After CETA, what next?

Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 1982.MICROFICHE COPY AVAILABLE IN ARCHIVES AND ROTCHBibliography: [unnumbered leaves 13-19]by Amy Ellen Weisman.M.C.P

Religion/Spirituality as a Predictor of Attrition from a Culturally Informed Family Treatment for Schizophrenia that Targets Religious Coping

Symposium Title: The Integration of Religion/Spirituality into Culturally-Informed, Cognitive-Behavioral Mental Health Treatments Chair: Kayla K. Thayer, Ph.D., Nova Southeastern University Discussant: Stevan Lars Nielsen, Ph.D., Brigham Young Universit

Evaluation of Harmful Algal Bloom Outreach Activities

With an apparent increase of harmful algal blooms (HABs) worldwide, healthcare providers, public health personnel and coastal managers are struggling to provide scientifically-based appropriately-targeted HAB outreach and education. Since 1998, the Florida Poison Information Center-Miami, with its 24 hour/365 day/year free Aquatic Toxins Hotline (1–888–232–8635) available in several languages, has received over 25,000 HAB-related calls. As part of HAB surveillance, all possible cases of HAB-related illness among callers are reported to the Florida Health Department. This pilot study evaluated an automated call processing menu system that allows callers to access bilingual HAB information, and to speak directly with a trained Poison Information Specialist. The majority (68%) of callers reported satisfaction with the information, and many provided specific suggestions for improvement. This pilot study, the first known evaluation of use and satisfaction with HAB educational outreach materials, demonstrated that the automated system provided useful HAB-related information for the majority of callers, and decreased the routine informational call workload for the Poison Information Specialists, allowing them to focus on callers needing immediate assistance and their healthcare providers. These results will lead to improvement of this valuable HAB outreach, education and surveillance tool. Formal evaluation is recommended for future HAB outreach and educational materials

The interplay of family cohesion, self-stigma, and suicidal ideation in people of color with psychotic spectrum disorders

Individuals with psychotic spectrum disorders (PSDs) are at an increased risk for suicide compared to the general populationBoth individuals with PSDs and communities of color are known to experience a high degree of mental health stigma. People of color also have strong family values that emphasize familial obligations and unity. The current study examined relationships between family cohesion, mental health self-stigma, and suicidal ideation among people of color with PSDs. The study sample consisted of 95 people of color with a PSD [Age in years: M = 38.27, SD=11.99; 65.3% male; 62.1% Latinx, 34.7% Black, 3.2% Other/Mixed]. Measures used were the suicidal ideation item from the BPRS interview, family cohesion subscale from the family environment scale, and three items asking participants about shame, guilt, or embarrassment experienced related to their PSD. In general, family cohesion was associated with less suicidal ideation, even when controlling for gender, education, and self-stigma. When examining conditional effects, family cohesion was associated with decreased suicidal ideation only when self-stigma was at or below the mean level observed. Additionally, self-stigma was associated with increased suicidal ideation only when family cohesion was above the mean level observed. Considering interactions between suicide risk and protective factors is paramount, as roles may shift

F117. SCHIZOTYPY PERSONALITY TRAITS RELATED TO PSYCHOLOGICAL FUNCTIONING AND INTERNALIZED STIGMA

Abstract Background People diagnosed with schizophrenia spectrum illnesses report higher levels of internalized stigma in comparison to other mental health diagnoses (Holzinger, Beck, Munk, Weithaas, & Angermeyer, 2003). Studies have shown high overlap between depression and symptoms of schizotypy in nonclinical adolescents (Fonseca-Pedrero, Paino, Lemos-Giráldez, & Muñiz, 2011), but the role that stigma plays in this relationship has yet to be examined. This is of importance because it can be targeted (Rüsch, Angermeyer, & Corrigan, 2005) and prior literature has found that awareness campaigns to reduce stigma can improve psychological functioning (Mittal, Sullivan, Chekuri, Allee, & Corrigan, 2012). Based on previous literature, we predict that schizotypal personality traits will be related to symptoms of depression, anxiety and stress (DASS), and that these will both be related to internalized stigma. Methods The current study is a sample of 494 college students who completed surveys to assess for schizotypal personality traits (SPQ; Raine, 1991), depression, anxiety and stress (Depression Anxiety Stress Scales DASS; Lovibond & Lovibond, 1995), and internalized stigma (ISMI; Boyd, Otilingam, & DeForge, 2014). Results Correlation coefficients indicated that higher endorsement of schizotypal personality was associated with greater DASS scores (r=.645; p<.01) and internalized stigma (r=.406; p<01). A multiple regression was conducted regressing SPQ on ISMI and DASS, F (2,491) = 183.949, p<.01, R2=.428. Controlling for ISMI scores, DASS was predictive of higher schizotypal personality ratings (Beta=.586; p<01). Controlling for DASS, ISMI scores were also predictive of schizotypal personality (Beta=.123; p=.002). Discussion As hypothesized, schizotypy, DASS, and internalized stigma were all positively associated. Internalized stigma could lead to symptoms of depression, anxiety and stress as well as schizotypy. It is possible that internalized stigma plays its own unique role in the onset of schyzotypy. This study is limited by the self-report and cross-sectional nature. Longitudinal studies are necessary to further assess causality in these variables. Screening for schizotypal personality traits when patients present for symptoms of depression and anxiety could be useful in early intervention efforts. Moreover, campaigns that target mental illness stigma could aid in improving psychological functioning, and in reducing schizotypal personality traits

