Caregiver Psychological Distress Research Articles

Nurturing families: A feasibility randomised controlled trial of a whole-family intervention with vulnerable families in Jordan.

Armed conflict and forced displacement can significantly strain nurturing family environments, which are essential for child well-being. Yet, limited evidence exists on the effectiveness of family-systemic interventions in these contexts. We conducted a two-arm, single-masked, feasibility Randomised Controlled Trial (fRCT) of a whole-family intervention with Syrian, Iraqi and Jordanian families in Jordan. We aimed to determine the feasibility of intervention and study procedures to inform a fully-powered RCT. Eligible families were randomised to receive the Nurturing Families intervention or enhanced usual care (1:1). Masked assessors measured outcomes at baseline and endline; primary outcome measures were caregiver psychological distress, family functioning, and parenting practices. Families and implementing staff participated in qualitative interviews at endline. Of the 62 families screened, 60 (98%) were eligible, 97% completed the baseline and 90% completed the endline. Qualitative feedback indicated specific improvements in adolescent well-being, caregiver distress and parenting, and family relationships. Data highlighted high participant engagement and adequate facilitator fidelity and competence. Outcome measures had good psychometric properties (most α>0.80) and sensitivity to change, with significant changes seen on most measures in the intervention but not control group. Findings indicate the acceptability and feasibility of intervention and study procedures. Subsequent full-scale evaluation is needed to determine effectiveness.

Musical and electrical stimulation as intervention in disorder of consciousness (DOC) patients: A randomised cross-over trial.

Disorders of consciousness (DOC), i.e., unresponsive wakefulness syndrome (UWS) or vegetative state (VS) and minimally conscious state (MCS), are conditions that can arise from severe brain injury, inducing widespread functional changes. Given the damaging implications resulting from these conditions, there is an increasing need for rehabilitation treatments aimed at enhancing the level of consciousness, the quality of life, and creating new recovery perspectives for the patients. Music may represent an additional rehabilitative tool in contexts where cognition and language are severely compromised, such as among DOC patients. A further type of rehabilitation strategies for DOC patients consists of Non-Invasive Brain Stimulation techniques (NIBS), including transcranial electrical stimulation (tES), affecting neural excitability and promoting brain plasticity. We here propose a novel rehabilitation protocol for DOC patients that combines music-based intervention and NIBS in neurological patients. The main objectives are (i) to assess the residual neuroplastic processes in DOC patients exposed to music, (ii) to determine the putative neural modulation and the clinical outcome in DOC patients of non-pharmacological strategies, i.e., tES(control condition), and music stimulation, and (iii) to evaluate the putative positive impact of this intervention on caregiver's burden and psychological distress. This is a randomised cross-over trial in which a total of 30 participants will be randomly allocated to one of three different combinations of conditions: (i) Music only, (ii) tES only (control condition), (iii) Music + tES. The music intervention will consist of listening to an individually tailored playlist including familiar and self-relevant music together with fixed songs; concerning NIBS, tES will be applied for 20 minutes every day, 5 times a week, for two weeks. After these stimulations two weeks of placebo treatments will follow, with sham stimulation combined with noise for other two weeks. The primary outcomes will be clinical, i.e., based on the differences in the scores obtained on the neuropsychological tests, such as Coma Recovery Scale-Revised, and neurophysiological measures as EEG, collected pre-intervention, post-intervention and post-placebo. This study proposes a novel rehabilitation protocol for patients with DOC including a combined intervention of music and NIBS. Considering the need for rigorous longitudinal randomised controlled trials for people with severe brain injury disease, the results of this study will be highly informative for highlighting and implementing the putative beneficial role of music and NIBS in rehabilitation treatments. ClinicalTrials.gov identifier: NCT05706831, registered on January 30, 2023.

