Dissertations / Theses on the topic 'Schizophrenia in children'

Thesis (M.A. (Research Psychology)) --University of Limpopo, 2013
Mothers who care for schizophrenic children go through various personal experiences and face enormous challenges. The aim of the study was to explore the experiences of mothers whose children were diagnosed with childhood schizophrenia. Participants consisted of eight mothers of children with schizophrenia from a rural village in the district of Vhembe, South Africa. They were interviewed at their homes, using in-depth, phenomenological interviews. Eight themes emerged from the participating mothers‟ articulations. They were identified as poverty and unemployment, emotional reactions of mothers, blaming witchcraft, dealing with the children‟s violence, aggression and destructiveness, financial and social support, effect of schizophrenia on the mother-child relationship, and the loss that mothers go through. The study reconfirmed that caring for individuals with schizophrenia is not an easy task for mothers. Recommendations were advanced on the basis of the findings. Keywords: caregiving, children, expressed emotion, objective burden, parenting, phenomenology, schizophrenia, subjective burden

Assignment (MA) -- University of Stellenbosch, 2004.
ENGLISH ABSTRACT: This literature review explores the research on the clinical presentation of childhood onset schizophrenia (COS) that has been conducted over the past ten years. A literature search was done using internet search engines and psychological databases to collect English language journals from 1994 onwards. Research indicates that COS is a stable diagnosis. Generally, there is a clear history of premorbid abnormalities, an insidious onset and a deteriorating course. For the majority of cases there seems to be a poor outcome. In conclusion, despite the limitations in the research conducted thus far, findings provide important insights regarding COS and several possibilities for future research.
AFRIKAANSE OPSOMMING: Hierdie literere oorsig fokus op navorsing wat die afgelope tien jaar gedoen is oor die kliniese aanbieding van skisofrenie wat in die kinderjare begin (COS). Daar is gebruik gemaak van Internet "soek enjins" en sielkundige databasisse ten einde Engelstalige joernale op te spoor wat vanaf 1994 tot nou oor die onderwerp verskyn het. Navorsing dui daarop dat COS 'n stabiele diagnose is. Oor die algemeen toon dit 'n duidelike geskiedenis van premorbiede abnormaliteite, 'n ongemerkte aanvang en verloop en agteruitgang oor tyd. In die meeste gevalle blyk daar 'n swak uitkoms te wees. Laastens bied die bevindinge belangrike insigte ten opsigte van COS en heelwat moontlikhede vir toekomstige navorsing, ten spyte van die beperkinge in die navorsing wat tot dusver gedoen is.

The integration of mental health services into primary health care and the shift toward community- and family-based care for people with chronic mental disorders have been widely advocated globally (Breen, Swartz & Flisher, 2009:327). This resulted in people with mental illnesses staying within their communities during their recovery, accessing care mainly from their family members and secondarily from health care professionals within communities. Families predominantly relied on cultural African explanations for disease and illness, which usually motivated the choice of treatment options (Curationis, 2002). Unfortunately, most clinicians are not adequately trained to understand how culture influences the clinical manifestation of mental disorders (Breen et al., 2009:327). This sometimes results in people consulting African healers who are considered to understand illnesses much better. It is for the above-mentioned reasons that the study seeks to explore the cultural beliefs of parents as caregivers of adult children living with schizophrenia. The study is expected to extract insightful information regarding the cultural beliefs in relation to metal illness to promote a better understanding of the phenomenon with the African cultural sphere. The goal of the study was to explore and describe the cultural beliefs of parents as caregivers of adult children living with schizophrenia in a community day care centre in Klipgat. The data was collected through non-probability purposive sampling. Rich, in-depth data was collected through semi-structured interviews from a random sample of 12 participants selected from the enrolment list of attendees at Mfihlakalo Day Care Centre. The research findings indicate that there is an evident existence of cultural beliefs that perceive the cause of mental illnesses, especially schizophrenia, as birth complications, communication from ancestors, witchcraft or stress. Mental health care users are as a result excluded from society and labelled as aggressive and abnormal. The families of mental health care users have a positive perception of their family members living with mental illness, regarding them as special people suffering from natural diseases, birth complications, and lack of nurturing. The research study concludes that even though the communities have negative perceptions of mental illnesses, the situation has vastly evolved through the years. Educational and awareness strategies have played a role in educating families and communities about mental illnesses, although the exposure has been noted as minimal. The research study suggests strong and effective psycho-educational programmes and support to promote knowledge empowerment and insight with regard to mental illness. Additionally, transparency regarding mental illness to reduce the stigma of those living mental illness and their immediate families, in turn promoting social inclusion.
Mini Dissertation (MSW)--University of Pretoria, 2016.
Social Work and Criminology
MSW
Unrestricted

Thesis (Ph. D.)--University of North Carolina at Greensboro, 2007.
Title from PDF t.p. (viewed Feb. 29, 2008). Directed by Thomas R. Kwapil; submitted to the Dept. of Psychology. Includes bibliographical references (p. 79-111).

Motivations Language has evolved as human’s primary communication tool. It allows us to flexibly manage the amount of information disclosed in communication to deal with complex social situations. Language impairment is a hallmark feature of schizophrenia, which could also be observed to a lesser extent in patients’ unaffected siblings. It significantly affects patients’ social functioning and clinical outcome. Despite ample evidence showing deficits across linguistic levels in schizophrenia, our understanding of patients’ performance in real-life communication, especially under non-cooperative (competitive or tactical) situations, is very limited. In this study we developed a novel method (conversational analysis paradigm, CAP) to investigate both cooperative and competitive communication performance in terms of verbal information value management among patients with schizophrenia and their unaffected siblings compared with healthy controls, and explored their relationships with clinical and cognitive functions. Methods Two studies were conducted. Study one consisted of a validation study (n=40) for CAP and a cross-sectional (n=130) study in investigating verbal information management in schizophrenia and healthy participants. Performance was compared between patients with schizophrenia spectrum disorders (n=65) and matched healthy controls (n=65). Relationships between cognitive functions, clinical features, social competence, and CAP performance were also investigated. In study two, CAP performances were compared among 31 pairs of patients with schizophrenia, their healthy siblings and 31 matched healthy controls (total n=93) to examine verbal information management deficits as a trait in siblings. Schizotypal personality trait was also measured to investigate the potential relationship with CAP in siblings and healthy controls. Results The CAP test demonstrated good inter-rater reliability (ICC 0.82) and adequate internal consistency (Cronbach’s alpha 0.71--‐0.72). Patients showed poorer performance in verbal information management under both cooperative and competitive conditions, which were associated with psychotic symptoms and social functioning. Patients’ poorer cooperatively communicating information, but not competitive controlling information, was associated with their cognitive functions. Performance of patients’ healthy siblings was intermediate between patients and healthy controls, especially during competitive communication. Verbal information management skills were correlated with schizotypal personality trait in siblings but not controls. More deviant verbal information management skills under competitive conditions were closely related to impaired immediate social network in patients and siblings. Discussion This study empirically documented the impaired verbal information management tactics in patients with schizophrenia and their healthy siblings compared using CAP. This specific domain of language impairment was related with cognitive functions, psychotic symptoms, real-life functioning, and schizotypal personality trait. Significance The current study has taken the first attempt to demonstrate an impairment of verbal information transfer in schizophrenia using a newly developed ecological test. Results of this study laid the groundwork for understanding language impairments related to schizophrenia, suggesting verbal information management as a candidate endophenotype of schizophrenia with intervention implications.
published_or_final_version
Psychiatry
Doctoral
Doctor of Philosophy

