Exploring the burden of care: A model for understanding caregiver burden
in children with psychosis
Abstract
Introduction: Caregiver burden is well characterized in adults
with psychosis but less is known about the burden experienced by carers
of children with psychosis. In this secondary analysis, we examined
burden reported by caregivers of children with clinical high risk for
psychosis and psychotic disorders to test an explanatory model for
caregiver burden. Methods: Cross-sectional analyses examined
burden experienced by caregivers of children with clinical high risk for
psychosis and psychosis who were recruited from an outpatient
psychiatric clinic. Caregiver burden was assessed with the Zarit Burden
Inventory. Structural equation modelling was employed to examine a model
assessing the simultaneous effects of factors related to burden among
caregivers of children at clinical high risk for psychosis and diagnosed
with psychotic disorders. Results: The study involved 85
caregivers of children aged 6-17. The latent variable for positive
caregiving attributes, which included parenting confidence and
communication, had a direct effect on caregiver burden, with greater
levels of positive caregiving attributes associated with decreased
burden. Direct effects of social support and the latent variable for
primary/secondary stressors on burden were not observed. There was a
significant indirect effect for social support through positive
caregiving attributes to mitigate the effects of primary/secondary
stressors on caregiver burden. Conclusion: The results provide
preliminary evidence supporting the importance of social support,
parenting confidence, and caregiver-child communication as key targets
for intervention. Moreover, our findings suggest that despite stressors,
such as suicidal behaviour and psychiatric hospitalisations, modifiable
factors exist to serve as protective buffers against caregiver burden.