Vasconcelos E Sa Debora, Barrowclough Christine, Hartley Samantha, Wearden Alison
School of Psychological Sciences, The University of Manchester, UK.
School of Psychological Sciences & Manchester Centre for Health Psychology, The University of Manchester, UK.
Br J Clin Psychol. 2017 Jun;56(2):172-188. doi: 10.1111/bjc.12132. Epub 2017 Apr 11.
There is evidence that self-blame is an important predictor of distress and depression in relatives of people with long-term psychosis, but there is limited research investigating the nature and correlates of self-blame in relatives of people with recent-onset psychosis. Self-blame motivates a tendency to engage with others and to repair wrongdoings; it might be that such cognitions also impact on relatives' behaviours towards the patient. This study examined the association between self-blame and psychological distress, and tested the prediction that greater self-blame would be associated with more behavioural control attempts to patients in a sample of relatives of people with recent-onset psychosis.
Statements pertaining to self-blame and behavioural control were extracted and rated from 80 interviews with relatives, who also completed the General Health Questionnaire-28. Content analysis was used to examine the nature of self-blame attributions. Regression analyses were used to explore the links between self-blame attributions and distress, and between self-blame and behavioural control in this recent-onset population.
Higher levels of self-blame were associated with more behavioural control attempts, and self-blame predicted relatives' behavioural responses when adjusting for the contribution of control attributions. Self-blame was also linked with distress, but did not emerge as an independent predictor in multivariate analysis. Most relatives who blamed themselves did so for not overseeing their family member's mental health problems properly or for perceiving themselves generally as poor carers.
This study extends findings related to self-blame to a population of relatives of people with recent-onset psychosis and highlights the possible role of blaming cognitions in promoting interpersonal engagement through behavioural control.
Self-blaming beliefs were linked with increased distress in relatives of people with recent-onset psychosis; Increased self-blame was associated with more behavioural control attempts; Most relatives blamed themselves for not overseeing their family member's mental health problems properly, and for perceiving themselves generally as poor carers. The cross-sectional study design limits inferences about causality.
有证据表明，自责是长期精神病患者亲属痛苦和抑郁的重要预测因素，但对近期发病精神病患者亲属自责的性质及相关因素的研究有限。自责促使人们倾向于与他人交往并弥补过错；或许这类认知也会影响亲属对患者的行为。本研究考察了自责与心理痛苦之间的关联，并检验了这样一种预测：在近期发病精神病患者的亲属样本中，更强的自责会与对患者更多的行为控制尝试相关联。
从对亲属的80次访谈中提取并评定了与自责和行为控制相关的陈述，这些亲属还完成了一般健康问卷-28。采用内容分析法来考察自责归因的性质。运用回归分析来探究近期发病人群中自责归因与痛苦之间以及自责与行为控制之间的联系。
更高水平的自责与更多的行为控制尝试相关联，并且在调整了控制归因的影响后，自责可预测亲属的行为反应。自责也与痛苦相关联，但在多变量分析中并未成为独立的预测因素。大多数自责的亲属是因为没有妥善监管其家庭成员的心理健康问题，或者总体上认为自己是不称职的照顾者。
本研究将与自责相关的研究结果扩展至近期发病精神病患者的亲属群体，并强调了自责认知在通过行为控制促进人际互动方面可能发挥的作用。
自责信念与近期发病精神病患者亲属的痛苦增加有关；自责增加与更多的行为控制尝试相关联；大多数亲属因没有妥善监管其家庭成员的心理健康问题以及总体上认为自己是不称职的照顾者而自责。横断面研究设计限制了对因果关系的推断。
