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当患有严重精神疾病的父母与子女失去联系时:应归咎于精神症状还是物质使用?

WHEN PARENTS WITH SEVERE MENTAL ILLNESS LOSE CONTACT WITH THEIR CHILDREN: ARE PSYCHIATRIC SYMPTOMS OR SUBSTANCE USE TO BLAME?

作者信息

Jones Danson, Macias Rosemarie Lillianne, Gold Paul B, Barreira Paul, Fisher William

机构信息

Community Intervention Research, McLean Hospital, Belmont, Massachusetts, USA.

出版信息

J Loss Trauma. 2008 Jul 1;13(4):261-287. doi: 10.1080/15325020701741849.

Abstract

This study compared parental psychiatric symptom severity, and the absence or presence of severe substance abuse, as predictors of contact with minor children for a representative sample of adults with diagnoses of serious mental illness (N = 45). Child contact and psychiatric symptom severity were measured during regularly scheduled 6-month research interviews over a total 30-month period following each participant's entry into the project. Severe substance abuse was documented as present or absent for the 6-month interval preceding each interview. Results revealed that incidence of severe substance abuse was repeatedly associated with less frequent parent-child contact, even after controlling for psychiatric symptoms, diagnosis, gender, age, ethnicity, and socioeconomic status. Neither psychiatric diagnosis nor symptom severity predicted frequency of child contact when substance abuse was taken into account. Mental health agencies offering parenting classes for adults with serious mental illness should incorporate substance use interventions to reduce loss of child custody and strengthen parent-child relationships.

摘要

本研究比较了父母的精神症状严重程度以及是否存在严重药物滥用情况,以此作为患有严重精神疾病的成年代表性样本(N = 45)与未成年子女接触情况的预测因素。在每位参与者进入项目后的总共30个月期间,通过定期安排的为期6个月的研究访谈来测量亲子接触情况和精神症状严重程度。在每次访谈前的6个月间隔内记录是否存在严重药物滥用情况。结果显示,即使在控制了精神症状、诊断、性别、年龄、种族和社会经济地位之后,严重药物滥用的发生率仍与亲子接触频率较低反复相关。当考虑药物滥用因素时,精神疾病诊断和症状严重程度均无法预测亲子接触频率。为患有严重精神疾病的成年人提供育儿课程的心理健康机构应纳入药物使用干预措施,以减少儿童监护权的丧失并加强亲子关系。

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