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Bromley E, Kennedy D, Miranda J, Sherbourne CD, Wells KB. The Fracture of Relational Space in Depression: Predicaments in Primary Care Help Seeking. CURRENT ANTHROPOLOGY 2016; 57:610-631. [PMID: 27990025 PMCID: PMC5155333 DOI: 10.1086/688506] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Primary care clinicians treat the majority of cases of depression in the United States. The primary care clinic is also a site for enactment of a disease-oriented concept of depression that locates disorder within an individual body. Drawing on theories of the self and stigma, this article highlights problematics of primary care depression treatment by examining the lived experience of depression. The data come from individuals who screened positive for depressive symptoms in primary care settings and were followed over ten years. After iterative mixed-methodological exploration of a large dataset, we analyzed interviews from a purposive sample of 46 individuals using grounded and phenomenological approaches. We describe two major results. First, we note that depression is experienced as located within and inextricable from relational space and that the self is experienced as relational, rather than autonomous, in depression. Second, we describe the ways in which the experience of depression contradicts a disease-oriented concept such that help-seeking intensifies rather than alleviates the relational problem of depression. We conclude by highlighting that an understanding of illness experience may be essential to improving primary care depression treatment and by questioning the bracketing of relational concerns in depression within the construct of stigma.
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Affiliation(s)
- Elizabeth Bromley
- Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA USA. Mailing address: 10920 Wilshire Blvd, Suite 300, Los Angeles, CA 90024; West Los Angeles VA Healthcare Center, Desert Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Los Angeles, CA USA. Mailing address: 11301 Wilshire Blvd, Los Angeles CA 90073
| | - David Kennedy
- RAND Corporation, Santa Monica, CA. Mailing address: 1776 Main Street, Santa Monica, CA 90407
| | - Jeanne Miranda
- Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA USA. Mailing address: 10920 Wilshire Blvd, Suite 300, Los Angeles, CA 90024
| | - Cathy Donald Sherbourne
- RAND Corporation, Santa Monica, CA. Mailing address: 1776 Main Street, Santa Monica, CA 90407
| | - Kenneth B Wells
- Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA USA. Mailing address: 10920 Wilshire Blvd, Suite 300, Los Angeles, CA 90024
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The Role of Self-Care for Parents in Recovery From Substance Use Disorders: An Integrative Review of Parental Self-Care. J Addict Nurs 2016; 27:180-9. [PMID: 27580191 DOI: 10.1097/jan.0000000000000133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Lack of stress modifiers, such as self-care behaviors (SCBs), can increase vulnerability to drug use for parents in recovery from substance use disorders (SUDs). PURPOSE The purpose of this integrative review was to determine how the existing literature describes, conceptualizes, and measures SCB for parents in the general population for its application to parents with a history of SUD. METHODS Framed by Bandura's Social Cognitive Theory of Substance Abuse, four qualitative and five quantitative studies identify SCB, although only one study describes SCB of parents in recovery. RESULTS Few studies addressed parental SCB, and most of those studies focused on behaviors for new mothers with or without SUDs during the early child years. CONCLUSIONS Exploring the role of SCB in relation to parental well-being for the general population is a needed area for further research, even more so for parents who are recovering from SUDs.
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Bussing R, Mason D, Garvan CW, Gurnani T, Koro-Ljungberg M, Noguchi K, Albarracin D. Willingness to use ADHD Self-Management: Mixed Methods Study of Perceptions by Adolescents and Parents. JOURNAL OF CHILD AND FAMILY STUDIES 2016; 25:562-573. [PMID: 26834448 PMCID: PMC4728136 DOI: 10.1007/s10826-015-0241-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Little is known about perceptions surrounding self-management for attention deficit hyperactivity disorder (ADHD), although such interventions appear commonly used and are considered essential components of the chronic care model. Our research is part of a mixed methods study that followed students at high and low risk for ADHD over 11 years. During the final study years, area-representative samples of 148 adolescents (54.8% participation; 97 ADHD high-risk group; 51 low-risk peers) and 161 parents (59.4% participation; 108 parents of high-risk adolescent; 53 parents of low-risk peer) completed a cross-sectional survey on community-identified self-management interventions for ADHD (activity outlets, sleep regulation, dietary restriction, homework help, family rules, and prayer). Respondents also answered open-ended questions addressing undesirable self-management effects, which were analyzed using grounded theory methods. High-risk adolescents expressed significantly lower willingness towards all self-management interventions than did adult respondents, except for increased activity outlets. They also reported lower receptivity towards sleep regulation and dietary restriction than did their low-risk peer group. No gender or race differences in self-management willingness were found, except for higher receptivity to prayer in African American respondents. Cost, perceived ineffectiveness, disruptions to routines, causation of interpersonal conflicts, and reduced future self-reliance were seen as potential undesirable effects. Findings suggest that activity-based ADHD interventions appear particularly acceptable across all demographic and risk groups, unlike sleep regulation and dietary approaches. Further research on self-care effectiveness is needed to incorporate adolescents' viewpoints about ADHD self-management, as interventions may be acceptable to adults, but resisted by adolescents.
