Date on Master's Thesis/Doctoral Dissertation

8-2008

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department

Psychological and Brain Sciences

Committee Chair

Lewine, Richard R.

Author's Keywords

Disappointment; Quality of life; Mental illness

Subject

Mentally ill--Social conditions; Disappointment

Abstract

The concept of quality of life (QOL) has been the topic of many research projects, yet several clinically relevant aspects of this concept have been overlooked. Specifically, few studies have addressed the impact of such demographic variables as race and sex on the life domains that have been particularly disappointing to patients with mental illnesses. The current research project aims to contribute to the understanding of the impact these variables have on quality of life, specifically addressing the following hypotheses: (1) Domains of disappointment will vary according to race and sex; (2) Race and sex will interact to predict which life domain is most disappointing; and (3) Demographic differences will be detected in the level of disappointment with most disappointing domain. Patients diagnosed with psychotic and affective disorders (n=125) were administered an open-ended, semi-structured interview designed to assess disappointments they have experienced as a result of their mental illness. They were asked to list the goals they have been prevented from accomplishing, which "loss" was most disappointing, and to rate that disappointment on a 1-5 Likert scale. Patient responses were coded according to the fourteen life domains listed in the Quality of Life Inventory (QLS-100 Skantze & Malm, 1993). Preliminary chi-square analyses indicated that the domains of Knowledge and Education, Contacts, and Work were most frequently endorsed as disappointing, with no statistically significant differences between sexes and races in the frequency with which these domains were endorsed. Additional analyses again indicated no demographic differences in the report of most disappointing domains. Similarly, no sex or race effects were detected in the level disappointment. Post-hoc analyses suggest the importance of other variables in determining which domains are reported as disappointing and the level of disappointment. The current level of patient functioning is associated with the frequency with which the Contacts domain is endorsed as disappointing, with higher functioning patients more frequently reporting this domain as disappointing. A multiple regression analysis to predict the level of disappointment suggests that race and illness duration are the best predictors of disappointment level. Clinical implications of these findings are discussed.

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