Being there for another with a serious mental illness

"A Lonely Road to Walk Along" - The Experiences of Being a Next of Kin to a Woman in Need of Compulsory Psychiatric Inpatient Care

It is seldom that it is only the patient who is affected when someone is admitted to compulsory psychiatric inpatient care, the next of kin is usually also impacted. The aim was to describe the lived experiences of being a next of kin to a woman in need of compulsory psychiatric inpatient care. Ten next of kin were interviewed and the material was analyzed with a Reflective Lifeworld Research approach. The results show loneliness and feelings that their existence has collapsed. An emotional duality is described in the realization that the care is needed but they are devastated that the woman is there. A trust exists, but it changes when the next of kin are no longer a part of the care process.

Perceived parental depression, intrusive rumination, and internalizing problems: A three-wave longitudinal study in adolescents

Research suggests that perceiving parental depression elicits internalizing problems in adolescents, but certain studies have indicated that adolescents' internalizing problems also increase their perception of parental emotion. To further investigate the inconsistent findings about the nature of this relationship, the current study used longitudinal data to examine the causal association between adolescents' internalizing problems and the parental depression they perceived, as well as the role of intrusive rumination in the relationship. Method: In this longitudinal study, 392 adolescents who experienced the catastrophic Jiuzhaigou earthquake in 2017 were surveyed at three time points after the earthquake: 12 months (T1), 21 months (T2) and 27 months (T3). A cross-lagged panel model was used to carry out the data analysis. Results: Mutual cause-and-effect relationships were found between intrusive rumination and both perceived parental depression and internalizing problems, respectively; a unilateral causal relationship in which internalizing problems positively predicted perceived parental depression was also found. In addition, internalizing problems predicted perceived parental depression via the mediating role of intrusive rumination; similarly, intrusive rumination predicted perceived parental depression via internalizing problems. Conclusions: Internalizing problems were a risk factor for perceived parental depression, and intrusive rumination played an important role in the relationship between internalizing problems and perceived parental depression.

Denying and Accepting a Family Member's Illness: Uncertainty Management as a Process

Doubt is a common, yet challenging form of uncertainty to have about another's illness. Although navigating illness uncertainty is a process of continual (re)appraisal and management, existing research narrowly examines windows of uncertainty experience. To illustrate how uncertainty management in the context of doubt is recursive, nonlinear, and ongoing, we apply a process approach to communication to uncertainty management theory. Drawing on interviews with 33 U.S. adults, our findings explicate a prominently teleological (i.e., goal-driven) process wherein participants' uncertainty management served to accept or deny illness, depending on the extent individuals valued their own and the other's identity and the relationship. Participants generally moved through this process along one of three trajectories: growth, stagnation, or resentment. We also observed dialectical, evolutionary, and life cycle processes in the data. Findings demonstrate the heuristic value of studying uncertainty management as a multiple motor process.

Why Is It Difficult for Social Network Members to Support People Living with Mental Illnesses?: Linking Mental Illness Uncertainty to Support Provision

For people living with mental illness, support from social network members, including family, romantic partners, and friends, is critical but often inadequate. However, robust theoretical explanations for why it might it be difficult to support people living with mental illness are lacking. We assessed an appraisal-based model of uncertainty, hypothesizing that fear and anxiety and supportive communication efficacy mediate the association between mental illness uncertainty and support provision (i.e., quantity and quality). We also predicted that perceptions of others' communication about their mental illness (i.e., ambiguity and volume) would exacerbate feelings of fear and anxiety in relation to uncertainty. Analyses of data gathered from 300 individuals across the United States (Mage = 34.07, SD = 9.49; 50% female) supported our central prediction; uncertainty had a negative direct or indirect effect on all support types and overall support quality, partly through decreases in supportive communication efficacy. Counter to predictions, fear and anxiety positively predicted support quantity for all types. Findings of this study point to a difficult situation for social network members: although uncertainty seems to motivate support provision by activating fear and anxiety, this effect could be undermined for forms of support that require complex communication skills (e.g., emotional, esteem, overall quality) through corresponding decreases in supportive communication efficacy. We discuss the theoretical and practical implications of this research for social support and relationships within the context of mental illness.

