Möller-Leimkühler Anne Maria
Dept. of Psychiatry, Ludwig-Maximilians-University, 80336 Munich, Germany.
Eur Arch Psychiatry Clin Neurosci. 2005 Aug;255(4):223-31. doi: 10.1007/s00406-004-0550-x. Epub 2004 Nov 19.
In the present study, part of the Munich 5-year follow-up study on key relatives of first-hospitalized schizophrenic and depressive patients, baseline results with respect to relatives' burden and predictors of burden are presented. Basing on a transactional stress model the following hypothesis was tested: the impact of the patients' illness on their relatives' stress outcome is moderated by the psychosocial resources of the relatives. Stress outcome was measured in terms of objective and subjective burden, well-being, self-rated symptoms and global satisfaction with life. Potential moderating variables included age and gender, generalized stress response and illness-related coping strategies, beliefs of control,perceived social support,personality factors, expressed emotion and life stressors. A total of 83 relatives, whose ill family members had been hospitalized in the Department of Psychiatry of the Ludwig-Maximilians-University of Munich for the first time, participated in the study. Findings did not entirely support the hypothesis. On the one hand, relatives' stress outcome was independent of the objective stressors (severity of the illness, kind of symptoms, level of psychosocial functioning at admission). On the other hand, burden was significantly associated with several psychosocial resources and dispositions of the relatives. Multivariate linear regression analyses indicated that expressed emotion, emotion-focused coping strategies and generalized negative stress response are the most relevant predictors of burden. It is argued that a multidimensional approach in burden assessment is necessary and has relevant implications for improving family intervention strategies.
在本研究中,作为慕尼黑对首次住院的精神分裂症患者和抑郁症患者的主要亲属进行的5年随访研究的一部分,呈现了亲属负担及负担预测因素的基线结果。基于一个相互作用应激模型,对以下假设进行了检验:患者疾病对其亲属应激结果的影响受到亲属心理社会资源的调节。应激结果通过客观和主观负担、幸福感、自评症状以及对生活的总体满意度来衡量。潜在的调节变量包括年龄和性别、一般应激反应和与疾病相关的应对策略、控制信念、感知到的社会支持、人格因素、情感表达及生活应激源。共有83名亲属参与了该研究,他们患病的家庭成员首次在慕尼黑路德维希 - 马克西米利安大学精神病学系住院。研究结果并未完全支持该假设。一方面,亲属的应激结果与客观应激源(疾病严重程度、症状类型、入院时心理社会功能水平)无关。另一方面,负担与亲属的几种心理社会资源和特质显著相关。多元线性回归分析表明,情感表达、以情绪为中心的应对策略和一般负面应激反应是负担最相关的预测因素。有人认为,在负担评估中采用多维方法是必要的,并且对改善家庭干预策略具有重要意义。