. Of the 38 patients who were depressed at 6 months 13 (34%) recovered. There were no patient characteristics associated with recovery.
Limitations: The findings apply to moderately depressed outpatients. There was no placebo control.
Conclusion: Most patients with depression will recover but many become unwell again within a year. Clinically long term monitoring and sustained efforts to treat patients with major depression seem warranted.
Abstract: Taking advantage of two large, population-based, and longitudinal datasets collected after the 1999 floods in Mexico (n = 561) and the September 11, 2001 terrorist attacks in New York (n = 1267), we examined the notion that resilience may be best understood and measured as one member of a set of trajectories that may follow exposure to trauma or severe stress. We hypothesized that resistance, resilience, recovery, relapsing/remitting, delayed dysfunction, and chronic dysfunction trajectories were all possible in the aftermath of major disasters. Semi-parametric group-based modeling yielded the strongest evidence for resistance (no or mild and stable symptoms), resilience (initially moderate or severe symptoms followed by a sharp decrease), recovery (initially moderate or severe symptoms followed by a gradual decrease), and chronic dysfunction (moderate or severe and stable symptoms), as these trajectories were prevalent in both samples. Neither Mexico nor New York showed a relapsing/remitting trajectory, and only New York showed a delayed dysfunction trajectory. Understanding patterns of psychological distress over time may present opportunities for interventions that aim to increase resilience, and decrease more adverse trajectories, after mass traumatic events.
Abstract: The new paradigm of recovery has highlighted the importance of positive social relationships, but little is known about their role in recovery among homeless individuals with serious mental illness and comorbid substance abuse. This study used within- and across-case analyses of longitudinal data from qualitative interviews with 41 dually diagnosed individuals entering residential programs to exit homelessness and receive needed services. Thematic findings include (a) "loner talk" and the need for privacy; (b) family ties as "good news, bad news"; (c) when it comes to a partner, other things come first; and (d) in search of positive people. Analyses of change in individual trajectories revealed that stronger social relationships did not coincide exactly with positive outcomes. Although positive life changes were gradual, negative changes could be precipitous. Social relationships were threatened by concentrated disadvantage, that is, a lack of social and economic currency. Findings are discussed with implications for improving services for the most vulnerable individuals who stand to benefit from the era of recovery.
Abstract: Obtaining funding for qualitative research remains a challenge despite greater openness to methodological pluralism. Such hurdles are presumably compounded when the proposed study employs empowerment theory, rendering it susceptible to charges of elevating ideology over rigor. This article draws on the authors' experience in securing large-scale funding for an empowerment-oriented qualitative study of homeless mentally ill adults. Lessons learned include the importance of weaving empowerment theory into the proposal's "argument," and infusing empowerment values into study protocols while simultaneously paying close attention to rigorous and transparent methods. Additional benefits accrue from having prior relationships with study sites and being willing to revise and resubmit proposals whenever possible. Though representing a fraction of all externally funded projects in the United States, qualitative research has tremendous untapped potential for success in this competitive arena-success that need not entail surrendering a commitment to empowerment values.
Abstract: Although research has demonstrated a strong linkage between meaning of life and positive emotion, few studies have examined this association in the context of acculturation. The purpose of this study was to investigate the predictive effects of meaning of life and acculturative stressor on positive affect in a sample of Chinese international students in Australia and Hong Kong, and to compare these effects between the two groups. Four hundred mainland Chinese postgraduate students at six universities in Hong Kong and 227 Chinese international students at the University of Melbourne in Australia completed a questionnaire that included measures of acculturative stressor, meaning of life, positive affect, and demographic information. The analyses revealed that (1) meaning of life had a strong positive contribution to predict positive affect in acculturation, and acculturative stress had a negative impact on positive affect within both samples; (2) social interaction had a significant negative predictive effect on positive affect in both samples, and academic work served as a significant negative predictor of positive affect in the Hong Kong sample; and (3) meaning of life was found to mediate the relationship between acculturative stress and positive affect in both samples. The theoretical and practical implications of the study are discussed.
