Graduation Year

2006

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Public Health

Major Professor

Marion Becker, Ph.D.

Co-Major Professor

Melinda S. Forthofer, Ph.D.

Keywords

Severe mental illness, Stigma, Social support, Empowerment, Anxiety

Abstract

Clinical and consumer recovery efforts continue to advance more successful recovery agendas. Limited research into the effect of the expectation to recover and what strategies are most effective in enhancing recovery impedes coherent recovery programming. What factors are significantly associated with recovery expectancy and recovery strategies is still largely unknown. Thus, this study addresses three key gaps in the field.

First, which factors associate with the expectation of recovery and is expectation related to strategy choice? Second, what are common strategies for recovery from mental illness and what factors are associated with each strategy? Third, does recovery expectancy or severity of mental illness mediate or moderate the relationship between clinical, social and service factors and recovery strategies? This study surveyed a sample of 350 randomly chosen participants from a community mental health organization with varying degrees of mental illness in a cross-sectional study utilizing instruments that measured clinical/historical, social, and service factors and recovery. The results were examined in multivariate analysis targeted to address the gaps noted above. The six recovery strategies included: (1) effective illness management, (2) positive future orientation, (3) meaningfulness, personal control, and hope, (4) recognizing support, (5) help seeking, and (6) symptom eradication.

Recovery expectancy was not significantly predicted by any of the clinical, social, or service factors. Although 25% of the variance was explained by the full model, factors associated with expectancy differ from recovery strategies and require further investigation. Except for symptom eradication, recovery expectancy was significantly negatively associated with each recovery strategy.Main effects models were significant for all six recovery strategies. The social factor constructs (social support, empowerment, stigma) were most consistently and robustly associated with all recovery strategies. Variance explained in full models ranged from 71% for positive future orientation to 19% for symptom eradication. However, no mediating or moderating effects were detected for recovery expectancy or illness severity. The results of this study further the understanding of recovery and provide information for development of recovery programs.

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