Aggressive Children With Mental Illness: A Conceptual Model of Family-Level Outcomes

The purpose of this research was to examine how families adapt and respond to an aggressive child with mental illness. This article presents findings from a qualitative study of four families, which were selected as typifying the experiences of a larger sample of 14 families; each family included a child with mental illness and a history of violent behavior. The analysis revealed a five-stage pattern in how families perceived and responded to victimization and their child or sibling's mental illness. The study suggests that families with a violent child with mental illness and other healthy children cannot live through episodes of violence without removing the child with mental illness from the home or suffering considerable damage to the family. The article concludes with recommendations for mental health practitioners and family intervention specialists.

Parents Caring For Adult Children With Serious Mental Illness

BACKGROUND

Parents often become the caregivers for their adult children with serious mental illness (SMI) due to the chronic and debilitating course of the illness and shortages in funding for community mental health services and residential placements.

OBJECTIVE

To examine parents' management styles when caring for adult children with SMI and parents' perspectives on what type of community-based mental health interventions would support and/or enhance overall family functioning.

DESIGN

A qualitative descriptive study using semistructured interviews with parents caring for adult children with SMI. The study was undergirded by Knafl and Deatrick's Family Management Style Framework.

RESULTS

Four major themes emerged from the data describing prolonged and difficult phases that parents and the family undergo in caring for an adult child with SMI.

CONCLUSIONS

Successful management of these phases must include increasing access to mental health information, mental health screening, early interventions, and violence prevention for adult children and their families.

Psychophenomenology of the postpsychotic adjustment process

A clinical phenomenological study with nine adults with schizophrenia explored the postpsychotic adjustment stage of recovery from a psychotic episode to map a psychological recovery trajectory. Participants (ages 21-37 years) were actively involved in an early psychosis outpatient treatment program. Psychophenomenological analysis of interview data resulted in 458 descriptive expressions reflecting four structural elements. Cognitive dissonance involved achieving pharmacological efficacy and cognitive efforts to "sort out" the experience. Insight was distinguished by mastery of autonomous performance of reality checks. Cognitive constancy was marked by resuming interpersonal relationships and age-appropriate activities. Ordinariness involved consistent engagement in daily activities reflective of prepsychosis functioning.

Choosing "the best of the hells": mothers face housing dilemmas for their adult children with mental illness and a history of violence

Family members in the United States--especially mothers--are frequently caregivers, and provide housing for their adult relatives and children with mental illness. They often do so with little support from the mental health system. The purpose of this analysis was to explore mothers' experiences related to housing options available to their adult children with a mental illness and a history of violence (MIHV) toward the mothers. The results of this study reveal a complex mixing of desires, feelings, internal factors, and external forces experienced by mothers of adult children with MIHV when considering whether or not these children can live in their homes. The findings from this study illuminate needs for greater familial involvement in mental health treatment decisions, respite for caregiving families, and housing as a crucial element of a comprehensive mental health treatment plan.

Emerging adulthood and the perception of parental depression

Few studies have examined children's perceptions of parental depression. This study was a qualitative analysis of the changes in the perception of parental depression between the ages of 17 and 19 years. Archived interview narratives of 16 respondents from a longitudinal, preventive intervention study of depression in families were analyzed. The respondents were purposefully selected to represent both genders as well as higher and lower levels of family adversity. The perceptions of parental depression were found to fall into three categories: self-oriented perspectives (resistance and negativity), ambivalent perspectives, and, other-oriented perspectives (acceptance and compassion). Over time, respondents from the high-adversity families showed shifts from self-orientation to other-orientation, whereas the perspectives of respondents from low-adversity families remained unchanged. Some respondents with depression in both parents and/or siblings revealed changes in perception toward one parent but no change toward other family members with depression.