Identify adolescents' help-seeking intention on suicide through self- and caregiver's assessments of psychobehavioral problems: deep clustering of the Tokyo TEEN Cohort study

Psychopathological and behavioral problems in adolescence are highly comorbid, making their developmental trajectories complex and unclear partly due to technical limitations. We aimed to classify these trajectories using deep learning and identify predictors of cluster membership. We conducted a population-based cohort study on 3171 adolescents from three Tokyo municipalities, with 2344 pairs of adolescents and caregivers participating at all four timepoints (ages 10, 12, 14, and 16) from 2012 to 2021. Adolescent psychopathological and behavioral problems were assessed by using self-report questionnaires. Both adolescents and caregivers assessed depression/anxiety and psychotic-like experiences. Caregivers assessed obsession/compulsion, dissociation, sociality problem, hyperactivity/inattention, conduct problem, somatic symptom, and withdrawal. Adolescents assessed desire for slimness, self-harm, and suicidal ideation. These trajectories were clustered with variational deep embedding with recurrence, and predictors were explored using multinomial logistic regression. Five clusters were identified: unaffected (60.5%), minimal problems; internalizing (16.2%), persistent or worsening internalizing problems; discrepant (9.9%), subjective problems overlooked by caregivers; externalizing (9.6%), persistent externalizing problems; and severe (3.9%), chronic severe problems across symptoms. Stronger autistic traits and experience of bullying victimization commonly predicted the four "affected" clusters. The discrepant cluster, showing the highest risks for self-harm and suicidal ideation, was predicted by avoiding help-seeking for depression. The severe cluster predictors included maternal smoking during pregnancy, not bullying others, caregiver's psychological distress, and adolescent's dissatisfaction with family. Approximately 40% of adolescents were classified as "affected" clusters. Proactive societal attention is warranted toward adolescents in the discrepant cluster whose suicidality is overlooked and who have difficulty seeking help. Japan Ministry of Health, Labor and Welfare, Japan Agency for Medical Research and Development, and Japan Science and Technology Agency.

Abstract 286: Assessing the Needs of Caregivers of Cardiac Arrest Survivors: A Qualitative Study

Background: Interventions addressing highly prevalent psychological distress in caregivers of cardiac arrest (CA) survivors are lacking.We conducted a prospective study to confirm our previous findings of information-based needs as the highest priority in a cross-sectionalsurvey of caregivers of CA survivors. Methods: Adult caregivers of CA survivors hospitalized at Columbia University Medical Center were eligible for recruitment.Caregivers completed an interview after transfer from the intensive care unit (ICU) to inpatient floors and a follow-up interview 1-monthpost-discharge. Interviews allowed for initial free response, followed by prompts for opinions on eight potential interventions addressingpatient-centered needs (i.e., CA education, information on neurological recovery or rehabilitation, having a designated member of thecare team) and caregiver-centered needs (i.e., peer-to-peer support, hospital-based resources, formal psychotherapy, self-care). Interviewtranscripts were used to identify top-ranked needs and temporal changes between post-ICU and 1-month post-discharge. Results: Of 33 caregivers who participated in post-ICU interviews between August 2021-July 2022, 22 who also completed 1-monthinterviews were analyzed. The highest ranked need during acute care (n=10; 45.5%) and 1-month post-discharge (n=8; 36.4%) wasaccess to a designated member of the patient’s medical care team to answer the caregiver’s questions throughout hospitalization and thetransition home. Patient-centered needs accounted for 81.8% (n=18) of caregiver desire for interventions at both time points. 37% (n=8)of caregivers shifted focus between patient- and caregiver-centered needs, observed in both directions, between the two interviews. Conclusions: Caregivers of CA survivors self-reported their greatest need during hospitalization and a month after hospital dischargeas access to trusted resources about their loved one’s medical condition. Studies with a longer follow-up to understand caregivers’journeys and timing of the switch from patient-to caregiver-centered needs are warranted.

Does asset poverty moderate how food insecurity is associated with adolescent problematic behavior? An application of the family stress model using multi-group path analyses

The Family Stress Model framework suggests that food insecurity could be associated with adolescent problematic behaviors through caregiver psychological distress. While assets such as savings could buffer the impacts of income on food insecurity, it remains unclear whether such moderating effects can be applied to other associations in the Family Stress Model framework. Using the 2017 and 2019 Panel Study of Income Dynamics and 2019 and 2020 Child Development Supplement data including 643 children (Mage = 13.7, SD = 2.6), multi-group path analyses found that the family stress process manifests differently in asset poor families and non-asset poor families. More specifically, the direct and indirect associations embedded by income, food insecurity, caregiver psychological distress, and child problematic behaviors are statistically stronger in the asset poor families than the non-asset poor families. These findings suggest the necessity to offer more comprehensive interventions to address economic needs (i.e., low income, food insecurity) and non-economic needs (i.e., caregiver mental health, child development) for the economically vulnerable.

