A comparison of experiences of care and expressed emotion among caregivers of young people with first-episode psychosis or borderline personality disorder features

2021 ◽  
pp. 000486742110502
Author(s):  
Sue M Cotton ◽  
Jennifer K Betts ◽  
Dina Eleftheriadis ◽  
Kate Filia ◽  
Mirra Seigerman ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Young People ◽  
Expressed Emotion ◽  
First Episode Psychosis ◽  
Borderline Personality ◽  
First Episode ◽  
Negative Experiences ◽  
Episode Psychosis ◽  
Caregiver Experiences

Objective: Caregivers of individuals with severe mental illness often experience significant negative experiences of care, which can be associated with higher levels of expressed emotion. Expressed emotion is potentially a modifiable target early in the course of illness, which might improve outcomes for caregivers and patients. However, expressed emotion and caregiver experiences in the early stages of disorders might be moderated by the type of severe mental illness. The aim was to determine whether experiences of the caregiver role and expressed emotion differ in caregivers of young people with first-episode psychosis versus young people with ‘first-presentation’ borderline personality disorder features. Method: Secondary analysis of baseline (pre-treatment) data from three clinical trials focused on improving caregiver outcomes for young people with first-episode psychosis and young people with borderline personality disorder features was conducted (ACTRN12616000968471, ACTRN12616000304437, ACTRN12618000616279). Caregivers completed self-report measures of experiences of the caregiver role and expressed emotion. Multivariate generalised linear models and moderation analyses were used to determine group differences. Results: Data were available for 265 caregivers. Higher levels of negative experiences and expressed emotion, and stronger correlations between negative experiences and expressed emotion domains, were found in caregivers of young people with borderline personality disorder than first-episode psychosis. Caregiver group (borderline personality disorder, first-episode psychosis) moderated the relationship between expressed emotion and caregiver experiences in the domains of need to provide backup and positive personal experiences. Conclusion: Caregivers of young people with borderline personality disorder experience higher levels of negative experiences related to their role and expressed emotion compared with caregivers of young people with first-episode psychosis. The mechanisms underpinning associations between caregiver experiences and expressed emotion differ between these two caregiver groups, indicating that different supports are needed. For borderline personality disorder caregivers, emotional over-involvement is associated with both negative and positive experiences, so a more detailed understanding of the nature of emotional over-involvement for each relationship is required to guide action.

scholarly journals Does co-occurring borderline personality disorder influence acute phase treatment for first-episode psychosis?

2017 ◽  
Vol 12 (6) ◽  
pp. 1166-1172 ◽  
Author(s):  
Shona M. Francey ◽  
Martina Jovev ◽  
Christina Phassouliotis ◽  
Sue M. Cotton ◽  
Andrew M. Chanen
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Acute Phase ◽  
First Episode Psychosis ◽  
Borderline Personality ◽  
First Episode ◽  
Episode Psychosis ◽  
Acute Phase Treatment

0260 CO-MORBID BORDERLINE PERSONALITY DISORDER AND FIRST EPISODE PSYCHOSIS: HOW MANY AND WHAT HAPPENS?

2006 ◽  
Vol 86 ◽  
pp. S113 ◽  
Author(s):  
S.M. Francey ◽  
M. Jovev ◽  
C. Phassouliotis ◽  
E. McDougall ◽  
S. Cotton ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
First Episode Psychosis ◽  
Borderline Personality ◽  
First Episode ◽  
Episode Psychosis

Longitudinal relationship between expressed emotion and cannabis misuse in young people with first-episode psychosis

2015 ◽  
Vol 30 (1) ◽  
pp. 20-25 ◽  
Author(s):  
C. González-Blanch ◽  
J.F. Gleeson ◽  
S.M. Cotton ◽  
K. Crisp ◽  
P.D. McGorry ◽  
...  
Keyword(s):  
Young People ◽  
Family Environment ◽  
Temporal Relationship ◽  
Expressed Emotion ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
Substance Involvement ◽  
Over Time

