The impact of psychosis on vocational functioning

Driessens, Corine Elizabeth Fernanda (2007) The impact of psychosis on vocational functioning. Stony Brook University, The Graduate School, Doctoral Thesis, 202pp.

Abstract

In order to further the field of psychiatric vocational rehabilitation, an innovative research model has been used to study the neurobiological, developmental, and psychosocial pathways through which psychotic affective disorders might affect vocational functioning among 226 participants enrolled in the Suffolk County Mental Health Project. This model was based on the social selection hypothesis, which theorizes that disruption of a career path or educational attainment can cause a decline in socio-economic status. It is also based on the results of empirical studies which have found that vocational decline within the psychiatric population is associated with past vocational functioning, social functioning deficits, and hospitalization history. Vocational profiles that assess functioning retrospectively before the first hospitalization and prospectively after the first hospitalization reveal that most vocational active participants experienced a descending career path. For students educational stagnation is dominantly present at the college level. Neuro-cognitive deficits in the form of lack of concentration and a short-term memory dysfunction, were associated with a downward vocational drift. From a social learning perspective, the adverse events of an interrupted educational path, during the development of a vocational personality was associated with a downward vocational drift. According to the open linked systems model, social impairments, stressors in the living situation, mood, limitations of medical treatment, and illness factors were found to be related to poor performance in the vocational domain. The participants enrolled in this study indicated that the vocational rehabilitative system on Long Island was unable to meet their needs. There was a specific demand for more effective vocational training, help locating resources to facilitate vocational functioning, help to maintain their vocational role, job development and placement services, and supported education programs. Policy reforms should therefore focus on promoting community-based psychosocial rehabilitation programs that have vocational services included in their package. Access to these services should be more readily available to all individuals with psychiatric disabilities. In addition, the participants included in this study mentioned that current legislation regarding vocational role protection was lacking.

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Contributors

Author: Corine Elizabeth Fernanda Driessens

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