Abstract
Religiousness, spirituality, and social support have all been identified as having a positive impact on overall mental health outcomes. The current study describes quantitative and qualitative assessment of parental and God representations among individuals diagnosed with schizophrenia or schizoaffective disorder (N = 46). Six salient themes emerged; participants described the importance of caregiver love and nurturance, need for God, loss of family members, love of God, concrete support provided by parents, and the ability to tolerate ambivalent feelings toward parents. Participants linked their relationships with parents and God to their process of recovery. Implications for clinical practice are discussed.
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Allan, G. (2003). A critique of using grounded theory as a research method. Electronic Journal of Business Research Methods, 2(1), 1–10.
Bankole, A. O., Cohen, C. I., Vahia, I., Kehn, M., Ramirez, P. M., & Diwan, S. (2007). Factors affecting quality of life in a multiracial sample of older persons with schizophrenia. The American Journal of Geriatric Psychiatry, 15(12), 1015–1023. doi:10.1097/JGP.0b013e31805d8572.
Bell, M. D. (2004). Object relations and reality testing deficits in schizophrenia. In P. W. Corrigan & D. L. Penn (Eds.), Social cognition in schizophrenia (2nd ed., pp. 285–311). Washington, DC: American Psychological Association. doi:10.1037/10407-010.
Bell, M., Lysaker, P., & Milstein, R. (1992). Object relations deficits in subtypes of schizophrenia. Journal of Clinical Psychology, 48(4), 433–444.
Bellamy, C. D., Jarrett, N. C., Mowbray, O., MacFarlane, P., Mowbray, C. T., & Holter, M. C. (2007). Relevance of spirituality for people with mental illness attending consumer-centered services. Psychiatric Rehabilitation Journal, 30(4), 287–294. doi:10.2975/30.4.2007.287.294.
Blatt, S. J., & Auerbach, J. S. (2001). Mental representation, severe psychopathology, and the therapeutic process. Journal of the American Psychoanalytic Association, 49(1), 113–159. doi:10.1177/00030651010490010201.
Blatt, S. J., Chevron, E. S., Quinlan, D. M., Schaffer, C. E., & Wein, S. J. (1988). The assessment of qualitative and structural dimensions of object representations (Rev. ed.). Unpublished research manual, Yale University: New Haven, CT.
Blatt, S. J., & Lerner, H. D. (1983). The psychological assessment of object representation. Journal of Personality Assessment. doi:10.1207/s15327752jpa4701_2.
Blatt, S. J., & Levy, K. N. (2003). Attachment theory, psychoanalysis, personality development, and psychopathology. Psychoanalytic Inquiry, 23(1), 102–150. doi:10.1080/07351692309349028.
Blatt, S. J., Wild, C. M., & Ritzler, B. A. (1975). Disturbances of object representations in schizophrenia. Psychoanalysis and Contemporary Science, 4, 235–288.
Borras, L., Mohr, S., Brandt, P. Y., Gilliéron, C., Eytan, A., & Huguelet, P. (2007). Religious beliefs in schizophrenia: Their relevance for adherence to treatment. Schizophrenia Bulletin, 33(5), 1238–1246. doi:10.1093/schbul/sbl070.
Corrigan, P., McCorkle, B., Schell, B., & Kidder, K. (2003). Religion and spirituality in the lives of people with serious mental illness. Community Mental Health Journal, 39(6), 487–499. doi:10.1023/B:COMH.0000003010.44413.37.
Cutcliffe, J. R. (2005). Adapt or adopt: Developing and transgressing the methodological boundaries of grounded theory. Journal of Advanced Nursing, 51(4), 421–428. doi:10.1111/j.1365-2648.2005.03514.x.
de Mamani, A. G. W., Tuchman, N., & Duarte, E. A. (2010). Incorporating religion/spirituality into treatment for serious mental illness. Cognitive and Behavioral Practice, 17(4), 348–357. doi:10.1016/j.cbpra.2009.05.003.
Diguer, L., Pelletier, S., Hébert, É., Descôteaux, J., Rousseau, J. P., & Daoust, J. P. (2004). Personality organizations, psychiatric severity, and self and object representations. Psychoanalytic Psychology, 21(2), 259–275. doi:10.1037/0736-9735.21.2.259.
Frese, F. J., Knight, E. L., & Saks, E. (2009). Recovery from schizophrenia: With views of psychiatrists, psychologists, and others diagnosed with this disorder. Schizophrenia Bulletin, 35(2), 370–380. doi:10.1093/schbul/sbn175.
