Psychological traits and behavioral coping of psychiatric consumers: the mediating role of self-esteem.
Health and Social Work › Vol. 30 Nbr. 2, May 2005
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Psychological traits and behavioral coping of psychiatric consumers: the mediating role of self-esteem.
Deinstitutionalization has increased the importance of community mental health services, resulting in increasing numbers of consumers living in communities and more community-based psychosocial rehabilitation (PSR.) services agencies (Reid, 1995; Segal, 1995). PSR service agencies differ from traditional community mental health programs that mainly focus on managing psychiatric symptoms. In addition to symptom control, PSR agencies aim to better support consumers' choices and to promote more effective adaptation to society (Silverstein, 2000). Specifically, these agencies focus on social or vocational rehabilitation services to enhance consumers' social and vocational skills, assuming that attaining higher levels of education (Mowbray, Collins, & Bybee, 1999) or obtaining competitive employment (Mueser et al., 1997) are critical for consumers' successful adaptation to modern society.
One of the most significant problems encountered by psychiatric consumers is the experience of the stigma of mental illness (MI) (Farina, Fisher, & Fisher, 1992), which limits opportunities for education, employment, and social relations. In addition to the nature of MI, limited opportunities are the consequences of not only social rejection and discrimination (Noe, 1997; Link, Cullen, Frank, & Wozniak, 1987), but also social withdrawal (Link, Cullen, Struening, Shrout, & Dohrenwend, 1989; Link, Struening, Rahav, Phelan, & Nuttbrock, 1997). To do well in education or employment, psychiatric consumers must successfully cope with the stigma of MI that may negatively influence their self-esteem and behavioral coping (Link et al., 1989). How can social workers help consumers develop healthy behavioral coping mechanisms with more selectively tailored interventions corresponding to their psychological and behavioral characteristics? Because of a lack of empirical research on this question, limited practice guidelines are available. THEORETICAL BACKGROUND Attitude theory posits that individuals' behaviors are directed by their attitudes, which are influenced by cognitive and affective traits (Fiske, 1998; Petty, Wegener, & Fabrigar, 1997). Attitudes are commonly defined as summary evaluations ...See the full content of this document
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