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Hejl JL, Hulgaard DR, Rasmussen ASD, Larsen LEN, Rask CU. Linking heart and mind - lived experiences of parents to children with congenital heart disease and mental health issues. Clin Child Psychol Psychiatry 2024:13591045241267129. [PMID: 39041634 DOI: 10.1177/13591045241267129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
Children with congenital heart disease are more likely to receive special educational services in schools and have an increased risk of mental health issues. We explored the lived experiences of parents caring for a child with heart disease and concurrent mental health issues in Denmark. Semi-structured interviews with ten parents (age 39-57 years) to these children (age 5-17 years) were analysed using interpretative phenomenological analysis. Three Group Experiential Themes (GETs) were generated from the analysis: The first GET, Parental roles and caring behaviours, described parental struggles of fulfilling their parenting role ideals and experiences with stigmatization of MHI. GET two, Parental reflections on their illness explanations, portrayed how parents utilize different illness explanations to make sense of their child's MHI. GET three, Differences in access to help and support, captured how the CHD affected overall access to mental health support. The results may inform various topics of importance for health professionals to address in their clinical encounters with these families.
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Affiliation(s)
- Julie L Hejl
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ditte R Hulgaard
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Regional Health Research, University of Southern Denmark, Aabenraa, Denmark
| | - Anne Sofie D Rasmussen
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Lærke Emilie N Larsen
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Charlotte U Rask
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Girod R, Thompson P, Davis C. Genetic counseling students' and recent graduates' attitudes toward psychiatric illness. J Genet Couns 2021; 31:713-721. [PMID: 34846769 DOI: 10.1002/jgc4.1538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 11/07/2021] [Accepted: 11/11/2021] [Indexed: 11/08/2022]
Abstract
Due to the high prevalence of mental illness in the general population, genetic counselors are likely to encounter patients with mental illness in practice, regardless of specialty. However, previous studies have shown that recent graduates of genetic counseling programs do not feel comfortable discussing mental illness in clinical encounters. One possible explanation for this discomfort is stigma toward mental illness, a well-documented phenomenon both in society and in the healthcare field. Previous studies of this phenomenon in genetic counselors and trainees have relied on self-report measures and are vulnerable to social desirability bias. We sought to gain a holistic understanding of attitudes toward mental illness held by genetic counseling trainees by measuring implicit and explicit biases. This study assessed 141 responses from genetic counseling students and recent graduates from master's graduate programs across North America. They were asked to complete a survey, which included a demographic questionnaire, a scale that has been validated for use for a variety of healthcare professionals (Nordt et al. 2006, Schizophrenia Bulletin, 32, 709), measuring explicit attitudes toward those with depression and schizophrenia (i.e., social distance and stereotype endorsement), and an implicit association test. Mean scores on the social distance and stereotype endorsement scales were higher for schizophrenia than depression, indicating higher levels of explicit bias toward the former than the latter. Participants held slightly significant implicit bias toward individuals with either physical or mental illness. These data suggest that unconscious or implicit bias may not contribute to unpreparedness to address psychiatric disorders in clinical practice that has been previously reported by new graduates. Therefore, genetic counseling trainees may be receptive to clinically relevant education pertaining to mental illness. These results could inform the curriculum of genetic counseling programs and facilitate provision of services to this population.
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Affiliation(s)
- Rebecca Girod
- Sarah Lawrence College, Human Genetics Program, Bronxville, New York, USA
| | - Patricia Thompson
- Sarah Lawrence College, Human Genetics Program, Bronxville, New York, USA
| | - Claire Davis
- Sarah Lawrence College, Human Genetics Program, Bronxville, New York, USA
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Hasson-Ohayon I, Goldzweig G, Lavi-Rotenberg A, Roe D, Pijnenborg GHM. Illness representations among parents of children and adults with serious mental disorders: A systematic review and theoretical model. Eur Psychiatry 2019; 58:27-37. [PMID: 30769239 DOI: 10.1016/j.eurpsy.2019.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/04/2019] [Accepted: 02/06/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Cognitive representations of an illness have an important impact on psychological outcomes. The current systematic review explored 1) the characteristics of illness representations held by parents of children and adults with serious mental illness (SMI), and 2) the associations of these representations with both parents' and patients' psychological outcomes. METHOD PSYINFO and PUBMED were screened for eligible studies published between January 2000 and August 2018. Selection was based on PRISMA guidelines. Reference lists of these papers were checked for additional references. Two independent coders extracted all relevant data. RESULTS The search resulted in 31 relevant studies, which were divided, by type of methodology, into three sections: quantitative, qualitative, and mixed quantitative-qualitative. In each section, findings were divided in accordance with the two research questions. CONCLUSION Parents struggle to make meaning of their child's illness, often holding stigmatizing ideas about the illness and blaming themselves for its existence. More longitudinal studies that include both of the child's parents, as well as interventional studies, are needed to expand our knowledge of ways to help parents construct more beneficial representations of their children's illnesses.
