TY - JOUR
T1 - Linking family cohesion and flexibility with expressed emotion, family burden and psychological distress in caregivers of patients with psychosis
T2 - A path analytic model
AU - Koutra, Katerina
AU - Simos, Panagiotis
AU - Triliva, Sofia
AU - Lionis, Christos
AU - Vgontzas, Alexandros N.
N1 - Publisher Copyright:
© 2016 Elsevier Ireland Ltd
PY - 2016
Y1 - 2016
N2 - The present study aimed to evaluate a path analytic model accounting for caregivers’ psychological distress that takes into account perceived family cohesion and flexibility, expressed emotion and caregiver's burden associated with the presence of mental illness in the family. 50 first-episode and 50 chronic patients diagnosed with schizophrenia or bipolar disorder (most recent episode manic severe with psychotic features) recruited from the Inpatient Psychiatric Unit of the University Hospital of Heraklion, Crete, Greece, and their family caregivers participated in the study. Family functioning was assessed in terms of cohesion and flexibility (FACES-IV), expressed emotion (FQ), family burden (FBS) and caregivers’ psychological distress (GHQ-28). Structural equation modelling was used to evaluate the direct and indirect effects of family dynamics on caregivers’ psychological distress. The results showed that neither family cohesion nor family flexibility exerted significant direct effects on caregivers’ psychological distress. Instead, the effect of flexibility was mediated by caregivers’ criticism and family burden indicating an indirect effect on caregivers’ psychological distress. These results apply equally to caregivers of first episode and chronic patients. Family interventions aiming to improve dysfunctional family interactions by promoting awareness of family dynamics could reduce the burden and improve the emotional well-being of family caregivers.
AB - The present study aimed to evaluate a path analytic model accounting for caregivers’ psychological distress that takes into account perceived family cohesion and flexibility, expressed emotion and caregiver's burden associated with the presence of mental illness in the family. 50 first-episode and 50 chronic patients diagnosed with schizophrenia or bipolar disorder (most recent episode manic severe with psychotic features) recruited from the Inpatient Psychiatric Unit of the University Hospital of Heraklion, Crete, Greece, and their family caregivers participated in the study. Family functioning was assessed in terms of cohesion and flexibility (FACES-IV), expressed emotion (FQ), family burden (FBS) and caregivers’ psychological distress (GHQ-28). Structural equation modelling was used to evaluate the direct and indirect effects of family dynamics on caregivers’ psychological distress. The results showed that neither family cohesion nor family flexibility exerted significant direct effects on caregivers’ psychological distress. Instead, the effect of flexibility was mediated by caregivers’ criticism and family burden indicating an indirect effect on caregivers’ psychological distress. These results apply equally to caregivers of first episode and chronic patients. Family interventions aiming to improve dysfunctional family interactions by promoting awareness of family dynamics could reduce the burden and improve the emotional well-being of family caregivers.
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U2 - 10.1016/j.psychres.2016.04.017
DO - 10.1016/j.psychres.2016.04.017
M3 - Article
C2 - 27085666
AN - SCOPUS:84979519291
SN - 0165-1781
VL - 240
SP - 66
EP - 75
JO - Psychiatry Research
JF - Psychiatry Research
ER -