S119. MULTICULTURAL IDENTITY INTEGRATION AND SCHIZOTYPAL PERSONALITY DISORDER

Abstract Background Schizotypal personality disorder (SPD) is often misdiagnosed and understudied. Moreover, when diagnosed correctly, SPD can be difficult to treat and is associated with significant functional impairment. Furthermore, SPD falls under a schizophrenia-spectrum phenotype and can aid in better understanding the trajectory, risk factors, and treatment for psychotic disorders. Given the lack of research on SPD and the underutilization of mental health services by ethnic minorities, this population may be at increased risk for poor outcomes (Delphin-Rittmon, et al., 2015). Yet, few studies assess cultural factors that may account for differences among minorities with psychotic related disorders or SPD. Multicultural identity integration (MII) may offer insights into the presentation of mental illness among ethnic minorities. According to Amoit et al.’s (2007) cognitive-developmental model of social identity configuration, there are four multiple identity configurations. The present study assessed three of the four—categorization, in which individuals identify with one of their cultural groups over others; compartmentalization, in which individuals preserve multiple, separate identities within themselves; and integration, where individuals merge their multiple cultural identities. Research finds that individuals who integrate their culture identities have better mental health outcomes, such as risk for depression, whereas those that do not integrate either culture and compartmentalize their identities, that is, maintain separate identities, have the worst outcomes (Nguyen & Benet-Martinez, 2013). We propose that individuals struggling to integrate identities and instead categorize or compartmentalize them will display higher symptom endorsement of SPD. Methods Participants included 261 ethnic minority students from the University of Miami. Students completed measures of schizotypy (Schizotypal Personality Questionnaire; Raine, 1991) and multicultural identities within the self (The Multicultural Identity Integration Scale; Yampolsky et al., 2013). All scales demonstrated good-to-excellent reliability. Results When correlating SPD symptoms to the three forms of identity integration, we found a significant correlation with categorization (r =.14, p=.02) and compartmentalization (r =.20, p<.01), however the correlation was non-significant with integration (r =.07, p=.30). When conducting a linear regression using levels of MII to predict SPD, increased levels of categorization (β=.42) and compartmentalization (β=1.53) were associated with greater endorsement of SPD symptoms (F(2,258)=5.49, R2=.04, p<.01). Discussion As hypothesized, increased categorization and compartmentalization of multiple cultural identities were associated with greater endorsement of SPD symptoms. Poor adjustment to a new culture and consequential integration of multiple identities may place individuals at risk for developing early symptoms of SPD. However, integration of identities was not significantly related to endorsement of SPD. Therefore, it seems that although poorer integration of identities may serve as a risk factor, greater integration may not necessarily serve as a protective factor. This study is limited by the constricted age range and SES inherent in a college sample. Gathering more information on immigration status, years in the US, etc. may be helpful in highlighting nuances within the data. Interventions targeting individuals with low identity integration may be beneficial to individuals at risk of developing SPD. This is especially true given the real-world functional impairment similar to schizophrenia found among those with SPD

Enculturation and acculturation's relationship to suicidal ideation in Hispanic/Latinx individuals with psychotic spectrum disorders