Glaser, B. G. (2001). The grounded theory perspective: Conceptualization contrasted with description. Mill Valley, CA: Sociology Press.
Hamilton, N. G. (1989). A critical review of object relations theory. American Journal of Psychiatry, 146(12), 1552–1560. doi:10.1176/ajp.146.12.1552.
Hansen, C. F., Torgalsbøen, A. K., Røssberg, J. I., Romm, K. L., Andreassen, O. A., Bell, M. D., & Melle, I. (2013). Object relations, reality testing, and social withdrawal in schizophrenia and bipolar disorder. The Journal of Nervous and Mental Disease, 201(3), 222–225. doi:10.1097/NMD.0b013e3182848ae0.
Harris, J. I., Nienow, T., Choi, A., Engdahl, B., Nguyen, X. V., & Thuras, P. (2015). Client report of spirituality in recovery from serious mental illness. Psychology of Religion and Spirituality, 7(2), 142–149. doi:10.1037/a0038538.
Hayes, L., Hawthorne, G., Farhall, J., O’Hanlon, B., & Harvey, C. (2015). Quality of life and social isolation among caregivers of adults with schizophrenia: Policy and outcomes. Community Mental Health Journal, 51(5), 591–597. doi:10.1007/s10597-015-9848-6.
Huguelet, P., Mohr, S., Jung, V., Gillieron, C., Brandt, P. Y., & Borras, L. (2007). Effect of religion on suicide attempts in outpatients with schizophrenia or schizo-affective disorders compared with inpatients with non-psychotic disorders. European Psychiatry, 22(3), 188–194. doi:10.1016/j.eurpsy.2006.08.001.
Jamison, S. C., & Kane, C. F. (1996). Object relations and nursing care of persons experiencing psychosis. Archives of Psychiatric Nursing, 10(3), 129–135. doi:10.1016/S0883-9417(96)80013-6.
Kate, N., Grover, S., Kulhara, P., & Nehra, R. (2014). Relationship of quality of life with coping and burden in primary caregivers of patients with schizophrenia. International Journal of Social Psychiatry, 60(2), 107–116. doi:10.1177/0020764012467598.
Kay, S. R., Flszbein, A., & Opfer, L. A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261–276.
Kay, S. R., Opler, L. A., & Lindenmayer, J. P. (1988). Reliability and validity of the positive and negative syndrome scale for schizophrenics. Psychiatry Research, 23(1), 99–110.
Kirkpatrick, L. A. (2005). Attachment, evolution, and the psychology of religion. New York, NY: Guilford Press.
Levy, K. N., Blatt, S. J., & Shaver, P. R. (1998). Attachment styles and parental representations. Journal of Personality and Social Psychology, 74(2), 407–419. doi:10.1037/0022-3514.74.2.407.
Lincoln, T. M., Köther, U., Hartmann, M., Kempkensteffen, J., & Moritz, S. (2015). Responses to stress in patients with psychotic disorders compared to persons with varying levels of vulnerability to psychosis, persons with depression and healthy controls. Journal of Behavior Therapy and Experimental Psychiatry, 47, 92–101. doi:10.1016/j.jbtep.2014.11.011.
Lindgren, K. N., & Coursey, R. D. (1995). Spirituality and serious mental illness: A two-part study. Psychosocial Rehabilitation Journal, 18(3), 93–111. doi:10.1037/h0095498.
Martin, P. Y., & Turner, B. A. (1986). Grounded theory and organizational research. The Journal of Applied Behavioral Science, 22(2), 141–157. doi:10.1177/002188638602200207.
Mohr, S., Perroud, N., Gillieron, C., Brandt, P. Y., Rieben, I., Borras, L., & Huguelet, P. (2011). Spirituality and religiousness as predictive factors of outcome in schizophrenia and schizo-affective disorders. Psychiatry Research, 186(2), 177–182. doi:10.1016/j.psychres.2010.08.012.
Overall, J. E., & Gorham, D. R. (1962). The brief psychiatric rating scale. Psychological Reports, 10(3), 799–812. doi:10.2466/pr0.1962.10.3.799.
Phillips, R. E., Lakin, R., & Pargament, K. I. (2002). Brief report: Development and implementation of a spiritual issues psychoeducational group for those with serious mental illness. Community Mental Health Journal, 38(6), 487–495. doi:10.1023/A:1020832218607.
