Schizoid Personality Traits Among the Homeless Mentally Ill: A Quantitative and Qualitative Report
Tóm tắt
This paper examines the interplay among schizoid personality traits, chronicity of homelessness, and engagement in treatment in a homeless mentally ill population. Both qualitative and quantitative information will be provided about a sample of 125 homeless mentally ill individuals receiving psychiatric treatment in a comprehensive services drop-in clinic. Naturalistic observations and a case vignette suggested that schizoid traits were prevalent and may have been playing a role in treatment engagement and chronicity of homelessness. This hypothesis was tested using quantitative research methods. The results showed that schizoid personality disorder and schizoid personality traits were prevalent in the sample. The presence of schizoid traits was positively correlated with chronicity of homelessness. Further, two schizoid traits (being content without sexual involvement with others, and lacking close friends or confidants) were positively correlated with remaining in treatment at 3 months. Implications of these findings for future research and treatment design will be discussed.
Tài liệu tham khảo
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Bachrach, L., Santiago, J., & Berren, M. (1990). Homeless mentally ill patients in the community: Results of a general hospital emergency room study. Community Mental Health Journal, 26, 415–423.
Burke, N., Rouff, L., & Shelby, S. (1997, October). Abuse as a precursor to intensified distress among the homeless. Paper presented at the American Psychiatric Association Annual Convention, Washington DC.
Burling, T., Seidner, A., Salvio, M., & Marshall, G. (1994). A cognitive-behavioral therapeutic community for substance dependent and homeless veterans: Treatment outcome. Addictive Behaviors, 19, 621–629.
Caton, C. (1995). Mental health service use among homeless and never-homeless men with schizophrenia. Psychiatric Services, 46, 1139–1143.
Fairbairn, W. (1952). Psychoanalytic studies of the personality. London: Routledge & Kegan Paul.
First, M., Spitzer, R., Gibbon, M., & Williams, J. (1995). The structured clinical interview for DSMIII-R personality disorders (SCID-II). Part I: Description. Journal of Personality disorders, 9, 83–91.
First, M., Spitzer, R., Gibbon, M., Williams, J., Davies, M., Borus, J., Howes, M., Kane, J., Pope, H., & Rounsaville, B. (1995). The structured clinical interview for DSM-III-R personality disorders (SCID-II). Part II: Multi-site test-retest reliability study. Journal of Personality Disorders, 9, 92–104.
Fischer, P., Shapiro, S., Breakey, W., Anthony, J., & Kramer, M. (1986). Mental health and social characteristics of the homeless: A survey of mission users. American Journal of Public Health, 76, 519–524.
Guntrip, H. (1961). Personality structure and human interaction: The developing synthesis of psychodyamic theory. New York: International Universities Press.
Hannappel, M., Calsyn, R., & Morse, G. (1989). Mental illness in homeless men: A comparison of shelter and street samples. Journal of Community Psychology, 17, 304–310.
Jencks, C. (1994). The Homeless. Cambridge: Harvard University Press.
Kalus, O., Bernstein, D. P., & Siever, L. J. (1993). Schizoid personality disorder: A review of current status and implications for DSM-IV. Special Feature: DSM-IV reviews of the personality disorders: III. Journal of Personality Disorders, 7, 43–52.
Kuhn, R., & Culhane, D. (1998). Applying cluster analysis to test a typology of homelessness by pattern of shelter utilization: Results from the analysis of administrative data. American Journal of Community Psychology, 26, 207–232.
Link, B., Phelan, J., Bresnahan, M., Stueve, A., Moore, R., & Susser, E. (1995). Lifetime and five-year prevalence of homelessness in the United States: New Evidence on an Old Debate. American Journal of Orthopsychiatry, 65, 347–354.
Longabaugh, R., & Eldred, S. (1973). Premorbid adjustments, schizoid personality and onset of illness as predictors of post-hospitalization functioning. Journal of Psychiatric Research, 10, 19–29.
