Jens Einar Jansen1,2, Susanne Harder2, Ulrik Helt Haahr1,3, Hanne-Grethe Lyse1, Marlene Buch Pedersen1, Anne Marie Trauelsen4,3, Erik Simonsen4,3,5. 1. Early Psychosis Intervention Center, Zealand Region Psychiatry Roskilde, Roskilde, Denmark. 2. Department of Psychology, University of Copenhagen, Copenhagen, Denmark. 3. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 4. Psychiatric Research Unit, Zealand Region Psychiatry Roskilde, Roskilde, Denmark. 5. Department of Psychology and Educational Studies, Roskilde University, Roskilde, Denmark.
Abstract
BACKGROUND: In first-episode psychosis, the family is considered an important part in the recovery process. This is often accompanied by significant distress, which is acknowledged in numerous studies. However, little is known about the psychological factors involved. METHOD: One hundred and twenty-seven caregivers of persons with first-episode psychosis completed a series of questionnaires aimed at investigating the contribution of expressed emotion and metacognitions to caregiver distress. RESULTS: Linear mixed model analysis found that emotional over-involvement and metacognitions independently predicted caregiver distress. Mediation analysis using bootstrapping showed that emotional over-involvement could be seen as mediating the effect of metacognitions on distress. CONCLUSION: The current study is a first step towards understanding the role of metacognitions in caregiver distress, thus opening up for the possibility of using interventions from 'contextual behaviour therapies'. Implications and future studies are discussed. KEY PRACTITIONER MESSAGE: This study is the first attempt to address caregiver concerns from the perspective of contextual cognitive behavioural therapy. The metacognitive framework for caregiver distress in first-episode psychosis may help develop new therapeutic interventions to better support families. The study proposes a psychological understanding of emotional over-involvement and caregiver distress.
BACKGROUND: In first-episode psychosis, the family is considered an important part in the recovery process. This is often accompanied by significant distress, which is acknowledged in numerous studies. However, little is known about the psychological factors involved. METHOD: One hundred and twenty-seven caregivers of persons with first-episode psychosis completed a series of questionnaires aimed at investigating the contribution of expressed emotion and metacognitions to caregiver distress. RESULTS: Linear mixed model analysis found that emotional over-involvement and metacognitions independently predicted caregiver distress. Mediation analysis using bootstrapping showed that emotional over-involvement could be seen as mediating the effect of metacognitions on distress. CONCLUSION: The current study is a first step towards understanding the role of metacognitions in caregiver distress, thus opening up for the possibility of using interventions from 'contextual behaviour therapies'. Implications and future studies are discussed. KEY PRACTITIONER MESSAGE: This study is the first attempt to address caregiver concerns from the perspective of contextual cognitive behavioural therapy. The metacognitive framework for caregiver distress in first-episode psychosis may help develop new therapeutic interventions to better support families. The study proposes a psychological understanding of emotional over-involvement and caregiver distress.
Authors: Jens Einar Jansen; Ulrik Helt Haahr; Susanne Harder; Anne Marie Trauelsen; Hanne-Grethe Lyse; Marlene Buch Pedersen; Erik Simonsen Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2014-07-23 Impact factor: 4.328