Prout, T. A., Cecero, J. J., & Dragatsi, D. (2012). Parental object representations, attachment to God, and recovery among individuals with psychosis. Mental Health, Religion, and Culture, 15(5), 449–466. doi:10.1080/13674676.2011.581273.
Quinlan, D. M., Blatt, S. J., & Chevron, E. S. (1992). The analysis of descriptions of parents: Identification of a more differentiated factor structure. Journal of Personality Assessment. doi:10.1207/s15327752jpa5902_10.
Rizzuto, A. M. (1979). The birth of the living God: A psychoanalytic study. Chicago, IL: University of Chicago Press.
Röhricht, F., Papadopoulos, N., Suzuki, I., & Priebe, S. (2009). Ego-pathology, body experience, and body psychotherapy in chronic schizophrenia. Psychology and Psychotherapy: Theory, Research and Practice, 82(1), 19–30. doi:10.1348/147608308X342932.
Rojas, S. M., Grzywacz, J. G., Zapata Roblyer, M. I., Crain, R., & Cervantes, R. C. (2016). Stressors among Hispanic adults from immigrant families in the United States: Familismo as a context for ambivalence. Cultural Diversity and Ethnic Minority Psychology. doi:10.1037/cdp0000082.
Russinova, Z., Wewiorski, N., Stepas, K. A., Prout, T. A., Cash, D., & Lyass, A. (2009). Use of prayer by persons with serious mental illnesses: Patterns and perceived benefits. Counseling et Spiritualité, 28(2), 59–82.
Ryan, E. R., & Bell, M. D. (1984). Changes in object relations from psychosis to recovery. Journal of Abnormal Psychology, 93(2), 209–215. doi:10.1037/0021-843X.93.2.209.
Sabogal, F., Marín, G., Otero-Sabogal, R., Marín, B. V., & Perez-Stable, E. J. (1987). Hispanic familism and acculturation: What changes and what doesn’t? Hispanic Journal of Behavioral Sciences, 9, 397–412. doi:10.1177/07399863870094003.
Sells, D. J., Stayner, D. A., & Davidson, L. (2004). Recovering the self in schizophrenia: An integrative review of qualitative studies. Psychiatric Quarterly, 75(1), 87–97. doi:10.1023/B:PSAQ.0000007563.17236.97.
Shah, R., Kulhara, P., Grover, S., Kumar, S., Malhotra, R., & Tyagi, S. (2011). Relationship between spirituality/religiousness and coping in patients with residual schizophrenia. Quality of Life Research, 20(7), 1053–1060. doi:10.1016/j.psychres.2011.07.034.
Shrout, P. E., & Fleiss, J. L. (1979). Intraclass correlations: Uses in assessing rater reliability. Psychological Bulletin, 86(2), 420–428. doi:10.1037/0033-2909.86.2.420.
Singh, M. M., & Kay, S. R. (1975). A comparative study of haloperidol and chlorpromazine in terms of clinical effects and therapeutic reversal with benztropine in schizophrenia. Theoretical implications for potency differences among neuroleptics. Psychopharmacologia, 43(2), 103–113.
Strauss, A. L., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). Thousand Oaks, CA: Sage.
Teising, M. (2000). ‘Sister, I am going crazy, help me’: Psychodynamic-oriented care in psychotic patients in inpatient treatment. Journal of Psychiatric and Mental Health Nursing, 7(5), 449–454. doi:10.1046/j.1365-2850.2000.00333.x.
Whitley, R., & Drake, R. E. (2010). Recovery: A dimensional approach. Psychiatric Services, 61(12), 1248–1250.
Wong-McDonald, A. (2007). Spirituality and psychosocial rehabilitation: Empowering persons with serious psychiatric disabilities at an inner-city community program. Psychiatric Rehabilitation Journal, 30(4), 295–300. doi:10.2975/30.4.2007.295.300.
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Authors Tracy A. Prout, Patricia Ottaviano, Alexa Taveras, Carolyn Sepulveda, and Julian Torres declare that they have no conflict of interest.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Prout, T.A., Ottaviano, P., Taveras, A. et al. Parental and God Representations Among Individuals with Psychosis: A Grounded Theory Analysis. J Relig Health 55, 2141–2153 (2016). https://doi.org/10.1007/s10943-016-0265-0
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DOI: https://doi.org/10.1007/s10943-016-0265-0