Ilanit Hason-ohayon - Academia.edu (original) (raw)

Papers by Ilanit Hason-ohayon

Research paper thumbnail of The need for friendships and information: Dimensions of social support and posttraumatic growth among women with breast cancer

Palliative and Supportive Care, 2015

Objective:Employing a cross-sectional design, the current study examined the relationships betwee... more Objective:Employing a cross-sectional design, the current study examined the relationships between various agents and types of support and posttraumatic growth (PTG) among women with breast cancer.Method:Eighty married women who were coping with breast cancer completed social support and PTG questionnaires.Results:All agents of social support (family, friends, belief-based), excluding spousal support, and all types of social support were found to be related to the various PTG dimensions and its total score. Regression analyses revealed that, among the agents of support, only support provided from friends and belief-based support uniquely contribute to prediction of total PTG score. While examining the contribution of various types of support, only cognitive support had a unique contribution to prediction of total PTG score.Significance of results:Various agents and types of support play different roles in the PTG process following breast cancer. Accordingly, friends as an agent of s...

Research paper thumbnail of A qualitative approach to the evaluation of psychosocial interventions for persons with severe mental illness

Psychological Services, 2006

This article describes the development and assessment of a qualitative interview for comprehensiv... more This article describes the development and assessment of a qualitative interview for comprehensively assessing both the process and the outcome of interventions for persons with severe mental illness (SMI). A open-ended 16-question Narrative Evaluation of Intervention Interview (NEII) was developed. The NEII contains questions that ask the participants to evaluate and describe both process and outcome of interventions for persons with SMI. Research participants were 64 persons with SMI attending rehabilitation programs in the community. Analysis of participants' responses to the NEII, using the open step of the grounded theory approach, produced a comprehensive set of themes. Interrater reliabilities for these themes ranged from moderate to high, and these themes differentiated between the three psychosocial interventions. Ways of modifying the NEII so as to make it more sensitive to participants' expectations and experiences are discussed.

Research paper thumbnail of Religiosity and Hope: A Path for Women Coping With a Diagnosis of Breast Cancer

Psychosomatics, 2009

Background: Both religiosity and hope are known for their positive role in coping with cancer. Ob... more Background: Both religiosity and hope are known for their positive role in coping with cancer. Objective: This study examines the mediating role of hope between religiosity and coping for women diagnosed with breast cancer. Method: Israeli Jewish women with breast cancer (Nϭ233) completed the Mental Adjustment to Cancer Scale, The Systems of Belief Inventory, and The Hope Scale. Results: By use of hierarchical regression, hope was found to be a mediator between religiosity and three coping styles. Conclusion: Special attention should be given to the role of hope for religious patients because it increases the positive effects of religion in coping with cancer.

Research paper thumbnail of Agents of support: psychometric properties of the Cancer Perceived Agents of Social Support (CPASS) questionnaire

Psycho-Oncology, 2010

Objective: The current study presents the development and the evaluation of the psychometric prop... more Objective: The current study presents the development and the evaluation of the psychometric properties of the Cancer Perceived Agents of Social Support (CPASS). The CPASS is a new self-rating instrument devised in order to enable both cancer patients and their spouses to report on the level of perceived social support they get. The CPASS evaluates the support given by different agents of support (spouse, family, friends and spiritual or religious beliefs) in several dimensions (emotional, cognitive and instrumental). Methods: The study sample comprised 662 cancer patients and their spouses recruited during a routine medical evaluation from three major cancer centers in Israel. The participants completed the CPASS and two other standardized instruments: The ENRICH Marital Satisfaction Scale (EMS) and the Brief Symptom Inventory (BSI). Results: Principal component analysis confirmed a three-factor structure based upon the agent of support (spouse; friends/family; spiritual/religious beliefs). Cronbach's a coefficients for the agent of support indexes were high (0.80-0.95), while Cronbach's a levels for the kind of support were lower (0.45-0.72). Smallest Space Analysis (SSA) also confirmed the theoretical structure of the CPASS. Pearson correlation coefficients to the other study variables were high and significant. Conclusions: As a whole, the CPASS was found to be a valid tool for the current Israeli sample. Theoretical and practical conclusions and socio-cultural implications are discussed.

