SERIOUSLY MENTALLY ILL WOMEN--COPING WITH PARENTHOOD

患有严重精神疾病的女性——应对为人父母的问题

• 批准号: 2407396
• 负责人: CAROL T MOWBRAY
• 金额: $ 47.9万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-09-01 至 2001-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2407396
• 关键词: behavioral /social science research tag; child behavior; child rearing; clinical research; coping; female; functional ability; health care service utilization; human subject; interview; longitudinal human study; major depression; maternal behavior; mental disorder diagnosis; mental disorders; psychological stressor; psychosocial rehabilitation; self concept; social adjustment; social support network; stress

As a result of improved services and policy changes, persons with serious mental illness spend more of their lives in the community and are capable and desirous of fulfilling normalized social roles. Women with SMI are sexually active and have normal fertility and childbirth rates. However, mental health services for SMI have all but ignored parenting issues. While the effects on children of having a mentally ill mother are well-documented, research on the mothers themselves 's lacking: samples are non representative, clinical characteristics inadequately measured, the effects of culture and context on outcomes not addressed, the mothers perspective not considered, nor have changes in mothers' parenting or functioning been analyzed. The currently funded RO1 study addresses all but the longitudinal gaps in this literature. A large, multicultural sample of SMI women (N=380) has been recruited from CMHC's and in patient psychiatric units in the Detroit metropolitan area. Extensive collaboration with agencies has ensured a representative sample. Furthermore, we have established phone follow-up tracking procedures and succeeded in locating 92% of participants due for one or more 3-month recontacts. However, to more fully inform services practices, longitudinal research is needed so that variables which can only be studied over time are included (i.e., persistent economic hardship, chronic stress, changes due to children's developmental stage) and causal directions established. A conceptual model is proposed for parenting as a mediator of the relationships between stress/resources and maternal and child outcomes. Additionally, the model proposes that mh services, especially if they are parenting- Oriented, may moderate the relationships set out in the model. The current application proposes to utilize the participant sample from our original grant to carry out a 3-year longitudinal study, and reinterview P's 18 and 36 months later. Since most women's children are school-age, this time frame will encompass significant transitional periods. It should also include changes in service receipt. This should increase the likelihood of changes being experienced in the mothers' parenting and overall community adaptation. Using this longitudinal data, we propose to: a) Examine the direct impact of changes in stressors on maternal and child outcomes, controlling for the effects of personal characteristics (demographics, psychiatric history) and prior functioning; b) Examine the extent to which this relationship is moderated by mental health service provision; c) Examine the extent to which parenting attitudes and experiences mediate the impact of stressors on maternal and child outcomes; d) Analyze the extent to which mental health services (overall and parenting-specific) can moderate the relationships between stress and parenting and between parenting and maternal/child outcomes.

由于服务的改善和政策的变化，有 严重的精神病患者一生中有更多的时间在社区度过 并有能力并渴望履行正常的社会角色。 患有SMI的女性性行为活跃，生育能力正常 出生率。然而，SMI的心理健康服务拥有所有 但忽视了养育子女的问题。而对孩子们的影响 有一位患有精神疾病的母亲是有充分记录的，关于 母亲自身的S缺失：样本不具代表性， 临床特征测量不充分，影响 关于结果的文化和背景没有得到解决，母亲们 没有考虑视角，也没有考虑母亲养育方式的变化 或功能被分析过。目前资助的RO1研究 解决了本文献中除纵向差距以外的所有问题。一个 已经招募了大量的多文化SMI女性样本(N=380) 来自底特律的CMHC和住院精神病室 都会区。与机构的广泛合作已经 确保了一个有代表性的样品。此外，我们已经建立了 电话跟踪追踪程序，定位成功率92% 一次或多次为期3个月的重新联系的参与者。然而，为了 更充分地了解服务实践，纵向研究是 所需要的，以便只能随着时间的推移才能研究的变量 包括(即持续的经济困难、长期的压力、 儿童发展阶段的变化)和因果关系 方向已确定。在此基础上，提出了一个概念模型 父母教养方式在人际关系中的中介作用 压力/资源和母婴结局。此外， 模型提出，MH服务，特别是如果他们是育儿- 以此为导向，可能会缓和模型中设定的关系。这个 当前的应用程序建议使用来自 我们原先拨款进行一项为期三年的纵向研究，以及 18个月和36个月后重新采访P。因为大多数妇女的孩子 是学龄儿童，这一时间框架将包含重要的 过渡期。它还应包括服务方面的变化 收据。这应该会增加发生变化的可能性 在母亲的养育和整个社区中有经验 适应。利用这些纵向数据，我们建议：a)检查 应激源变化对母婴的直接影响 结果，控制个人特征的影响 (人口统计、精神病史)和以前的功能；b) 检查这种关系在多大程度上受到 精神卫生服务的提供；c)审查 育儿态度和经历在压力源的影响中起中介作用 关于孕产妇和儿童的结果；d)分析 心理健康服务(全面的和针对父母的)可以 缓和压力和养育之间的关系，以及压力和父母之间的关系 养育子女和母婴结局。