Psychiatric Rehabilitation Journal最新文献

Objective: Stigma and self-stigma reduce self-esteem and increase hopelessness and suicidality. While psychotic disorders are widely recognized as the most stigmatizing of all mental health disorders, there is a dearth of research investigating how stigma and self-stigma are experienced by young people at ultra-high risk (UHR) for psychosis. These experiences warrant investigation given the unique position of this population, as while they do not have a psychotic disorder, they may be exposed to stigma by virtue of the UHR label and/or symptoms.

Methods: Twelve young people at UHR aged 14-25 years were recruited to participate in either an individual interview or focus group. Transcripts were analyzed using reflexive thematic analysis.

Results: Five themes were developed including: (1) being at UHR is an inherently difficult, uncertain experience; (2) stigma is pervasive; (3) stigma becomes internalized; (4) stigma and self-stigma are painful; and (5) defending against stigma (containing three subthemes of (a) hiding one's UHR status; (b) rebutting stigma; and (c) educating self and others). Results indicated that young people at UHR for psychosis experience pervasive stigma that leads them to seek ways to protect themselves and their loved ones from stigma.

Conclusions and implications for practice: Our findings affirm exposure to stigma and self-stigma in particular compound the distress experienced by young people at UHR for psychosis. The themes found in this research give further impetus to the need to develop effective interventions to reduce stigma within, and toward, young people at UHR for psychosis. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: We examined the feasibility and clinical outcomes of implementing a brief intervention for treating posttraumatic stress disorder (PTSD) in persons with serious mental illness receiving services at a large, urban community mental health agency. The Brief, Relaxation, Education and Trauma Healing (BREATHE) program is a standardized, three-session intervention that targets PTSD symptoms through teaching breathing retraining and personalized psychoeducation about trauma and PTSD.

Method: A total of 60 clinicians were trained in the BREATHE intervention throughout the agency, which was offered to 233 clients who screened positive for probable PTSD. Self-report assessments of PTSD and depressive symptom severity were obtained before the first session, after the third session, and at a 3-month follow-up. Participant satisfaction was assessed in a brief survey.

Results: Of the 233 clients offered the BREATHE program, 211 (91%) accepted and attended at least one session. Most participants attended all three BREATHE sessions (59%) or two sessions (32%), with completers reporting high levels of satisfaction with the program. Participants showed clinically significant improvements in PTSD and depression symptoms from pretreatment to posttreatment and the 3-month follow-up.

Conclusions and implications for practice: This brief intervention for PTSD was feasible to implement in a large agency serving a diverse population of persons with serious mental illness, showed high client acceptability in terms of participation and satisfaction, and was associated with significant reductions in PTSD and depressive symptoms. Further research is needed to evaluate the impact of the BREATHE program for treating PTSD in this population. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Substance use disorders are prevalent in Veterans and associated with a wide range of deleterious effects. Helping Veterans with substance use disorders identify and engage in meaningful and constructive goal-directed activities may be key to promoting recovery. Work, particularly, has been identified as beneficial. Despite the effects of therapeutic work activities, we still do not have a good understanding of who is enrolling in these services.

Methods: This study provides an in-depth descriptive look at psychiatric diagnoses, internal factors, disability level, and demographic characteristics of Veterans (N = 78) early in the course of recovery from substance use disorder who expressed an interest in engaging in work services as part of their recovery.

Results: Compared to normative scores, our sample exhibited deficits in multiple areas of functioning, including global disability, physical health, social relationships, physical safety, self-esteem, and substance use. Of the 78 Veterans, 17 (22%) chose competitive employment, and 61 (78%) chose therapeutic work activity. Compared to Veterans who chose competitive employment, Veterans in the therapeutic work activity branch reported higher rates of medical disabilities that impair the ability to work, were more likely to be retired from employment, had more previous treatment program participation, and had longer periods of abstinence from alcohol.

