Catherine H. Stein

Campus mental health services: Recommendations for change.

College officials indicate that the number of students with serious mental illnesses has risen significantly. Recent media attention surrounding several high profile suicides has opened discussion of mental illness on campus. The authors summarize literature on college students and mental illness, including barriers to service receipt. Recommendations to improve campus-based responses to serious mental illness are presented on the basis of well-accepted service principles.

Felt Obligation Towards Parents in Mexican-American and Anglo-American Young Adults:

The present study compares self-reports of felt obligation towards parents, cultural attitudes about family functioning and perceptions of family interactions in a sample of 100 Mexican-American and Anglo-American young adults. On average, Mexican-American men and women reported significantly higher levels of familism, more collectivist attitudes and more helping behavior in relationships with parents than did Anglo-Americans, while Anglo respondents reported having more contact with social systems outside the family system. Mexican-American young adults generally reported feeling significantly more obligated to avoid conflict, provide assistance and strive for self-sufficiency in their relationships with parents than did Anglo-Americans. Cultural attitudes of familism and collectivism were related to reports of felt obligation for Mexican-American respondents but not for Anglo-American respondents. Implications of results for family development theory are discussed.

A Psychological Measure of Islamic Religiousness: Development and Evidence for Reliability and Validity

A 60-item Psychological Measure of Islamic Religiousness (PMIR) was developed in three stages: (a) Domains of Islam relevant to physical and mental health were identified via theory and semistructured interviews with 25 Muslims; (b) an initial version of PMIR was pilot tested with 64 Muslims from the United States and Israel; and (c) desirable psychometric qualities of the final measure were established based on an international, Internet-solicited sample of 340 Muslims, as follows. The PMIR yielded seven distinct, highly reliable factors: Islamic Beliefs; Islamic Ethical Principles & Universality; Islamic Religious Struggle; Islamic Religious Duty, Obligation & Exclusivism; Islamic Positive Religious Coping & Identification; Punishing Allah Reappraisal; and Islamic Religious Conversion. All scales demonstrated desirable variability and strong discriminant, convergent, predictive, and incremental validity using multiple mental and physical criterion variables. The findings indicate that Islam is central to the well-being of Muslims and the PMIR provides a scientifically based, multidimensional understanding of Islam needed to advance the nearly nonexistent psychological theory, practice, and research focused on Muslims.

Ties that Bind: Three Studies of Obligation in Adult Relationships with Family:

This article reports three exploratory studies that describe aspects of obligation in ongoing relationships with family. Using independent samples of young married couples and single, college-age adults, five dimensions of felt obligation were identified as expectations for appropriate behavior about: (1) family contact and participation in family ritual; (2) assistance; (3) conflict avoidance; (4) self-sufficiency; and (5) personal sharing in specific relationships with kin. Initial evidence of convergent and discriminant validity was established for the felt obligation measure. Gender differences in felt obligation dimensions were found across studies with women generally reporting higher levels of obligation than did men. Felt obligation differed as a function of kinrole relationship (i.e. parents and in-laws, mother, father) across the three studies. Among married couples, felt obligation towards parents was related to higher levels of psychological symptomatology, depression and neuroticism for men but were not significantly related to mental health scores for women. The usefulness of the concept of felt obligation in the study of adult family relationships is discussed.

Lessons Learned and Challenges Faced in Developing the Psychological Measure of Islamic Religiousness

Between 2004 and 2006, we conducted a three-stage program of research with the aim of developing and validating a measure of Islamic practices and beliefs that could be utilized in mental health research. The outcome of these efforts was a Psychological Measure of Islamic Religiousness (PMIR) that possesses desirable psychometric properties. In this article, we describe the rationale behind developing the measure, the assumptions that guided our investigation, the challenges we faced in developing the PMIR, and the lessons we learned through this process. We offer several concrete suggestions to deal with the challenges that arise in psychological investigations of Muslims and Islam.

The Relationship Between Case Manager Expectations and Outcomes of Persons Diagnosed with Schizophrenia

The present study examined the relationship between case managers’ expectations about the abilities of persons diagnosed with schizophrenia and the outcomes (as indicated via chart review) of a randomly selected sample of clients diagnosed with schizophrenia on their caseload. Results indicate that clients of case managers with higher expectations averaged significantly more months of progress in employment than clients of case managers with lower expectations. Case manager expectations were also better predictors of the number of days employed than other case manager and consumer characteristics, however the type of expectation was a critical determinant of the direction of the effect. Case manager expectations were not related to outcomes in living situation.

Measuring personal loss among adults coping with serious mental illness.

Psychometric properties of a brief self-report measure of personal loss for adults coping with psychiatric disability are examined. The Personal Loss from Mental Illness Scale (PLMI) is a 20-item measure that assesses overall perceptions and four interrelated aspects of personal loss from mental illness. Using a sample of 158 adults with serious mental illness, the PLMI was found to have a meaningful factor structure, good internal consistency and high test–retest reliability. Construct validity is evidenced by positive correlations between personal loss scores, number of psychiatric hospitalizations, self-reports of loneliness, psychological symptoms, and problems with alcohol. PLMI scores were unrelated to scores on a personal growth measure and negatively correlated with scores on a positive well-being scale. Implications of the PLMI for research on coping, adaptation and recovery from serious mental illness are discussed.

Aspirations, ability, and support : Consumers' perceptions of attending college

Research examines aspirations and plans for college, perceptions of social support and acceptance, and perceived intellectual and emotional capacity for college reported by 80 adults with coping with serious mental illness. The role of␣consumers’ age, prior college experience, hospitalization history, and feelings of personal loss due to mental illness in accounting for their views about college is examined. In general, consumers expressed strong aspirations for college, provided a positive assessment of their intellectual abilities, and mixed feelings about their emotional capacity to attend college. Participants were generally very optimistic about the level of acceptance from faculty and students and support from family and friends if they were to attend college. Amount of personal loss expressed by consumers accounted for a significant amount of variance in their reported aspirations and perceived capacity for college beyond that of age, prior college experience, and number of recent psychiatric hospitalizations. Participants’ perceptions of support and acceptance were not related to total number of reported hospitalizations, but were positively related to the number of hospitalizations reported in the past year.

The Power of Theater to Promote Individual Recovery and Social Change

Although theatrical activities are used in a variety of therapeutic settings, little attention has been paid to the ways that theater can enhance the recovery process and community integration for people living with psychiatric disabilities. Community-based theater involving people with psychiatric disabilities offers unique opportunities for personal growth, social connection, and advocacy efforts. This Open Forum posits that theater has the power to both facilitate individual recovery and improve the social conditions of people living with mental illness. Critical elements of theatrical activities that relate to processes of recovery and community integration are examined. Implications for future research and program development are discussed.

Psychiatric Advance Directives: Perspectives of Community Stakeholders

The present study compares the familiarity with and attitudes about psychiatric advance directives among multiple community stakeholders in two Ohio communities. One community was involved in a pilot psychiatric advance directive education project, and one was not. A total of 272 legal and law enforcement personnel, clergy, healthcare professionals, mental health professionals, consumers, and family members completed a newly developed measure of opinions about psychiatric advance directives. Results indicate significant differences in opinions among members of the various stakeholder groups, and implications for advance directive education are discussed.