The proposed research takes a first step toward tailoring treatment to the needs of young adult chronically mentally ill clients. Client differences in interpersonal functioning which interact with the interpersonal intensity of treatment will be examined. In particular, interpersonally intense treatment, e.g., case management, is expected to be optimal for individuals who are comfortable and secure in relationships, but not for those who are either preoccupied with relationships or dismissing of relationships. In this longitudinal study, 120 young adult chronically mentally ill adults will be randomly assigned to case management or to """"""""standard care."""""""" Social support networks, general quality of life, use of treatment, time in psychiatric hospitals, and physical and psychiatric symptomatology will be assessed at six month intervals for three years. Individuals secure in relationships are expected to show more positive outcomes when in case management than in standard care, as evidenced by better use of treatment, less time hospitalized, etc. Individuals dismissing of relationships are expected to show the opposite pattern, becoming more symptomatic and using treatment more poorly, in case management. Individuals preoccupied with relationships are expected to show different types of problems in the two treatments. After three years, group and individual data will be used to reassign subjects who are inappropriately assigned to appropriate treatment. Following reassignment, subjects appropriately assigned are expected to show significant gains in functioning.
| Dozier, M; Lomax, L; Tyrrell, C L et al. (2001) The challenge of treatment for clients with dismissing states of mind. Attach Hum Dev 3:62-76 |
| Huang, Q H; Hruby, V J; Tatro, J B (1999) Role of central melanocortins in endotoxin-induced anorexia. Am J Physiol 276:R864-71 |
| Dozier, M; Cue, K L; Barnett, L (1994) Clinicians as caregivers: role of attachment organization in treatment. J Consult Clin Psychol 62:793-800 |
| Dozier, M; Kobak, R R (1992) Psychophysiology in attachment interviews: converging evidence for deactivating strategies. Child Dev 63:1473-80 |
| Dozier, M (1991) Functional measurement assessment of young children's ability to predict future behavior. Child Dev 62:1091-9 |