Abstract: Purpose The study aim was to evaluate the effects on helplessness and recovery of an empowering program for patients with chronic schizophrenia. Design and Methods A repeated-measure design with a control group was used. The subjects consisted of 46 patients with schizophrenia admitted in three psychiatric hospitals in South Korea. The experimental group (n = 23) received the empowering program twice a week for 60min, with a total of 6 weeks. Findings This finding revealed that the empowering program was effective on helplessness (F = 185.218, p <.001) and recovery (F = 159.402, p <.001, F = 34.154, p <.001) of hospitalized persons with schizophrenia. Practice Implications This study demonstrated that the empowering program can be a useful psychiatric nursing intervention.
Abstract: The ascendance of the recovery movement in mental health care has led to the development and implementation of educational curricula for mental health providers to assist in mental health care system transformation efforts. The Medical College of Georgia (MCG) partnered with the Georgia State Department of Human Resources (DHR) to develop, implement, and evaluate such an educational curriculum for providers within an academic medical institution. This effort, entitled Project GREAT, led to the creation of a curriculum based on the SAMHSA-defined (2006) critical components of recovery. As an initial evaluation of educational curriculum effectiveness, the authors examined effects of the training program on recovery-based knowledge and recovery-consistent attitudes. We also compared MCG provider knowledge and attitudes to those of a similar group of providers at a neighboring medical institution who did not receive the intervention and training. Findings generally supported the effectiveness of the intervention in increasing providers' knowledge of recovery and a shift in recovery-supporting attitudes.
Abstract: Background: A number of studies have examined the prevalence and correlates of posttraumatic stress disorder (PTSD), depression, and related psychiatric conditions in soldiers returning from, Operations Enduring Freedom and Iraqi Freedom (OEF/OIF), but none have examined whether factors such as psychological resilience and social support may protect against these conditions in this population. Methods: A total of 272 predominantly older reserve/National Guard OEF/OIF veterans completed a mail survey assessing traumatic stress and depressive symptoms, resilience, and social support. Results: Resilience scores in the full sample were comparable to those observed in civilian outpatient primary-care patients. Respondents with PTSD, however, scored significantly lower on this measure and on measures of unit support and postdeployment social support. A hierarchical regression analysis in the full sample suggested that resilience (specifically, increased personal control and positive acceptance of change) and postdeployment social support were negatively associated with traumatic stress and depressive symptoms, even after adjusting for demographic characteristics and combat exposure. Conclusions: These results suggest that interventions to bolster psychological resilience and postdeployment social support may help reduce the severity of traumatic stress and depressive symptoms in OEF/OIF veterans.
Abstract: Adverse childhood experiences (ACEs), such as childhood abuse, neglect, and household dysfunction, have been identified as salient risk factors for adult depression. However, not all individuals who experience ACEs go on to develop depression. The extent to which resilience- or the ability to demonstrate stable levels of functioning despite adversity- may act as a buffer against depression among individuals with a history of ACEs has not been adequately examined. To address the associations between ACEs, depression, and resilience, 4006 adult participants were recruited from primary care clinics. Participants completed self-report questionnaires including: the Adverse Childhood Experiences Questionnaire, a retrospective measure of childhood adversity; the Patient Health Questionnaire-9, a measure of the presence and severity of the major symptoms of depression; and the Connor Davidson Resilience Scale, a measure of psychological resilience. Results from regression analyses indicated that, while controlling for a range of demographic variables, both ACEs and resilience independently predicted symptoms of depression, F(9, 3040) = 184.81, R2 = 0.354. Further, resilience moderated the association between ACEs and depression, F(10, 3039) = 174.36, p < 0.001, R2 = 0.365. Specifically, the association between ACEs and depression was stronger among individuals with low resilience relative to those with high resilience. This research provides important information regarding the relationships among ACEs, resilience, and depression. Results have the potential to inform the development of treatments aimed to reduce symptoms of depression among primary care patients with a history of childhood adversity.
