Browsing by Subject "mental illness"

Now showing 1 - 10 of 25
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    The adverse childhood experiences questionnaire: Two decades of research on childhood trauma as a primary cause of adult mental illness, addiction, and medical diseases
    (Taylor & Francis, 2019-01-01) Zarse, Emily M.; Neff, Mallory R.; Yoder, Rachel; Hulvershorn, Leslie; Chambers, Joanna E.; Chambers, R. Andrew; Psychiatry, School of Medicine
    Objective. In 1998, Felitti and colleagues published the first study of the Adverse Childhood Experiences-Questionnaire (ACE-Q), a 10-item scale used to correlate childhood maltreatment and adverse rearing contexts with adult health outcomes. This paper qualitatively reviews nearly two decades of research utilizing the ACE-Q, highlighting its contribution to our understanding of the causal roots of common, interlinked comorbidities of the brain and body.Methods. An OVID/PubMed search was conducted for English language articles published before 2016, containing the phrase “Adverse Childhood Experiences” in which the ACE-Q was utilized. Source review included a manual search of bibliographies, resulting in 134 articles, including 44 based on the original ACE-Q study population.Results. ACE-Q research has demonstrated that exposures to adverse childhood experiences converge dose-dependently to potently increase the risk for a wide array of causally interlinked mental illnesses, addictions, and multi-organ medical diseases. The intergenerational transmission of this disease burden via disrupted parenting and insecure rearing contexts is apparent throughout this literature. However, the ACE-Q does not tease out genetic or fetal drug exposure components of this transmission.Conclusions. Adverse childhood experiences and rearing may generate a public health burden that could rival or exceed all other root causes. Translating this information to health-care reform will require strengthening brain-behavioral health as core public and preventative health-care missions. Greater integration of mental health and addiction services for parents should be accompanied by more research into brain mechanisms impacted by different forms and interactions between adverse childhood experiences.
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    Celebrating the Legacy of the Institute of Psychiatric Research (IPR), and Moving Brain Research Forward
    (2022-06-22) Lahiri, Debomoy K.; Nurnberger, John I.
    The Institute for Psychiatric Research (IPR) at Indiana University (IU) School of Medicine was a free-standing four-story building on the main IUPUI campus (791 Union Drive) just east of Eskenazi Hospital's present location. It was built in 1955-56 by the State of Indiana to house the laboratories of neuroscience investigators operating under the leadership of the IU Department of Psychiatry. For nearly six decades IPR was the home of innovative research (primarily NIH-funded) in neurochemistry, electrophysiology, genetics, neuroanatomy, animal behavior, and molecular biology. For many years it was also the home of neuroscience education on the IUPUI campus. In 2014 the IPR building was demolished as part of the construction of Eskenazi hospital to replace the venerable Wishard hospital campus. IPR faculty relocated to the IU Neuroscience Building at 320 West 15th Street, where they now continue their work along with researchers at Stark Neurosciences Research Institute and other departments. Former IPR faculty Debomoy Lahiri and John Nurnberger have assembled a history of IPR along with illustrations of the building and the faculty and staff who worked there and contributed significantly to psychiatric research.
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    A Cluster Randomized Trial of Adding Peer Specialists To Intensive Case Management Teams in the Veterans Health Administration
    (Springer, 2015-01) Chinman, Matthew; Oberman, Rebecca S.; Hanusa, Barbara H.; Cohen, Amy N.; Salyers, Michelle P.; Twamley, Elizabeth W.; Young, Alexander S.; Psychology, School of Science
    Use of Peer Specialists (PSs)—individuals with serious mental illness who use their experiences to help others with serious mental illness—is increasing. However, their impact on patient outcomes has not been demonstrated definitively. This cluster randomized, controlled trial within the Veterans Health Administration compared patients served by three intensive case management teams that each deployed two PSs for one year, to the patients of three similar teams without PSs (Usual Care). All patients (PS group=149, Usual Care=133) had substantial psychiatric inpatient histories and a primary Axis 1 psychiatric disorder. Before and after the year PSs worked, patients were surveyed on their recovery, quality of life, activation (health self-management efficacy), interpersonal relations, and symptoms. Patients in the PS group improved significantly more (z=2.00, df=1, p=0.05) than those receiving Usual Care on activation. There were no other significant differences. PSs helped patients become more active in treatment, which can promote recovery.