Research paper thumbnail of Preliminary report of the relationship between experience of death of a relative, illness perception, and psychological outcome among BRCA carriers

Psychology, Health & Medicine, 2013

With recent advances in mapping the genetic mutations involved in breast cancer and the availabil... more With recent advances in mapping the genetic mutations involved in breast cancer and the availability of genetic testing, it has become necessary to explore the psychological consequences of women who have tested positive for the gene mutations involved in breast cancer (BReast CAncer gene one and two, BRCA1/2). Findings regarding psychological consequences of positive results in genetic testing for breast cancer are ambiguous and insufficient. The aim of the current study was to explore the relationship between experience of the death of a relative due to breast cancer, perception of the illness, distress, and well-being among BRCA1/2 mutation women carriers. Forty asymptomatic carriers who attended BRCA1/2 clinics in Israel completed self-administered questionnaires assessing socio-demographic variables, illness perception, and well-being. It was found that experiencing the death of a relative as a result of breast cancer was significantly correlated with illness perception. Carriers who experienced the death of a relative perceived breast cancer as having a stronger identity (i.e. as having severe symptoms), dire consequences, and as being uncontrollable in comparison to carriers who had not experienced the death of a relative. Nevertheless, psychological distress and well-being were not found to be significantly correlated to either an experience of death of a relative as a result of breast cancer or to illness perception. Implications and limitations are discussed in light of these findings. Among these is the need to consider the illness perception of healthy BRCA carriers women.

Research paper thumbnail of The psychometric properties of the illness management and recovery scale: Client and clinician versions

Psychiatry Research, 2008

The present study examined the psychometric properties of the clinician and client versions of th... more The present study examined the psychometric properties of the clinician and client versions of the Illness Management and Recovery (IMR) scale. Using a 5-point behaviorally anchored response format, these scales were designed to tap the critical illness management and recovery domains targeted by the IMR program. This program is a curriculum-based approach to helping persons with a serious mental illness (SMI) acquire the knowledge and skills they need to manage their illness effectively and to achieve personal recovery goals. Two hundred and ten persons with a diagnosis of a SMI and their 13 clinicians filled-out the client and clinician versions of the IMR questionnaire. The clients also responded to measures of coping efficacy and social support. While indicating limitations of the IMR scales and pointing to how they could be improved, this study provided some support for the construct and concurrent validity of the client and clinician versions of the IMR questionnaire. Moderate reliabilities were uncovered for these parallel versions of the questionnaire. Client responses to the client IMR scale and clinician responses to the clinician IMR scale were shown to be characterized by similar major components of the IMR intervention.

Research paper thumbnail of Family psychoeducation and therapeutic alliance focused interventions for parents of a daughter or son with a severe mental illness

Psychiatry Research, 2011

This study compared the effectiveness of a family psychoeducational intervention (FPEI) and a the... more This study compared the effectiveness of a family psychoeducational intervention (FPEI) and a therapeutic alliance focused intervention (TAFI) for parents of daughters and sons with severe mental illness (SMI). A process-outcome model was used to compare the effectiveness of the two interventions and to evaluate how they achieved their outcomes. Extent of effectiveness was assessed in terms of the family burden (FB) of the parents and the quality of life (QoL) and psychiatric symptoms of the daughters and sons. This study did not uncover a difference in effectiveness between the two interventions. However, at post-treatment, the participants in both interventions reported statistically significant less FB and attributed more QoL and less psychiatric symptoms to their daughters and sons than at pre-treatment. In addition, these pre-and posttreatment differences were mediated by specific mediating variables. These results are discussed in terms of the great psychotherapy debate (Wampold, 2001) as to the relative effectiveness of technique oriented interventions as compared to context oriented interventions.

Research paper thumbnail of Personal and Interpersonal Perceived Control and the Quality of Life of Persons With Severe Mental Illness

Journal of Nervous & Mental Disease, 2006

Studies have been carried out to explore the impact of sense of control on the outcome of persons... more Studies have been carried out to explore the impact of sense of control on the outcome of persons with severe mental illness (SMI). However, few studies have compared the differential effects of perceived personal control (control of the self) and perceived interpersonal control (the control of significant others). In the present study, we investigated the relations between perceived personal and perceived interpersonal control and different domains of quality of life (QOL) of persons with SMI. Measures of perceived personal and interpersonal control and QOL were administered to 145 participants with a diagnosis of SMI (schizophrenia, affective disorders, anxiety disorders, personality disorders). The results showed personal control to be positively related to various domains of QOL (beta = .28-.31, p < 0.001-0.01) while interpersonal control was negatively related to the physical domain of QOL (beta= -.20, p < 0.05). Theoretical, empirical, and clinical implications of the distinction between personal and interpersonal control for persons with SMI are discussed.

