Date of Award

2014

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

First Advisor

Psychology

Second Advisor

Copyright © 2013 Alison Merri Stoner

Third Advisor

Doctor of Philosophy (PhD)

Abstract

Previously a long-term mental health treatment option, inpatient psychiatric care is now an acute service for brief crisis stabilization and psychiatric reconstitution. Although lengths of stay have declined, rehospitalization rates have risen, calling into question the effectiveness of inpatient treatment and the extent to which inpatient and post-discharge, community-based services are working together to promote community tenure for youth. The present study had three aims: (1) evaluate the utility of the Child and Adolescent Needs and Strengths (CANS; Lyons, 1999) as an outcome assessment and decision support tool for youth inpatient hospitalization, (2) confirm a social ecological theory-informed factor structure of the CANS, and (3) identify individual youth and greater social ecological factors predicting time to psychiatric rehospitalization. Demographic, service-related variables, CANS, and Acuity of Psychiatric Illness--Child/Adolescent version (CAPI; Lyons, 1998) data was collected from 226 youth admitted to a private psychiatric inpatient hospital (M age=8.71, SD=1.95). Results from factor analysis strategies revealed that none of the tested models demonstrated good fit and factor analysis strategies did not converge with respect to the number of factors extracted and the items comprising these factors. However, results suggested a model of youth social and emotional functioning comprised of multiple, inter-related components. Survival analysis identified history of fire setting and previous psychiatric hospitalization as significant predictors of time to psychiatric rehospitalization. Future research identifying evidence-based assessment tools for use in this treatment milieu and identifying factors across the social ecologies of youth that promote psychiatric stabilization and community tenure is indicated.

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Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

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