Abstract: The purpose of this cross-sectional correlational research was to examine how burden,
social support, sense of belonging, problem-focused coping, and emotion-focused coping influenced
psychological distress in family caregivers of people with a major depressive disorder. The conceptual
model was built on Lazarus and Folkman’s theory of stress and coping, and related literature.
Multistage sampling was employed to recruit 204 family caregivers of people with a major
depressive disorder. The caregivers were asked to complete 6 questionnaires including: the
Involvement Evaluation Questionnaire, Social Support Questionnaire, Sense of Belonging Instrument,
Ways of Coping Questionnaire, General Health Questionnaire-12, and General Information
Questionnaire. Structural equation modeling was used to examine a hypothesized model.
The results revealed that the hypothesized model fitted the empirical data and 64% of the
variance of psychological distress was explained. Burden had the strongest positive direct effect
on psychological distress and an indirect effect on psychological distress through emotion-focused
coping. Social support had an indirect effect on psychological distress through emotion-focused
coping. Sense of belonging had a negative direct effect on psychological distress. Findings indicated
that the Causal Model of Psychological Distress of Thai Family Caregivers of People with Major
Depressive Disorder provides a guideline for understanding psychological distress of these family
caregivers caring for people with a major depressive disorder. Mental health care providers,
including nurses, should help to relieve burden, strengthen the sense of belonging, and promote
appropriate coping strategies in order to decrease psychological distress of such family caregivers.