Examining the cognitive model of caregiving – A structural equation modelling approach

Hesse, Klaus; Klingberg, Stefan

doi:10.1016/j.psychres.2014.02.023

Cited by 8 publications

(9 citation statements)

References 56 publications

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“…20,21 However, negative family atmosphere not only affects patients with schizophrenia, but also represents an increased burden to the caregiver as well. 41 Thus, increased stress and the burden of care might lead to a more pronounced level of EEs, thus, forming a second vicious circle between paranoia, family atmosphere, increased burden of care, and more pronounced Note: FA, family atmosphere; PA, paranoia; IPS, interpersonal self-concept; df, degrees of freedom; χ 2 /df, normal chi-squared statistic; SE, standard error of the unstandardized coefficient; P, significant level of the coefficient; CFI, Comparative Fit Index; TLI, TuckerLewis Index; RMSEA, root mean squared error of approximation; BIC, Bayes Information Criterion; AIC, Akaike's Information Criterion; n.a., not applicable (no absolute threshold definable).…”

Section: Discussionmentioning

confidence: 99%

The Vicious Cycle of Family Atmosphere, Interpersonal Self-concepts, and Paranoia in Schizophrenia—A Longitudinal Study

Hesse

Kriston

Mehl

et al. 2015

SCHBUL

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Recent cognitive models of paranoid delusions highlight the role of self-concepts in the development and maintenance of paranoia. Evidence is growing that especially interpersonal self-concepts are relevant in the genesis of paranoia. In addition, negative interpersonal life-experiences are supposed to influence the course of paranoia. As dysfunctional family atmosphere corresponds with multiple distressing dyadic experiences, it could be a risk factor for the development and maintenance of paranoia. A total of 160 patients with a diagnosis of schizophrenia were assessed twice within 12 months. Standardized questionnaires and symptom rating scales were used to measure interpersonal self-concepts, perceived family atmosphere, and paranoia. Data were analyzed using longitudinal cross-lagged structural equation models. Perceived negative family atmosphere was associated with the development of more pronounced negative interpersonal self-concepts 12 months later. Moreover, paranoia was related to negative family atmosphere after 12 months as well. As tests revealed that reversed associations were not able to explain the data, we found evidence for a vicious cycle between paranoia, family atmosphere, and interpersonal self-concepts as suggested by theoretical/ cognitive model of paranoid delusions. Results suggest that broader interventions for patients and their caretakers that aim at improving family atmosphere might also be able to improve negative self-concepts and paranoia.

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Section: Discussionmentioning

confidence: 99%

The Vicious Cycle of Family Atmosphere, Interpersonal Self-concepts, and Paranoia in Schizophrenia—A Longitudinal Study

Hesse

Kriston

Mehl

et al. 2015

SCHBUL

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“…Kuipers et al () specialized their CBT/family work in psychiatric population since 1980s and proposed three different cognitive models for three types of caregivers (positive relationships, emotional overinvolved relationship and critical and hostile relationships with people diagnosed with psychosis), in which specific caregivers’ appraisal, reactions and interventions were explained and guided to support specific types of caregivers. Hess and Klingberg () supported Kuipers's cognitive models of caregiving statistically by structural equation modelling approach that the two pairs of attribution–emotion pathways (over themselves and service users), which were intermediated by family relationship/expressed emotion, did associate with the care burden and psychological distress of caregivers of people diagnosed with schizophrenia. Lobban and Barrowclough () also suggested a CBT framework for working with service users and families to promote the use of cognitive model to pacify their interpersonal dynamics.…”

Section: Introductionmentioning

confidence: 95%

Cognitive behavioural family intervention for people diagnosed with severe mental illness and their families: A systematic review and meta‐analysis of randomized controlled trials

Fai

Chan

Chien

et al. 2019

Psychiatric Ment Health Nurs

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Accessible Summary What is known on the subject? Cognitive behavioural therapy for psychosis (CBTp) and family intervention (FI) for psychosis are effective evidence‐based interventions, but they are practically difficult to be implemented in many clinical settings. The CBTp and FI approaches have been integrated to form cognitive behavioural family intervention (CBFI). This brief intervention may be more feasible to implement in clinical practice. A few individual studies reported the effectiveness of CBFI, but no systematic review and meta‐analysis have been conducted. What the paper adds to existing knowledge CBFI was effective for reducing overall positive and negative symptoms immediately following the intervention. Compared to CBTp, the intervention seems to be more effective to reduce delusions. What are the implications for practice? The results of this review suggest that the brief CBFI is an effective family‐inclusive intervention that could be integrated into clinical practice. Mental health nurses with adequate training and support may implement and develop CBFI to improve the recovery of people diagnosed with SMI and support their families. AbstractIntroductionCognitive behavioural family intervention (CBFI) may be an effective brief psychosocial intervention for people diagnosed with severe mental illness (SMI) and their families. No systematic review has summarized the effectiveness of CBFI.AimThis review aimed to systematically examine the trial evidence of the effectiveness of CBFI versus treatment as usual (TAU) on improving the outcomes of people diagnosed with SMI and their families.MethodEligible randomized controlled trials were identified from nine databases. Three investigators independently took part in selection of articles, data extraction and risk assessment. Pooled treatment effects were computed using random‐effects models.ResultsFour studies consisting of 524 participants were included. The risk of bias was low–unclear in most areas. The pooled CBFI effect on four service user outcomes including overall positive symptoms, delusions, overall negative symptoms and general psychopathology was significantly improved at post‐treatment, compared with TAU, whereas effects on hallucinations and insight were equivocal.DiscussionThe findings reveal that CBFI is superior to TAU in treating positive and negative symptoms immediately following the intervention.Implications for PracticeMental health nurses may practise CBFI to enrich the psychiatric nursing service and promote nurse‐led intervention. However, there is currently no substantial evidence that the intervention is effective over the longer term.

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“…In addition, the models used in this simulation study are similar to models published in actual practice (e.g. Bavarian et al, 2014;Hesse & Klingberg, 2014;Tam, 2014).…”

Section: Number Of Factors and Indicators Per Factormentioning

confidence: 99%

Factorial Invariance Testing under Different Levels of Partial Loading Invariance within a Multiple Group Confirmatory Factor Analysis Model

French

Finch

2016

J. Mod. App. Stat. Meth.

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Examining the cognitive model of caregiving – A structural equation modelling approach

Cited by 8 publications

References 56 publications

The Vicious Cycle of Family Atmosphere, Interpersonal Self-concepts, and Paranoia in Schizophrenia—A Longitudinal Study

The Vicious Cycle of Family Atmosphere, Interpersonal Self-concepts, and Paranoia in Schizophrenia—A Longitudinal Study

Cognitive behavioural family intervention for people diagnosed with severe mental illness and their families: A systematic review and meta‐analysis of randomized controlled trials

Factorial Invariance Testing under Different Levels of Partial Loading Invariance within a Multiple Group Confirmatory Factor Analysis Model

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