Caregiver experiences of racism and child mental health outcomes: cross-sectional analysis from Aotearoa New Zealand.

This study aimed to estimate the prevalence of vicarious racism experienced by children (0-14 years) in Aotearoa New Zealand and investigate the association between vicarious racism and diagnosed child mental health conditions. Adult and child 2016/2017 New Zealand Health Survey data were merged to create child-caregiver dyads. Multivariable logistic regression models were used to investigate the association between the caregiver experiences of racism (exposure) and diagnosed child mental health conditions (outcome), adjusting for confounders and exploring potential pathway variables. Looking at 2,989 dyads, the prevalence of "any" vicarious racism was higher for Māori (28.1%; 95% CI 24.2-31.9), Pacific (23.2%; 95% CI 17.9-28.5) and Asian (29%; 95% CI 23.6-34.5) children compared to European/Other children (12.5%; 95% CI 10.2-14.8). A statistically significant association was identified between >2 reports of vicarious racism and the outcome (OR= 2.53, 95% 1.18-5.43). Adding caregiver psychological distress reduced this association (OR= 1.92, 95% 0.91-4.08). Children in Māori, Pacific and Asian ethnicity groupings experience higher exposure to vicarious racism than those in the European/Other grouping. Multiple experiences of vicarious racism are associated with increased odds of diagnosed child mental health conditions in a dose-response distribution.

Social determinants of health, psychological distress, and caregiver burden among informal cancer caregivers of cancer survivors during treatment.

This study compared three ethnic/racial groups of informal cancer caregivers on social determinants of health and tested social determinants of health as predictors of psychological distress and caregiver burden. This study was a secondary analysis of baseline data of a sequential multiple assignment randomized trial (SMART) testing symptom management interventions with caregiver-survivor dyads. Caregivers completed baseline measures of social determinants of health (SDoH), functional limitations, psychological distress, and caregiver burden. Hispanic, non-Hispanic White, and non-Hispanic other races caregivers were compared on these variables. Multivariate tests of associations between SDoH and caregiver burden and psychological distress were conducted in structural equation modeling with caregiver burden and psychological distress as latent variables. Hispanic caregivers reported significantly higher caregiver burden, specifically for finances, family, and schedules. Caregiver burden was significantly predicted by having income barely or not meeting needs, being female, socially isolated, married, Hispanic, and having poor physical functioning. Significant predictors of caregivers' psychological distress: being female, being socially isolated, and having poor physical functioning. Hispanic caregivers experience significant challenges associated with caregiver burden, especially if they are female, socially isolated, and have poor physical functioning. Assessment of these SDoH is important in caregiver health to provide supportive care during caregiving. NCT03743415 www.clinicaltrials.gov.

Effectiveness of the caregiver support intervention on child psychosocial wellbeing among Syrian refugees in Lebanon: Mediation and secondary analysis of a Randomized Controlled Trial

BackgroundWar and violence have a serious negative impact on the wellbeing and mental health of many children. Caregivers play an important role in mitigating or exacerbating this impact. ObjectiveThis study evaluates the impact of the nine session Caregiver Support Intervention on improving children's wellbeing and examines putative mediators of changes in children's psychosocial wellbeing. Participants and setting240 female caregivers were randomly allocated (1:1) to the CSI or a waitlist control comparison condition. The study was implemented in Lebanon, in an area characterized by high levels of poverty and a high number of the Syrian refugees. MethodsA parallel group Randomized Controlled Trial reporting on caregiver-reported child-level wellbeing. We used a combination of the Kid- and Kiddy-KINDL (parent version) for index children ages three to 12. Putative mediators of the CSI on children's psychosocial wellbeing included harsh parenting, caregiver psychological distress, caregiver wellbeing. Measurements were conducted at baseline, post-intervention and 3-months follow-up. ResultsWe demonstrated a statistically significant change in caregiver reported children's psychosocial wellbeing at post-intervention (Mdiff =4.39, 95 % CI = 1.12, 7.65, p < 0.01, d = 0.28) but not at follow-up (Mdiff = −0.97, 95 % CI = -4.27, 2.32, p > 0.05). The proportion of the total effect of the CSI intervention on child psychosocial wellbeing mediated by caregiver distress, caregiver wellbeing and harsh parenting was 77 %. ConclusionThe CSI holds potential for down-stream short-term effect on improving children's psychosocial wellbeing, beyond the previously reported positive caregiver outcomes. This effect was not sustained three months post intervention. The study confirms caregiver wellbeing and parenting support as dual pathways mediating child psychosocial wellbeing.Prospective trial registration: ISRCTN22321773