Adults with schizophrenia are characterised by widespread cognitive and emotion dysfunctions. The neurodevelopmental hypothesis of schizophrenia posits that these abnormalities may precede the onset of overt clinical symptoms of illness, with progressive deterioration as individuals approach and transition to first-episode psychosis. The present thesis explored differences in cognitive performance and motor function in the childhood and adolescence of individuals who subsequently developed schizophrenia compared to those who did not, and examined cognitive and facial emotion processing abnormalities among children at-risk for schizophrenia and schizophrenia spectrum disorders. The findings presented in Chapter Four indicate that lower IQ and motor dysfunction, but not poor scholastic achievement, precede the prodromal phase of schizophrenia. Chapter Six provides evidence that at age 9 to 12 years, children presenting with a triad of antecedents of schizophrenia and children with a high familial loading for the disorder displayed diverse cognitive impairments. The results of Chapter Seven indicate that youth presenting with a triad of antecedents of schizophrenia and youth with a positive family history of the disorder exhibit some cognitive deficits that remain stable from 9 to 15 years, some deficits that increase with age, and other early deficits that show recuperation towards levels of typically developing children by 15 years. Finally, Chapter Nine demonstrates that children presenting with multiple antecedents of schizophrenia are characterised by poor facial emotion processing abilities. The findings of the present thesis indicate that children presenting with antecedents of schizophrenia display similar cognitive and facial emotion processing abnormalities to adults with schizophrenia and children with a positive family history of the disorder. However, only longitudinal follow-up of the children examined in the present thesis will establish the extent to which the triad of multiple antecedents is predictive of later psychotic or non-psychotic disorders.

In this thesis I explored cognition, psychopathology and the role of Catechol-O-Methyltransferase (COMT) in children at increased risk of schizophrenia with the aim of making a contribution to our understanding of the processes that take place early in the development of psychosis. Two samples were studied. The first sample came from the population-based Avon Longitudinal Study of Parents and Children (ALSPAC) where I examined the relationships between a priori selected cognitive domains and psychotic experiences (PEs). The results indicated that impaired processing speed and attention were related to greater risk of PEs in children, with processing speed being a key cognitive feature. Moreover, the relationships between cognition and later occurrence of PEs were similar to those that have previously been reported between cognition and schizophrenia. I also examined whether genetic variation in COMT was associated with PEs indirectly through cognition and anxiety disorders. The findings showed that COMT was indirectly associated with PEs through processing speed, IQ and attention. The second sample comprised children with 22q11.2 Deletion Syndrome (22q11.2DS). I examined the nature and prevalence of psychopathology and cognitive dysfunction in the sample and their siblings and to what extent the children’s intellectual impairment indirectly influences the risk of psychopathology associated with the deletion. There were high rates of psychopathology and cognitive impairments in children with 22q11.2DS. However, I found no evidence for an indirect association between the deletion and the risk of psychopathology through cognition. Finally, there was no evidence that COMT is related to the susceptibility of children with 22q11.2DS to cognitive and psychiatric problems. These findings have potentially important implications for our understanding of the development of psychosis during childhood and they also show that using different research designs to investigate specific aims in samples at increased risk enables the researcher to widen their scope of interpretation.

Vorliegende Arbeit beschäftigt sich mit der Thematik „Familien schizophren erkrankter Eltern“ als einem speziellen Gebiet der sozialpsychiatrischen Forschung. Eine psychiatrische Erkrankung wie die Schizophrenie bzw. schizoaffektive Störung wirkt sich nicht nur auf die Patienten selbst, sondern auf die gesamte Familie aus und beeinträchtigt v. a. die psychosoziale Entwicklung von minderjährigen Kindern, die erheblichen Belastungen ausgesetzt sind. Empirische Befunde belegen die Häufigkeit von Elternschaft innerhalb der speziellen Patientengruppe und machen deutlich, dass die Anwesenheit von Kindern eine nicht selten vorkommende Konstellation ist und einen wachsenden Bedarf an Unterstützungsangeboten mit sich bringt. Die subjektive Lebensqualität der Erkrankten als ein Kriterium einer erfolgreichen Behandlung findet in einem weiteren Artikel seine Beachtung und wird in seinem Zusammenhang mit Elternschaft und Partnerschaft analysiert. Dabei wird die Notwendigkeit eines Einbezugs der familiären Situation in die Planung von Interventionen hervorgehoben und die Nutzung von Partnerschaft und Elternschaft als Ressourcen herausgestellt, die zur Steigerung der Lebensqualität der Patienten beitragen können. Die Kinder als die schwächsten Glieder in der Kette der Betroffenheit werden im dritten Artikel bezüglich ihrer speziellen Belastungssituation betrachtet und es werden ihre Bewältigungsmechanismen qualitativ wie quantitativ erfasst. Dabei werden jene Copingstile diskutiert, die für die Kinder in ihrer besonderen Lage einen protektiven Faktor darstellen oder hinderlich sein können. In allen Beiträgen wird die Notwendigkeit einer Integration der Familie (Partner wie Kinder) in die Betreuung und Behandlung der Patienten hervorgehoben.

