Multiple measures of social support networks in the seriously mentally ill: Correlation to hospitalization, symptoms, and adaptive functioning.

摘要

Social support has been indicated as a significant predictor in psychiatric health and illness, and implicated in the cycles of hospitalization, relapse and recovery. Research has suggested that hospitalization also increases the likelihood of a patient to feel isolated, alienated and potentially react by withdrawing from existing social supports. This study seeks to better understand how the reported quality of social support networks and frequency of activities relates to psychiatric relapse and symptoms.; The author undertakes an analysis of a pilot sample of recently-discharged, multiply-hospitalized inner-city adults with serious and persistent mental illness, and explores three different methods of assessing social networks (peer use, reported qualities, and reported activities).; Study results confirm a reduction in recent use peer supports for those who spent time inpatient, but there were no differences for post-discharge, partially supporting Lally and Clausen's finding of increased isolation in subjects who have spent time inpatient via multiple visits to hospitals within the last year. However, their assertion that patients are often demoralized by their inpatient stay and end up feeling less capable, less masterful, or more distressed after their inpatient stay was not supported in this study, and may instead be an artifact of the illness. No differences were found in demoralization/depression, and instead, this study found that individuals likely to need psychiatric inpatient stays experience reduced sense of mastery at time of entry, but increased sense of control 90 days post hospitalization. Sense of mastery was also correlated to future hospitalizations.; Each of the three social measures appear to target different aspects of social networks and social functioning, and total social network seems to be most useful in long term (1 year post interview) prediction of hospital use. The number and quality of social contacts in this population relates to treatment success (measured by hospitalizations, demoralization, subjective appraisals) over and above objective symptoms.; The author includes a multiple regression/correlation analysis and a sample of the Structural Equation Model and Diagram in the discussion for reference and as a potential model for future study.