UBC Theses and Dissertations
From adolescence to adulthood : a study of the relationship between social factors and outcome for young psychiatric patients Evans, Deirdre Aileen
Adolescents who were admitted to the Adolescent Psychiatric Unit at Vancouver General Hospital for assessment between 1981 and 1983 who were queried to be in the process of developing a long term psychotic illness were followed retrospectively after five to seven years. At the time of assessment the subjects were between 13 and 16 years of age. The study was intended to act as a pilot project for a larger study. In tune with a biopsychosocial emphasis, outcome was defined as a multi-directional and multi-dimensional concept, involving both positive and negative outcomes in a variety of dimensions. Independent variables were drawn from a structured interview which pertained to the subjects' experience with family relationships, peer relationships, use of treatment resources, educational and employment achievement, drug and alcohol usage, legal difficulties, and quality of life issues since their hospitalization. Three structured outcome measures were used as dependent variables. These included scales which assessed current levels of family functioning, satisfaction and happiness, and community adjustment. Bivariate analysis was conducted using SPSSX:3. The resulting description of the population indicated a heterogeneous group with a variety of outcomes. Although some of the subjects fit the profile for chronic mental illness, diagnosis did not predict outcome. Positive outcome appeared to be associated with stability in overall family functioning, and in particular with the subjects' reports of a positive relationship with their fathers; with the ongoing use of treatment resources; with ease in establishing peer relationships; with self-motivatioin in the area of employment; and with the ability of subjects to move from alternate school settings back into the regular system. Subjects who described their families as having problems with control issues and with task accomplishment appeared to have had trouble in a number of areas during the intervening couse. Acceptance of the need for ongoing treatment was associated with the subjects' characterization of their families as being within norms for social values and norms at the time of outcome, suggesting the tendency of families and treatment personnel who have similar values to ally. Subjects who had had minimal or sporadic contact with treatment resources described their families as being weak in most areas of functioning, and in particular in the area of values and norms. The findings suggest several avenues for further exploration in a larger study. They also support a consideration by treatment resource personnel of the need to involve families as resources in the treatment process, and point to areas in which treatment interventions can be made.
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