Prospective Change in Symptoms and Social Functioning in Participants of Community-Based Psychosocial Rehabilitation Programs: A Latent Growth Curve Model Analysis

서지정보

· 발행기관 : 한국정신건강사회복지학회
· 수록지 정보 : 정신건강과 사회복지 / 29호 / 94 ~ 121페이지
· 저자명 : 허만세

초록

Reducing psychiatric symptoms is one of the goals of community based psychosocial rehabilitation programs, although the primary focus of rehabilitative interventions is on improving clients' functioning rather than on reducing symptoms. Unlike many studies of functional improvement, there are relatively small numbers of studies focused on symptom reduction as a treatment outcome. These studies have not showed consistent findings that psychiatric symptoms are reduced in community based psychosocial rehabilitation programs. In addition, there have been no studies on the longitudinal relationship between psychiatric symptoms and social functioning with individuals diagnosed with schizophrenia receiving community based psychosocial rehabilitation, although the hypothetical longitudinal relationship between psychiatric symptoms and social functioning has been supported from the perspectives of two theories: the stress vulnerability theory of schizophrenia and cognitive rehabilitation theories. This is a gap of knowledge in psychosocial intervention literature. The purpose of the study was to examine prospective change in social functioning and in symptomatology as well as test whether the change in symptomatology would be related to the change in social functioning in adults diagnosed with schizophrenia receiving community based psychosocial rehabilitation. The sample consisted of 145 individuals diagnosed with schizophrenia or schizoaffective disorder at four community based psychosocial rehabilitation programs in Los Angeles in the United States. All the study hypotheses were modeled statistically using latent growth curve modeling and the hypothesized models were tested using structural equation modeling. Study findings are as follows. First, social functioning was improved over a 12 month rehabilitative period. Second, age was a significant factor in explaining individual difference in functional improvement while education was related to only individual difference in participants' social functioning at baseline. Third, the individual difference in symptomatology at baseline was inversely related to both the individual difference in the participants' social functioning level at baseline and the individual difference of their functional improvement. Fourth, symptomatology was improved in the 12 month rehabilitative period. Fifth, the rate of change in psychiatric symptoms was not related to the rate of change in social functioning. Based on these findings, Several recommendations for practice are suggested.

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