Date Presented 03/22/24
There are little differences in participation patterns between SMI diagnosis. In spite of a disparity between objective and subjective participation dimensions, integrated index is explained by demographic, cognitive, and illness-related factors.
Primary Author and Speaker: LENA Lipskaya-Velikovsky
Contributing Authors: Jasmin Bar-Yosef, Tal Jarus
PURPOSE: Participation is an important component of health and recovery, and it is vulnerable in serious mental illness (SMI). Previous research has mainly focused on objective dimensions, addressing specific diagnoses. Inspired by a comprehensive approach to participation, the recovery model, and a transdiagnostic approach in research and practice, we investigated objective and subjective dimensions of participation in a range of diagnoses to delineate differences, and to identify factors associated with the participation.
DESIGN: Secondary analysis of cross-sectional studies (N=10).
METHOD: Data from 500 men (42.3%) and women (57.7%), aged 18-60 (M=34.4; SD=10.9) who had been diagnosed with psychotic, affective, post-traumatic, or personality disorder was analysed. Participation objective (intensity, diversity) and subjective (satisfaction, enjoyment) dimensions were measured with the Adult Subjective Assessment of Participation. We also addressed cognitive functioning, symptoms, functional capacity, demographic, and illness-related factors.
RESULTS: Differences between diagnoses were found only in participation intensity (F(3, 497)=15.2, p<.001). Regression analysis revealed that subjective dimensions are explained mostly by symptoms’ severity, while objective dimensions are explained by a range of personal and illness-related factors (6.8<F<37.18, p<.01; 0.1<Adj.R2<0.32). Clustering was done integrating objective and subjective dimensions. Belonging to the integrated clusters was explained by gender, family status, cognition and symptoms severity (χ2(3)=12.2, p<.01, 72.5% correct classification).
CONCLUSION: The study supports a transdiagnostic approach to participation. Demographic, personal, and illness-related factors are important for participation, predominantly explaining objective dimensions.
IMPACT STATEMENT: Given the disparity between objective and subjective dimensions in SMI, the integrated approach to participation is of importance.
References
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Lipskaya-Velikovsky, L., Jarus, T., Easterbrook, A., & Kotler, M. (2016). Participation in daily life of people with schizophrenia in comparison to the general population: Comparaison de la participation à la vie quotidienne des personnes atteintes de schizophrénie à celle de la population générale. Canadian Journal of Occupational Therapy, 83(5), 297-305. https://doi.org/10.1177/0008417416647158
