Schizophrenia, a serious mental disorder marked by cognitive, affective, and socio-occupational dysfunction, affects approximately one percent of the population worldwide. Although clearly a biologically induced disorder, mounting evidence now indicates that the illness is also highly responsive to the sociocultural and emotional atmosphere of the family. Existing therapies have shown an improvement in symptoms following family oriented interventions. However, most programs in the United States are offered only in English and are not culturally informed. Therefore, existing programs fail to meet the needs of many Hispanics, the fastest growing and now largest minority group in the United States. The purpose of this application is to request funds to support the development, implementation, and evaluation of a family-focused, Culturally Informed Therapy for Schizophrenia (CIT-S) conducted in both English and Spanish. This treatment will incorporate elements found to be effective in prior family treatment studies of mental illness, while adding new cultural components hypothesized to enhance treatment efficacy. The intervention will include 15 sessions with emphasis on: Fortifying a strong sense of family unity; educating relatives about the illness; helping participants tap into cultural, spiritual and/or existential beliefs that may aid them in conceptualizing and coming to terms with the illness; and teaching effective communication and problem solving skills to help create a stable and therapeutic home environment. Comprehensive assessments will be conducted prior to treatment, after the 15th session (termination), and at 6-month and 12-month follow-up points (from date of first treatment session) to evaluate participants' emotional and mental health and to assess beliefs, values, and attributions targeted by the intervention. Monthly hospitalization/relapse phone screenings and general """"""""check-ins"""""""" will also be conducted. To maintain treatment gains, after completing the 12-month study, participants will be invited to attend weekly drop-in multifamily support groups, where CIT-S skills will be reinforced. In the pilot phase of the study (described in this application), treatment efficacy will be evaluated by comparing CIT-S with a Treatment as Usual (TAU) control condition. In subsequent years, the PI will assess which aspects of the treatment are most closely associated with unproved patient and family functioning. The treatment will then be refined, retaining beneficial elements, and revising or discarding those that do not appear to enhance participant well-being. In subsequent stages a full-scale clinical trial (funded through an RO1 or similar award) will be conducted comparing CIT-S to a traditional family focused therapy that is matched in length. The Pi's long term goal is to develop effective culturally informed family interventions for schizophrenia and related disorders, in Spanish and in English. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Planning Grant (R34)
Project #
5R34MH071250-02
Application #
7049551
Study Section
Special Emphasis Panel (ZMH1-ERB-S (01))
Program Officer
Hsiao, John
Project Start
2005-04-07
Project End
2008-01-31
Budget Start
2006-02-01
Budget End
2007-01-31
Support Year
2
Fiscal Year
2006
Total Cost
$199,060
Indirect Cost
Name
University of Miami Coral Gables
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
625174149
City
Coral Gables
State
FL
Country
United States
Zip Code
33146
Brown, Caitlin A; Weisman de Mamani, Amy (2018) The mediating effect of family cohesion in reducing patient symptoms and family distress in a culturally informed family therapy for schizophrenia: A parallel-process latent-growth model. J Consult Clin Psychol 86:1-14
Gurak, Kayla K; Weisman de Mamani, Amy; Ironson, Gail (2017) Does religiosity predict attrition from a culturally-informed family treatment for schizophrenia that targets religious coping? J Consult Clin Psychol 85:937-949
Gurak, Kayla; Weisman de Mamani, Amy (2016) Risk and Protective Factors, Perceptions of Family Environment, Ethnicity, and Schizophrenia Symptoms. J Nerv Ment Dis 204:570-7
de Mamani, Amy Weisman; Suro, Giulia (2016) The effect of a culturally informed therapy on self-conscious emotions and burden in caregivers of patients with schizophrenia: A randomized clinical trial. Psychotherapy (Chic) 53:57-67
Tabak, Naomi T; Weisman de Mamani, Amy (2014) Religion's effect on mental health in schizophrenia: examining the roles of meaning-making and seeking social support. Clin Schizophr Relat Psychoses 8:91-100
Wasserman, Stephanie; Weisman, Amy; Suro, Giulia (2013) Nonreligious coping and religious coping as predictors of expressed emotion in relatives of patients with schizophrenia. Ment Health Relig Cult 16:16-30
Garcia, Cristina P; Sacks, Stephanie A; Weisman de Mamani, Amy G (2012) Neurocognition and cognitive biases in schizophrenia. J Nerv Ment Dis 200:724-7
Wasserman, Stephanie; de Mamani, Amy Weisman; Suro, Giulia (2012) Shame and guilt/self-blame as predictors of expressed emotion in family members of patients with schizophrenia. Psychiatry Res 196:27-31
Aldebot, Stephanie; de Mamani, Amy G Weisman (2009) Denial and acceptance coping styles and medication adherence in schizophrenia. J Nerv Ment Dis 197:580-4
Weisman de Mamani, Amy G; Kymalainen, Jennifer A; Rosales, Grace A et al. (2007) Expressed emotion and interdependence in White and Latino/Hispanic family members of patients with schizophrenia. Psychiatry Res 151:107-13