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Affiliation(s)
- Regina Bussing
- Department of Psychiatry, University of Florida, Gainesville, FL
| | - Dana Mason
- Department of Psychiatry, University of Florida, Gainesville, FL
| | - Cynthia Wilson Garvan
- Department of Health Care Environments and Systems, University of Florida, Gainesville, FL
| | - Tina Gurnani
- Child & Adolescent Psychiatry, Department of Psychiatry, Mount Sinai St. Luke's, New York, NY
| | | | - Kenji Noguchi
- Department of Psychology, University of Southern Mississippi Gulf Coast, Long Beach, MS
| | - Dolores Albarracin
- Deparment of Psychology, Liberal Arts and Sciences, and Department of Business Administration, College of Business, University of Illinois, Champaign, IL
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Benevides TW, Carretta HJ, Mandell DS. Differences in Perceived Need for Medical, Therapeutic, and Family Support Services Among Children With ASD. Pediatrics 2016; 137 Suppl 2:S176-85. [PMID: 26908473 DOI: 10.1542/peds.2015-2851p] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Identifying racial and ethnic differences in perceived need for treatment among families of children with autism spectrum disorder (ASD) will improve understanding of disparities in care seeking. We described racial and ethnic differences in perceived need for services that children with ASD and their families frequently use. METHODS We conducted bivariate analyses of racial and ethnic categories and perceived need for 6 common services used by children with ASD as found in the 2005 to 2006 (n = 2123) and the 2009 to 2010 (n = 3055) National Survey of Children With Special Health Care Needs data sets. Multivariate logistic regressions within concatenated data sets were conducted to examine associations between racial and ethnic category and perceived service needs while controlling for predisposing, enabling, and child factors. RESULTS Compared with caregivers of white non-Hispanic children with ASD, caregivers of Hispanic children reported less need for prescription medications in adjusted multivariate analyses. Caregivers of black non-Hispanic children with ASD reported less need for prescription medications and for child and family mental health services than caregivers of white non-Hispanic children. Both English-speaking Hispanic caregivers and black non-Hispanic caregivers reported greater need for occupational, speech, and physical therapy than white non-Hispanic caregivers. No racial or ethnic differences were found in perceived need for specialty medical care or respite care. CONCLUSIONS Caregivers of children with ASD from different racial and ethnic backgrounds may differentially perceive need for different types of care. Their perceptions may in turn affect how they prioritize and seek care, independent of their child's specific needs.
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Affiliation(s)
- Teal W Benevides
- Department of Occupational Therapy, College of Health Professions, Thomas Jefferson University, Philadelphia, Pennsylvania;
| | - Henry J Carretta
- Florida State University, Department of Family Medicine & Rural Health Division of Health Affairs, College of Medicine, Tallahassee, Florida; and
| | - David S Mandell
- Center for Mental Health Policy and Services Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Linguistic analysis of the Preschool Five Minute Speech Sample: what the parents of preschool children with early signs of ADHD say and how they say it? PLoS One 2014; 9:e106231. [PMID: 25184287 PMCID: PMC4153579 DOI: 10.1371/journal.pone.0106231] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 07/31/2014] [Indexed: 11/19/2022] Open
Abstract
A linguistic analysis was performed on the Preschool Five Minute Speech Sample (PFMSS) of 42 parents. PFMSS is a validated measure for Expressed Emotion (EE) to assess parent-child relationship. Half of these parents (n = 21, clinical group) had preschool children with early symptoms of attention deficit hyperactivity disorder (ADHD), the rest had typically developing children. Early symptoms of ADHD were identified with the Werry-Weiss Peters Rating Scale. The linguistic component of the PFMSS was analysed with keyword and linguistic pattern identification. The results of these two complementary analyses (i.e., EE and linguistic analysis) provided relevant recommendations that may improve the efficacy of psychological treatment for ADHD such as parenting interventions. We discuss the practical implications of these findings.