Research paper thumbnail of Call It a Monster for Lack of Anything Else

Journal of Nervous & Mental Disease, 2008

Individuals diagnosed with schizophrenia often appear to be unaware of having an illness or activ... more Individuals diagnosed with schizophrenia often appear to be unaware of having an illness or actively reject their diagnostic label. It is unclear, however, how this lack of awareness relates to important outcomes. Broadening the definition of awareness to include "narrative insight" may clarify this issue. The objective of this study was to identify profiles of narrative insight and test how these relate to standardized measure of insight. Sixty-five individuals with schizophrenia spectrum disorders participated in an assessment that included the Scale of Unawareness of Mental Disorder (SUMD) and an in-depth semi-structured interview. Qualitative analysis revealed 5 central themes related to insight on the basis of which each interview was then rated. Cluster analysis of these ratings resulted in 4 profiles of narrative insight: (1) accepts illness/rejects label, (2) rejects illness/searches for a name (3) passive insight of illness and label, and (4) integrative insight. The SUMD differentiated between individuals assigned to profile 2 who showed low insight to their illness and those assigned to the other profiles of narrative insight, but could not differentiae between them. Results support the claim that illness narratives are multifaceted and that traditional measures of insight may not be sensitive to different ways in which people understand their illness. Keywords Severe mental illness; insight; narratives One of the most important advances of modern descriptive psychiatry is improved reliability of psychiatric diagnoses. But, even when offered by clinicians with the greatest of care and concern, reliable diagnoses are often rejected by the individuals for whom they are intended, leaving clinicians feeling frustrated and helpless. These mental health consumers, in turn, are often left feeling just as frustrated and helpless, as they often find it impossible to relate their experiences to the carefully rendered reliable diagnostic label. They may not agree with

Research paper thumbnail of Qualitative assessment of verbal and non-verbal psychosocial interventions for people with severe mental illness

Journal of Mental Health, 2006

Background: Various forms of psychosocial interventions for people with severe mental illness (SM... more Background: Various forms of psychosocial interventions for people with severe mental illness (SMI) exist. These interventions include verbal interventions as well as activity-based interventions. Aims: To compare three psychosocial interventions with persons with SMI ...

Research paper thumbnail of Parents of adolescents with psychiatric disorders: insight into the disorder, self-stigma and parental stress

Comprehensive Psychiatry, 2014

Background: Parents of adolescents with mental disorders experience stress partially due to the w... more Background: Parents of adolescents with mental disorders experience stress partially due to the way they perceive and experience their offspring's disorder. The current study assessed the mediator role of self-stigma in the relationship between insight into the disorder and parental stress of parents of adolescents with mental disorders. Method: A total of 37 parents of adolescents with psychiatric disorders were assessed for their level of insight, self-stigma and parental stress. Results: The hypothesized mediation model was confirmed and is consistent with previous study on parents of adults with severe mental illness. Discussion: The positive association between insight and parental stress is mediated by these parents' self-stigma, suggesting that insight increases the self-stigma, which in turn increases the parental stress. These results may have clinical implications with regard to the treatment of the family of adolescents with mental disorders.

Research paper thumbnail of Insight into mental illness, self-stigma, and the family burden of parents of persons with a severe mental illness

Comprehensive Psychiatry, 2011

Parents of persons with severe mental illness (SMI) often experience burden due to the illness of... more Parents of persons with severe mental illness (SMI) often experience burden due to the illness of their daughter or son. In the present study, the possibility that parents' self-stigma moderates the relationship between the parents' insight into a daughter's or son's illness and the parents' sense of burden was investigated. Levels of insight into a daughter's or son's mental illness, parent self-stigma, and parent burden of 127 parents of persons with an SMI were assessed. Regression analysis was used to test the putative moderating role of parents' self-stigma. Self-stigma was found to mediate rather than moderate the relationship between insight and burden. Accordingly, parent insight into the mental illness of a daughter or son appears to increase parent burden because it increases parent self-stigma. The implications of these findings for practice, theory, and future research are discussed.

Research paper thumbnail of Insight into severe mental illness, hope, and quality of life of persons with schizophrenia and schizoaffective disorders

Psychiatry Research, 2009

Controversy exists as to the cognitive, emotional and behavioral consequences of lack of insight ... more Controversy exists as to the cognitive, emotional and behavioral consequences of lack of insight for persons with schizophrenia. This study tested a mediation model of the relations between insight into mental illness, hope, and the aspects of quality of life of persons with schizophrenia. According to this model, insight into mental illness may impact negatively on the quality of life of persons with schizophrenia by reducing these persons' hope. Sixty persons with schizophrenia or schizoaffective disorder completed questionnaires that assessed their insight, quality of life, and hope. The study's results show that for six of seven aspects of quality of life and for general awareness of illness, the above-hypothesized mediation model was confirmed. These results suggest that increasing the hope of persons with schizophrenia may directly and positively increase both their quality of life and the usefulness of their insight into their illness.

