Adolescent Psychiatric Patients' Interactions with Their Mothers

Article excerpt

Few studies have focused on the interactions between adolescents with psychiatric problems and their parents. One might expect that these adolescents would not only have disturbed interactions with their parents, but would also have distorted perceptions of their interaction behaviors. Research in this area has focused on perceptions of relationships rather than actual interactions. Studies examining the interactions of adolescent psychiatric inpatients have been limited to audio rather than videotaped interactions, and did not assess the subjects' perceptions of the interactions. In a study by Hauser, Houlihan, Powers and Jacobsen (1987), for example, detailed analyses were made of audiotaped parent-child interactions. Conversation patterns differentiated psychiatric and nonpsychiatric adolescents. More disturbed mother-adolescent interactions were noted in the psychiatric sample.

The interactions of normal adolescents and their parents could serve as a model for studying disturbed adolescents. In a study by Callan and Noller (1986), normal adolescents and parents coded their own and their partners' behaviors during a video replay of dyadic interactions. The authors reported differences in how the adolescents and their parents behaved and in how they perceived their interactions. The adolescents rated their parents as more anxious, less involved, and less dominant than the parents rated themselves. The adolescents were rated as less involved and less dominant than their parents. In a second study, outside coders were added to the procedure (Noller & Callan, 1988). These observers rated family members more negatively than family members rated themselves, raising the possibility that the adolescents and their parents had distorted perceptions of their inter-actions.

The purpose of the present study was to determine (1) whether adolescents with psychiatric problems and their mothers interact differently as a function of symptom profile (internalizing/externalizing, depressed/nondepressed, and high and low anxiety); (2) whether adolescents rate their mothers similarly to the way their mothers rate them; and (3) whether their perceptions of the interactions are congruent with ratings by an objective observer. The findings would indicate whether brief interactions should be videotaped as a portion of the psychiatric intake process. The videotape would help familiarize the clinical staff with the dynamics of parent-adolescent interaction, which they might not otherwise have an opportunity to observe. In addition, the ratings would give them information on adolescents' and parents' perceptions of each other's behaviors.

METHOD

Subjects

Thirty-eight adolescent-mother dyads were recruited from two clinical sites; twenty dyads from an inpatient adolescent psychiatric unit in Miami and 18 from an outpatient unit in Northern California. Although these were convenience samples, it was expected that recruiting from two psychiatric settings in different areas of the country would offer greater generalizability of the results. Both of these sites served children and adolescents with the typical range of psychiatric diagnoses, including depression, conduct disorder, adjustment disorder, attention deficit hyperactivity disorder, and psychoses. On average, children remained in these treatment programs for three months.

The adolescents (63% female, 37% male) ranged in age from 11 to 18 (M = 14.3 years) and included a broad representation of family income levels (median income = $20,000-30,000 per year, range = $10,000-90,000 per year). However, most of the patients would be categorized as low socioeconomic status. The ethnic distribution was 45% white (non-Hispanic), 35% Hispanic, and 20% black. The average education of the parents was 11.3 years (range = 8 to 16). The exclusion criteria for recruiting were the unavailability of the mother, inappropriate diagnoses, or active psychosis in the adolescent. …