Children of parents with mental illness (COPMI) are a substantial, yet until quite recently, marginalised group within society. Whilst extensive empirical research has been conducted into their risk for adverse psychosocial outcomes as well as potential for resilience, there has been relatively little focus on their personal experiences and understandings of such experiences. In recent years, national and international mental health service policies and guidelines for service provision have been developed to address the specific needs of families and children where parents have mental illness, including serious mental illnesses such as schizophrenia and bipolar disorder. These policies and related service provision guidelines have appropriately focused health professionals' attention on the needs and importance of prevention and early intervention for COPMI. There has not, however, been an associated focus on the needs and experiences of adult children of parents with mental illness (ACOPMI), who have remained significantly marginalised in respect to policy and mental health service provision whilst also demonstrating an increased risk for psychosocial adversity yet potential for resilience. Thus, there has been a gap in knowledge of the experiences of adult children with parents who have mental illness, and their needs have not been served adequately. This narrative inquiry set out to extend the limited understandings of the needs and experiences of adult children of parents with serious mental illnesses (ACOPSMI) such as schizophrenia and major depression. These illnesses have been recognised through research as having potential for long-term and often adverse impacts on children. A lengthy unstructured narrative interview and member check process was conducted with nine ACOPSMI in Australia over a nine month period. The inclusion of the researcher's experience through the use of auto-ethnography resulted in a total of ten participants in the study. Postmodern assumptions have provided a framework for this inquiry and so in this thesis multiplicity, diversity and attending to the voices of those on the margins have been privileged. In order to identify the concerns of ACOPSMI using methods that allowed their voices and stories to be heard from multiple perspectives, a dual analytic process was developed. As per Lather's (1997) recommendation of doing a 'double science', a conventional or realist interpretation of participants' experiences was initially performed. Field texts were analysed according to van Manen's (1990) interpretive phenomenological thematic approach. This initial analytic phase sought to develop and build upon the existing literature which had used similar approaches. In order to thicken interpretations and add a fresh dimension to conventional understandings, the postmodern or alternate story of their experiences was then illuminated through a postmodern narrative analysis. This approach employed an analytic framework developed from the work of several other postmodern and/or narrative writers. From the initial analysis, four phenomenological themes of participants' experiences were uncovered. Consistent with previous literature, these adult children experienced a number of difficulties in growing up with parents with serious mental illness, including assuming responsibility for their parent and family, experiencing negative emotional impacts and developing their own mental health problems, and finding it challenging to connect emotionally with their parents and others. They also, however, demonstrated considerable resilience and effective ways of coping with their experience which assisted many of them to forge productive lives and overcome negative impacts of their past. This thesis discusses these participants' experiences from both conventional and alternate perspectives, as well as addressing the inter-textuality of meanings that may be found between the spaces of such findings. In the light of participants' experiences, recommendations have been developed for health professionals' practice which seek to inform and guide them in working with adult children and families where parents have serious mental illness.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
Full Text

Made available in DSpace on 2015-12-06T23:02:56Z (GMT). No. of bitstreams: 0 Previous issue date: 2003
A Schedule for Affective Disorders and Schizophrenia for School-Age Childrenl Present and Lifetime Version (K-SADS-PL) e uma entrevista psiquiatrica semiestruturada para identificar transtornos na faixa etaria de 6 a 18 anos. Objetivos: Traduzir a K-SADS-PL do ingles (versao original) para o portugues e avaliar suas propriedades psicometricas (estudo de validade e confiabilidade). Metodos: Estudo de corte transversal envolvendo uma amostra consecutiva de criancas e adolescentes (N=78) agendadas para primeiro atendimento em ambulatorio de Saúde mental da Universidade Federal do Rio de Janeiro (Servico de Saúde Mental Infanto-Juvenil do Instituto de Psiquiatria). A validade de conteudo foi avaliada comparando-se a retrotraducao da versao brasileira com o instrumento original. A validade de constructo foi avaliada: (1) comparando-se a frequencia de transtornos detectados pela K-SADS-PL com dados de prevalencia encontrados na literatura, (2) comparando-se os padroes de comorbidade baseados na K-SADS-PL com os referidos na literatura, (3) examinando-se a validade convergente da K-SADS-PL em relacao ao Child 8ehavior Checklist- CBCL (N=78), e (4) verificando-se a existencia de associacao entre transtornos mentais nas criancas, identificados pela K-SADSPL, e problemas de Saúde mental nas maes, identificados pelo Self-Report Questionnaire (SRQ-20). O estudo da confiabilidade entre-avaliadores foi baseado na pontuacao da K-SADS-PL obtida por duas psiquiatras da infancia, uma aplicando a secao de rastreamento e a outra observando (N=30). O estudo da confiabilidade teste-reteste foi baseado na pontuacao da secao de rastreamento obtida pela mesma psiquiatra da infancia em duas ocasioes, com intervalo de tempo de uma a oito semanas (N=16). Resultados: Adultos e criancas de diferentes faixas etarias nao apresentaram dificuldades para entender os itens da versao traduzida da KSADS-PL. A retrotraducao da versao brasileira evidenciou equivalencia de conteudo com o instrumento original. A validade de constructo foi comprovada na medida em que achados da literatura foram compativeis com resultados da K-SADS-PL em termos de taxas de transtornos mentais observadas nas criancas, padroes de comorbidade e evidencia de associacao entre transtornos psiquiatricos nas criancas e problemas de Saúde mental materna. A K-SADS-PL tambem apresentou evidencias de validade convergente, quando comparada a...(au)
BV UNIFESP: Teses e dissertações

Thesis (M.A.)--University of Alabama at Birmingham, 2007.
Title from PDF title page (viewed Jan. 29, 2010). Additional advisors: Robert J. Collins, Peter Donahue, Lawrence G. Wharton. Includes bibliographical references (p. 51).