Manfaat Dukungan Emosional dan Koping Spiritual terhadap Distress Psikologis pada Pelaku Rawat Orang Dengan Skizofrenia

&#x0D; This study aims to analyze the benefits of emotional support and spiritual coping against psychological distress in caregivers of people with schizophrenia. The method used is a systematic review through an adjusted article search for the formulation of research questions with the PICO formula in the EBSCOhost, ProQuest, SpringerLink, ScienceDirect, and Clinicalkey for Nursing databases. The results showed that emotional support and spiritual coping can improve coping skills thereby reducing psychological distress and minimizing the effects of loss of self to depression. In conclusion, emotional support and spiritual coping have benefits as adaptive coping to psychological distress in caregivers of people with schizophrenia.&#x0D; Keywords: Emotional Support, Psychological Disorders, Spiritual Coping

Objective burden, caregiver psychological distress, and patient religion and quality of life are associated with high-intensity burden of care among caregivers of advanced cancer patients in a Latino population.

Family caregivers (FCs) of cancer patients experience burden of care. The aims of this study are to describe the caregiving phenomenon among FCs of advanced cancer patients in a Latino community and to identify caregiver and patient characteristics associated with high-intensity subjective caregiver burden. In this cross-sectional study, advanced cancer patient-caregiver dyads assessed at a Palliative Care Unit in Santiago, Chile, enrolled in a longitudinal observational study were included. FCs completed questions to describe the caregiving phenomenon and surveys to assess burden of care, psychological distress, and perception of patients' symptoms; patients completed surveys to assess physical distress and quality of life (QOL). We explored associations between high-intensity subjective caregiver burden with caregiver and patient variables. Two hundred seven dyads were analyzed. FCs were on average 50years old and 75% female. Thirty-two percent of FCs experienced high-intensity subjective burden of care. Eighty two percent of FCs took care of the patient daily and 31% took care of the patient alone. In univariate analysis, high-intensity caregiver burden was associated with caregiver depression (59% vs. 27%; p<0.001), anxiety (86% vs. 67%; p=0.003), caring for the patient alone (45% vs. 24%; p=0.002), perception of patient symptom distress, patient religion, and worse patient QOL (mean [standard deviation] 58 [33] vs. 68 [27]; p=0.03). In multivariate analysis, FC depression (OR [95% confidence interval] 3.07 [1.43-6.60]; p=0.004), anxiety (3.02 [1.19-7.71]; p=0.021), caring for the patient alone (2.69 [1.26-5.77]; p=0.011), caregiver perception of patient's fatigue (1.26 [1.01-1.58]; p=0.04), and patient's religion (3.90 [1.21-12.61]; p=0.02) were independently associated with caregiver burden. FCs of advanced cancer patients in a Latino community frequently experience high-intensity burden of care and are exposed to measures of objective burden. High-intensity burden is associated with both caregiver and patient factors. Policies should aim to make interventions on patient-caregiver dyads to decrease caregiving burden among Latinos.

Psychological distress scale among caregivers in delivering care of patients with post-stroke rehabilitation: A validity and reliability testing study