Research paper thumbnail of Metacognitive function and fragmentation in schizophrenia: Relationship to cognition, self-experience and developing treatments

Schizophrenia Research: Cognition, 2019

Research paper thumbnail of Predicting therapy success from the outset: the moderating effect of insight into the illness on metacognitive psychotherapy outcome among persons with schizophrenia

Clinical Psychology & Psychotherapy, 2019

The degree to which a person recognizes their mental disorder, attributes symptoms to the disorde... more The degree to which a person recognizes their mental disorder, attributes symptoms to the disorder, and recognizes that treatment may be necessary, is frequently referred to as clinical insight. The current study investigates whether clinical insight at baseline moderates the effects on metacognitive capacity of 40 sessions of Metacognitive Reflection and Insight Therapy (MERIT) among 35 participants with psychosis. Findings showed that clinical insight did not predict drop-out from therapy. Multilevel analyses provided support for our hypotheses that insight at baseline significantly moderates metacognitive gains at both post-measurement and follow-up. Our findings demonstrate that lacking clinical insight substantially hampers the effect of this psychosocial intervention. We posit that research efforts should shift from developing interventions which enhance clinical insight, to interventions which are effective in absence of clinical insight. Key Practitioner Message  Clinical insight moderates the effects of 40 sessions of metacognitive psychotherapy  Insight was not related to drop-out from therapy  Future work should be focused on developing interventions which require no clinical

Research paper thumbnail of Between self-clarity and recovery in schizophrenia: reducing the self-stigma and finding meaning

Comprehensive Psychiatry, 2014

Research paper thumbnail of Attitudes toward the sexuality of persons with physical versus psychiatric disabilities

Rehabilitation Psychology, 2014

Research has shown that attitudes toward different disabilities form a hierarchy, with observers ... more Research has shown that attitudes toward different disabilities form a hierarchy, with observers exhibiting more positive attitudes toward persons with physical disabilities than toward persons with psychiatric disabilities. In addition, investigations of attitudes toward persons with a disability indicate that they are often perceived as asexual. The current study examined whether involvement of persons with either a physical or psychiatric disability in a sexual relationship moderates the relation between their type of disability and attitudes toward them. After reading one of six randomly assigned vignettes, university students (N = 195) filled out a semantic differential-based attitude scale (Katz & Shurka, 1977; Kravetz, Katz, & Albez, 1994). The six vignettes consisted of a male with a physical disability/with a psychiatric disability/without a disability, who was either involved/not involved in a sexual relationship. An interaction between type of disability and involvement in a sexual relationship was found for two subscales of the attitudes scale, occupation and intelligence. Involvement in a sexual relationship was found to generate more positive attitudes when the target person had a physical disability but more negative attitudes when he had a psychiatric disability. Involvement in a sexual relationship seems to work in favor of persons with a physical disability because of the association of such a relationship with normality and adaptation. However, attributing such a relationship to persons with a psychiatric disability seems to be stigmatic.

Research paper thumbnail of Illness Management and Recovery: Generic Issues of Group Format Implementation

American Journal of Psychiatric Rehabilitation, 2007

A recent development in psychiatric rehabilitation is the identification and standardization of e... more A recent development in psychiatric rehabilitation is the identification and standardization of evidence-based practices (EBP). In this article we report on the implementation of one of the EBPs, Illness Management and Recovery (IMR), in a group format in two settings and cultures, Israel and the United States (North Carolina) to address generic issues of implementation that arise across settings. The

Research paper thumbnail of Agents of support: psychometric properties of the Cancer Perceived Agents of Social Support (CPASS) questionnaire

Psycho-Oncology, 2010

Objective: The current study presents the development and the evaluation of the psychometric prop... more Objective: The current study presents the development and the evaluation of the psychometric properties of the Cancer Perceived Agents of Social Support (CPASS). The CPASS is a new self-rating instrument devised in order to enable both cancer patients and their spouses to report on the level of perceived social support they get. The CPASS evaluates the support given by different agents of support (spouse, family, friends and spiritual or religious beliefs) in several dimensions (emotional, cognitive and instrumental).

Research paper thumbnail of The psychometric properties of the illness management and recovery scale: Client and clinician versions

Psychiatry Research, 2008

The present study examined the psychometric properties of the clinician and client versions of th... more The present study examined the psychometric properties of the clinician and client versions of the Illness Management and Recovery (IMR) scale. Using a 5-point behaviorally anchored response format, these scales were designed to tap the critical illness management and recovery domains targeted by the IMR program. This program is a curriculum-based approach to helping persons with a serious mental illness (SMI) acquire the knowledge and skills they need to manage their illness effectively and to achieve personal recovery goals. Two hundred and ten persons with a diagnosis of a SMI and their 13 clinicians filled-out the client and clinician versions of the IMR questionnaire. The clients also responded to measures of coping efficacy and social support. While indicating limitations of the IMR scales and pointing to how they could be improved, this study provided some support for the construct and concurrent validity of the client and clinician versions of the IMR questionnaire. Moderate reliabilities were uncovered for these parallel versions of the questionnaire. Client responses to the client IMR scale and clinician responses to the clinician IMR scale were shown to be characterized by similar major components of the IMR intervention.