AbstractCarers’ expressed emotion (EE) and patients’ cannabis misuse are two of the most robust predictors of psychotic relapse. We aimed to examine the temporal relationship between EE and cannabis misuse. Sixty-three key carers of young people with first-episode psychosis (FEP) were assessed at baseline and 7-month follow-up. EE was measured in carers using the Family Questionnaire (FQ) and cannabis misuse in patients using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Correlational and hierarchical logistic regression analyses were conducted to examine the temporal relationship between EE components (i.e. criticism and emotional over involvement) and cannabis misuse. Carers’ criticism at baseline significantly predicted cannabis misuse according to the ASSIST at 7-month follow-up. The association remained significant after controlling for baseline symptom severity and social functioning (B = 0.15, P = .02). Conversely, baseline cannabis misuse was not associated with carers’ criticism at 7-month follow-up. Patients in families with high criticism showed a tendency to increase cannabis misuse over time whereas the opposite trend was observed in those with carers with low criticism. A family environment characterized by high criticism may become a key risk factor for worsening cannabis misuse over time in young people with FEP. Further studies should investigate the potential mechanisms (e.g., patient's anxiety or perceived stress) through which criticism increases cannabis misuse in FEP.

scholarly journals The Positive and Negative Experiences of Caregiving for Siblings of Young People with First Episode Psychosis

2017 ◽  
Vol 8 ◽  
Author(s):  
Siann Bowman ◽  
Mario Alvarez-Jimenez ◽  
Darryl Wade ◽  
Linsey Howie ◽  
Patrick McGorry
Keyword(s):  
Young People ◽  
First Episode Psychosis ◽  
First Episode ◽  
Negative Experiences ◽  
Episode Psychosis

scholarly journals Therapeutic interventions in Australian primary care, youth mental health settings for young people with Borderline Personality Disorder or borderline traits

2020 ◽  
Author(s):  
Nikki O’Dwyer ◽  
Debra Rickwood ◽  
Dean Buckmaster ◽  
Clare Watsford
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Young People ◽  
Youth Mental Health ◽  
Borderline Personality ◽  
Therapeutic Interventions ◽  
First Episode ◽  
Evidence Based ◽  
Data Set

Abstract Background This study aimed to investigate what therapeutic interventions were being applied by clinicians working with young people with a diagnosis of Borderline Personality Disorder or borderline traits in Australian primary mental health care settings. Given the current lack of evidence-based guidelines for treatment with this client population, investigating what is being implemented is needed. The study also aimed to determine whether the interventions clinicians are using are effective in reducing distress and increasing functioning for these clients. Methods Participant data came from the national minimum data set for headspace youth mental health centers across Australia. Young people’s data were included in the study if the young person was diagnosed with Borderline Personality Disorder or borderline traits during their first episode of care (N=701). Clinician data that indicated the type of intervention used at each client session and outcome measures routinely captured were analyzed to determine interventions used and outcomes achieved. Results Results demonstrated that CBT was the most frequently used modality of intervention followed by supportive counselling and IPT, but that most clients received a variety of intervention types. There were no or only weak relationships between changes in outcomes and the amount of any type of intervention that was provided. No significant relationship was found with the amount of CBT a client received and changes in symptoms or functioning, despite being the most commonly employed modality. Conclusions The study highlights the need for evidence-based treatment guidelines for early intervention in young people with borderline personality disorder traits.

scholarly journals Therapeutic interventions in Australian primary care, youth mental health settings for young people with borderline personality disorder or borderline traits

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Nikki O’Dwyer ◽  
Debra Rickwood ◽  
Dean Buckmaster ◽  
Clare Watsford
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Young People ◽  
Youth Mental Health ◽  
Borderline Personality ◽  
Therapeutic Interventions ◽  
First Episode ◽  
Evidence Based ◽  
Data Set

Abstract Background This study aimed to investigate what therapeutic interventions were being applied by clinicians working with young people with a diagnosis of Borderline Personality Disorder or borderline traits in Australian primary mental health care settings. Given the current lack of evidence-based guidelines for treatment with this client population, investigating what is being implemented is needed. The study also aimed to determine whether the interventions clinicians are using are effective in reducing distress and increasing functioning for these clients. Methods Participant data came from the national minimum data set for headspace youth mental health centers across Australia. Young people’s data were included in the study if the young person was diagnosed with Borderline Personality Disorder or borderline traits during their first episode of care (N = 701). Clinician data that indicated the type of intervention used at each client session and outcome measures routinely captured were analyzed to determine interventions used and outcomes achieved. Results Results demonstrated that CBT was the most frequently used modality of intervention followed by supportive counselling and IPT, but that most clients received a variety of intervention types. There were no or only weak relationships between changes in outcomes and the amount of any type of intervention that was provided. No significant relationship was found with the amount of CBT a client received and changes in symptoms or functioning, despite being the most commonly employed modality. Conclusions The study highlights the need for evidence-based treatment guidelines for early intervention in young people with borderline personality disorder traits.

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