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Solem MB, Christophersen KA, Martinussen M. Predicting parenting stress: children's behavioural problems and parents' coping. INFANT AND CHILD DEVELOPMENT 2011. [DOI: 10.1002/icd.681] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Garro LC, Yarris KE. "A massive long way": interconnecting histories, a "special child," ADHD, and everyday family life. Cult Med Psychiatry 2009; 33:559-607. [PMID: 19787444 PMCID: PMC2759016 DOI: 10.1007/s11013-009-9155-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Focusing on one family from a study of dual-earner middle-class families carried out in Los Angeles, California, this article draws on interview and video-recorded data of everyday interactions to explore illness and healing as embedded in the microcultural context of the Morris family. For this family, an important aspect of what is at stake for them in their daily lives is best understood by focusing on 9-year-old Mark, who has been diagnosed with attention-deficit/hyperactivity disorder (ADHD). In this article, we grapple with the complexity of conveying some sense of how Mark's condition is experienced and relationally enacted in everyday contexts. Through illuminating connections between lives as lived and lives as told, we explore the narrative structuring of healing in relation to Mark's local moral world with the family at its center. We examine how his parents understand the moral consequences of the child's past for his present and future, and work to encourage others to give due weight to his troubled beginnings before this child joined the Morris family. At the same time, we see how the Morris parents act to structure Mark's moral experience and orient to a desired future in which Mark's "success" includes an appreciation of how he is accountable to others for his actions. Through our analyses, we also seek to contribute to discussions on what is at stake in everyday life contexts for children with ADHD and their families, through illuminating aspects of the cultural, moral and relational terrain that U.S. families navigate in contending with a child's diagnosis of ADHD. Further, given that ADHD is often construed as a "disorder of volition," we seek to advance anthropological theorizing about the will in situations where volitional control over behavior is seen to be disordered.
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Affiliation(s)
- Linda C Garro
- Department of Anthropology, University of California, Los Angeles, 90095, USA.
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Lin MJ, Huang XY, Hung BJ. The experiences of primary caregivers raising school-aged children with attention-deficit hyperactivity disorder. J Clin Nurs 2009; 18:1693-702. [DOI: 10.1111/j.1365-2702.2008.02604.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Williamson P, Koro-Ljungberg M, Bussing R. Analysis of critical incidents and shifting perspectives: transitions in illness careers among adolescents with ADHD. QUALITATIVE HEALTH RESEARCH 2009; 19:352-365. [PMID: 19224878 PMCID: PMC3623297 DOI: 10.1177/1049732308329683] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Adolescence represents a developmental period during which the severity of mental health problems for children with attention deficit/hyperactivity disorder (ADHD) might change. It is a time when teens are consolidating their self-identity and possibly questioning the label of an ADHD diagnosis, treatment, and types of interventions. In this study we investigated the shared critical events related to help seeking reported by 8 teenagers with ADHD, their mothers, and their teachers and how the reported events and constructed shared focus on specific problems might explain teenagers' transitions in their illness careers. Data collected through a qualitative application of the experience sampling method illuminated diverse illness career transitions, including continuing treatment, transitioning from being treated to untreated or from being untreated to treated, and remaining untreated. Our findings support a model of shifting perspectives on illness and wellness among adolescents with ADHD, rather than a progression of adaptation to a chronic disorder.
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Affiliation(s)
- Pamela Williamson
- University of Cincinnati, Cincinnati, Ohio, USA, Edwards Center (One), 45-51 Corry Boulevard, Room 4150H, Cincinnati, OH 45221, 513.556.9137, 513.556.1581 fax, ML-0022
| | - Mirka Koro-Ljungberg
- University of Florida, Gainesville, Florida, USA, 1414 Norman Hall PO BOX 117047, Gainesville, FL 32611
| | - Regina Bussing
- University of Florida, Gainesville, Florida, USA, 1600 SW Archer Rd, Rm HD-G-003, PO BOX 100157, Gainesville, FL 32610-0157
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Enhancing chronic disease management: a review of key issues and strategies. Complement Ther Clin Pract 2007; 13:232-9. [PMID: 17950178 DOI: 10.1016/j.ctcp.2007.06.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2007] [Revised: 04/20/2007] [Accepted: 06/10/2007] [Indexed: 11/21/2022]
Abstract
This paper highlights three selected issues and potential strategies towards meeting chronic disease management needs. First, the orientation of the biomedical science model often gives insufficient attention to chronic health care needs. A second issue is that the use of complementary and alternative medicine (CAM) may offer for some an opportunity to enhance their chronic disease management efforts. A third issue is that our understanding of this potential is limited, as many who use CAM do not disclose such use. With reference to proposed solutions/strategies, first, an improved focus to respect patient/client values and goals may encourage people to disclose their use of CAM. Second, a community-based participatory approach shows promise in enhancing communication plus helps integrate CAM within new models of chronic disease management. Lastly, those in public health could help facilitate such an approach plus be a monitor of CAM practices. Overall, this review provides a springboard for further research and practice in CAM and the management of chronic diseases.
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