Research paper thumbnail of The need for friendships and information: Dimensions of social support and posttraumatic growth among women with breast cancer

Palliative and Supportive Care, 2015

Objective:Employing a cross-sectional design, the current study examined the relationships betwee... more Objective:Employing a cross-sectional design, the current study examined the relationships between various agents and types of support and posttraumatic growth (PTG) among women with breast cancer.Method:Eighty married women who were coping with breast cancer completed social support and PTG questionnaires.Results:All agents of social support (family, friends, belief-based), excluding spousal support, and all types of social support were found to be related to the various PTG dimensions and its total score. Regression analyses revealed that, among the agents of support, only support provided from friends and belief-based support uniquely contribute to prediction of total PTG score. While examining the contribution of various types of support, only cognitive support had a unique contribution to prediction of total PTG score.Significance of results:Various agents and types of support play different roles in the PTG process following breast cancer. Accordingly, friends as an agent of s...

Research paper thumbnail of A qualitative approach to the evaluation of psychosocial interventions for persons with severe mental illness

Psychological Services, 2006

This article describes the development and assessment of a qualitative interview for comprehensiv... more This article describes the development and assessment of a qualitative interview for comprehensively assessing both the process and the outcome of interventions for persons with severe mental illness (SMI). A open-ended 16-question Narrative Evaluation of Intervention Interview (NEII) was developed. The NEII contains questions that ask the participants to evaluate and describe both process and outcome of interventions for persons with SMI. Research participants were 64 persons with SMI attending rehabilitation programs in the community. Analysis of participants' responses to the NEII, using the open step of the grounded theory approach, produced a comprehensive set of themes. Interrater reliabilities for these themes ranged from moderate to high, and these themes differentiated between the three psychosocial interventions. Ways of modifying the NEII so as to make it more sensitive to participants' expectations and experiences are discussed.

Research paper thumbnail of Religiosity and Hope: A Path for Women Coping With a Diagnosis of Breast Cancer

Psychosomatics, 2009

Background: Both religiosity and hope are known for their positive role in coping with cancer. Ob... more Background: Both religiosity and hope are known for their positive role in coping with cancer. Objective: This study examines the mediating role of hope between religiosity and coping for women diagnosed with breast cancer. Method: Israeli Jewish women with breast cancer (Nϭ233) completed the Mental Adjustment to Cancer Scale, The Systems of Belief Inventory, and The Hope Scale. Results: By use of hierarchical regression, hope was found to be a mediator between religiosity and three coping styles. Conclusion: Special attention should be given to the role of hope for religious patients because it increases the positive effects of religion in coping with cancer.

Research paper thumbnail of Agents of support: psychometric properties of the Cancer Perceived Agents of Social Support (CPASS) questionnaire

Psycho-Oncology, 2010

Objective: The current study presents the development and the evaluation of the psychometric prop... more Objective: The current study presents the development and the evaluation of the psychometric properties of the Cancer Perceived Agents of Social Support (CPASS). The CPASS is a new self-rating instrument devised in order to enable both cancer patients and their spouses to report on the level of perceived social support they get. The CPASS evaluates the support given by different agents of support (spouse, family, friends and spiritual or religious beliefs) in several dimensions (emotional, cognitive and instrumental). Methods: The study sample comprised 662 cancer patients and their spouses recruited during a routine medical evaluation from three major cancer centers in Israel. The participants completed the CPASS and two other standardized instruments: The ENRICH Marital Satisfaction Scale (EMS) and the Brief Symptom Inventory (BSI). Results: Principal component analysis confirmed a three-factor structure based upon the agent of support (spouse; friends/family; spiritual/religious beliefs). Cronbach's a coefficients for the agent of support indexes were high (0.80-0.95), while Cronbach's a levels for the kind of support were lower (0.45-0.72). Smallest Space Analysis (SSA) also confirmed the theoretical structure of the CPASS. Pearson correlation coefficients to the other study variables were high and significant. Conclusions: As a whole, the CPASS was found to be a valid tool for the current Israeli sample. Theoretical and practical conclusions and socio-cultural implications are discussed.