On s’est proposé : 1) de déterminer si les formes auto-et-hétéro-évaluatives du questionnaire Screen for Child Anxiety Related Emotional Disorders (SCARED), la Youth- Self Report (YSR) et la Child Behavior ChekList (CBCL) constituent de bons prédicteurs des diagnostics des différents troubles anxieux posés à l’aide de l'entretien semi-structuré Schedule for Affective Disorders and Schizophrenia for School-Age-Children- Present version (Kiddie-SADS-P) sur un échantillon français d’enfants consultants ; 2) de vérifier l’aptitude de la SCARED à discriminer les enfants consultants des enfants tout-venant ; 3) d’étudier l’influence du sexe sur le niveau d’anxiété et 4) d’évaluer le niveau de concordance parents/enfants dans l’évaluation de ces troubles. Méthode : 69 enfants âgés de 6 à 12 ans, consultant pour une aide psychologique au sein de Réseaux d’Aide Spécialisée aux Enfants en Difficulté (RASED) ont été évalués au moyen de l'entretien semi-structuré Kiddie-SADS et des questionnaires SCARED, CBCL et YSR. Les protocoles de la SCARED (forme enfant et forme parent) ont été comparés à ceux d'un groupe témoin composé de 48 dyades enfant/parent issus des mêmes écoles. Résultats: Les scores d'anxiété auto-évalués par les enfants à la SCARED constituent de bons prédicteurs des critères de troubles anxieux évalués au moyen de l'entretien Kiddie-SADS. Contrairement aux études internationales, aucune différence entre les filles et les garçons n'apparait dans notre échantillon. A cause du faible taux d'accord entre parent/enfant sur le niveau des troubles anxieux, les deux évaluations apparaissent nécessaires pour l'obtention d'un diagnostic adéquat
The aims of this study were : 1) to examine if the self-report and other-report forms of the questionnaire Screen for Child Anxiety Related Emotional Disorders (SCARED), the Youth Self-Report (YSR), and the Child Behavior ChekList (CBCL) are good predictors of the different anxiety disorders diagnosed using the semi-structured interview Schedule for Affective Disorders and Schizophrenia for school-age children-Present version (Kiddie-SADS-P) on a French sample of referred children, 2) to check the ability of the SCARED to discriminate referred and non-referred children, 3) to study the influence of gender on the anxiety level, and 4) to evaluate the level of parent/child agreement in the assessment of these disorders. Method: 69 children aged 6 to 12 years, referred to a "RASED" (a psychological/educational support facility located in the French schools) were assessed using the Kiddie-SADS semi-structured interview, and the SCARED, CBCL and YSR questionnaires. The SCARED questionnaires (self-report and parent-report) were compared with a control group scores of 48 parent/child dyads selected from the same schools. Results: The self-reported SCARED anxiety scores are good predictors of anxiety disorders criteria, assessed using the Kiddie-SADS interview. Contrary to international studies, no difference between girls and boys appears in our sample. Because of the low levels of agreement between parent/child about levels of anxiety disorders the two assessments appear necessary to obtain a proper diagnosis

Introdução: Atualmente, muito tem se estudado a respeito de a esquizofrenia e do transtorno afetivo-bipolar (TAB) pertencerem a um continuum de sinais e sintomas que caracterizam o espectro da psicose, com etiologias que se sobrepõem parcialmente. O estudo comparativo de crianças filhas de pacientes com esquizofrenia e com transtorno bipolar pode ajudar na compreensão do quanto à vulnerabilidade para o desenvolvimento dessas patologias se assemelha e em quais momentos se diferencia. Os objetivos deste estudo foram comparar crianças e adolescentes em risco para esquizofrenia, para transtorno bipolar e um grupo sem risco para estes transtornos em relação a: 1) presença de problemas de saúde mental, diagnóstico psiquiátrico, competência social, quociente intelectual (QI); 2) associação entre presença de diagnóstico ou sintomas psiquiátricos nas crianças e a presença de diagnóstico psiquiátrico materno (esquizofrenia ou transtorno bipolar do humor), gravidade do diagnóstico materno, complicações obstétricas, nível socioeconômico dos pais, escolaridade da mãe. Métodos: Foi realizado estudo transversal comparando filhos de mulheres com diagnóstico de esquizofrenia e transtorno afetivo bipolar, segundo critérios do DSM-IV, e filhos de mulheres sem transtornos mentais graves, na faixa etária de 6 a 18 anos. Os instrumentos utilizados para avaliação da psicopatologia das crianças e adolescentes foram o Child Behavior Checklist (CBCL), Youth Self Report (YSR) e o Schedule for affective disorders and schizophrenia for school aged children-lifetime version (KSADS- PL). A psicopatologia das mães foi avaliada com o uso da escala Structured Clinical Interview for DSM-IV Disorders (SCID-I/P) e o funcionamento/gravidade destas mulheres com a Global Assessment of Functioning (GAF). Para a avaliação do QI e funcionamento social das crianças foram utilizados as escalas Wechsler Abbreviated Scale of Intelligence (WASI) e Children\'s Global Assessment Scale (CGAS) respectivamente. O nível socioeconômico foi avaliado com o uso da escala da Associação Brasileira de Empresas de Pesquisa (ABEP) e um instrumento contendo dados demográficos e de gestação e parto foi criado para ser utilizado neste estudo. Resultados: Foram incluídos no estudo 67 filhos de mães com esquizofrenia, 65 filhos de mães com transtorno bipolar e 63 controles. Os filhos de mulheres com transtorno bipolar apresentaram maior prevalência de problemas comportamentais que os outros grupos, com maior prevalência tanto de problemas de internalização quanto de externalização, e apresentaram maior prevalência de diagnóstico de transtorno de déficit de atenção e hiperatividade e de transtorno de conduta. Os filhos de mulheres com esquizofrenia apresentaram pior eficiência intelectual quando comparados aos jovens em risco para transtorno bipolar, e pior ajustamento social quando comparados aos controles. Foi detectada uma diferença na presença de comportamentos agressivos entre os gêneros no grupo em risco para esquizofrenia. Os meninos em risco para esquizofrenia apresentaram prevalência muito menor de comportamentos agressivos que as meninas deste grupo e que tanto meninas quanto meninos dos demais grupos. Os fatores que se associaram à presença de problemas comportamentais nestas crianças e adolescentes além do diagnóstico materno foram: gravidade da doença materna, moradia com a mãe, ter sofrido riscos pela presença de psicopatologia materna, nível socioeconômico, escolaridade da mãe, possuir pai com problemas com uso de álcool ou outras substâncias, intercorrências durante a gestação e parto, mãe não ter sido internada durante crise na gestação. Conclusões: Os filhos de mães com TAB apresentaram mais problemas comportamentais e diagnósticos psiquiátricos, enquanto os filhos de mulheres com esquizofrenia apresentaram mais prejuízos cognitivos e de competência social e funcional. Contribuindo, assim, para a discussão de que as duas patologias possam ser entendidas como entidades diagnósticas distintas na medida em que diferenças aparecem nos jovens vulneráveis a elas
Introduction: Nowadays a lot has been studied about schizophrenia and bipolar affective disorder being part of a continuum of signals and symptoms which characterize the spectrum of psychosis, with etiologies that are partially superseded. The comparative study of children who were sons of patients with schizophrenia and bipolar disorder can help understanding how much this vulnerability for these pathologies development is similar and in what moments it differs. The aims of this study have been to compare children and adolescents at risk for schizophrenia, bipolar disorder and a group without risk for these disorders in relation to: 1) The presence of mental health problems, psychiatric diagnosis, social competence, intelligence quotient; 2) The association between diagnosis presence or psychiatric symptoms in children and the presence of maternal psychiatric diagnosis (schizophrenia or mood bipolar disorder), severity of maternal diagnosis, obstetric complications, socioeconomic level, mother\'s educational level. Methods: A cross-sectional study has been done comparing the sons of women with schizophrenia and bipolar disorder, according to DSM-IV criteria, and sons of women without severe mental disorder, within the age group of 6 to 18. The instruments used for the evaluation of the children\'s and adolescents\' psychopathology were the Child Behavior Checklist (CBCL), the Youth Self Report (YSR) and the Schedule for affective disorders and schizophrenia for school aged children-lifetime version (KSADS-PL). The psychopathology of the mothers was evaluated with the use of the scale Structured Clinical Interview for DSM-IV Disorders (SCID) and the functioning/severity of these women with Global Assessment of Functioning (GAF). For the evaluation of the intelligence quotient and children social function were used Wechsler Abbreviated Scale of Intelligence (WASI) and Children\'s Global Assessment Scale (CGAS) respectively. The socioeconomic level was evaluated with the use of the scale from Associação Brasileira de Empresas de Pesquisa (ABEP) and an instrument containing demographic data and gestation/childbirth was created to be used in this study. Results: 67 sons of schizophrenic mothers were included in the study, 65 sons of mothers with bipolar disorder and 63 controls. The sons of women with bipolar disorder presented higher prevalence of behavior problems compared to the other groups, with a higher prevalence of both internalization and externalization problems, and they also presented higher diagnosis prevalence of attention deficit /hyperactivity disorder, and conduct disorder. The sons of women with schizophrenia presented worst intellectual efficiency when compared to youngsters with risk of bipolar disorder, and worst social adjustment when compared to the controls. A difference in the presence of aggressive behavior was detected among the genders in the group at risk for schizophrenia. Boys at risk for schizophrenia presented a much smaller prevalence of aggressive behavior compared to the girls in this group and also compared to boys and girls from the other groups. Besides the maternal diagnosis, the factors which were associated to the presence of behavior problems in these children and adolescents were: severity of the maternal disease, sharing residence with the mother, having suffered risk because of the presence of maternal psychopathology, socioeconomic level, mother\'s educational level, father who has a history of alcohol or other substance abuse, complications during gestation and childbirth, mother not being hospitalized when suffering a psychiatric crisis during pregnancy. Conclusions: The sons of mothers with bipolar disorder presented more behavior problems and psychiatric diagnosis, while the sons of mothers suffering from schizophrenia presented more cognitive, social and functional competence impairments. This conclusion corroborates for the discussion that both pathologies may be understood as distinct diagnostic entities insofar as differences appear in the youngsters who are vulnerable to them