Abstract: This study explores the concept of family resilience where a parent has a mental illness. Eleven Australian adults who have grown up in a household with a parent who had a diagnosed mental illness participated in an in-depth interview. The interviews focused on the ways in which these families responded to challenges in everyday life, particularly related to parental mental illness. Families developed resilience through processes such as shared humour or regular family rituals and routines. In some cases, open communication about mental illness enabled families to better cope when parents were unwell and to build a greater sense of family connectedness. However, data suggest that parental mental illness potentially creates stress and confusion for families and there are multiple social and cultural barriers that make it difficult for families to acknowledge and speak openly about mental illness. For participants, resilience tended to be about maintaining a balance between stress/distress and optimism and strength within their family. The article highlights the importance of family context when describing resilience, and identifies specific clinical implications for working with families affected by parental mental illness.
Abstract: Although the strengths perspective seems a natural framework for social workers practicing in mental health, it often plays a minor role in planning and evaluation. Two issues complicate its use: (a) The concept of strengths has different meanings and functions, depending on whether viewed as part of assessment, intervention, or outcome, and (b) the strengths perspective is an applied concept operating only through the medium of a specific intervention, not a modality whose efficacy can be independently evaluated. When these factors are ignored, the role of the strengths perspective can seem vague, peripheral, too obvious and "soff" to be a serious component of the change process-yet, understood in context, it is an essential element of social works unique approach.
Abstract: Stroke can lead to physical, mental and social long-term consequences, with the incidence of stroke increasing with age. However, there is a lack of evidence of how to improve long-term outcomes for people with stroke. Resilience, the ability to ‘bounce back’, flourish or thrive in the face of adversity improves mental health and quality of life in older adults. However, the role of resilience in adjustment after stroke has been little investigated. The purpose of this study is to report on the development and preliminary evaluation of a novel intervention to promote resilience after stroke. We applied the first two phases of the revised UK Medical Research Council (UKMRC) framework for the development and evaluation of complex interventions: intervention development (phase 1) and feasibility testing (phase 2). Methods involved reviewing existing evidence and theory, interviews with 22 older stroke survivors and 5 carers, and focus groups and interviews with 38 professionals to investigate their understandings of resilience and its role in adjustment after stroke. We used stakeholder consultation to co-design the intervention and returned to the literature to develop its theoretical foundations. We developed a 6-week group-based peer support intervention to promote resilience after stroke. Theoretical mechanisms of peer support targeted were social learning, meaning-making, helping others and social comparison. Preliminary evaluation with 11 older stroke survivors in a local community setting found that it was feasible to deliver the intervention, and acceptable to stroke survivors, peer facilitators, and professionals in stroke care and research. This study demonstrates the application of the revised UKMRC framework to systematically develop an empirically and theoretically robust intervention to promote resilience after stroke. A future randomised feasibility study is needed to determine whether a full trial is feasible with a larger sample and wider age range of people with stroke.
Abstract: This article is an attempt to present a framework with specific methods that need to be included in addiction treatment by mental health professionals, besides providing a basis for further discussion to strengthen key processes for resilience, making alcoholic families, especially children, more resourceful in handling crises, and at the same time equipping them to meet future challenges.
Abstract: Personal empowerment is a guiding philosophy of many mental health service programs, but there has been little empirical research on the empowerment Process M, these programs. The authors examine social processes and consumer orientations within. a self-help drop-in center for individuals with psychiatric disabilities, using intensive interviews and focus groups. They investigate motives for consumer involvement, bases for program retention, and processes of Participant change. Motives for involvement in the center were primarily instrumental., whereas the bases Of retention were more, often maintaining social support and developing self-esteem. Participants valued the center's nonstigmalizing environment and its supportive consumer staff. Some used the opportunity to become a staff member to move into a more normalize social role; all seemed to derive benefits from, helping peers. There were indications of some staff members adopting a more authoritarian posture, but participants repeatedly lauded most staff for their supportive orientation. The authors conclude that the "helper/therapy" process was a key to successful empowerment.