A stroke is a condition of blockage in the cardiovascular system. Patients who have passed the stroke phase are post-stroke rehabilitation patients who receive outpatient care. Caregivers help patients carry out daily activities during the rehabilitation process. Workload as a caregiver is a cause of psychological distress. The physical and emotional domains affect caregivers experiencing psychological distress, so caregivers become less psychologically healthy and less optimal in helping post-stroke rehabilitation patients. Researchers adapted the scale, namely Kessler's 10 Psychological Distress Scale (K-10), to see the level of psychological distress in caregivers of post-stroke rehabilitation patients—adaptation using Indonesian with the research participation of 43 people from Yogyakarta. Data were taken using accidental sampling on caregivers of post-stroke rehabilitation patients in Yogyakarta. Reliability testing was conducted using Cronbach's alpha, with the final result of p = 0.884, and construct validity testing using confirmatory factor analysis (CFA) with a measurement model. The results of this scale indicate that Cronbach's alpha is 0.884, and the CFA model is considered appropriate. Based on this, the results of this study suggest that the Psychological Distress Scale is reliable and valid so that it can be used for caregivers of post-stroke rehabilitation patients in Indonesia. In addition, this research scale can be used in health psychology, especially psychological distress.&#x0D; Keywords: Stroke; caregiver; nursing care; community care; rehabilitation care

When Family Life Contributes to Cancer Caregiver Burden in Palliative Care.

The difficulties of caring for a family member with advanced cancer are well documented. Support from a caregiver's social network-especially other family-is vital to reducing caregiver burden and psychological distress. However, the family environment is not always supportive as reports of family conflict and dissatisfaction with support are common. Despite knowing that family relationships are complex, little is known about the types of family stress that caregivers of advanced cancer patients face in their daily lives. To address this gap, researchers applied concepts from the double ABCX model to conduct a reflexive thematic analysis of interviews with 63 caregivers of cancer patients receiving outpatient palliative care. Four themes of family stress were identified: failed support, relational tensions, denial, and additional care work. Findings inform clinical assessment and caregiver intervention development by revealing the importance of measuring the mundane machinations of family life for caregivers of adult cancer patients.

Developmental trajectories of socio-emotional outcomes of children and young people in out-of-home care – Insights from data of Pathways of Care Longitudinal Study (POCLS)

BackgroundThere has been a limited understanding of the longitudinal trajectory and determinants of socio-emotional outcomes among children in out-of-home care (OOHC). ObjectivesThis study aimed to examine child socio-demographics, pre-care maltreatment, placement, and caregiver factors associated with trajectories of socio-emotional difficulties of children in OOHC. Participants and settingThe study sample (n = 345) included data from the Pathways of Care Longitudinal Study (POCLS), a prospective longitudinal cohort of children aged 3–17 years who entered the OOHC system in New South Wales (NSW) Australia, between 2010 and 2011. MethodsGroup-based trajectory models were used to identify distinct socio-emotional trajectory groups based on the Child Behaviour Check List (CBCL) Total Problem T-scores completed at all four Waves 1–4. Modified Poisson regression analysis was conducted to assess the association (risk ratios) of socio-emotional trajectory group membership with pre-care maltreatment, placement, and caregiver-related factors. ResultsThree trajectories of socio-emotional development were identified: ‘persistently low difficulties’ (average CBCL T-score changed from 40 to 38 over time), normal (average CBCL T-score changed from 52 to 55 over time), and clinical (average CBCL T-score remained at 68 over time) trajectories. Each trajectory presented a stable trend over time. Relative/kinship care, as compared with foster care, was associated with the “persistently low” socio-emotional trajectory. Being male, exposure to ≥8 pre-care substantiated risk of significant harm (ROSH) reports, placement changes, and caregiver's psychological distress (more than two-fold increased risk) were associated with the clinical socio-emotional trajectory. ConclusionsEarly intervention to ensure children have a nurturing care environment and psychological support to caregivers are vital for positive socio-emotional development over time among children in long-term OOHC.

The Application of Family Stress Model to Investigating Adolescent Problematic Behaviors: The Moderating Role of Assets.

The Family Stress Model framework proposes that household income can influence child and youth development through caregiver psychological distress. While prior studies have observed stronger associations among households with lower income, the role of assets has been ignored. This is unfortunate, as many existing policies and practices that intend to improve child and family well-being are focused on assets. The purpose of this study is to clarify whether asset poverty moderates the direct and indirect effects of paths linking household income, caregiver psychological distress, and adolescent problematic behaviors. Using the 2017 and 2019 Panel Study of Income Dynamic Main Study and 2019 and 2020 Child Development Supplements, we find that the family stress processes consisting of household income, caregiver psychological distress, and adolescent problematic behaviors are less intensive for families with more assets. These findings not only add our knowledge of FSM by taking account the moderating role of assets but also advance our understanding that assets can benefit child and family well-being through alleviating family stress processes.

