The present application requests two years of support to complete an ongoing research project on family factors associated with recovery from severe psychiatric illness in hospitalized young adults and adolescents, with particular emphasis on schizophrenia. The design is quasi-naturalistic in nature and attempts to study the relationship between patient and family variables over time, throughout the course of a relatively lengthy hospitalization (mean of 12 months) and a one-year post-hospitalization follow-up, where the patient is living in the community. Repeated measures of several familial attributes previously shown to be risk factors for poor course and outcome are collected for patients and families from three diagnostic groups. A total of 49 families have completed the initial phase of this study; the goal for the full sample is 60 families, as follows: 1) 30 young adult schizophrenia-spectrum cases; 2) 15 young adult affective disorder and/or borderline personality disorder; and 3) 15 adolescent conduct disorder and either dysthymia or borderline personality disorder. The patients and their families participate in multiple laboratory and """"""""natural"""""""" reassessments throughout the course of hospitalization at the Yale Psychiatric Institute. Preliminary analyses of data on family members' attitudes, behavior, and communication style suggest that meaningful subgroups of patients and families can be delineated. Intergenerational data that includes the parents' perceptions of their own parents' style of attachment and emotional behavior towards them, suggest new strategies for treating schizophrenics in a family context. This information will address the need for our mental health delivery system to develop effective, uncomplicated, and readily available intervention programs for people with a schizophrenic illness. In our culture of rapidly escalating health care costs, the identification of subgroups of families of schizophrenics with different sets of needs. requiring different types of intervention, would be particularly useful.
| Diamond, D; Doane, J A (1994) Disturbed attachment and negative affective style. An intergenerational spiral. Br J Psychiatry 164:770-81 |
| Becker, D F; Doane, J A; Wexler, B E (1993) Effects of emotion on perceptual asymmetry in adolescent inpatients with attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 32:318-21;discussion 322-3 |