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Affiliation(s)
| | - Gil Goldzweig
- School of Behavioral Sciences, The Academic College of Tel-Aviv Yaffo, Israel
| | | | - David Roe
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel; Department of Clinical Medicine, Psychiatry, Aalborg University, Denmark
| | - Gerdina Hendrika Maria Pijnenborg
- GGZ Drenthe Mental Health Institute, Department of Psychotic Disorders, Assen, the Netherlands; Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
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Ratheesh A, Cotton SM, Davey CG, Adams S, Bechdolf A, Macneil C, Berk M, McGorry PD. Ethical considerations in preventive interventions for bipolar disorder. Early Interv Psychiatry 2017; 11:104-112. [PMID: 27027848 DOI: 10.1111/eip.12340] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 01/17/2016] [Accepted: 02/18/2016] [Indexed: 11/28/2022]
Abstract
AIM Early intervention and prevention of serious mental disorders such as bipolar disorder has the promise of decreasing the burden associated with these disorders. With increasing early and preventive intervention efforts among cohorts such as those with a familial risk for bipolar disorder, there is a need to examine the associated ethical concerns. The aim of this review was to examine the ethical issues underpinning the clinical research on pre-onset identification and preventive interventions for bipolar disorder. METHODS We undertook a PubMed search updated to November 2014 incorporating search terms such as bipolar, mania, hypomania, ethic*(truncated), early intervention, prevention, genetic and family. RESULTS Fifty-six articles that were identified by this method as well as other relevant articles were examined within a framework of ethical principles including beneficence, non-maleficence, respect for autonomy and justice. The primary risks associated with research and clinical interventions include stigma and labelling, especially among familial high-risk youth. Side effects from interventions are another concern. The benefits of preventive or early interventions were in the amelioration of symptoms as well as the possibility of minimizing disability, cognitive impairment and progression of the illness. Supporting the autonomy of individuals and improving access to stigma-free care may help moderate the potential challenges associated with the risks of interventions. CONCLUSIONS Concerns about the risks of early identification and pre-onset interventions should be balanced against the potential benefits, the individuals' right to choice and by improving availability of services that balance such dilemmas.
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Affiliation(s)
- Aswin Ratheesh
- Orygen, The National Centre for Excellence in Youth Mental Health, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Susan M Cotton
- Orygen, The National Centre for Excellence in Youth Mental Health, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Christopher G Davey
- Orygen, The National Centre for Excellence in Youth Mental Health, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Sophie Adams
- Orygen, The National Centre for Excellence in Youth Mental Health, Parkville, Victoria, Australia
| | - Andreas Bechdolf
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.,Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Hospital am Urban and Vivantes Hospital im Friedrichshain, Charite Universitätsmedizin, Berlin, Germany
| | - Craig Macneil
- Orygen, The National Centre for Excellence in Youth Mental Health, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Michael Berk
- Orygen, The National Centre for Excellence in Youth Mental Health, Parkville, Victoria, Australia.,Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia.,Department of Psychiatry, Deakin University, Geelong, Victoria, Australia.,IMPACT Strategic Research Centre, Geelong, Victoria, Australia
| | - Patrick D McGorry
- Orygen, The National Centre for Excellence in Youth Mental Health, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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Abstract
We provide the first detailed analysis of how, for what purposes and with what consequences people related to someone with a diagnosis of schizophrenia use ‘gene talk'. The article analyses findings from a qualitative interview study conducted in London and involving 19 participants (mostly women). We transcribed the interviews verbatim and analysed them using grounded theory methods. We analyse how and for what purposes participants mobilized ‘gene talk' in their affectively freighted encounter with an unknown interviewer. Gene talk served to (re)position blame and guilt, and was simultaneously used imaginatively to forge family history narratives. Family members used ‘gene talk' to recruit forebears with no psychiatric diagnosis into a family history of mental illness, and presented the origins of the diagnosed family member's schizophrenia as lying temporally before, and hence beyond the agency of the immediate family. Gene talk was also used in attempts to dislodge the distressing figure of the schizophrenia-inducing mother. ‘Gene talk', however, ultimately displaced, rather than resolved, the (self-)blame of many family members, particularly mothers. Our article challenges the commonly expressed view that genetic accounts will absolve family members' sense of (self-)blame in relation to their relative's/relatives' diagnosis.
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