Outcome of a controlled trial of the effectiveness of intensive case management for chronic public inebriates

OBJECTIVE

The objective of this study was to test whether an intensive case management intervention would be effective with a group of homeless chronic public inebriate clients. The primary goals of the case management were to improve the financial and residential stability of the clients and to reduce their use of alcohol.

METHOD

Subjects (N = 298, 81% male) were interviewed at baseline, randomly assigned to treatment and control conditions and given follow-up interviews at 6-month intervals for 2 years. Case management services were provided for the duration of the project. Follow-up rates for the first three interviews averaged 82%.

RESULTS

Repeated measures MANCOVAs showed significant group differences favoring the case-managed group in all three areas targeted by the intervention: total income from public sources, nights spent in "own place" out of the previous 60 nights and days drinking out of the previous 30 days. The results held whether the three variables were analyzed jointly or separately and for alternative measures of drinking and homelessness. Although statistically significant, the group differences are generally not large.

CONCLUSIONS

The results indicate that case management had a beneficial effect on the clients receiving it. This effect may have been the result of an increase in services received by the case-managed clients.

The folk psychiatry model: Developing a measure of lay perceptions of PTSD

Whereas existing data verify the importance of support networks in facilitating resilience following trauma, the sociocultural perceptions of posttrauma difficulties that provide context for these interactions remain largely unexplored. Folk psychiatry models propose that lay explanations of mental illness can be quantified along distinct moralizing, medicalizing, and psychologizing dimensions. The current project aimed to develop a trauma-specific measure capturing lay explanations of posttraumatic stress disorder (PTSD) based on this framework. Data were collected from three samples of Mechanical Turk respondents (N₁ = 367; N₂ = 365; N₃ = 401) as well as an independent sample of university students (N₄ = 311). Factor analysis of the final, 13-item Folk Psychiatry Measure-PTSD (FPM-P) indicated close fit of a correlated three-factor model in MTurk and student respondents. Across samples, moralizing beliefs about PTSD (e.g., people with PTSD lack a moral compass) evidenced moderate-to-strong correlations with general attitudes toward those with mental illness, including positive associations with authoritarianism, social restrictiveness, blame, anger, and perceived dangerousness. Negative associations with benevolence and support for community-based care were also noted. Medicalizing beliefs (e.g., PTSD is caused by a chemical imbalance) demonstrated more modest associations with negative attitudes, as noted through weak correlations with increased authoritarianism, anger, and lower benevolence toward those experiencing psychological difficulties. Finally, psychologizing explanations (e.g., people with poor relationships and low social support are at greater risk of developing PTSD) evidenced weak but positive associations with benevolence and pity for those with mental health concerns. Implications and cultural-based nuances of the scale are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Public beliefs about trauma and its consequences: Profiles and correlates of stigma

Public stereotypes about trauma exposure and its likely consequences have the potential to influence levels of support extended to survivors in the larger community. The current project sought to examine unique profiles of stereotype endorsement both within and across participants sampled from distinct populations. Trauma-related stereotypes involving symptom course, dangerousness, employability, social functioning, predictability, character, and treatment need were examined in undergraduate (N ₁ = 404; N ₂ = 502) and MTurk (N ₃ = 364) samples. Sympathizing [low overall endorsement], Fearful [high overall endorsement], Pejorative [high endorsement + moralizing beliefs], Safety-Focused [intermediate endorsement + dangerousness], and Performance-Focused [intermediate endorsement + employability] groups were replicated in latent profile models across all samples. Stereotype profiles demonstrated hypothesized associations with general perspectives of mental illness although support for consistent relations with respondent characteristics (e.g., sex; personal exposure to trauma; reported exposure in friends/family) was limited. Data suggest that trauma stereotypes are endorsed at high frequencies in the general community and conform to systematic patterns of prejudice that may be overlooked in more global assessments of stigma.