McIntyre L L, Blacher J, Baker B L
University of California, Riverside, California, USA.
J Intellect Disabil Res. 2002 Mar;46(Pt 3):239-49. doi: 10.1046/j.1365-2788.2002.00371.x.
The present authors studied the impact of dual diagnosis [i.e. intellectual disability (ID) and mental disorder] in young adults on their mothers' perceived levels of stress and decisions about placement.
The mothers of 103 young adults with severe ID were interviewed using a 2-3-h in-depth protocol of measures designed to assess their child's adaptive functioning, maladaptive behaviour, mental health problems and negative impact on the family, as well as their own thoughts on out-of-home placement. The Scales of Independent Behavior--Revised Problem Behavior Scale assessed problem behaviours and the Reiss Screen assessed mental disorder.
These measures were highly correlated (r = 0.64), but tapped some different domains of maladaptive behaviour and proved to be most predictive when employed together. Behaviour and/or mental health (B/MH) problems significantly predicted the mothers' perceived negative impact of the young adult on the family, even after controlling for other young adult characteristics. These problems also predicted the family's steps toward seeking out-of-home placement, as did better young adult health and the mother's higher educational attainment; stress did not predict additional variance in placement once these variables were accounted for.
The discussion focuses on the implications for service provision to families of young adults with B/MH problems.
作者研究了年轻成年人的双重诊断（即智力残疾和精神障碍）对其母亲感知到的压力水平及安置决策的影响。
对103名重度智力残疾的年轻成年人的母亲进行访谈，采用2至3小时的深入测量方案，旨在评估其孩子的适应性功能、适应不良行为、心理健康问题及对家庭的负面影响，以及她们对家庭外安置的想法。《独立行为量表——修订版问题行为量表》评估问题行为，《赖斯筛查量表》评估精神障碍。
这些测量高度相关（r = 0.64），但涉及适应不良行为的一些不同领域，并且一起使用时预测性最强。行为和/或心理健康（B/MH）问题显著预测了母亲感知到的年轻成年人对家庭的负面影响，即使在控制了其他年轻成年人特征之后也是如此。这些问题还预测了家庭寻求家庭外安置的步骤，年轻成年人更好的健康状况和母亲更高的教育程度也是如此；一旦考虑这些变量，压力并不能预测安置方面的额外差异。
讨论聚焦于对有B/MH问题的年轻成年人家庭提供服务的意义。
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