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    Correlates of attendance in mental health services for individuals with psychotic disorders: A critical review
    (Taylor & Francis, 2016) Bonfils, Kelsey A.; Bouchard, Lauren; Kukla, Marina; Miller, Alex P.; McGuire, Alan B.; Department of Psychology, School of Science
    Low attendance to mental health care results in loss of time, money, and treatment gains. No prior review in this area has taken into account the quality of studies or varying definitions of attendance. The current review provides a critical evaluation of variables associated with attendance in consumers with psychotic symptoms participating in outpatient mental health services, with a focus on study quality and operationalization of attendance. EMBASE, MEDLINE, PsycINFO, CINAHL, and the Cochrane Library were searched for empirical articles relevant to attendance to mental health services by individuals diagnosed with a psychotic disorder. Eligible articles were rated for quality by two coauthors; high-quality articles were reviewed in-depth. Twenty-eight articles were eligible; 11 articles qualified for in-depth review. Four attendance outcome types were identified, including the prediction of dropout, time engaged, categorical attendance, and continuous attendance. Ongoing substance use during treatment was consistently associated with lower attendance in high-quality articles. More high-quality research using systematically defined outcome types is needed to identify reliable associations with attendance. Commonly tested variables such as demographics show little utility in predicting attendance. Future research in this area should expand upon current findings focusing on clinically and theoretically relevant variables.
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    Development and preliminary validation of the romantic relationship functioning scale
    (2014) Bonfils, Kelsey A.; Salyers, Michelle P.; Minor, Kyle S.; McGrew, John H., 1953-; Grahame, Nicholas J.
    Background: Research has repeatedly shown that individuals with severe mental illness desire interpersonal and romantic relationships and that social support (including spousal relationships) is beneficial. In addition, social deficits in mental disorders can often get in the way of developing fulfilling relationships. However, there is little currently available to help clinicians and researchers assess romantic relationship functioning in those with mental illness. The aim of this pilot study was to examine reliability and validity of a new measure of functioning in romantic relationships, the Romantic Relationship Functioning Scale (RRFS). Method: The RRFS was constructed based on theory proposed by Redmond, Larkin, and Harrop (2010). In an analog study, we tested the measure in a sample of college students (N=387), examining reliability, stability over time, factor structure, and relationships with measures of psychopathology and related measures of social functioning to assess convergent validity. Results: The RRFS exhibited a hierarchical four-factor structure, supporting the use of a total score. Although subscales were supported in the factor analysis, other psychometric evidence was weaker, and the use of a total score is advocated. Internal consistency and test-retest reliability were acceptable for the total scale (>.8). The RRFS had moderate to large correlations in the expected direction with all psychopathology measures. In predictive models, overall mental health, social functioning, and fewer interpersonal difficulties predicted higher romantic relationship functioning. Conclusions: The RRFS total score shows preliminary evidence of reliability and validity. The RRFS has potential to be of use in treatment centers for undergraduates and for individuals with diagnosed mental disorders. Future research should further investigate the RRFS subscales and the measure’s performance in clinical samples.
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    The economic burden of untreated mental illness in Indiana
    (2023-06-16) Taylor, Heather
    Objective: We sought to estimate the economic burden of untreated mental illness at the societal level. Design, Setting, and Participants: This cross-sectional study used multiple data sources to tabulate the annual cost of untreated mental illness among residents ages 5 and older in Indiana in 2019. Data sources included: 1) the National Survey on Drug Use and Health, 2) the National Survey of Children’s Health, 3) Indiana government sources, and 4) Indiana Medicaid enrollment and claims data. Analysis of these data occurred between January and May of 2022. Main Outcomes and Measures: Outcomes included: 1) direct non-healthcare costs (costs incurred by the criminal justice system and homeless shelters), 2) indirect costs (costs incurred by unemployment, workplace productivity losses through absenteeism and presenteeism, all-cause mortality, suicide, caregivers’ direct healthcare, caregivers’ productivity losses, and missed primary education), and 3) direct healthcare costs (disease-related healthcare expenditures) Results: We estimated the number individuals in Indiana with untreated MI in 2019 to be 429,407 (95% CI: 349,526 to 528,171). The economic burden of untreated mental illness in Indiana was estimated at $4.2 billion annually (Range of uncertainty (RoU): $2.1 billion, $7.0 billion).. The cost of untreated mental illness includes $3.3 billion (RoU: $1.7 billion, $5.3 billion) for indirect costs, $708.5 million (RoU: $335 million, $1.2 billion) for direct healthcare costs, and $116.4 million for non-health care costs. Conclusion and Relevance: In this cross-sectional study, untreated mental illness was found to have significant financial consequences for society. These findings put into perspective the case for action and should be considered by policymakers, clinicians, and employers when allocating societal resources and funding. States can replicate this comprehensive framework as they prioritize key areas for action regarding mental health services and treatments.
