Friday, 14 January 2005 - 10:00 AM

This presentation is part of: Consumer-Driven Services for Persons with Severe Mental Illness

Factors Predicting Self-Efficacy among Psychiatric Service Consumers: Testing Age Differences Using Multi-Group Structural Equation Modeling

Purpose: It is important for psychiatric service consumers to attain successful psychosocial rehabilitation. One issue that is related to this success is self efficacy which has been linked to psychological, behavioral and health outcomes. With self efficacy varying with age, it is not clear what contributes to self efficacy for older and younger consumers. By identifying predictive factors of self-efficacy and age differences, social workers could develop age sensitive practice and policy. This study aims to answer two questions: (1) what are the predictive factors of self-efficacy among psychiatric service consumers? (2) Do the predictive factors of self-efficacy among psychiatric consumers aged 50 and over differ from those among individuals 50 or younger?

Methods: The sample consists of 417 psychiatric service consumers served by 25 psychosocial rehabilitation agencies in southeast Michigan - supported education programs, consumer-run drop-in centers, and clubhouse programs. Predictive factors of self-efficacy include race (black=1), sex (male=1), education (12 and over =1), household income (log-transformed to fix the distribution), psychiatric symptoms, and perceptions of treatment environment. Dependent variable was Mental Health Self-efficacy. Data were processed using Structural Equation Modeling (SEM) in AMOS 4. First, the model was fitted for the total group (N=417). Second, the same model was fitted for each of two age groups: over 50 (n=121) and under 50 (n=296). Third, after testing factorial invariance in measurement models, age differences in the parameters were tested using multi-group SEM.

Results: Measurement models (for symptoms, perceptions of agency environment, and self-efficacy) presented acceptable fit indices. Structural model for the total group fit the data well - IFI=0.98; RMSEA=0.07. Controlling for race, gender, and education (all ns), income (B=.12, p<.05), psychiatric symptoms (B=-.39, p<.00), and perceptions of psychosocial treatment environment (B=.15, p<.05) were significantly associated with self-efficacy, indicating consumers with more income, fewer symptoms, and more positive perceptions of treatment environment have greater self-efficacy. The findings of the total group were replicated among younger consumers. However, for older consumers, neither income (B=.10, ns) nor perceptions of environment (B=-.03, ns) was significantly associated with self-efficacy, although symptoms (B=-.47, p<.00) were significantly predictive of self-efficacy. Factorial invariance tests indicated that measurement models did not differ between the two age groups. Multi-group SEM showed: (1) Younger adults who perceived the treatment environment more positively had significantly greater self-efficacy, whereas this relationship was opposite among older adults (c²(1)=3.80, p=.05). (2) The relationship between income and self-efficacy was much stronger among younger consumers than among older adults, not statistically significant (c²(1)=1.04, ns).

Implications: The findings of the current study suggest that psychiatric symptoms, economic hardships, and negative treatment environment could be stressors for consumers and undermine self-efficacy. These findings suggest that income maintenance policy, symptoms control, and positive treatment environment are critical to self-efficacy which is essential for successful psychosocial rehabilitation. The findings of age differences suggest that income and agency environment would be more critical to younger consumers. The identified age difference should be considered when social workers work with psychiatric consumers served by psychosocial rehabilitation agencies.

See more of Consumer-Driven Services for Persons with Severe Mental Illness
See more of Oral and Poster

See more of Celebrating a Decade of SSWR (January 13 - 16, 2005)