4.1. Psychological factors in caregiver distress
Within a stress-appraisal-coping framework, psychological factors seem to account for a great deal of variation in caregiver distress al- though there are still a limited number of studies on early psychosis samples. For the purpose of overview and synthesis, we organised the encountered psychological variables into the three non-mutually exclu- sive groups of coping, appraisal/attribution and interpersonal response. There were considerable data to support the link between distress and coping as well as distress and appraisal of various illness related factors — ranging across control, symptoms, loss, interpersonal func- tioning and utility of EE behaviour. Moreover, there was a strong associ- ation between EE, especially EOI, and caregiver distress. EE has received much attention in the published research on psychotic disorders, although not so much as a predictor of caregiver distress as a risk factor for relapse (Butzlaff & Hooley, 1998; Hooley, 2007; Kavanagh, 1992). Finally, there seems to be less knowledge as to whether some caregivers are more vulnerable to appraising the caregiving experience as more negative and to having more negative interpersonal responses faced with a difficult caregiving situation. One way of understanding this might be in terms of caregivers' abilities to form complex accounts of their own and other people's mental states and utilising this knowledge to regulate emotions and to solve interpersonal problems with the person with a psychotic disorder. In the included studies, these abilities were examined in terms of social cognition, metacognition and neurot- icism, which might operate as vulnerability factors within the stress- appraisal-coping model. However, while studies on individual charac- teristics are promising, more studies are needed before firm clinical implications can be drawn.
4.1. จิตวิทยาปัจจัยทุกข์ภูมิปัญญาWithin a stress-appraisal-coping framework, psychological factors seem to account for a great deal of variation in caregiver distress al- though there are still a limited number of studies on early psychosis samples. For the purpose of overview and synthesis, we organised the encountered psychological variables into the three non-mutually exclu- sive groups of coping, appraisal/attribution and interpersonal response. There were considerable data to support the link between distress and coping as well as distress and appraisal of various illness related factors — ranging across control, symptoms, loss, interpersonal func- tioning and utility of EE behaviour. Moreover, there was a strong associ- ation between EE, especially EOI, and caregiver distress. EE has received much attention in the published research on psychotic disorders, although not so much as a predictor of caregiver distress as a risk factor for relapse (Butzlaff & Hooley, 1998; Hooley, 2007; Kavanagh, 1992). Finally, there seems to be less knowledge as to whether some caregivers are more vulnerable to appraising the caregiving experience as more negative and to having more negative interpersonal responses faced with a difficult caregiving situation. One way of understanding this might be in terms of caregivers' abilities to form complex accounts of their own and other people's mental states and utilising this knowledge to regulate emotions and to solve interpersonal problems with the person with a psychotic disorder. In the included studies, these abilities were examined in terms of social cognition, metacognition and neurot- icism, which might operate as vulnerability factors within the stress- appraisal-coping model. However, while studies on individual charac- teristics are promising, more studies are needed before firm clinical implications can be drawn.
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