Abstract: Objective: Artificial intelligence can provide important support of patient health. However, limits to realized benefits can arise as patients assume an active role in their health decisions. Methods: Distinguishing the concepts of health literacy and patient empowerment, we analyze conditions that bias patient use of the Internet and limit access to and impact of artificial intelligence. Results: Improving health literacy in the face of the Internet requires significant guidance. Patients must be directed toward the appropriate tools and also provided with key background knowledge enabling them to use the tools and capitalize on the artificial intelligence technology. Conclusion: Benefits of tools employing artificial intelligence to promote health cannot be realized without recognizing and addressing the patients' desires, expectations, and limitations that impact their Internet behavior. In order to benefit from artificial intelligence, patients need a substantial level of background knowledge and skill in information use-i.e., health literacy. Practice implications: It is critical that health professionals respond to patient search for information on the Internet, first by guiding their search to relevant, authoritative, and responsive sources, and second by educating patients about how to interpret the information they are likely to encounter. (C) 2013 Elsevier Ireland Ltd:All rights reserved.
Abstract: This first person account describes recovery as discovery of new meanings and opportunities in life. It travels through a journey from illness to wellness, from darkness and despair to light and hope, from futility to fruitfulness, as well as, from a state of death and loss to new life.
Abstract: Objectives: To investigate change in positive emotion over a 3-month Follow-up period and determine whether this change is associated with recovery of functional status in persons with stroke. Design: A longitudinal study using information from the Stroke Recovery in Underserved Patient (SRUP) database. Positive emotion and functional status were assessed within 72 hours of discharge from,in in-patient medical rehabilitation facility and at 3-month follow-up using established measurement instruments. Participants: The study included 840 adults 55 years old or older with a first-time stroke and admitted to one of eleven in-patient medical rehabilitation facilities in the United States. Results: The mean age was 72.9 (SD = 9.52) years. 78.6% were non-Hispanic white and 51.7% were women. The average length of stay was 20.2 (SD = 10.1) days and the most prevalent type of stroke was ischemic (75.0%). Positive emotion increased for 35.6% of the sample. decreased for 29.2%. and 35.2% reported no change. Increases in positive emotion change score compared to no change (b = -3.2, SE = 1.5, p = .032) or a decline (b = -8.9, SE= 1.4,p = .001 ) was significantly associated with improved functional status at the 3-month follow-up after adjusting for sociodemographic and clinical variables as well as depressive symptoms. Conclusion: Positive emotion is a dynamic process and can change over time. In persons with stroke. increases in positive emotion over a 3-month period was significantly associated with an increasing likelihood of recovery of functional status compared to no change or a decline in positive emotion. Understanding factors that influence both increases and decrease,.; in positive emotion has implications for stroke rehabilitation programming and quality of life post-hospital discharge.
Abstract: A substantial literature has documented that sexual abuse relates to suicidal behaviors but relatively less is known about resilience to suicide, especially cognitive deterrents to suicide. The present study investigated the effects of a history of sexual victimization on reasons for living. Female participants (N=138; M age=24.4 years; SD=7.3 years; range=18 to 53 years; 79% Caucasian) completed the Sexual Experiences Survey (SES) and the Reasons for Living (RFL) Inventory. According to SES responses, participants were classified into 5 mutually exclusive groups: no victimization, sexual contact, sexual coercion, attempted rape, and rape. Analyses of variance showed that degree of sexual victimization had a significant effect on the RFL Total scale and 2 subscales (Survival and Coping Beliefs; Moral Objections). The general pattern was that mean RFL scores in the no victimization group were significantly higher than the mean scores in the sexual coercion and rape groups. An implication is that having a history of sexual victimization, especially sexual coercion and rape, limits one's later reasons for not committing suicide. Bolstering these modifiable deterrents to suicide should be part of suicide prevention efforts among at-risk women.
