Date of Submission

2003

Degree Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

Department Chair

Arthur Freeman, Ed.D., ABPP

First Advisor

Barbara A. Golden, Psy.D., Chairperson

Second Advisor

Robert A. DiTomasso, Ph.D., ABPP

Third Advisor

Meryll E. Udell, Ph.D.

Abstract

The aim of this study was to describe the characteristics of 600 individuals who presented to two Psychiatric Emergency Services (PES) located in one county of southern New Jersey. A retrospective chart analysis investigated demographic, clinical, and psychosocial variables that describe the PES presenter. It also examined how these variables differ between the urban and suburban sites, and how they affected the disposition decision. Because there is a paucity of information investigating the role that psychosocial stressors play, there was specific focus on psychosocial stressors as defined by Axis IV of the multiaxial system outlined in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision, (2000 [DSM-IV-TR].) Results of this correlational study found that those patients who presented with "threat of harm to self or others" had a greater chance of being admitted. Presence of social support did not affect disposition decision, though if a patient was connected with case management, there was a greater chance they were hospitalized. Patients with substance abuse had more psychosocial stressors. There were some significant differences between the urban and suburban PES sites in reference to the psychosocial stressors with which the patients presented. The urban presenters experienced more homelessness, unemployment, and had fewer social supports, and the suburban presenters experienced more occupational stress. These findings describe the differences between urban and suburban sites, the affect that psychosocial stressors may have on a patient, and how these variables may impact the disposition decision.

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