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The need for closure in caregivers of people with psychosis

Published online by Cambridge University Press:  11 April 2011

Juliana Onwumere ,
Elizabeth Kuipers ,
Paul Bebbington ,
Graham Dunn ,
Daniel Freeman ,
David Fowler  and
Philippa Garety
Juliana Onwumere*
Affiliation:
Institute of Psychiatry at King's College London, London (United Kingdom)
Elizabeth Kuipers
Affiliation:
Institute of Psychiatry at King's College London, London (United Kingdom) In affiliation with the Biomedical Research Centre at the Institute of Psychiatry, King's College, London (United Kingdom)
Paul Bebbington
Affiliation:
Department of Mental Health Sciences, University College London, London (United Kingdom)
Graham Dunn
Affiliation:
Health Methodology Research Group, School of Community Based Medicine, University of Manchester, Manchester (United Kingdom)
Daniel Freeman
Affiliation:
Institute of Psychiatry at King's College London, London (United Kingdom)
David Fowler
Affiliation:
School of Medicine, Health Policy & Practice, Elizabeth Fry Building, University of East Anglia, Norwich (United Kingdom)
Philippa Garety
Affiliation:
Institute of Psychiatry at King's College London, London (United Kingdom) In affiliation with the Biomedical Research Centre at the Institute of Psychiatry, King's College, London (United Kingdom)
*
Address for correspondence: Dr. J. Onwumere, Institute of Psychiatry at King's College London, Box P077, Department of Psychology, Institute of Psychiatry, London SE5 8AF (United Kingdom). E-mail: [email protected]
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Summary

Aim – The aim of the study was to determine how carer need for closure relates to expressed emotion. It also examined the links between carer need for closure and patient functioning including patient need for closure. Methods – In a cross-sectional study, 70 caregivers of patients with psychosis completed the Need for Closure Scale (NFCS), the Camberwell Family Interview (CFI) and measures of distress, burden, coping and social network. The NFCS was assessed in terms of its two primary dimensions: a need for simple structure (NFSS) and Decisiveness. Patients also completed measures of psychotic symptoms and affect, and in 50 matched caregiver patient dyads, direct comparisons were undertaken between caregiver and patient NFCS scores. Results – No links were found between caregiver NFC and EE in this predominately low EE sample. More decisive carers had higher levels of self esteem, were less distressed, and resorted less to avoidant coping. The need for simple structure was greater in carers who lacked a confidante. As predicted, patients reported significantly higher NFSS and lower Decisiveness scores than carers, but no relationship was observed between caregiver NFC and patient symptoms of psychosis. Conclusions – Carers reporting confident decision making were also more likely to report adaptive functioning in terms of having lower levels of avoidant coping and distress, and higher levels of self esteem. The results suggest that this style of thinking might be a helpful way of coping with some of the difficulties involved in caring for someone with psychosis.

Keywords

psychosiscaregiversreasoningexpressed emotion
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 19 , Issue 2 , June 2010 , pp. 159 - 167
Copyright
Copyright © Cambridge University Press 2010

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