Abstract: Aim:To consider how early intervention in psychosis can support a recovery paradigm.
Methods:Significant numbers of those developing a first episode of psychosis are on a path to a persisting and potentially life long condition. Constituting the schizophrenia spectrum disorders, such conditions demand the particular qualities and attitudes inherent within recovery-based practice.
This paper explores some of these qualities and attitudes by examining the tension between a traditional 'clinical' narrative used by many health providers and a 'human' narrative of users of services and their families.
Results:We draw out key features and constructs of recovery practice as they relate to the EI paradigm. These include: woodshedding, turning points, discontinuous improvement models, therapeutic optimism, gradualism and narratives of story telling. We also highlight the role of family members and other close supporters and believe their potential contribution requires greater consideration.
Conclusions:The early intervention (EI) paradigm can resonate and indeed offer a stronghold for recovery-based practice where traditional mental health services have sometimes struggled. Conversely, failure of caregivers to provide such an approach in the early phase of illness can cause unnecessary and sometimes disastrous consequences.
Methods:Significant numbers of those developing a first episode of psychosis are on a path to a persisting and potentially life long condition. Constituting the schizophrenia spectrum disorders, such conditions demand the particular qualities and attitudes inherent within recovery-based practice.
This paper explores some of these qualities and attitudes by examining the tension between a traditional 'clinical' narrative used by many health providers and a 'human' narrative of users of services and their families.
Results:We draw out key features and constructs of recovery practice as they relate to the EI paradigm. These include: woodshedding, turning points, discontinuous improvement models, therapeutic optimism, gradualism and narratives of story telling. We also highlight the role of family members and other close supporters and believe their potential contribution requires greater consideration.
Conclusions:The early intervention (EI) paradigm can resonate and indeed offer a stronghold for recovery-based practice where traditional mental health services have sometimes struggled. Conversely, failure of caregivers to provide such an approach in the early phase of illness can cause unnecessary and sometimes disastrous consequences.
Abstract: The aim of this longitudinal exploratory study was to identify and follow persons with the first episode of major depression (MD) to determine whether sense of coherence (SOC) changes over time. An additional purpose was to assess whether SOC is associated with depressive symptoms, aggression, and functional status either immediately after diagnosis or at 4 years postdiagnosis. The study design was longitudinal; participants participated in semistructured interviews and completed surveys every 6 months starting at diagnosis and concluding 4 years later. The sample consisted of 33 adult patients who were being treated for the first episode of MD according to the Diagnostic and Statistical Manual of Mental Disorders Twenty-two participants completed all nine sessions. SOC was measured using the SOC scale; depressive symptoms using the Montgomery (3)sberg Depression Rating Scale; aggression, including the total score and subscales of anger and hostility, using the Aggression Questionnaire-revised Swedish version; and functional status using the Global Assessment of Functioning (GAF) scale and the 36-item Short-Form Health Survey (SF-36). At baseline, SOC was significantly correlated with total aggression (r = 45) and the hostility subscale (r = .73); baseline SOC was unrelated to depressive symptoms or functional status. SOC increased significantly over time (P < .0001). At the 4-year follow-up, SOC was significantly related to depressive symptoms (r = .60), the aggression summary score (r = .65), the anger subscale (r = .52), the hostility subscale (r = .77), the GAF (r = .64), and the physical and mental health components of the SF-36 (r =.74 and .72, respectively). The finding that SOC increases as patients recover from MID suggests that treatment of depression may also bolster the patient's ability to cope, in addition to lowering depressive symptoms. The relationship between SOC and aggression in MD, with higher SOC correlated with lower aggression, needs to be examined further.
