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Objective and subjective dimensions of family burden

Towards an integrative framework for research

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Summary

In this article the consequences for those in close contact with a severely disturbed psychiatric patient, the burden of the family, are elaborated within an integrative framework. Burden areas are described and their objective and subjective dimensions are distinquished. The framework comprises three approaches: the systems approach, role theory and the stress process. An outline of the more important burden instruments developed up to now and suggestions for further research are given.

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References

  • Barrett J, Kurionsky J, Gurland B (1972) Community tenure following emergency discharge. Am J Psychiatry 128: 958–964

    Google Scholar 

  • Billings AG, Moos RH (1982) Psychosocial theory and research on depression: an integrative framework and review. Clin Psychol Rev 2: 213–237

    Google Scholar 

  • Brown GW, Carstairs GM, Topping G (1958) Post-hospital adjustment of chronic mental patients. Lancet II: 685–689

    Google Scholar 

  • Brown GW, Rutter M (1966a) The measurement of family activities and relationships. Hum Relat 19: 239–263

    Google Scholar 

  • Brown GW, Bone M, Dalison BH, Wing JK (1966b) Schizophrenic and social care. A comparative follow-up study of 339 schizophrenic patients (Maudsley Monographs No 17). Oxford University Press, Oxford

    Google Scholar 

  • Brown GW, Birley JLT, Wing JK (1972) Influence, of family life on the course of schizophrenic disorder: a replication. Br J Psychiatry 121: 241–258

    Google Scholar 

  • Cobb S (1976) Social support as a moderator of life stress. Psychosom Med 38: 300–314

    Google Scholar 

  • Coyne JC, Kessler RC, Tal M, Turnbull J, Wortman CB, Greden JF (1987) Living with a depressed person. J Consult Clinical Psychology 55: 347–352

    Google Scholar 

  • Creer C, Wing JK (1974) Schizophrenia at home. Institute of Psychiatry, London

    Google Scholar 

  • Creer C, Sturt E, Wykes T (1982) The role of relatives In: Wing JK (ed) Longterm Community care experience in a London borough. Psychol Med Monogr [Suppl 2]: 29–39

  • Deykin E (1961) The reintegration of the chronic schizophrenic patient discharged to his family and community as perceived by the family. Ment Hygiene 45: 235–246

    Google Scholar 

  • El Islam MF (1979) A better outlook for schizophrenics living in extended families. Br J Psychiatry 135: 343–347

    Google Scholar 

  • El Islam MF (1982) Rehabilitation of schizophrenics by the extended family. Acta Psychiatr Scand 65: 112–119

    Google Scholar 

  • Engel GL (1980) The clinical application of the biopsychosocial model. Am J Psychiatry 137: 535–544

    Google Scholar 

  • Fadden GB (1984) The relatives of patients with depressive disorders: a typology of burden and strategies of coping. M. Phil Thesis. Institute of Psychiatry, University of London

  • Fadden G, Bebbington P, Kuipers L (1987) Caring and its burdens. A study of the spouses of depressed patients. Br J Psychiatry 151: 660–667

    Google Scholar 

  • Freeman HE, Simmons OG (1958) Mental patients, in the community. Family settings and performance level. Am Sociol Rev 22: 147–154

    Google Scholar 

  • Freeman HE, Simmons OG (1959) Social class and posthospital performance levels. Am Sociol Rev 24: 345–451

    Google Scholar 

  • Gibbons JS, Horn SH, Powell JM, Gibbons JL (1984) Schizophrenic patients and their families: a survey in p psychiatric service based on a DGH unit. Br J Psychiatry 144: 70–77

    Google Scholar 

  • Giel R, Arongo MV de, Hafeiz Babikir A (1983) The burden of mental illness on the family. Acta Psychiatr Scand 68: 186–201

    Google Scholar 

  • Grad J, Sainsbury P (1963) Mental illness and the family. Lancet I: 544–547

    Google Scholar 

  • Grad J, Sainsbury P (1968) The effects that patients have on their families in a community care and a control psychiatric service. Br J Psychiatry 114: 265–278

    Google Scholar 

  • Gubman GD, Tessler RC, Willis G (1987) Living with the mentally ill: factors affecting household complaints. Schizophr Bull 13: 727–736

    Google Scholar 

  • Herz MI, Endicott J, Spitzer RL (1977) Brief hospitalization: a two-year follow-up. Am J Psychiatry 134: 502–507

    Google Scholar 

  • Hoenig J, Hamilton MW (1966a) The schizophrenic patient in the community and the effect on the household. Int J Soc Psychiatry 26: 165–176

    Google Scholar 

  • Hoenig J, Hamilton MW (1966b) The burden on the household in an extramural psychiatric service. In: Freeman HL, Farndale WAJ (eds) New aspects of the mental health services. Pergamon. Oxford, pp 612–635

    Google Scholar 

  • Hoenig J (1968) The de-segregation of the psychiatric patients. Proc R Soc Med 61: 115–120

    Google Scholar 

  • Jacob M, Frank E, Kupfer DJ, Carpenter LL (1987) Recurrent depression: an assessment of family burden and family attitudes. J Clin Psychiatry 44: 395–400

    Google Scholar 

  • Knights A, Hirsch SR, Platt SD (1980) Clinical change as a function of brief admission to hospital in a controlled study using the Present State Examination. Br J Psychiatry 137: 170–180

