Publication Date

2016-07-03

Availability

Embargoed

Embargo Period

2017-07-03

Degree Type

Thesis

Degree Name

Master of Science (MS)

Department

Psychology (Arts and Sciences)

Date of Defense

2016-05-10

First Committee Member

Amy Weisman de Mamani

Second Committee Member

Saneya Tawfik

Third Committee Member

Edward Rappaport

Abstract

Research suggests that group based psychosocial treatments for schizophrenia provide benefits to patients and family members alike. However, few of these existing treatments consider cultural factors that may enhance their efficacy with diverse populations. The current study examined the potential impact of two cultural constructs, collectivism and spiritual/religious coping on patient and family member functioning in order to assess the relative importance of addressing these constructs in psychosocial treatments for schizophrenia. We first examined whether collectivistic ideals and use of spiritual/religious coping strategies related to psychiatric and psychological functioning among 113 patients and 50 family members of patients with schizophrenia. We hypothesized that higher self-report ratings of collectivism and adaptive spiritual coping would be associated with better psychiatric and psychological functioning among patients and family members at baseline. We then examined the feasibility of a group based Culturally Informed Therapy for Schizophrenia (CIGT-S), which incorporates collectivistic principles and spiritual coping into the treatment protocol. The feasibility of the group protocol was tested by examining its impact on patient symptom severity, as well as its impact on patient and family member self-report ratings of depression, anxiety, and stress. For these analyses, baseline data was compared to group termination data from 12 patients and 11 family members. We also conducted between groups analyses by comparing waitlist termination data from 20 patients and 13 family members to group termination data from 12 patients and 11 family members. Finally, we examined participant satisfaction with the group protocol, including qualitative reports on components of the protocol that participants deemed most valuable. Results indicated that for patients, neither collectivistic self-construals nor positive religious coping were significantly related to symptom severity or depression, anxiety, and stress. Rather, higher independent self-construals were associated with lower symptom severity. Among family members, results indicated that positive religious coping was not significantly associated with depression, anxiety, and stress, but that greater collectivistic self- construals were associated with greater depression, anxiety, and stress. Results examining the feasibility of the CIGT-S protocol indicated that patients demonstrated lower levels of symptom severity upon completion of the CIGT-S program, however no other significant effects were found. Finally, results examining overall patient and family member satisfaction with the treatment protocol indicated that patients and family members both reported being highly satisfied by the treatment program. This was also represented in participant’s open ended responses to our satisfaction questionnaire. These findings demonstrate the potential of a culturally adapted group intervention inclusive of patients with schizophrenia and their family members to impart positive impacts on patient symptom severity.

Keywords

schizophrenia; culture; group therapy

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