Deborah Perlick, Ph.D., M.D. - US grants

[unreadable] DESCRIPTION (provided by applicant): There is a critical need for psychosocial interventions to help alleviate the stress and stress-related health and mental health problems experienced by family members caring for a relative with bipolar disorder, a recurrent and disabling mental disorder affecting 1% of the population. The proposed research aims to develop and test the first intervention to directly target the self-care deficits and compromised mental and physical health of caregivers of patients with bipolar illness, as well as the high perceived stress, and ineffective coping that help promote them. A Stage 1-3 treatment development study will create, manualize and pilot test a health-promoting intervention (HPI) that combines psychoeducation about caregiving stress and associated health and mental health risks with CBT techniques to identify and modify barriers to caregiver self-care. In Stages 1-2 a team of 3 clinical investigators from 3 research sites will develop the manual, adherence/competence and outcome measures, and run 6 feasibility cases. In Stage 3, 46 primary caregivers (PC's) of patients with SCID-diagnosed Bipolar I or II Disorder will be randomized to receive either the 15-session HPI delivered by the clinical investigators, or up to 4 sessions of a self-administered, videotaped psychoeducational control condition (CC). The efficacy of HPI vs. CC in reducing depression and poor physical health (primary outcomes) and caregiver burden, anxiety, self-care/prevention deficits, ineffective coping, and costs to caregivers (secondary outcomes) will be evaluated using multivariate regression and/or random effects models, in an intent-to-treat design. Training materials will be developed for a larger-scale study. [unreadable] [unreadable]

[unreadable] DESCRIPTION (provided by applicant): Studies have shown that family members who care for relatives with severe mental illness experience mental illness stigmatization and discrimination, as well as consumers, leading to feelings of self-blame, incompetence, withdrawal from social supports and increased caregiver burden and/or depression. The proposed research aims to reduce the adverse effects of stigma directed towards family caregivers of people with schizophrenia by assessing the feasibility, acceptability and initial efficacy of a program developed by NAMI-Connecticut (Trade Zavatsky, Program Director, P.I.) and researchers at Mount Sinai (Deborah Perlick, Ph.D., P.I.), termed In Our Own Voice-Family Companion (IOOV-FC). IOOV-FC is modeled after In Our Own Voice (IOOV), developed by the National Alliance on Mental Illness (NAMI) to reduce stigma directed towards consumers. During Year 1,10 each of family members, consumers and clinicians will evaluate the acceptability and construct validity of the prepilot version of IOOV-FC and 2 focus groups of each stakeholder will convene to identify the stigma-related needs of family members to develop a new version of IOOV-FC. IOOV-FC aims to improve stigma coping through contact and social comparison with other families in a peer-led discussion of mental illness stigma encountered from the onset of symptoms to recovery. Twelve family members will be trained to deliver IOOV-FC. Families of consumers with schizophrenia will be randomized to receive either IOOV-FC (N = 70) or a family education course delivered by an expert (N = 70) and will be evaluated pre- intervention, immediately and 3 and 6 months post-intervention on measures of self-stigma and social withdrawal. The major analysis will be a mixed effects model in which time, treatment group, and their interactions (time x treatment group) are fixed effects, and subjects are random effects; likelihood ratio tests will evaluate group differences at each follow-up point. Because mental illness stigma is a barrier to mental health service use, and families influence consumers' use of services, equipping families to better cope with mental illness stigma will facilitate access to mental health care for both consumers and their family members. The proposed research represents a novel approach to improving stigma coping based on sound social psychological principles and modeled after a widely-disseminated anti-stigma program for consumers. [unreadable] [unreadable] [unreadable]