Abstract: The aim of this study was to estimate the rates of recovery, treatment-seeking, and natural recovery from pathological gambling (PG) in men and women in a community-based national survey, and to examine the role of gambling problem recognition in recovery from PG. Participants were 4,764 individuals from a community-based Australian national twin registry (104 with a lifetime history of PG) who were administered a structured psychiatric telephone interview. Women were more likely than men to recover from (56% versus 36%; odds ratio = 2.3) and to seek treatment for PG (32% versus 13%; odds ratio = 3.2). Most individuals who recovered from PG did so without treatment (82%), but this was higher among men than among women (92% versus 57%; odds ratio = 5.3). This is the first study to document sex differences in treatment-seeking and recovery from PG. These findings highlight the value in continuing to develop self-help and brief treatments for PG that will appeal to those who are unlikely to seek formal help.
Abstract: The National Institute of Drug Abuse has promoted drug abuse research in the past two decades focusing on women and gender differences. One hundred twenty-eight Hispanic and White women have participated in this comparative descriptive study that has examined the differences between chemically dependent (CD) women in recovery and non-chemically dependent (non-CD) women in regard to resilience and self-differentiation-demographic variables associated with resilience and self-differentiation and recovery variables associated with resilience and self-differentiation in the CD women. Findings indicate that the CD women and Hispanic women have scored significantly lower on measures of resilience and self-differentiation. Among the recovery variables, resilience and self-differentiation are significant for children support but community support is not significant. The finding that Hispanic and White women in recovery score lower on resilience and self-differentiation is important for designing treatment strategies supportive of women in recovery.
Abstract: This article describes and presents an initial analysis of variables generally associated with empowerment towards perceived beliefs concerning quality of life work domains for individuals with disabilities. The model examines the domains of importance, satisfaction, control and degree of interference of disability that an individual feels towards work. The internet based study used results from 70 individuals with disabilities in varying aspects of work. The variables composing empowerment that correlated strongly with the work domains include: self-advocacy, self-efficacy, perceived stigma, and family resiliency as measured through coping. Quality of Life concerning work was measured through the DSC-C a domain specific QOL instrument.
Abstract: The aim was to explore the association of self-esteem and resilience with smoking and cannabis use among adolescents, separately for gender. A sample of 3694 adolescents (mean age 14.3 years) from elementary schools in Slovakia filled out the Rosenberg Self-esteem scale, the Resiliency scale and answered questions about cigarette and cannabis use. Logistic regression models showed associations between negative self-esteem and risky behavior, but only among boys. Regarding resilience, structured style and family cohesion were associated with a lower probability of smoking and cannabis use among both boys and girls. In contrast, social competence increased the probability of smoking and cannabis use among both groups. Negative self-esteem seems to play an important role regarding smoking and cannabis use among boys. Resilience seems to have mixed effects, some aspects being protective while other aspects increase the likelihood of smoking and use of cannabis. These results imply that the prevention of substance use should target not only specific individual characteristics, but also the possible risk or protective influences of the social environment, i.e. the family and social network.
Abstract: Aims and objectives.
To describe next of kin empowerment in an intensive care situation.
Background：Next of kin is important in reducing intensive care patients' fear and anxiety. However, admission to an intensive care unit is often recognised as an extremely stressful event, causing next of kin to experience shock, fear, anxiety and vulnerability. More knowledge is needed about how next of kin in intensive care can be empowered.
Design：The study was conducted using a phenomenological method.
Methods：Ten interviews were conducted with intensive care patients' next of kin.
Findings：Perceptions of both a genuine will and a capacity to help and relieve were found to be essential for next of kin's experiences of empowerment in an intensive care situation. All informants were empowered by a caring atmosphere where they received continuous, straightforward and honest information that left room for hope and in which closeness to the patient was facilitated and medical care was perceived as the best possible. Some of the informants were also strengthened by support from other family members and/or by being involved in caring for the patient.
