Silver School of Social Work, New York University, 1 Washington Square North, Room 416, New York, NY 10003, USA.
Am J Orthopsychiatry. 2012 Jul;82(3):421-30. doi: 10.1111/j.1939-0025.2012.01159.x.
This qualitative study assessed the frequency and subjective meaning of adverse experiences using case study analyses of interviews with 38 formerly homeless adults with co-occurring serious mental illness (SMI) and substance abuse histories. Adverse life events were inventoried using an adaptation of Lloyd and Turner's (2008) 41-item checklist. Participants averaged 8.8 adverse events, with approximately one-third having experienced incarceration (37%), suicidality (32%), abandonment by one or both parents (30%), and death of their mother (34%). Cross-case analyses yielded 3 themes: social losses because of death and estrangement; the significance of chronic stressors as well as acute events; and the cumulative lifetime nature of adversity. Findings suggest that life course experiences of trauma and loss have a cumulative influence in the lives of this population in addition and in relation to SMI, substance abuse, and homelessness. In this context, the mental health recovery movement should address prior adverse experiences beyond comorbid diagnoses in this population.
本定性研究通过对 38 名有共病严重精神疾病 (SMI) 和药物滥用史的曾经无家可归成年人的访谈进行案例研究分析，评估了不良经历的频率和主观意义。使用 Lloyd 和 Turner (2008) 的 41 项清单的改编本对不良生活事件进行了清单式记录。参与者平均有 8.8 个不良事件，约三分之一的人有监禁经历 (37%)、自杀意念 (32%)、父母一方或双方遗弃 (30%) 和母亲去世 (34%)。跨案例分析产生了 3 个主题：由于死亡和疏远而导致的社会损失；慢性压力源和急性事件的重要性；以及逆境的终生性质。研究结果表明，除了 SMI、药物滥用和无家可归之外，创伤和丧失的人生经历对这一人群的生活还有累积影响。在这种情况下，心理健康恢复运动应该解决这一人群中除了合并诊断之外的先前不良经历。