Conclusions and implications for practice: These findings, though descriptive and preliminary, help us better understand Veterans who are interested in engaging in work activities to promote their recovery, their preference for work therapy versus vocational rehabilitation services, and what additional services they may find most appealing based on their characteristics. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: The purpose of this study was to examine the characteristics of people who stay in intensive case management (ICM) for longer than 5 years.

Method: We conducted a secondary analysis of client data collected by a community mental health organization from 2012 to 2022. Using the Gelberg-Andersen Model for Access to Health Services, we conducted a logistic regression with 22 predictor variables, predicting clients in ICM for 5 years or less (N = 531) and those in ICM for longer than 5 years (N = 289).

Results: People who were older and those with psychotic disorder, co-occurring substance use disorder, dual diagnosis (with developmental disability), chronic medical condition, and also in another program in the same agency were more likely to be in ICM for longer than 5 years. People who were returning ICM clients and those who completed the ICM program (rather than withdrawing or disengaging) were more likely to be in ICM for 5 years or less. Higher dose of ICM (in contacts) predicted a shorter time in ICM.

Conclusions and implications for practice: People with serious mental illness, dual diagnosis, concurrent substance use, and chronic medical conditions and those who are older may need additional supports within ICM and when transitioning out of ICM. People in ICM for a longer time have lower numbers of contacts, indicating that a less intense service may meet their needs. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Campus engagement, including participation in student organizations and groups, is important for both academic and health outcomes. Yet, college students with serious mental illnesses demonstrate lower levels of campus engagement compared to peers without mental illnesses. To inform psychiatric rehabilitation approaches that might enhance this outcome, the purpose of this study was to test an integrated model of self-determination and self-efficacy theories to predict campus engagement within this student population.

Methods: Sixty-seven college students with serious mental illnesses completed measures assessing self-determination constructs (autonomy, competence, and relatedness), college self-efficacy, and campus engagement. Correlational and path analytic models examined relationships among these variables.

Results: Bivariate and multivariate analyses supported the interrelationships among the variables. Specifically, the theory-driven path model demonstrated that autonomy (but not competence or relatedness) was a significant predictor of college self-efficacy, which in turn was associated with campus engagement.

Conclusions and implications for practice: Findings particularly highlight the importance of autonomy and self-efficacy for promoting campus engagement among college students with serious mental illnesses. As such, they may be relevant targets for psychiatric rehabilitation interventions, such as supported education, that are designed to enhance student success. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: There is minimal research on the prevalence of chronic medical conditions among young adults with mental health conditions. This exploratory study assessed the prevalence and number of chronic medical conditions and their association with mental health status.

Methods: A cross-sectional, online survey was completed in March-June 2021, by 967 U.S. young adults (age 18-25 years) with self-identified serious mental health conditions, recruited nationally via social media, email, and websites. Medical conditions were assessed using items from the National Health Interview Survey and National Health and Nutrition Examination Survey; mental health was assessed with the Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 scales. Multivariable regression analysis examined associations between mental health and the six most prevalent medical conditions, as well as the number of conditions, controlling for background characteristics.

Results: We found notable prevalence of obesity (18.5%), migraines (18.2%), allergies (14.8%), asthma (9.2%), and gastrointestinal disorders (9.2%). Controlling for all other factors, high levels of anxiety were associated with greater likelihood of obesity and gastrointestinal disorders, while high levels of depression were associated with lower likelihood of obesity. While 23.2% reported two or more medical conditions, anxiety but not depressive symptoms was associated with a greater number of co-occurring medical conditions.

Conclusions and implications for practice: A notable prevalence of chronic conditions puts young adults with mental health conditions at significant risk of adverse physical health outcomes from a young age. Results can inform the design of tailored health promotion and self-management programs to improve outcomes among this population. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: The Supported Employment Demonstration (SED), a large, multisite randomized controlled trial, provided evidence-based supported employment to help individuals recently denied Social Security disability benefits for reason of mental illness to gain competitive employment and avoid disability. Monthly, client-level measurement of participation in individual placement and support permitted the first detailed exploration of potential ethnoracial disparities in the IPS participation process, from enrollment to end of follow-along job supports, in a vulnerable population with ready access to the intervention.

