Breitborde Nicholas J K, López Steven R, Chang Christina, Kopelowicz Alex, Zarate Roberto
Dept. of Psychiatry, STEP Program, Yale University, Room B38, New Haven, CT 06519, USA.
Soc Psychiatry Psychiatr Epidemiol. 2009 Sep;44(9):716-23. doi: 10.1007/s00127-008-0492-0. Epub 2009 Feb 3.
The study of emotional over-involvement (EOI) has focused primarily on its relationship with patients' course of illness. We know little about the predictors and possible consequences of EOI for caregivers. Based on past research, we tested the hypotheses that EOI is associated with worse physical and psychological health among caregivers and examined whether caregiver burden and social support may mediate this relationship.
In a sample of 37 Mexican American caregivers and their ill relatives recruited from two outpatient clinics, we examined the relationships between EOI, caregiver burden, caregivers' level of social support, and caregivers' health. Additionally, we examined whether caregiver burden and social support may mediate the relationship between EOI and caregivers' health. Cross-sectional analysis indicates that at baseline EOI was not associated with caregiver burden or social support, but was related to worse current health. Longitudinal analysis, however, indicates that EOI at baseline was associated with greater burden, less instrumental support, and worse health among caregivers at follow-up. Moreover, objective burden and instrumental support mediated the relationship between EOI and several health outcomes. Consequently, EOI may be a marker of poor current health status and predicts worse future health among Mexican-American caregiving relatives of individuals with schizophrenia. Moreover, changes in burden and social support associated with EOI appear to mediate the relationship between EOI and several health outcomes among caregivers. These findings suggest that it might be important for family interventions to not only address the functioning of individuals with schizophrenia but also their caregiving relatives.
对情感过度投入（EOI）的研究主要集中在其与患者病程的关系上。我们对照顾者情感过度投入的预测因素和可能后果知之甚少。基于以往的研究，我们检验了以下假设：情感过度投入与照顾者较差的身心健康相关，并探讨了照顾者负担和社会支持是否可能介导这种关系。
在从两家门诊诊所招募的37名墨西哥裔美国照顾者及其患病亲属的样本中，我们研究了情感过度投入、照顾者负担、照顾者社会支持水平和照顾者健康之间的关系。此外，我们还研究了照顾者负担和社会支持是否可能介导情感过度投入与照顾者健康之间的关系。横断面分析表明，在基线时，情感过度投入与照顾者负担或社会支持无关，但与当前较差的健康状况有关。然而，纵向分析表明，基线时的情感过度投入与随访时照顾者更大的负担、更少的工具性支持和更差的健康状况相关。此外，客观负担和工具性支持介导了情感过度投入与几种健康结果之间的关系。因此，情感过度投入可能是当前健康状况不佳的一个标志，并预示着患有精神分裂症个体的墨西哥裔美国照顾亲属未来健康状况更差。此外，与情感过度投入相关的负担和社会支持的变化似乎介导了情感过度投入与照顾者几种健康结果之间的关系。这些发现表明，家庭干预不仅关注精神分裂症患者的功能，还关注他们的照顾亲属可能很重要。
