Linking family cohesion and flexibility with expressed emotion, family burden and psychological distress in caregivers of patients with psychosis: A path analytic model. (30th June 2016)

• Record Type: Journal Article
• Authors: Koutra, Katerina; Simos, Panagiotis; Triliva, Sofia; Lionis, Christos; Vgontzas, Alexandros N.
• Is Part Of: Psychiatry research. Volume 240(2016)
• Page Start: 66
• Page End: 75
• Publication Date: 2016-06-30
• Subjects: Family cohesion -- Flexibility -- Expressed emotion -- Burden -- Psychological distress -- Path analysis; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2016.04.017
• Languages: English
• ISSNs: 0165-1781

Abstract

Abstract: 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. Highlights: We test a path analytic model accounting for caregivers' psychological distress that takes into account family cohesion and flexibility, expressed emotion and burden. Family caregivers of 50 first episode and 50 chronic patients with psychosis participated in the study. Neither family cohesion nor flexibility was found to have significant direct effects on caregivers' psychological distress. Instead, the effect of flexibility on caregivers' psychological distress was mediated by caregivers' criticism and family burden. These results apply equally to caregivers of first episode and chronic patients.