Coping, Community Functioning and Severe Mental Illness

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DESCRIPTION (provided by applicant): The candidate is requesting five years of funding through the Mentored Patient-Oriented Career Development Award (K23) program to improve his methodological skills in mental health services research, specifically to better study the relationship between coping and functional outcomes among persons diagnosed with severe mental illness. The ultimate goal is to develop expertise in innovative methods of assessing coping from the behavioral science literature, and to use this expertise to conduct clinically relevant research that will enhance the existing knowledge base on the nature of the relationship between coping efforts and community functioning of persons diagnosed with severe mental illness. The candidate's strong clinical background with this population and research background in the study of coping within it provide an excellent foundation for this work. The proposed training goals include enhanced skills in: 1) qualitative interviewing and event-structure data analysis, 2) daily process assessment methods, 3) multilevel modeling statistical analysis, 4) clinical outcomes research and psychiatric rating assessment approaches, and 5) coping theory. These training activities will allow the candidate to incorporate methodological and statistical advances to better understand the nature of the relationship between the use of coping strategies and community functioning among persons diagnosed with severe mental illness in his future work. The research plan for this award is divided into two exploratory studies that will complement the proposed training activities by establishing their feasibility and laying the groundwork for an RO1 application to conduct a larger study. In the first study, the candidate will conduct intensive clinical and qualitative interviews with a sample of 30 persons diagnosed with severe mental illness at two points in time: just before beginning participation in professional and consumer-run illness self-management programs, and 6 months later. Narrative data from both rounds of interviews will be analyzed using event-structure analysis to relate types and sequences of coping strategies used to specific community functioning outcomes. In the second study, the same participants will complete daily self-assessments of symptoms, coping strategies, and social functioning behavior for two separate periods of 14 days as they participate in the illness self-management groups. This data will be analyzed using multilevel modeling approaches and will provide a crucial adjunct to the retrospective data from the first study.