A qualitative phenomenological research method was used to explore and describe the lived experience of six fathers of young adult children with schizophrenia who volunteered to participate in this study. The following six themes emerged from the analysis of these fathers' stories through the seven steps of phenomenological analysis outlined by Colaizzi (1978): reflection on roles and responsibilities, a sense of devastation and vulnerability, a sense of sadness and loss, a sense of frustration with the mental health system, a sense of admiration for their child, and a sense of having gained personally. The findings of the study indicated that reflection on their early roles and responsibilities as fathers before the onset of their child's illness helped the participants in this study make meaning of the roles and responsibilities they assumed as their child's illness progressed. The participants experienced a sense of devastation and vulnerability when their child received the diagnosis of schizophrenia, as they began to face the realities of living with a child with schizophrenia, and especially when dealing with crisis situations. They also experienced a sense of sadness and loss. Five kinds of losses were described: loss of who their child once was, loss of their child's potential to be productive, loss of dreams for their child's future, loss experienced in fathers' present lives, as well as loss of hopes and dreams for their own future. A sense of frustration was reported in response to various aspects of the mental health system. Two additional themes emerged from the analysis of the participants' stories that were not reported as themes in previous studies: a sense of admiration for their child and a sense of having gained personally. The study concludes with a discussion of implications for counselling practice, implications for mental health policy, as well as implications for future research.
Education, Faculty of
Educational and Counselling Psychology, and Special Education (ECPS), Department of
Graduate

碩士
國立陽明大學
衛生福利研究所
93
For parents with schizophrenia children receiving long-term institutional care, sending their children to institutions indicates the lost of partial freedom and difficulties of returning back to society for their children. Henceforth, this research aims to understand their care-giving experiences with their ill children based on the parents’ subjective perceptions, and how these experiences also leave impacts on themselves to eventually lead to the decision of sending their children to institutions. Nine parents with schizophrenia children from Yuli Hospital, Department of Health, Executive Yuan I target for the first-hand research by conducting in-depth interviews, transcribing interview contents for thematic analysis to record data, and processing the material analysis in the perspective of paragon interpretations. From the interview records, I discover that these parents of schizophrenia children usually confront this condition with an assigned fatal attitude to take care of their ill children as their life-long burden. I further sort their care-giving experiences into four phrases, and in each phrase, their care-giving experience would also be altered according to the actual medication progress. In the first phrase, the core experience of the parents is to seek for an explanation for the illness that occurs in the initial stage of schizophrenia symptom as parents just start to experience the children’s change from normality to abnormality. In the second phrase, the medical treatment has taken place. The parents confirm the fact of their beloved children’s illness, and actively look for all kinds of therapies with the hope of curing their children back to the well original condition. During this period of time, they would usually have a lot of interactions with the medical systems, and also try to work out the strategies to carry on with children’s schizophrenia. In the third phrase, which arrives after the medical treatment, parents discover that their children’s conditions could go up and down when they return from a hospital. They start questioning the reasons for the unstable condition of their children. After several frustrations, they begin to gradually lose faith in the medication, and they come to accept that “this kind of illness” has no cure, and they would give up the therapy as well. As it comes to this point, parents could be disappointed and depressed, and they probably just accept it as a matter of fact. In the forth phrase, parents then are aware of the end of their own care-giving to their children as their capacity would be decrease with their aging, so they start worrying for the children’s future. Therefore, they would take actions to arrange children’s future. In addition to these discoveries, I also find that there is a connotative discipline from the Chinese family tradition consciousness in most of the decisions on sending off their children to institutions. To truly understand the meanings of parents’ care-giving to their schizophrenia children from the parental stance and perceptions does not only break the myth of such experience, but also provides an opportunity to comprehend the decision making, from their personal description, on the sending off their children to institutions before their life end. The research outcome has advanced into three suggestions: 1.Promote the supporting environment of community care; 2.Invite these parents and their schizophrenia children to join the therapy programs in hospitals; 3.Establish small long-term caring institutions in communities.