Conclusions：Next of kin empowerment was found to be associated with being met with human warmth and sensitivity. This emphasises the importance of discussing attitudes and behaviours as well as surveillance and treatment when trying to improve the care of next of kin in intensive care unit and when working with staff development.
Relevance to clinical practice：Knowledge of how to empower next of kin in an intensive care situation allows caring staff to support these persons in a more sensitive and appropriate way. Findings underline the importance of creating caring relations with patients' next of kin.
To describe next of kin empowerment in an intensive care situation.
Background：Next of kin is important in reducing intensive care patients' fear and anxiety. However, admission to an intensive care unit is often recognised as an extremely stressful event, causing next of kin to experience shock, fear, anxiety and vulnerability. More knowledge is needed about how next of kin in intensive care can be empowered.
Design：The study was conducted using a phenomenological method.
Methods：Ten interviews were conducted with intensive care patients' next of kin.
Findings：Perceptions of both a genuine will and a capacity to help and relieve were found to be essential for next of kin's experiences of empowerment in an intensive care situation. All informants were empowered by a caring atmosphere where they received continuous, straightforward and honest information that left room for hope and in which closeness to the patient was facilitated and medical care was perceived as the best possible. Some of the informants were also strengthened by support from other family members and/or by being involved in caring for the patient.
Conclusions：Next of kin empowerment was found to be associated with being met with human warmth and sensitivity. This emphasises the importance of discussing attitudes and behaviours as well as surveillance and treatment when trying to improve the care of next of kin in intensive care unit and when working with staff development.
Relevance to clinical practice：Knowledge of how to empower next of kin in an intensive care situation allows caring staff to support these persons in a more sensitive and appropriate way. Findings underline the importance of creating caring relations with patients' next of kin.
Abstract: Purpose of review：The recovery model refers to subjective experiences of optimism, empowerment and interpersonal support, and to a focus on collaborative treatment approaches, finding productive roles for user/consumers, peer support and reducing stigma. The model is influencing service development around the world. This review will assess whether optimism about outcome from serious mental illness and other tenets of the recovery model are borne out by recent research.
Recent findings：Remission of symptoms has been precisely defined, but the definition of 'recovery' is a more diffuse concept that includes such factors as being productive and functioning independently. Recent research and a large, earlier body of data suggest that optimism about outcome from schizophrenia is justified. A substantial proportion of people with the illness will recover completely and many more will regain good social functioning. Outcome is better for people in the developing world. Mortality for people with schizophrenia is increasing but is lower in the developing world. Working appears to help people recover from schizophrenia, and recent advances in vocational rehabilitation have been shown to be effective in countries with differing economies and labor markets. A growing body of research supports the concept that empowerment is an important component of the recovery process.
Summary：Key tenets of the recovery model - optimism about recovery from schizophrenia, the importance of access to employment and the value of empowerment of user/consumers in the recovery process - are supported by the scientific research. Attempts to reduce the internalized stigma of mental illness should enhance the recovery process.
Recent findings：Remission of symptoms has been precisely defined, but the definition of 'recovery' is a more diffuse concept that includes such factors as being productive and functioning independently. Recent research and a large, earlier body of data suggest that optimism about outcome from schizophrenia is justified. A substantial proportion of people with the illness will recover completely and many more will regain good social functioning. Outcome is better for people in the developing world. Mortality for people with schizophrenia is increasing but is lower in the developing world. Working appears to help people recover from schizophrenia, and recent advances in vocational rehabilitation have been shown to be effective in countries with differing economies and labor markets. A growing body of research supports the concept that empowerment is an important component of the recovery process.
Summary：Key tenets of the recovery model - optimism about recovery from schizophrenia, the importance of access to employment and the value of empowerment of user/consumers in the recovery process - are supported by the scientific research. Attempts to reduce the internalized stigma of mental illness should enhance the recovery process.