    Google Scholar 

  • Kreisman D, Joy V (1974) Family response to the illness of a relative. A review of the literature. Schizophr Bull 1: 34–57

    Google Scholar 

  • Lazarus RS, Cohen JB (1977) Environmental stress. In: Altman I, Wohlwill JF (eds) Human behaviour and the environment: current theory and research, vol 1. Plenum, New York pp 90–121

    Google Scholar 

  • Lazarus RS (1981) The stress and coping paradigm. In: Eisdorfer C, Cohen A, Kleinman A, Maxim P (eds) Theoretical basis for psychopathology, Spectrum, New York, pp 177–214

    Google Scholar 

  • Mandelbrote B, Folkard S (1961) Some factors related to outcome and social adjustment in schizophrenia. Acta Psychiatr Scand 37: 223–235

    Google Scholar 

  • Methorst GJ (1985) Mannen en vrouwen van psychiatrische patienten, Thesis, Wageningen

  • Noh S, Turner RJ (1987) Living with psychiatric patients: implications for the mental health of family members. Soc Sci Med 25: 263–271

    Google Scholar 

  • Noh S, Avison WR (1988) Spouses of discharged psychiatric patients: factors associated with their experience of burden. J Marriage Fam 50: 377–389

    Google Scholar 

  • Pai S, Kaipur RL (1981) The burden on the family of a psychiatric patient; development of an interview schedule. Br J Psychiatry 138: 332–335

    Google Scholar 

  • Pai S, Kaipur RL (1982) Impact of treatment intervention of the relationship between dimensions of clinical psychopathology, social dysfunction and burden on the family. Psychol Med 12: 651–658

    Google Scholar 

  • Pasamanick B, Scarpitti FR, Dinith S (1967) Schizophrenics in the community; an experimental study in the prevention of hospitalization. Appleton Century Crofts, New York

    Google Scholar 

  • Pearlin LI, Schooler C (1978) The structure of coping. J Health Soc Behav 19: 2–21

    Google Scholar 

  • Pearlin LI, Lieberman MA, Managhan EG, Mullan JT (1981) The stress process. J Health Soc Behav 22: 337–356

    Google Scholar 

  • Platt S (1981) Social adjustment as a criterion of treatment success: just what are we measuring? Psychiatry 44: 95–112

    Google Scholar 

  • Platt S (1985) Measuring the burden of psychiatric illness on the family; an evaluation of some rating scales. Psychol Med 15: 383–393

    Google Scholar 

  • Platt S, Weyman A, Hirsch S, Hewett S (1980) The Social Behaviour Assessment Schedule (SBAS); rationale, contents, scoring and reliability of a new interview schedule. Soc Psychiatry 15: 43–55

    Google Scholar 

  • Platt S, Weyman A, Hirsch S (1983) Social Behaviour Assessment Schedule (SBAS), 3rd edn. Windsor, Berkshire: NFER-Nelson

    Google Scholar 

  • Rabkin J (1972) Opinions about mental illness, a review of the literature. Psychol Bull 77: 153–171

    Google Scholar 

  • Raymond ME, Slaby AE, Lieb J (1975) Familial response to mental illness. Soc Casework 56: 492–498

    Google Scholar 

  • Sainsbury P, Grad J (1962) Evaluation of treatment and services. In: The burden on the community. A symposium. Oxford University Press, London

    Google Scholar 

  • Sainsbury P, Grad J (1966) Evaluating the community psychiatric service in Chichester. Aims and methods of research. Milbank Q 44: 231–242

    Google Scholar 

  • Schene AH (1986) Thuis bezorgd; een literatuurstudie naar het verschijnsel “Burden on the family”. NcGv, Utrecht

    Google Scholar 

  • Schene AH (1987) The burden on the family scale. Department of Ambulatory and Social Psychiatry, University of Utrecht, Utrecht

    Google Scholar 

  • Spitzer RL, Giboon M, Endicott J (1971) Family evaluation form. New York State Department of Mental Hygiene, New York

    Google Scholar 

  • Tessler RC, Killian LM, Gubman GD (1987) Stages in family response to mental illness; an ideal type. Psychosoc Rehabil J 10: 3–16

    Google Scholar 

  • Tessler R, Fisher G, Gamache G (1989) A role strain approach to the measurement of family burden: the properties and utilities of a new scale. Paper presented at the Annual meeting of the Eastern Sociological Society, Baltimore

  • Treudley MB (1946) Mental illness and family routines. Ment Hygiene 15: 407–418

    Google Scholar 

  • Turner RJ (1983) Direct, indirect and moderating effects of social support on psychological distress and associated conditions. In: Kaplan HB (ed) Psychosocial stress, trends in theory and research. Academic, New York, pp 105–156

    Google Scholar 

  • Waalker VN, MacBriddle A, Vachon MLS (1977) Social support networks and the crisis of bereavement. Soc Sci Med 11: 35–41

    Google Scholar 

  • Wing JK, Monck E, Brown GW, Carstairs GM (1964) Morbidity in the community of schizophrenic patients discharged from London Mental Hospitals in 1959. Br J Psychiatry, 110: 10–21

    Google Scholar 

  • Yarrow M, Schwarz C, Murphy H, Deasy L (1955) The psychological meaning of mental illness in the family. J Soc Issues 11: 12–24

    Google Scholar 

Download references

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Schene, A.H. Objective and subjective dimensions of family burden. Soc Psychiatry Psychiatr Epidemiol 25, 289–297 (1990). https://doi.org/10.1007/BF00782883

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