by Chui Shu-fai, Fred.
Includes questionaire in Chinese.
Thesis (M.S.W.)--Chinese University of Hong Kong, 1995.
Includes bibliographical references (leaves [45-68] (3rd gp.)).
Chapter ONE --- INTRODUCTION --- p.1
Chapter TWO --- THE IMPACT OF PARENTAL MENTAL ILLNESS ON CHILDREN --- p.8
Chapter 2.1 --- Impact of parental mental illness on children --- p.8
Chapter 2.2 --- Studies about the impact of parental affective disorder on children --- p.9
Chapter 2.3 --- Children of schizophrenic patients --- p.12
Chapter 2.3.1 --- Effect of psychiatric symptoms and behavioral change --- p.14
Chapter 2.3.2 --- Impairment of interaction --- p.15
Chapter 2.4 --- Parents with depression versus parents with schizophrenia: their differential impacts on children --- p.16
Chapter 2.4.1 --- Parenting --- p.16
Chapter 2.4.2 --- Children at risk --- p.18
Chapter 2.4.3 --- Problems faced by the children --- p.20
Chapter 2.5 --- Discussion on the above findings --- p.22
Chapter 2.6 --- Resilience in Children / Adolescents --- p.25
Chapter 2.7 --- Limitations of some empirical studies about children of mentally ill --- p.27
Chapter THREE --- "STRESS, COPING RESOURCES AND MENTAL HEALTH" --- p.30
Chapter 3.1 --- Concept of Stress --- p.30
Chapter 3.2 --- "Life events, daily hassles and life strains" --- p.36
Chapter 3.3 --- Objective burdens and subjective burdens arising from the mentally ill in the family --- p.37
Chapter 3.4 --- "Stressors as management problems, psychological problems and social / economic costs faced by the children" --- p.39
Chapter 3.4.1 --- Management problems --- p.39
Chapter 3.4.2 --- Psychological problems --- p.41
Chapter (a) --- Self-blame and Guilt
Chapter (b) --- Anger
Chapter (c) --- Feeling of Embarrassment and shame
Chapter (d) --- Anxieties caused by parent's hospitalization
Chapter (e) --- Sense of inferiority caused by the prejudice and rejection of community
Chapter 3.4.3 --- Social / economic costs --- p.47
Chapter (a) --- Disruption of family functioning
Chapter (b) --- Conflict in the family
Chapter (c) --- Financial difficulties
Chapter (d) --- Reduction in social life
Chapter 3.5 --- Perceived Stress --- p.50
Chapter 3.5.1 --- Measurement of perceived stress --- p.52
Chapter 3.6 --- Stress and Coping in Children/Adolescents --- p.53
Chapter 3.7 --- Coping Resources --- p.56
Chapter 3.7.1 --- Health and energy --- p.58
Chapter 3.7.2 --- Positive beliefs --- p.58
Chapter 3.7.3 --- Social skills --- p.61
Chapter 3.8 --- Coping resources being examined in this study --- p.62
Chapter 3.8.1 --- Self-efficacy --- p.63
Chapter (a) --- Self-efficacy as a coping resource
Chapter (b) --- Social self-efficacy
Chapter (c) --- Measurement of self-efficacy
Chapter 3.8.2 --- Self-esteem --- p.71
Chapter (a) --- Measurement of Self-esteem
Chapter 3.8.3 --- knowledge / Information --- p.73
Chapter (a) --- Knowledge about schizophrenia
Chapter (b) --- Measurement about mental health knowledge
Chapter 3.8.4 --- Attitude toward the ex-mental patient --- p.76
Chapter (a) --- Mental health knowledge and attitude toward mental patient
Chapter (b) --- Adolescent's attitude toward the mentally-ill
Chapter (c) --- Measurement of attitude toward mental illness and mental patients
Chapter 3.9 --- Mental Health --- p.81
Chapter 3.9.1 --- Concept of “Mental´ح --- p.81
Chapter 3.9.2 --- Concept of “Health´ح --- p.81
Chapter 3.9.3 --- Mental health as a concept --- p.82
Chapter 3.9.4 --- Measurement of mental health --- p.84
Chapter FOUR --- LITERATURE REVIEW ON THE RELATIONSHIPS AMONG VARIABLES UNDER STUDY --- p.85
Chapter 4.1 --- Stress and mental health --- p.85
Chapter 4.2 --- Coping resources and perceived stress --- p.87
Chapter 4.2.1 --- Self-efficacy and perceived stress --- p.87
Chapter 4.2.2 --- Self-esteem and perceived stress --- p.88
Chapter 4.2.3 --- Knowledge and perceived stress --- p.89
Chapter 4.2.4 --- Attitude and perceived stress --- p.89
Chapter 4.3 --- Coping resources and mental health --- p.90
Chapter 4.3.1 --- Self-efficacy and mental health --- p.90
Chapter 4.3.2 --- Self-esteem and mental health --- p.92
Chapter 4.3.3 --- Knowledge and mental health --- p.93
Chapter 4.3.4 --- Attitude and mental health --- p.94
Chapter 4.4 --- Conceptual framework --- p.94
Chapter 4.5 --- Research questions and hypotheses --- p.99
Chapter 4.6 --- Definition of concepts --- p.103
Chapter 4.6.1 --- Definition of stressors --- p.103
Chapter 4.6.2 --- Definition of perceived stress --- p.103
Chapter 4.6.3 --- Definition of social self-efficacy --- p.103
Chapter 4.6.4 --- Definition of self-esteem --- p.104
Chapter 4.6.5 --- Definition of knowledge about schizophrenia --- p.104
Chapter 4.6.6 --- Definition of behavioral intentions / attitude --- p.104
Chapter 4.6.7 --- Definition of mental health --- p.105
Chapter FIVE --- RESEARCH METHODOLOGY --- p.106
Chapter 5.1 --- Sample Design --- p.106
Chapter 5.2 --- Instruments for Measurement --- p.107
Chapter 5.2.1 --- Scale measuring the stressors (ST-ALL) and Perceived Stress (PS-ALL) --- p.107
Chapter 5.2.2 --- Rosenberg Self-esteem Scale (RSES) --- p.108
Chapter 5.2.3 --- Adolescent Social Self-efficacy Scale (SEFF) --- p.108
Chapter 5.2.4 --- Knowledge about Schizophrenia Scale (SKS) --- p.109
Chapter 5.2.5 --- Behavioral Intention toward Ex-mental Patients Scale (BIEMPS) --- p.109
Chapter 5.2.6 --- General Health Questionnaire (GHQ-30) --- p.110
Chapter 5.2.7 --- Chinese Version of Hopelessness Scale (C-Hope) --- p.111
Chapter 5.2.8 --- Demographic /personal data --- p.111
Chapter SIX --- RESULTS --- p.112
Chapter 6.1 --- Psychometric properties of the measuring instruments --- p.112
Chapter 6.1.1 --- Measurement of stress
Chapter (a) --- Stressor Scale (ST-ALL)
Chapter (b) --- Perceived Stress Scale (PS-ALL)
Chapter 6.1.2 --- Measurement of coping resources --- p.113
Chapter (a) --- Adolescent Social Self-efficacy Scale (SEFF)
Chapter (b) --- Rosenberg Self-esteem Scale (RSES)
Chapter (c) --- Knowledge about Schizophrenia Scale (SKS)
Chapter (d) --- Behavioral intention towards Ex-mental Patients Scale (BIEMPS)
Chapter 6.1.3 --- Measurement of mental health --- p.115
Chapter (a) --- General health questionnaire - 30 (GHQ-30)
Chapter (b) --- Chinese-Hopelessness Scale (C-Hope)
Chapter 6.2 --- Demographic characteristics of the respondents --- p.133
Chapter 6.2.1 --- Sex and Age of Respondents --- p.133
Chapter 6.2.2 --- Relationship of Respondents to Their Schizophrenic Parents --- p.133
Chapter 6.2.3 --- Education Level of Respondents --- p.133
Chapter 6.2.4 --- No. of Siblings of the Respondents and Their Rank among siblings --- p.134
Chapter 6.2.5 --- Religion of respondents --- p.134
Chapter 6.2.6 --- Out-patient or in-patient status of respondents' schizophrenic parents and number of years of treatment --- p.134
Chapter 6.2.7 --- Education Level of the Parents --- p.135
Chapter 6.2.8 --- "Occupation of the respondents' parents, the family's income and its source" --- p.135
Chapter 6.2.9 --- Type of accommodation and family size within the same household --- p.136
Chapter 6.2.10 --- Marital status of respondents' parents --- p.136
Chapter 6.2.11 --- Principal caregivers of the respondents' schizophrenic parents --- p.136
Chapter 6.3 --- Respondents' perception of the existing services and expressed needs --- p.140
Chapter 6.3.1 --- Number of respondents who had visited social workers in the past 6 months and their satisfaction with the service of social workers --- p.140
Chapter 6.3.2 --- The social services which were considered by the respondents as important for their schizophrenic parents --- p.140
Chapter 6.3.3 --- The social services which were needed by respondents --- p.141
Chapter 6.4 --- "Findings of stress, coping and mental health of respondents" --- p.144
Chapter 6.4.1 --- Stress --- p.144
Chapter (a) --- Stressors faced by respondents
Chapter (b) --- Perceived stress experienced by respondents
Chapter 6.4.2 --- Coping resources --- p.148
Chapter (a) --- Distribution of responses to the items in the Social Self-efficacy Scale
Chapter (b) --- Distribution of responses to the items in the Rosenberg Self-esteem Scale
Chapter (c) --- Distribution of responses to the items in the Knowledge about Schizophrenia Scale
Chapter (d) --- Distribution of responses to the items in the Behavioral Intention toward Ex-mental Patient Scale
Chapter 6.4.3 --- Mental health --- p.152
Chapter (a) --- Distribution of responses to the items in the General Health Questionnaire-30 (GHQ-30)
Chapter (b) --- Distribution of responses to the items in the Chinese version of Hopelessness Scale (C-Hope)
Chapter 6.5 --- "Interrelationships amongst stress, coping and mental health of the respondents" --- p.166
Chapter 6.5.1 --- Relationship between perceived stress and psychological well being --- p.166
Chapter (a) --- Relationship between perceived stress and GHQ-30
Chapter (b) --- Relationship between perceived stress and hopelessness
Chapter 6.5.2 --- Relationships between perceived stress and coping resources --- p.167
Chapter (a) --- Relationship between perceived stress and social self-efficacy
Chapter (b) --- Relationship between perceived stress and self-esteem
Chapter (c) --- Relationship between perceived stress and knowledge about schizophrenia
Chapter (d) --- Relationship between perceived stress and behavioral intentions towards ex-mental patients
Chapter (e) --- Differential effects of coping resources on perceived stress
Chapter 6.5.3 --- Relationships amongst the various measures of coping resources and psychological well-being --- p.169
Chapter (a) --- Relationship between social self-efficacy and psychological well-being
Chapter (b) --- Relationship between self-esteem and mental health
Chapter (c) --- Relationship between knowledge about schizophrenia and psychological well-being
Chapter (d) --- Relationship between attitude toward ex-mental patient and psychological well-being (C-Hope)
Chapter (e) --- Differential effects of coping resources on psychological well-being
Chapter SEVEN --- DISCUSSION --- p.175
Chapter 7.1 --- Psychometric properties of the tools --- p.175
Chapter 7.1.1 --- Measurement of stress --- p.175
Chapter (a) --- Stressor Scale (ST-ALL)
Chapter (b) --- Perceived Stress Scale (PS-ALL)
Chapter 7.1.2 --- Measurement of coping resources --- p.178
Chapter (a) --- Social Self-efficacy Scale (SEFF)
Chapter (b) --- Rosenberg Self-esteem Scale (RSES)
Chapter (c) --- The Knowledge about Schizophrenia Scale (SKS)
Chapter (d) --- Behavioural Intentions Toward Ex-mental Patients (C-BIEMP)
Chapter 7.1.3 --- Measurement of psychological well-being --- p.181
Chapter (a) --- GHQ
Chapter (b) --- Chinese version of Hopelessness Scale
Chapter 7.2 --- Characteristics of respondents --- p.183
Chapter 7.2.1 --- "Sex, age and education" --- p.183
Chapter 7.2.2 --- "Housing condition, family size and family income" --- p.183
Chapter 7.2.3 --- Religion --- p.184
Chapter 7.2.4 --- Caregivng role --- p.185
Chapter 7.3 --- Respondents' perception of the existing service and expressed concern --- p.185
Chapter 7.3.1 --- Number of respondents who had visited social worker in the past 6 months and their satisfaction with the service of social workers --- p.185
Chapter 7.3.2 --- The social services which were considered by respondents as important for their schizophrenic parents --- p.185
Chapter 7.3.3 --- Social services most needed by respondents --- p.189
Chapter 7.4 --- "Stress, coping resources and mental health of respondents" --- p.192
Chapter 7.4.1 --- Stress --- p.192
Chapter (a) --- Stressors faced by respondents
Chapter (b) --- Perceived Stress
Chapter 7.4.2 --- Coping Resources --- p.201
Chapter (a) --- Social Self-efficacy
Chapter (b) --- Self-esteem
Chapter (c) --- Knowledge about schizophrenia
Chapter (d) --- Behavioral intentions toward ex-mental patients
Chapter 7.4.3 --- Mental health of respondents --- p.210
Chapter (a) --- General Health Questionnaire
Chapter (b) --- Hopelessness Scale
Chapter 7.5 --- Findings on relationships among major variables --- p.211
Chapter 7.5.1 --- Relationship between perceived stress and psychological well-being --- p.211
Chapter 7.5.2 --- Relationships between perceived stress and coping resources --- p.212
Chapter 7.5.3 --- Relationship between coping resources and mental health --- p.215
Chapter 7.6 --- Limitations --- p.216
Chapter 7.6.1 --- Use of variables --- p.216
Chapter 7.6.2 --- Sampling --- p.217
Chapter 7.6.3 --- Data Collection --- p.219
Chapter 7.6.4 --- Measuring Instruments --- p.219
Chapter EIGHT --- CONCLUSIONS AND RECOMMENDATIONS --- p.220
Chapter 8.1 --- Conclusions --- p.220
Chapter 8.2 --- Recommendations --- p.225
Chapter 8.2.1 --- Education on management of problems arising from mental patients --- p.225
Chapter 8.2.2 --- Training on stress management --- p.226
Chapter 8.2.3 --- Social skills training --- p.226
Chapter 8.2.4 --- Special counselling service --- p.227
Chapter 8.2.5 --- Mental health education for the patients and their family members as well --- p.228
Chapter 8.2.6 --- Public education --- p.230
Chapter 8.2.7 --- Promotion of teamwork approach among different professionals --- p.231
Chapter 8.2.8 --- Cooperation among different professionals and special training for them --- p.231
Chapter 8.2.9 --- Community support service and utilitarian support --- p.233
Chapter (a) --- Financial assistance
Chapter (b) --- Special home help /family aid service
Chapter (c) --- Outreaching psychiatric service / Community nursing service
Chapter (d) --- Volunteer service
Chapter (e) --- Aftercare service team
Chapter (f) --- Social club for ex-mental patients
Chapter (g) --- Respite service
Chapter 8.2.10 --- Concluding remarks --- p.236
APPENDIX A QUESTIONNAIRE (English Version)
APPENDIX B QUESTIONNAIRE (Chinese Version)
APPENDIX C TABLE31
REFERENCES