Abstract: Models of addiction treatment that view the sources and solutions to severe alcohol and other drug (AOD) problems as rooted within the vulnerability and resiliency of each individual stand in marked contrast to models that focus on the ecology of AOD problem development and resolution via complex interactions between individuals, families, and communities. An integration of the latter model into mainstream addiction treatment would necessitate a reconstruction of the treatment-community relationship and new approaches to community resource development and mobilization. Such an integration Would redefine core addiction treatment services and to whom, by whom, when, where, and for how long such services arc delivered. This article draws on historical and contemporary events in the history of addiction treatment and recovery in the United States to illuminate the relationship between recovery and community. Principles and strategies that could guide the development and mobilization of community resources to Support the long-term recovery of individuals and families are identified.
Abstract: In 2004, the federal government made a major commitment to support expanded substance abuse (SA) recovery services by initiating the Access to Recovery (ATR) program. The initial ATR I program awarded grants to 14 states, including Washington State. We evaluated Washington's ATR I program to determine its effect on Medicaid costs for working age disabled clients. We compared per member per month (PMPM) Medicaid costs during 1 year follow-up for clients who received ATR services (N = 1,347) with costs for a matched comparison group of 1,243 clients and used multiple regression techniques to estimate changes in Medicaid costs associated with ATR. ATR was found to be associated with reductions in PMPM Medicaid costs of $66 (p = 11) to $136 (p = .05) depending upon months of Medicaid eligibility. Recovery services aimed at facilitating engagement in SA treatment and aftercare appear to foster modest savings in Medicaid costs for working age disabled clients.
Abstract: This study elucidates the role of pets in recovery processes among adults with serious mental illness. Data derive from interviews with 177 HMO members with serious mental illness (52.2% women, average age 48.8 years) in the Study of Transitions and Recovery Strategies (STARS). Interviews and questionnaires addressed factors affecting recovery processes and included questions about pet ownership. Data were analyzed using a modified grounded theory method to identify the roles pets play in the recovery process. Primary themes indicate pets assist individuals in recovery from serious mental illness by (a) providing empathy and "therapy"; (b) providing connections that can assist in redeveloping social avenues; (c) serving as "family" in the absence of or in addition to human family members; and (d) supporting self-efficacy and strengthening a sense of empowerment. Pets appear to provide more benefits than merely companionship. Participants' reports of pet-related contributions to their well-being provide impetus to conduct more formal research on the mechanisms by which pets contribute to recovery and to develop pet-based interventions.
Abstract: Introduction: Generally agreed outcome criteria in psychosis are required to evaluate the effectiveness of new treatment strategies. The aim of this study is to explore clinical recovery in first-episode patients, defined by meeting criteria for both symptomatic and functional remission. Method: In a sample of first-episode patients (N = 125), symptomatic and functional remission during the last 9 months of a 2-year follow-up period were examined, as well as recovery and its predictors. Results: Half the patients (52.0%) showed symptomatic remission and a quarter (26.4%) functional remission, while one-fifth (19.2%) met both criteria sets and were considered recovered. Recovery was significantly associated with short duration of untreated psychosis and better baseline functioning. Conclusion: Most functionally remitted patients were also symptomatically remitted, while a minority of symptomatically remitted patients were also functionally remitted. Treatment delay may affect chance of recovery.
Abstract: Very little is known about the married life of couples with schizophrenia. In this paper, authors report perceptions and experiences of 5 married couples with schizophrenia on their strategies in forming and maintaining healthy marriage. Our data reveal that participants had realistic expectations of marriage, and recognized benefits as well as obstacles in their marriages with respect to their recovery. This paper examines the importance of extended family members, mental health professionals, and the larger society's attitudes toward marriage as a factor in the recovery process for persons with schizophrenia. The authors identify implications for mental health professionals regarding the respect of client dignity and the applicability of a strengths perspective when working with couples with schizophrenia. The authors argue that mental health professionals' decisions regarding the balance between respecting a client's self-determination and protecting a client from risks associated with cohabitation and marriage should no longer be a dilemma for those working with people with mental illness.