Research paper thumbnail of Preliminary report of the relationship between experience of death of a relative, illness perception, and psychological outcome among BRCA carriers

Psychology, Health & Medicine, 2013

With recent advances in mapping the genetic mutations involved in breast cancer and the availabil... more With recent advances in mapping the genetic mutations involved in breast cancer and the availability of genetic testing, it has become necessary to explore the psychological consequences of women who have tested positive for the gene mutations involved in breast cancer (BReast CAncer gene one and two, BRCA1/2). Findings regarding psychological consequences of positive results in genetic testing for breast cancer are ambiguous and insufficient. The aim of the current study was to explore the relationship between experience of the death of a relative due to breast cancer, perception of the illness, distress, and well-being among BRCA1/2 mutation women carriers. Forty asymptomatic carriers who attended BRCA1/2 clinics in Israel completed self-administered questionnaires assessing socio-demographic variables, illness perception, and well-being. It was found that experiencing the death of a relative as a result of breast cancer was significantly correlated with illness perception. Carriers who experienced the death of a relative perceived breast cancer as having a stronger identity (i.e. as having severe symptoms), dire consequences, and as being uncontrollable in comparison to carriers who had not experienced the death of a relative. Nevertheless, psychological distress and well-being were not found to be significantly correlated to either an experience of death of a relative as a result of breast cancer or to illness perception. Implications and limitations are discussed in light of these findings. Among these is the need to consider the illness perception of healthy BRCA carriers women.

Research paper thumbnail of The psychometric properties of the illness management and recovery scale: Client and clinician versions

Psychiatry Research, 2008

The present study examined the psychometric properties of the clinician and client versions of th... more The present study examined the psychometric properties of the clinician and client versions of the Illness Management and Recovery (IMR) scale. Using a 5-point behaviorally anchored response format, these scales were designed to tap the critical illness management and recovery domains targeted by the IMR program. This program is a curriculum-based approach to helping persons with a serious mental illness (SMI) acquire the knowledge and skills they need to manage their illness effectively and to achieve personal recovery goals. Two hundred and ten persons with a diagnosis of a SMI and their 13 clinicians filled-out the client and clinician versions of the IMR questionnaire. The clients also responded to measures of coping efficacy and social support. While indicating limitations of the IMR scales and pointing to how they could be improved, this study provided some support for the construct and concurrent validity of the client and clinician versions of the IMR questionnaire. Moderate reliabilities were uncovered for these parallel versions of the questionnaire. Client responses to the client IMR scale and clinician responses to the clinician IMR scale were shown to be characterized by similar major components of the IMR intervention.

Research paper thumbnail of Family psychoeducation and therapeutic alliance focused interventions for parents of a daughter or son with a severe mental illness

Psychiatry Research, 2011

This study compared the effectiveness of a family psychoeducational intervention (FPEI) and a the... more This study compared the effectiveness of a family psychoeducational intervention (FPEI) and a therapeutic alliance focused intervention (TAFI) for parents of daughters and sons with severe mental illness (SMI). A process-outcome model was used to compare the effectiveness of the two interventions and to evaluate how they achieved their outcomes. Extent of effectiveness was assessed in terms of the family burden (FB) of the parents and the quality of life (QoL) and psychiatric symptoms of the daughters and sons. This study did not uncover a difference in effectiveness between the two interventions. However, at post-treatment, the participants in both interventions reported statistically significant less FB and attributed more QoL and less psychiatric symptoms to their daughters and sons than at pre-treatment. In addition, these pre-and posttreatment differences were mediated by specific mediating variables. These results are discussed in terms of the great psychotherapy debate (Wampold, 2001) as to the relative effectiveness of technique oriented interventions as compared to context oriented interventions.

Research paper thumbnail of Personal and Interpersonal Perceived Control and the Quality of Life of Persons With Severe Mental Illness

Journal of Nervous & Mental Disease, 2006

Studies have been carried out to explore the impact of sense of control on the outcome of persons... more Studies have been carried out to explore the impact of sense of control on the outcome of persons with severe mental illness (SMI). However, few studies have compared the differential effects of perceived personal control (control of the self) and perceived interpersonal control (the control of significant others). In the present study, we investigated the relations between perceived personal and perceived interpersonal control and different domains of quality of life (QOL) of persons with SMI. Measures of perceived personal and interpersonal control and QOL were administered to 145 participants with a diagnosis of SMI (schizophrenia, affective disorders, anxiety disorders, personality disorders). The results showed personal control to be positively related to various domains of QOL (beta = .28-.31, p < 0.001-0.01) while interpersonal control was negatively related to the physical domain of QOL (beta= -.20, p < 0.05). Theoretical, empirical, and clinical implications of the distinction between personal and interpersonal control for persons with SMI are discussed.