碩士
長庚大學
護理學研究所
90
Abstract The study used grounded theory approach to explore the process of how the low-income parents take care of their children with chronic schizophrenia. Twelve subjects were recruited by the theoretical sampling. The interviews were tape recorded, transcribed verbatim, and analyzed by the constant comparative data analysis. In order to increase the rigor, this study used four criteria set by Lincoln and Guba (1985). These criteria were credibility, transferability, dependability, and confirmability. A core category , establishing the new trajectory of the life , emerged from the data. The new trajectory was the process adopted by the low-income parents to maintain the equilibrium of the family while taking care of their children with chronic schizophrenia and facing lots of situation changes continuously. A child suffering from the chronic schizophrenia was a great impact to the low-income family. Because of confusion and disturbance, the family life departed from the normal trajectory. So, the caregivers needed to establish the new trajectory of the life for the family. The new trajectory was a cycle dynamic process that included three factors：detecting the influence of the disease, being aware of the life changes, and adopting coping strategies. The special finding was that the parents not only manifested many the negative emotional reactions, but also presented the positive emotions (like gratification and expectation) and the neutral emotion (reluctancy to let go). While taking care of their children, they generally expressed that they were in the plight such as the economic dilemma and the lack of social support. These aging parents were in a difficult situation when the childrens’ condition was altering. And it made worse particularly while they had to face the violent behavior from their children. Moreover, those whom can develop “the new life trajectory” were more able to accept the existing differences and understand the disease. Thus, they were more able to early select the effective strategies to help the family to “establish the new trajectory of the life ”. In addition, they were able to manage the negative emotion and have more positive emotions. Factors related to the caregiving process included the pre-existing condition and the caregiving factors. Finally, the coping results included compromise, resolute, change and abandonment. The findings benefit the health care providers to have the further understanding of how the low-income parents take care of a child with chronic schizophrenia. Based on the findings, the health care providers can instruct the caregivers to assess the caregiving situation, and taking better strategies through weighing the possible outcome. Moreover, the health care providers can apply the more suitable intervention to them as well. Thus, the findings will help the caregiver, who take care of a child with chronic schizophrenia for a long time, decrease the caring problem and stress, and obtain the better social support.