Suicide is a leading cause of premature death in people with schizophrenia (Inoue et al., 2020). Hispanic/Latinx (H/L) individuals, the largest ethnic minority group in the U.S., face potential hurdles (e.g., discrimination, language barriers) when trying to receive care for psychotic spectrum disorders, which may increase their risk for suicidal ideation. Drawing from prior literature, we tested the hypotheses that greater acculturation and lower enculturation would be associated with increased suicidal ideation in a sample of 45 H/L individuals with psychotic spectrum disorders using a linear regression analysis controlling for gender and education. As hypothesized, greater acculturation and lower enculturation were associated with greater suicidal ideation. In line with prior research, results of this study suggest that maintaining beliefs and traditions from one's home culture may be beneficial to H/Ls with psychotic spectrum disorders and may reduce suicidal ideation whereas there may be detrimental aspects of mainstream United States culture on one's desire to live. Thus, encouraging H/L patients with psychotic spectrum disorders to maintain a sense of ethnic pride and stay engaged with practices and values from their culture of origin may help reduce suicidal ideation in this vulnerable population

T62. ASSESSING THE EFFECT OF FAMILY COHESION AND INSIGHT ON SUICIDAL IDEATION AMONG INDIVIDUALS WITH SCHIZOPHRENIA

Abstract Background Suicide is the leading cause of premature death among those with schizophrenia (Palmer, Pankratz, & Bostwick, 2005). However, it is unclear what places someone at high risk of suicide. Given the difficulties of living with schizophrenia, many individuals rely on family for assistance with housing, food, and other critical needs (National Alliance on Mental Illness, 2018). Moreover, family members are often individuals’ sole source of emotional support (Awad & Voruganti, 2008). Thus, family members are vital to the lives and functioning of those with schizophrenia. Indeed, greater family cohesion has been associated with lower psychiatric symptom severity in patients with schizophrenia (Weisman, Rosales, Kymalainen, & Armesto, 2005). Similarly, perceived family cohesion was found to be protective against suicidal attempts in non-clinical samples (Borowsky, Ireland, & Resnick, 2001). However, no research has assessed the relationship between suicidal ideation and family cohesion in schizophrenia. Additionally, given how disabling schizophrenia can be, becoming aware of one’s limitations may be dismaying and lead to suicidal ideation. Crumlish and colleagues (2005) found that greater insight at 6 months predicted suicide attempts in individuals with schizophrenia 4 years later. Therefore, the present study assesses whether patient’s perceptions of family cohesion and cognitive insight are associated with suicidal ideation. It is hypothesized that lower levels of family cohesion and greater insight will predict greater endorsement of suicidal ideation, and these effects will be mediated by depression, anxiety, and stress. Methods Individuals with schizophrenia (N = 120) were assessed using the family cohesion index (FC) of the Family Environment Scale (Moos & Moos, 1994), the suicidal ideation (SI) item (1–7 Likert rating) from the Brief Psychiatric Rating Scale (Ventura, Lukoff, Nuechterlein, Liberman, Green, & Shaner, 1993), Beck’s Cognitive Insight Scale (CI; Beck, et al., 2004), and the Depression, Anxiety and Stress Scale (DASS; Lovibond & Lovibond, 1995). Participants were, on average, 40.3 years old (SD = 15.75), male (62.5%), and Hispanic (48.3%, Caucasian=17.5%, Black=27.5%, Other=2.5%, missing=4.2%). Results As expected, significant relationships were found between SI and FC (r = -.22, p = .02), SI and CI (r = .26, p = .02), SI and DASS (r = .43, p < .001), and FC and DASS (r = -.41, p < .001). CI was not significantly correlated with DASS (r = .17, p = .15) nor FC (r = .12, p = .33). A mediation model was assessed in which SI was regressed on FC and DASS and DASS was regressed on FC. Additionally, SI was regressed on CI. Increases in observed DASS (depression: b = .02, SE = .004, p < .001), cognitive insight (b = .06, SE = .02, p = .02), and decreases in family cohesion (b = -.14, SE = .06, p = .02) were all significantly associated with a greater likelihood of suicidal ideation. Moreover, a Sobel test of mediation revealed a significant indirect effect from FC to SI, through DASS (Sobel = 3.24, SE = .03, p = .001). Discussion Family cohesion may be protective for individuals with schizophrenia, or, stated differently, weaker family cohesion may be a stressor, exacerbating suicidal ideation through increased depression, anxiety, and stress. Insight also played an important role, with more insightful individuals endorsing greater suicidal ideation. Individuals who are more aware of their disorder and limitations are at greater risk for suicidal ideation. It is important to note that both insight and family cohesion independently predicted suicidal ideation. Study findings suggest that interventions aimed at increasing family cohesion and revamping detrimental attributions resulting from greater insight may be warranted