Research paper thumbnail of Call It a Monster for Lack of Anything Else

Journal of Nervous & Mental Disease, 2008

Individuals diagnosed with schizophrenia often appear to be unaware of having an illness or activ... more Individuals diagnosed with schizophrenia often appear to be unaware of having an illness or actively reject their diagnostic label. It is unclear, however, how this lack of awareness relates to important outcomes. Broadening the definition of awareness to include "narrative insight" may clarify this issue. The objective of this study was to identify profiles of narrative insight and test how these relate to standardized measure of insight. Sixty-five individuals with schizophrenia spectrum disorders participated in an assessment that included the Scale of Unawareness of Mental Disorder (SUMD) and an in-depth semi-structured interview. Qualitative analysis revealed 5 central themes related to insight on the basis of which each interview was then rated. Cluster analysis of these ratings resulted in 4 profiles of narrative insight: (1) accepts illness/rejects label, (2) rejects illness/searches for a name (3) passive insight of illness and label, and (4) integrative insight. The SUMD differentiated between individuals assigned to profile 2 who showed low insight to their illness and those assigned to the other profiles of narrative insight, but could not differentiae between them. Results support the claim that illness narratives are multifaceted and that traditional measures of insight may not be sensitive to different ways in which people understand their illness. Keywords Severe mental illness; insight; narratives One of the most important advances of modern descriptive psychiatry is improved reliability of psychiatric diagnoses. But, even when offered by clinicians with the greatest of care and concern, reliable diagnoses are often rejected by the individuals for whom they are intended, leaving clinicians feeling frustrated and helpless. These mental health consumers, in turn, are often left feeling just as frustrated and helpless, as they often find it impossible to relate their experiences to the carefully rendered reliable diagnostic label. They may not agree with

Research paper thumbnail of Qualitative assessment of verbal and non-verbal psychosocial interventions for people with severe mental illness

Journal of Mental Health, 2006

Background: Various forms of psychosocial interventions for people with severe mental illness (SM... more Background: Various forms of psychosocial interventions for people with severe mental illness (SMI) exist. These interventions include verbal interventions as well as activity-based interventions. Aims: To compare three psychosocial interventions with persons with SMI ...

Research paper thumbnail of Parents of adolescents with psychiatric disorders: insight into the disorder, self-stigma and parental stress

Comprehensive Psychiatry, 2014

Background: Parents of adolescents with mental disorders experience stress partially due to the w... more Background: Parents of adolescents with mental disorders experience stress partially due to the way they perceive and experience their offspring's disorder. The current study assessed the mediator role of self-stigma in the relationship between insight into the disorder and parental stress of parents of adolescents with mental disorders. Method: A total of 37 parents of adolescents with psychiatric disorders were assessed for their level of insight, self-stigma and parental stress. Results: The hypothesized mediation model was confirmed and is consistent with previous study on parents of adults with severe mental illness. Discussion: The positive association between insight and parental stress is mediated by these parents' self-stigma, suggesting that insight increases the self-stigma, which in turn increases the parental stress. These results may have clinical implications with regard to the treatment of the family of adolescents with mental disorders.

Research paper thumbnail of Insight into mental illness, self-stigma, and the family burden of parents of persons with a severe mental illness

Comprehensive Psychiatry, 2011

Parents of persons with severe mental illness (SMI) often experience burden due to the illness of... more Parents of persons with severe mental illness (SMI) often experience burden due to the illness of their daughter or son. In the present study, the possibility that parents' self-stigma moderates the relationship between the parents' insight into a daughter's or son's illness and the parents' sense of burden was investigated. Levels of insight into a daughter's or son's mental illness, parent self-stigma, and parent burden of 127 parents of persons with an SMI were assessed. Regression analysis was used to test the putative moderating role of parents' self-stigma. Self-stigma was found to mediate rather than moderate the relationship between insight and burden. Accordingly, parent insight into the mental illness of a daughter or son appears to increase parent burden because it increases parent self-stigma. The implications of these findings for practice, theory, and future research are discussed.

Research paper thumbnail of Insight into severe mental illness, hope, and quality of life of persons with schizophrenia and schizoaffective disorders

Psychiatry Research, 2009

Controversy exists as to the cognitive, emotional and behavioral consequences of lack of insight ... more Controversy exists as to the cognitive, emotional and behavioral consequences of lack of insight for persons with schizophrenia. This study tested a mediation model of the relations between insight into mental illness, hope, and the aspects of quality of life of persons with schizophrenia. According to this model, insight into mental illness may impact negatively on the quality of life of persons with schizophrenia by reducing these persons' hope. Sixty persons with schizophrenia or schizoaffective disorder completed questionnaires that assessed their insight, quality of life, and hope. The study's results show that for six of seven aspects of quality of life and for general awareness of illness, the above-hypothesized mediation model was confirmed. These results suggest that increasing the hope of persons with schizophrenia may directly and positively increase both their quality of life and the usefulness of their insight into their illness.

