Psychopathology. Stages of research. Interventions

Transcription

1 Psychopathology Change in the way look at problems. Similar to change in biology. Also look over life cycle. Look at how they adapt to change. 1 Burden Stages of research Diagnosable symptomatology Positive adjustment and coping Possible role in etiology and in relapse Family members as change agents 2 Depression Agoraphobia Alcoholism Schizophrenia. Interventions 3 1

2 Childhood disorders autism hyperactivity Marriage and psychopathology depression alcoholism Parental psychopathology alcoholism depression 4 Autism Most severe behavior disorder of childhood Aloof mothers hypothesis Evidence for organic etiology 5 Autism (cont d) Parents Happily married Normal rates of psychological disturbance May be vulnerable to burnout Siblings Stresses Positive reactions 6 2

3 Autism (cont d) Positive adjustment related strongly to resources within the family. Adequacy of social support, family cohesiveness and expressiveness more promising predictors of favorable family functioning than is severity of the child's disorder 7 Onset in infancy Hyperactivity Affects large number of children Accounts for a significant proportion of referrals for treatment. 8 Hyperactivity (cont d) Parents lower parenting self-esteem poorer marital adjustment higher rates of separation & divorce Mothers: higher levels of stress than mothers of nondisordered boys Sibling interactions highly negative Family environment: less supportive more stressful 3

4 Hyperactivity (cont d) Medication responders show improvement in family functioning Medication nonresponders--family functioning remained unchanged Conclusion--disturbed family patterns caused by disturbed child behaviour. 10 Child disorders: Conclusions Challenge for all family members May interfere with the well-being of all family members Family members may respond poorly Not inevitably associated with poor outcome for all family members Considerable variability among the families of disordered children Depression Lack of intimate relationship with a spouse or boyfriend increases women's vulnerability. Prior to onset: increase in arguments with the spouse Vulnerable to hostile statements by family members. 12 4

5 Depression: Marriage Interactions: negative verbal and nonverbal behaviors Spouses: report negative mood rejecting behaviours. Divorce rate 2 years after discharge is 9 times that of the general population. Alcoholism Marital functioning often improved under conditions of intoxication; Alcohol use may provide a temporary solution to a dysfunctional marital system 14 Alcoholism: Recovery Few differences between spouses of recovered alcoholics and community control spouses. Spouses of relapsed or nonrecovered alcoholics functioned more poorly. Marital adjustment improves over time for alcoholics who recover from the disorder and their spouses. 5

6 Conclusions: Marriage Marital distress associated with several types of mental disorder Treatments that focus not only on the person's symptoms, but also on improving the marital relationship appear promising 16 Alcoholic Parents Children at risk for conduct problems, alcohol abuse, learning difficulties, health problems, and mood problem Not all have difficulties Alcoholic Fathers:less responsibility Different patterns in times when father is drinking or abstinent Depressed Parents Mothers of infants-- withdraw do not look at child lack responsiveness interrupt flow of feeding less playful less affectionate 18 6

7 Depressed Parents (cont d) Mothers of children less warm less consistent difficulties in negotiating conflict situations 19 Children of Depressed Parents Infants-- more drowsy less relaxed -higher rates of insecure attachment Toddlers-- empathic less likely to become aggressive more likely to try to appease a frustrating adult Children (cont d) At risk for range of emotional problems 30-77% experience diagnosable disorder 21 7