Aim-A longer duration of untreated psychosis (DUP) is associated with greater morbidity in the early course of schizophrenia. This formative, hypothesis-generating study explored the effects of stigma, as perceived by family members, on DUP.Methods-Qualitative interviews were conducted with 12 African American family members directly involved in treatment initiation for a relative with first-episode psychosis. Data analysis relied on a grounded theory approach. A testable model informed by constructs of Link's modified labelling theory was developed.Results-Four main themes were identified, including: (i) society's beliefs about mental illnesses; (ii) families' beliefs about mental illnesses; (iii) fear of the label of a mental illness; and (iv) a raised threshold for the initiation of treatment. A grounded theory model was developed as a schematic representation of the themes and subthemes uncovered in the family members' narratives. Conclusions-The findings suggest that due to fear of the official label of a mental illness, certain coping mechanisms may be adopted by families, which may result in a raised threshold for treatment initiation, and ultimately treatment delay. If the relationships within the grounded theory model are confirmed by further qualitative and quantitative research, public educational programs could be developed with the aim of reducing this threshold, ultimately decreasing DUP.

While mode of onset is a reliable illness-related determinant of DUP, further research is needed on the complex ways in which family-related variables influence DUP.

Findings highlight the value of incorporating Nia as an adjunctive intervention for abused, suicidal, low-income women. They underscore the ways the intervention needs to be bolstered to address more directly more mediating and moderating constructs, as well as the need to target more effectively the key outcomes.

Aim-This study employed a qualitative research methodology to explore common themes pertaining to the period of untreated psychosis prior to treatment initiation in hospitalized, urban, African American, first-episode psychosis patients.Methods-Twelve family members of 10 patients were interviewed at length to gather detailed narrative accounts of factors related untreated psychosis and treatment delay. Using qualitative analysis, verbatim transcripts were reviewed by two researchers to identify prominent themes useful for generating future research hypotheses.Results-Four themes emerged as informative of the period of untreated psychosis prior to treatment initiation: (1) misattribution of symptoms or problem behaviors (e.g., depression, drug use, adolescent rebellion), (2) positive symptoms causing unusual or dangerous behaviors that served as a catalyst for initiating treatment, (3) views about personal autonomy of an adult or nearly adult patient, and (4) system-level factors (e.g., unaffordability of healthcare, inefficiency on the part of healthcare providers).Conclusions-Family members encountered numerous barriers when seeking treatment, including their own misattributions, the nature of the patient's symptoms, financial issues, and system-level delays. The themes uncovered in this formative analysis merit further exploration with additional qualitative and quantitative research.

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There is a need for early intervention efforts to be directed to families (and their loved ones who live with them with emerging psychotic disorders or frank untreated psychotic syndromes), particularly families facing major socioeconomic challenges.

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Objective This study investigated the impact of avoidant coping on treatment outcome in rape-related PTSD. Method Adult women with rape-related Posttraumatic Stress Disorder (PTSD; N = 62) received nine sessions of prolonged exposure (PE) or eye movement desensitization and reprocessing (EMDR). Mean age for sample was 34.7 years old, and race or ethnicity was reported as 67.7% Caucasian, 25.8% African American, 3.2% Latina, and 3.2% Other. PTSD was assessed with the PTSD Symptom Scale-Self Report and avoidant coping was assessed using the Disengagement Subscale of the Coping Strategies Inventory (CSI-D). Results Pretreatment avoidant coping was negatively associated with posttreatment PTSD symptom severity even when controlling for initial severity of total PTSD symptoms and when removing PTSD avoidance symptoms from the analysis to account for potential overlap between avoidant coping and PTSD avoidance symptoms (ΔR2 = .08, b* = −0.31, 95% CI [−0.17, −0.01], t (60) = −2.27, p = .028). The CSI-D mean score of 100 predicted a 96% likelihood of experiencing clinically significant change (CSC) during treatment. A CSI-D mean score of 61 was associated with a 40% likelihood of experiencing CSC. Conclusions PE and EMDR appear to be beneficial for women who frequently engage in avoidant coping responses following rape. A small subset of women with initially low levels of avoidant coping are unlikely to experience a therapeutic response from PE or EMDR.