Vorliegende Arbeit beschäftigt sich mit der Thematik „Familien schizophren erkrankter Eltern“ als einem speziellen Gebiet der sozialpsychiatrischen Forschung. Eine psychiatrische Erkrankung wie die Schizophrenie bzw. schizoaffektive Störung wirkt sich nicht nur auf die Patienten selbst, sondern auf die gesamte Familie aus und beeinträchtigt v. a. die psychosoziale Entwicklung von minderjährigen Kindern, die erheblichen Belastungen ausgesetzt sind. Empirische Befunde belegen die Häufigkeit von Elternschaft innerhalb der speziellen Patientengruppe und machen deutlich, dass die Anwesenheit von Kindern eine nicht selten vorkommende Konstellation ist und einen wachsenden Bedarf an Unterstützungsangeboten mit sich bringt. Die subjektive Lebensqualität der Erkrankten als ein Kriterium einer erfolgreichen Behandlung findet in einem weiteren Artikel seine Beachtung und wird in seinem Zusammenhang mit Elternschaft und Partnerschaft analysiert. Dabei wird die Notwendigkeit eines Einbezugs der familiären Situation in die Planung von Interventionen hervorgehoben und die Nutzung von Partnerschaft und Elternschaft als Ressourcen herausgestellt, die zur Steigerung der Lebensqualität der Patienten beitragen können. Die Kinder als die schwächsten Glieder in der Kette der Betroffenheit werden im dritten Artikel bezüglich ihrer speziellen Belastungssituation betrachtet und es werden ihre Bewältigungsmechanismen qualitativ wie quantitativ erfasst. Dabei werden jene Copingstile diskutiert, die für die Kinder in ihrer besonderen Lage einen protektiven Faktor darstellen oder hinderlich sein können. In allen Beiträgen wird die Notwendigkeit einer Integration der Familie (Partner wie Kinder) in die Betreuung und Behandlung der Patienten hervorgehoben.:Inhaltsverzeichnis 1 Einführung 4 2 Publikationen 19 2.1 Zur Prävalenz von Elternschaft bei schizophrenen Patienten 20 2.2 Lebenszufriedenheit und subjektive Relevanz von Lebensbereichen bei schizophren Erkrankten. Welche Bedeutung haben Partnerschaft und Elternschaft? 21 2.3 Coping bei Kindern schizophren erkrankter Eltern - eine täuschend gute Bewältigung 22 3 Zusammenfassung 23 4 Literaturverzeichnis 28 5 Danksagung 39 6 Erklärung 40 7 Publikationen 41 8 Vorträge und Workshops 44