Burden and Psychological Distress in Caregivers of Persons with Addictions

Addiction is a complex psychosocial problem that has significant psychosocial effects on family members. The aim of this study is to gain insight into the burden and psychological distress suffered by caregivers of drug abusers. Ninety-nine caregivers of hard drug addicts participated in this study. The test group consisted of 50 participants and the control group had 49 participants. The participants filled out the General Demographic Questionnaire; Caregiving and the Experience of Subjective and Objective Burden; SCL-90-R; and WHOQOL-BREF. Caregivers of addicts who were preparing to join the community exhibited a significantly higher objective burden, subjective burden, subjective stress burden and greater psychological distress in comparison to caregivers of addicts in the community, and their quality of life was poorer (p &lt; 0.001). The following showed to be risk factors for psychological distress: families with a greater number of children, marital, employment and economic status and duration of addiction. The protective factors were better quality of life, long-term marriage and higher education level of caregivers. Caring for addicts who are living with their families is a significant responsibility and burden for caregivers.

Family Risk Exposure Profiles During Early Childhood: Developmental Processes and Adolescent Well-Being.

Although prior work indicates that exposure to multiple family risk factors negatively impacts adjustment in childhood and adolescence, few studies have examined whether children in high-risk families transition in and out of adversity during early childhood and whether patterns of change matter for adjustment in adolescence. Using data from a sample of 216 caregiver-child dyads participating in a study of prenatal cocaine exposure (116 exposed and 100 non-exposed; 50.9% girls), we used latent transition analysis to identify distinct profiles of early exposure to caregiver substance use (SU) and SU-related familial risk (caregiver psychological distress, exposure to violence, harshness, and low sensitivity) and the association between these profiles and adolescent well-being (i.e., hope, happiness, and life satisfaction). Assessments occurred when children were 13, 24, 36, and 48 months and during kindergarten (Mmonths = 66.16, SD = 4.47) and early adolescence (Myears = 13.26, SD = 0.88). Caregivers self-identified as 72.09% Black, 15.81% White, 10.23% Hispanic/Latinx, 1.40% other, and 0.47% American Indian. Four profiles of varying levels of exposure to caregiver SU and SU-related risks were identified from infancy to kindergarten: SU/family risks, no SU/low family risks, SU/negative parenting, and SU/low family risks. Most children stayed in the same profile (64.2%), while the rest transitioned between profiles. Children exposed to caregiver SU and family adversity had lower positive outcomes in adolescence. Stable membership in the SU/family risks profile had significant maladaptive consequences on adolescent well-being. Implications for research and the design of tailored interventions to promote well-being among at-risk youth are discussed.

Associations between Affiliate Stigma and Quality of Life among Caregivers of Individuals with Dementia

Introduction: The associations between affiliate stigma, caregiving burden, psychological distress, and quality of life (QoL) among family caregivers of people living with dementia (PwD) have been demonstrated in the literature. However, there is a dearth of literature regarding how these factors could form a psychological mechanism. The present study proposed a theoretical model to portray the relationships between these factors. Methods: Utilizing convenience sampling and cross-sectional study design, 275 family caregivers (145 females [52.7%]; mean age = 52.71 years) were recruited from a general hospital from October 2013 to September 2014. Each participant completed the following instruments in a quiet room in the general hospital without disturbance: Caregiver Burden Inventory, World Health Organization QoL Questionnaire-Brief, Affiliate Stigma Scale, and Beck Anxiety Inventory alongside the Taiwan Depression Questionnaire (assessing psychological distress). Structural equation modeling was used to examine the proposed theoretical model. Results: Affiliate stigma (standardized coefficient [β] = −0.338; P = 0.011) and psychological distress (β = −0.538; P &lt; 0.001) were negatively associated with QoL, caregiving burden was positively associated with psychological distress (β = 0.818; P &lt; 0.001), and affiliate stigma was positively associated with caregiving burden (β = 0.793; P &lt; 0.001). Moreover, a significant mediated effect was observed between affiliate stigma and QoL via sequential mediators of caregiving burden and psychological distress (unstandardized coefficient = −1.17 and 95% confidence interval = −1.88, −0.46). Conclusion: Affiliate stigma, caregiving burden, and psychological distress are key factors contributing to low QoL among family caregivers of PwD. Health-care providers should design programs to help reduce affiliate stigma, caregiving burden, and psychological distress for family caregivers of PwD to facilitate their QoL.