Research paper thumbnail of Metacognitive function and fragmentation in schizophrenia: Relationship to cognition, self-experience and developing treatments

Schizophrenia Research: Cognition, 2019

Research paper thumbnail of Predicting therapy success from the outset: the moderating effect of insight into the illness on metacognitive psychotherapy outcome among persons with schizophrenia

Clinical Psychology & Psychotherapy, 2019

The degree to which a person recognizes their mental disorder, attributes symptoms to the disorde... more The degree to which a person recognizes their mental disorder, attributes symptoms to the disorder, and recognizes that treatment may be necessary, is frequently referred to as clinical insight. The current study investigates whether clinical insight at baseline moderates the effects on metacognitive capacity of 40 sessions of Metacognitive Reflection and Insight Therapy (MERIT) among 35 participants with psychosis. Findings showed that clinical insight did not predict drop-out from therapy. Multilevel analyses provided support for our hypotheses that insight at baseline significantly moderates metacognitive gains at both post-measurement and follow-up. Our findings demonstrate that lacking clinical insight substantially hampers the effect of this psychosocial intervention. We posit that research efforts should shift from developing interventions which enhance clinical insight, to interventions which are effective in absence of clinical insight. Key Practitioner Message  Clinical insight moderates the effects of 40 sessions of metacognitive psychotherapy  Insight was not related to drop-out from therapy  Future work should be focused on developing interventions which require no clinical

Research paper thumbnail of Between self-clarity and recovery in schizophrenia: reducing the self-stigma and finding meaning

Comprehensive Psychiatry, 2014

Research paper thumbnail of Attitudes toward the sexuality of persons with physical versus psychiatric disabilities

Rehabilitation Psychology, 2014

Research has shown that attitudes toward different disabilities form a hierarchy, with observers ... more Research has shown that attitudes toward different disabilities form a hierarchy, with observers exhibiting more positive attitudes toward persons with physical disabilities than toward persons with psychiatric disabilities. In addition, investigations of attitudes toward persons with a disability indicate that they are often perceived as asexual. The current study examined whether involvement of persons with either a physical or psychiatric disability in a sexual relationship moderates the relation between their type of disability and attitudes toward them. After reading one of six randomly assigned vignettes, university students (N = 195) filled out a semantic differential-based attitude scale (Katz & Shurka, 1977; Kravetz, Katz, & Albez, 1994). The six vignettes consisted of a male with a physical disability/with a psychiatric disability/without a disability, who was either involved/not involved in a sexual relationship. An interaction between type of disability and involvement in a sexual relationship was found for two subscales of the attitudes scale, occupation and intelligence. Involvement in a sexual relationship was found to generate more positive attitudes when the target person had a physical disability but more negative attitudes when he had a psychiatric disability. Involvement in a sexual relationship seems to work in favor of persons with a physical disability because of the association of such a relationship with normality and adaptation. However, attributing such a relationship to persons with a psychiatric disability seems to be stigmatic.

Research paper thumbnail of Illness Management and Recovery: Generic Issues of Group Format Implementation

American Journal of Psychiatric Rehabilitation, 2007

A recent development in psychiatric rehabilitation is the identification and standardization of e... more A recent development in psychiatric rehabilitation is the identification and standardization of evidence-based practices (EBP). In this article we report on the implementation of one of the EBPs, Illness Management and Recovery (IMR), in a group format in two settings and cultures, Israel and the United States (North Carolina) to address generic issues of implementation that arise across settings. The

Research paper thumbnail of Agents of support: psychometric properties of the Cancer Perceived Agents of Social Support (CPASS) questionnaire

Psycho-Oncology, 2010

Objective: The current study presents the development and the evaluation of the psychometric prop... more Objective: The current study presents the development and the evaluation of the psychometric properties of the Cancer Perceived Agents of Social Support (CPASS). The CPASS is a new self-rating instrument devised in order to enable both cancer patients and their spouses to report on the level of perceived social support they get. The CPASS evaluates the support given by different agents of support (spouse, family, friends and spiritual or religious beliefs) in several dimensions (emotional, cognitive and instrumental).

Research paper thumbnail of The psychometric properties of the illness management and recovery scale: Client and clinician versions

Psychiatry Research, 2008

The present study examined the psychometric properties of the clinician and client versions of th... more The present study examined the psychometric properties of the clinician and client versions of the Illness Management and Recovery (IMR) scale. Using a 5-point behaviorally anchored response format, these scales were designed to tap the critical illness management and recovery domains targeted by the IMR program. This program is a curriculum-based approach to helping persons with a serious mental illness (SMI) acquire the knowledge and skills they need to manage their illness effectively and to achieve personal recovery goals. Two hundred and ten persons with a diagnosis of a SMI and their 13 clinicians filled-out the client and clinician versions of the IMR questionnaire. The clients also responded to measures of coping efficacy and social support. While indicating limitations of the IMR scales and pointing to how they could be improved, this study provided some support for the construct and concurrent validity of the client and clinician versions of the IMR questionnaire. Moderate reliabilities were uncovered for these parallel versions of the questionnaire. Client responses to the client IMR scale and clinician responses to the clinician IMR scale were shown to be characterized by similar major components of the IMR intervention.