Avaluació de la incidència de la teràpia institucional en l'organització de la personalitat d'adolescents amb trastorns psíquics greus
SUMMARY: OBJECTIVE: To evaluate the impact of an institutional therapy programme on adolescents (aged between 12 and 18 years, both sexes) personality, relationships, and coping strategies suffering severe mental disorders and coming from broken families. PROCEDURE: Three evaluations were carried out. At income (n=31), after 8 (n=25) and 15 months (n=19). Participants were evaluated with the Rorschach test, YSR, CRI, and WISC-R. Income scores bring information about kind, degree, and variety of mental dysfunctions. Scores obtained after 8 and 15 months were compared with income ones in order to explore statistically (Wilcoxon) and clinically significant differences (Cohen; ES>0.37 Lipsey). A total of 17 indices were calculated (minimum least squares regression) and their correlation (Spearman) with some other variables of participants were explored. RESULTS. At income, severe dysfunctions were observed in domains such as emotions, thoughts, perception, behaviour, interpersonal relationships, coping styles, and social relationships. After 8 months under treatment, changes were minimum. After 15 months, stress control and tolerance, self-perception, social conventions, internalisation, externalisation, approach strategies, and thoughts improved. Additionally, ideational passivity, dependence on the environment, and avoidance as a coping strategy augmented. Improvement was negatively and significantly associated to psychiatric hospitalisations and their duration. Family support was negatively and significantly associated to psychic immobility. DISCUSSION: Variables such as abandonment, lack, family situation, sense of controlling everything, and therefore, absence of motivation to change and lack of insight and feelings of distrust could hinder treatment benefits and explain poor results. CONCLUSIONS: This programme is not recommended for subjects with many or long psychiatric inpatient stays. Age, psychopathology, family situation, comorbidity, and perspectives about the future conform some strong pathological personality features that could hardly change. The programme must be reviewed to identify and modify factors that could be contributing to augment passivity, avoidance, and dependence on the environment.
Advisor:Forns Santacana, Maria
School:Universitat de Barcelona
Source Type:Master's Thesis
Keywords:personalitat avaluació i tractament psicològic
Date of Publication:05/22/2006