Method: Monthly participation data in a subsample of enrollees randomized to receive supported employment enabled decomposition of IPS service participation into take-up, effectiveness, and follow-along support phases, yielding times to participation duration milestones, job start, and end of follow-along supports for 614 non-Hispanic White, non-Hispanic Black, and Hispanic SED enrollees. Cox proportional hazards models provided differences in the monthly hazard of each event by race and ethnicity.

Results: Black non-Hispanics (hazard ratio [HR] = 1.50) and Hispanics (HR = 1.52) were both more likely than White non-Hispanics to complete consecutive 3-month periods of supported employment participation. However, ethnoracial group was not significantly associated with either increased effectiveness, measured as the monthly likelihood of finding a job during IPS participation, or likelihood of ending follow-along job supports.

Conclusions and implications for practice: Potential clients' race and ethnicity are associated with a differential willingness to engage IPS services. For this reason, ethnoracial differences in IPS penetration may persist even when structural barriers to IPS access are removed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Meaning in life is crucial for the recovery of individuals with serious mental illness (SMI). The aim of the present study was to identify profiles of meaning in life among individuals with SMI based on the presence of meaning and search for meaning and to examine their associations with recovery.

Methods: Latent profile analysis for a sample of 207 individuals with SMI in South Korea was employed to identify the latent profile of meaning in life using the presence of meaning and searching for meaning as an indicator. Next, multinomial logistic regression was used to examine the relationship between demographic variables and latent profiles. Last, categorical regression was applied to explore the association of latent profiles with recovery.

Results: Latent profile analysis revealed three distinctive profiles: meaning diffusion (10.1%), meaning moratorium (27.5%), and meaning achievement (62.3%). Among demographic variables, only age had a negative effect. Compared with meaning moratorium (reference group), meaning achievement positively predicted recovery, whereas meaning diffusion negatively predicted recovery.

Conclusions and implications for practice: The finding could help psychiatric rehabilitation practitioners focus on helping individuals with SMI in promoting meaning in life for their recovery journey. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: The rates and severity of mental health conditions among young adults are troublesome. Mental health conditions among college students impact educational attainment, future employment and earnings, as well as quality of life. Our objective was to assess students' experience and perceptions of the core components of NITEO, a college reentry program designed to assist young adults who have dropped out of or taken a leave of absence from college.

Methods: We conducted a qualitative study of the core components of NITEO, employing an applied interpretive approach and conducting semistructured interviews with 31 former NITEO students. Data were examined using thematic analysis.

Results: Analyses revealed four themes: (a) NITEO catalyzes personal growth and connection, (b) coaching builds skills and promotes accountability, (c) peer mentors are supportive role models, and (d) other students in the program impact the program experience. These findings suggest that the different components of NITEO foster skills and resilience while providing a supportive community.

Conclusions and implications for practice: Our study illuminates the potential of programs such as NITEO to facilitate recovery and return to college for students on leave or who have dropped out due to mental health conditions. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: The present research investigates the dynamics of consent in the context of antipsychotic drug therapy, with a particular emphasis on the essential attributes that constitute free and informed consent within medical treatment scenarios.

Method: Twenty individuals treated with antipsychotic drugs with consent underwent semistructured interviews.

Results: The following major themes were identified: (a) lack or total absence of information regarding the treatment, emphasizing side effects, risks, chances of success, and treatment alternatives. (b) A subjective experience of the lack of free choice that was sometimes also accompanied by the conditioning of psychiatric rehabilitation services or receiving treatment in an open ward by taking antipsychotic medication.

Conclusions and implications for practice: The research findings may indicate a problem in obtaining informed consent for antipsychotic treatment that should be addressed. The themes highlight the need to examine the interface between rehabilitation services and psychiatric treatment from the legal and ethical perspective of the autonomy of individuals receiving care. (PsycInfo Database Record (c) 2025 APA, all rights reserved).