McAdams, D. (1992). The intimacy motive. In Smith, C (Ed.), Motivation and Personality, Handbook of Thematic Content Analysis. New York: Cambridge University Press.
Mellsop, G. (1973). Antecedents of schizophrenia: The “schizoid” myth? Australian & New Zealand Journal of Psychiatry, 7, 208–211.
Morse, G., & Calsyn, R. (1986). Mentally disturbed homeless people in St. Louis: Needy, willing, but underserved. International Journal of Mental Health, 14, 74–94.
Morse, G., Calsyn, R., Allen, G., & Kenny, D. (1994). Helping homeless mentally ill people: What variables mediate and moderate program effects. American Journal of Community Psychology, 22, 661–683.
Murray, R., Baier, M., North, C., Lato, M., & Eskew, C. (1995). Components of an effective transitional residential program for homeless mentally ill clients. Archives of Psychiatric Nursing, 9, 152–157.
National Coalition for the Homeless. (1999). NCH Fact Sheet #2. Retrieved September 27, 1999 from the World Wide Web: http://nch.ari.net/members.html.
Nestadt, F., Liang, K, Lamacz, M., et al. (1994). An evaluation of the structure of schizophrenia spectrum disorders. Journal of Personality Disorders, 8, 288–298.
Orwin, R., Sonnefeld, L., Garrison-Mogren, R., & Smith, N. (1994). Pitfalls in evaluating the effectiveness of case management programs for homeless persons: Lessons from the NIAAA community demonstration program. Evaluation Review, 18, 153–207.
Passero, J., Zax, M., & Zozus, R. (1991). Social network utilization as related to family history among the homeless. Journal of Community Psychology, 19, 70–78.
Reich, J., Yates, W., & Nduaguba, M. (1989). Prevalence of DSM-III personality disorders in the community. Social Psychiatry & Psychiatric Epidemiology, 24, 12–16.
Robertson, M. (1986). Mental disorder among homeless persons in the United States: An overview of recent empirical literature. Administration in Mental Health, 14, 14–27.
Rosenheck, R., & Leda, C. (1991). Who is served by programs for the homeless? Admission to a domiciliary care program for homeless veterans. Hospital and Community Psychiatry, 42, 176–181.
Rosenheck, R., Leda, C., & Gallup, P. (1992). Combat stress, psychosocial adjustment, and service use among homeless Vietnam veterans. Hospital and Community Psychiatry, 43, 145–149.
Rossi, P., Wright, J., Fisher, G., & Willis, G. (1987). The urban homeless: estimating composition and size. Science, 23, 1336–1341.
Schumacher, J. Milby, J. B., Raczynski, J. M., & Caldwell, E. (1995). Validity of self-reported crack cocaine users among homeless persons in treatment. Journal of Substance Abuse Treatment, 12, 335–339.
Scott, J. (1993). Homelessness and mental illness. British Journal of Psychiatry, 162, 314–324.
Slagg, N., Lyons, J., Cook, J., Wasner, D., & Ruth, A. (1994). A profile of clients served by a mobile outreach program for the homeless mentally ill. Hospital and Community Psychiatry, 45, 1139–1141.
Susser, E. (1991). Personal History Interview. New York: Author.
Torgalsboen, A. (1999). Comorbidity in schizophrenia: A prognostic study of personality disorders in recovered and non-recovered schizophrenia patients. Scandinavian Journal of Psychology, 40, 147–152.
Westen, D. (1997). Divergences between clinical and research methods for assessing personality disorders: Implications for research and the evolution of Axis II. American Journal of Psychiatry, 154, 895–903.
Widiger, T. A., & Rogers, J. H. (1989). Prevalence and comorbidity of personality disorders. Psychiatric Annals, 19, 132–136.
Zimmerman, M., & Coryell, W. (1989). DSM-III personality disorder diagnoses in a nonpatient sample: Demographic correlates and comorbidity. Archives of General Psychiatry, 46, 682–689.