Publication Date

2014-05-19

Availability

Open access

Embargo Period

2014-05-19

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PHD)

Department

Psychology (Arts and Sciences)

Date of Defense

2013-05-16

First Committee Member

Amy Weisman de Mamani

Second Committee Member

Edward Rappaport

Third Committee Member

Amanda Jensen-Doss

Fourth Committee Member

Brian Doss

Fifth Committee Member

Isaac Prilleltensky

Abstract

Research has demonstrated that taking care of a patient with schizophrenia has serious mental health costs to caregivers that include high levels of burden and poorer overall mental health. Thus, it is necessary to pinpoint predictors of caregiver distress and develop strategies to reduce it. We have developed a family focused, culturally-informed treatment for schizophrenia (CIT-S). We examined this intervention and its ability to decrease the maladaptive behaviors, beliefs, and values that we believe contribute to caregiver distress. CIT-S was compared against a three-session psychoeducation condition in a sample of 113 caregivers of patients with schizophrenia. Specifically, we hypothesized that schizophrenia caregivers who completed CIT-S would demonstrate lower levels of caregiver burden, shame and guilt/self-blame, as well as increased perceived interdependence when compared to participants who completed psychoeducation. Additionally, we hypothesized that shame, guilt/self-blame and interdependence would mediate the relationship expected between treatment type and caregiver burden. In line with hypotheses, CIT-S was found to decrease caregivers’ burden and guilt/self-blame when compared to the psychoeducation condition. Also consistent with hypotheses, reductions in guilt/self-blame were found to mediate the changes in caregiver burden associated with treatment type. Treatment type did not appear to influence shame nor interdependence. Study implications are discussed and a case vignette is provided.

Keywords

Schizophrenia; caregivers; burden; shame; guilt; interdependence

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