Social support mediates the relationship between dispositional gratitude and psychological distress in caregivers of autistic children

ABSTRACT Grateful caregivers report lower levels of psychological distress. Social support, engendered by gratitude and buffering against stress, might mediate this effect. Here we explored whether the protective psychological effect of dispositional gratitude might be mediated by increased social support. A sample of 126 caregivers of autistic children completed questionnaires assessing dispositional gratitude, social support and psychological distress. Gratitude inversely predicted psychological distress, as did social support after adjusting for gratitude. Gratitude positively predicted social support. Gratitude no longer predicted psychological distress after adjusting for social support. Indirect effects analysis revealed the gratitude-distress relationship occurred indirectly via social support. Grateful caregivers reported higher levels of social support, and this predicted lower psychological distress. Gratitude, relatively stable as a disposition, has a state component that is sensitive to change, and healthcare professionals might do well to recommend gratitude enhancing interventions for caregivers of autistic children.

A prospective observational study of change in caregiver burden and psychological distress in caregivers of patients with alcohol dependence.

Alcohol use disorder has a substantial impact on patients' caregivers, leading to burden and adverse effects on their psychological health. Currently, there is limited literature which is available to suggest whether the burden and psychological distress of the family members change when patients with alcohol dependence undergo treatment. This study aimed to longitudinally examine the change in burden, depression, anxiety, and stress experienced by caregivers of patients with alcohol dependence undergoing treatment. This prospective observational study recruited treatment-seeking men with alcohol dependence and their caregivers as dyads. The burden, depression, anxiety, and stress of caregivers were assessed at baseline and at six weeks, using the Family Burden Interview Schedule and Depression Anxiety Stress Scale, respectively. Pre and post values were compared using paired t-test. Interaction effects of resumption of drinking were assessed using repeated measures test. Of the 101 dyads recruited in the study, 60 could be followed up at six weeks. Significant decrements were seen in burden, depression, anxiety, and stress of caregivers at six weeks compared to baseline (mean 62.3%, 54.2%, 65.9%, and 53.4%, respectively, all P < 0.001). The decrement in burden and depression was lower in those caregivers where the patients had resumed alcohol use within the span of six weeks. Findings suggest that engagement in treatment by patients with alcohol dependence may reduce the burden and psychological distress among their caregivers, more so in situations where the patients had quit alcohol. However, the change in burden and psychological distress could be due to several other factors as well.

Predicting Marital Burnout Based on the Severity of Early Maladaptive Schemas and Criteria for Mate Selection in Female Teachers

Objective: The study aims to investigate the relationship between caregiving burden, social support, and psychological distress among mothers of children with autism spectrum disorder (ASD). It specifically examines the mediating role of social support in the linkage between caregiving burden and psychological distress. Methods and Materials: The study employed a descriptive correlational method. The target population comprised all female teachers in Shiraz city in 2021. A purposive sample of 200 teachers was selected. Data were collected using the Young Schema Questionnaire (YSQ), Rafahi and colleagues’ Mate Selection Criteria Questionnaire (2008), and the Pines Marital Burnout Scale (1996). The collected data were analyzed using Pearson correlation coefficients and multivariate regression in SPSS-24 software. Findings: The results indicated that mate selection criteria with a beta coefficient of -0.13, positive perfectionism with a beta coefficient of 0.31, and negative perfectionism with a beta coefficient of -0.19 significantly predicted marital burnout. Additionally, schemas in the domains of rejection and disconnection (beta = 0.59), impaired autonomy and performance (beta = 0.26), impaired limits (beta = 0.19), and other-directedness (beta = 0.20) were significant predictors of marital burnout in female teachers. Conclusion: The study concludes that both early maladaptive schemas and mate selection criteria are significant predictors of marital burnout among female teachers. The findings suggest that interventions targeting these schemas and criteria can be beneficial in addressing marital burnout.