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    The economic burden of untreated mental illness in Indiana
    (2022-11-28) Taylor, Heather; Blackburn, Justin; Menachemi, Nir
    We use a prevalence-based approach to estimate annual costs, in a wide-range of categories, associated with untreated mental illness (MI) in Indiana. Economic burden of untreated MI in Indiana is estimated at $4.2 billion annually representing 1.2% of the state’s gross domestic product. Considering average Indiana wages, $4.2 billion is equivalent to approximately 100,000 jobs. Cost of untreated MI includes $3.3 billion for indirect costs such as premature mortality, $708.5 million for direct healthcare costs, and $116.4 million for non-health care costs including incarceration. On average, each individual experiencing untreated MI incurs $18,940 of societal costs; much of which is borne by employers in the form of premature mortality, unemployment, absenteeism and presenteeism.
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    Explicit and Implicit Stigma of Mental Illness as Predictors of Recovery Attitudes of Assertive Community Treatment Practitioners
    (2017) Stull, Laura G.; McConnell, Haley; McGrew, John H.; Salyers, Michelle P.; Psychiatry, School of Medicine
    While explicit negative stereotypes of mental illness are well established as barriers to recovery, implicit attitudes also may negatively impact outcomes. The current study is unique in its focus on both explicit and implicit stigma as predictors of recovery attitudes of mental health practitioners.Assertive Community Treatment practitioners (n = 154) from 55 teams completed online measures of stigma, recovery attitudes, and an Implicit Association Test (IAT).Three of four explicit stigma variables (perceptions of blameworthiness, helplessness, and dangerousness) and all three implicit stigma variables were associated with lower recovery attitudes. In a multivariate, hierarchical model, however, implicit stigma did not explain additional variance in recovery attitudes. In the overall model, perceptions of dangerousness and implicitly associating mental illness with "bad" were significant individual predictors of lower recovery attitudes.The current study demonstrates a need for interventions to lower explicit stigma, particularly perceptions of dangerousness, to increase mental health providers' expectations for recovery. The extent to which implicit and explicit stigma differentially predict outcomes, including recovery attitudes, needs further research.
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    Helping veterans achieve work: A Veterans Health Administration nationwide survey examining effective job development practices in the community.
    (APA, 2018-06) Kukla, Marina; McGuire, Alan B.; Strasburger, Amy M.; Belanger, Elizabeth; Bakken, Shana K.; Psychology, School of Science
    Objective: Veterans Health Administration vocational services assist veterans with mental illness to acquire jobs; one major component of these services is job development. The purpose of this study was to characterize the nature of effective job development practices and to examine perceptions and intensity of job development services. Method: A national mixed-methods online survey of 233 Veterans Health Administration vocational providers collected data regarding frequency of employer contacts, perceptions of job development ease/difficulty, and effective job development practices when dealing with employers. Qualitative responses elucidating effective practices were analyzed using content analysis. Results: Vocational providers had a modest number of job development employer contacts across 2 weeks (M = 11.0, SD = 10.6) and fewer were face-to-face (M = 7.6, SD = 8.4). Over 70% of participants perceived job development to be difficult. Six major themes emerged regarding effective job development practices with employers: using an employer-focused approach; utilizing a targeted marketing strategy; engaging in preparation and follow-up; going about the employer interaction with genuineness, resilience, and a strong interpersonal orientation; serving as an advocate for veterans and educator of employers; utilizing specific employer-tailored strategies, such as arranging a one-on-one meeting with a decision maker and touring the business, individualizing a prescripted sales pitch, connecting on a personal level, and engaging in ongoing communication to solidify the working relationship. Conclusions and implications for practice: Respondents highlight several potentially effective job development strategies; tools and resources may be developed around these strategies to bolster job development implementation and allow opportunities for fruitful employer interactions.
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    The Impact of the Working Alliance on Vocational Outcomes for People with Severe Mental Illness Enrolled in Employment Programs
    (2007-07) Kukla, Marina Elizabeth; Bond, Gary R., 1944-
    This study was a subset of a large two-year randomized controlled trial of two employment programs providing services to people with severe mental illness (SMI). Because prior research has found that the strength of the relationship, or working alliance, between service providers and people with SMI is related to a variety of beneficial outcomes, the purpose of the current study was to address the working alliance between participants and their vocational workers and its association with employment outcomes, including the total duration of paid employment over two years and mean paid job tenure after two years. Another primary purpose of the current study was to determine whether working alliance differences exist between a team vocational approach (Diversified Placement Approach) and an individual vocational approach (Individual Placement and Support Model). The final aim of the current study was to investigate the psychometric properties of the ad hoc scale utilized to measure the working alliance. Contrary to expectations, no relationship was found between the working alliance and employment outcomes after two years. As expected, it was found that participants in the individual vocational approach (IPS) had higher working alliance scores across the study than participants in the team vocational program (DPA). Finally, the working alliance measure used in this study was found to have promising psychometric properties, including adequate criterion-related validity and test-retest reliability, although the internal consistency was a bit low. The scale items are a loose fit with existing theory, however, necessitating the addition of items and revision of the current scale and underlying theory to enhance its utility in clinical and research settings.