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Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 12/2009

01-12-2009 | Original Paper

Aggression and trauma experiences among carer-relatives of people with psychosis

Authors: Carmel M. Loughland, Gali Lawrence, Joanne Allen, Mick Hunter, Terry J. Lewin, Nico E. Oud, Vaughan J. Carr

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 12/2009

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Abstract

Background

Exposure to aggression and associated psychological outcomes are poorly characterised among carer-relatives of people with psychosis.

Method

Carer-relatives (N = 106) completed questionnaires assessing socio-demographics and perceived prevalence of aggression in their caring role in the last 12 months. Carers exposed to moderate–severe levels of aggression were re-approached to assess PTSD and coping strategies.

Results

Most respondents (77.4%) reported experiencing moderate–severe levels of aggression. Increased contact with (M = 15.12 vs. M = 6.71 days per month), and significantly higher ratings of affective, antisocial, negative and psychotic symptomology in affected relatives were associated with experiences of moderate–severe aggression. Approximately half of the moderate–severe respondents reported potentially significant levels of PTSD (52%, N = 34), which was associated with greater exposure to verbal aggression and increased usage of coping strategies.

Conclusions

Comparable ratios of physical to non-physical aggression to those reported by professional carers working in acute psychiatric treatment settings were reported. Carer-relatives require greater levels of information and support to assist them in their community caring roles.
Literature
1.
Barrowclough C, Parle M (1997) Appraisal, psychological adjustment and expressed emotion in relatives of patients suffering from schizophrenia. Br J Psychiatry 171:26–30CrossRefPubMed
2.
Barrowclough C, Tarrier N, Johnston M (1996) Distress, expressed emotion, and attributions in relatives of schizophrenia patients. Schizophr Bull 22:691–702PubMed
3.
Bebbington PE, Nayani T (1995) The psychosis screening questionnaire. Int J Methods Psychiatr Res 5:11–20
4.
Bowers L, Allan T, Simpson A, Jones J, Whittington R (2009) Morale is high in acute inpatient psychiatry. Soc Psychiatry Psychiatr Epidemiol 44(1):39–46CrossRefPubMed
5.
Boye B, Bentsen H, Ulstein L, Notland TH, Lersbryggen A, Lingjaerde O, Malt UF (2001) Relatives’ distress and patients’ symptoms and behaviours: a prospective study of patients with schizophrenia and their relatives. Acta Psychiatr Scand 104:42–50CrossRefPubMed
6.
Brewin CR, Andrews B, Rose S (2000) Fear, helplessness and horror in posttraumatic stress disorder: investigating DSM-IV criterion A2 in victims of violent crime. J Trauma Stress 13:499–509CrossRefPubMed
7.
Brewin CR, Andrews B, Valentine JD (2000) Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol 68:748–766CrossRefPubMed
8.
Brizer DA, Convit A, Krakowski M, Volavka J (1987) A rating scale for reporting violence on psychiatric wards. Hosp Community Psychiatry 38:769–770PubMed
9.
Caldwell MF (1993) Incidence of PTSD among staff victims of patient violence. Hosp Community Psychiatry 43:838–839
10.
Caldwell MF (1992) Incidence of PTSD among staff victims of patient violence. Hosp Community Psychiatry 43:838–839PubMed
11.
Carr VJ, Lewin TJ, Sly KA, Conrad AM, Tirupati S, Cohen M, Ward PB, Coombs T (2008) Adverse incidents in acute psychiatric inpatient units: rates, correlates and pressures. Aust NZ J Psychiatry 42:267–282CrossRef
12.
Creamer M, Bell R, Failla S (2003) Psychometric properties of the impact of event scale-revised. Behav Res Ther 41:1489–1496CrossRefPubMed
13.
Dean K, Walsh E, Morgan C, Demjaha A, Dazzan P, Morgan K, Lloyd T, Fearon P, Jones PB, Murray RM (2007) Aggressive behaviour at first contact with services: findings from the AESOP First Episode Psychosis Study. Psychol Med 37:547–557CrossRefPubMed
14.
Ehlers A, Clark DM (2001) A cognitive model of posttraumatic stress disorder. Behav Res Ther 38:319–345CrossRef
15.
Ferriter M, Huband N (2003) Experiences of parents with a son or daughter suffering from schizophrenia. J Psychiatr Ment Health Nurs 10:552–560CrossRefPubMed
16.
Folkman S, Lazarus RS (1988) Manual for the Ways of Coping Questionnaire. Consulting Psychological Press, Palo Alto
17.
Fortune DnG, Smith JV, Garvey K (2005) Perceptions of psychosis, coping, appraisals, and psychological distress in the relatives of patients with schizophrenia: an exploration using self-regulation theory. Br J Clin Psychol 44:319–331CrossRefPubMed
18.
Holbrook TL, Hoyt DB, Stein MB, Sieber WJ (2001) Perceived threat to life predicts posttraumatic stress disorder after major trauma: risk factors and functional outcome. J Trauma 51:292–299CrossRef
19.
Ivanović M, Vuletić Z, Bebbington P (1994) Expressed emotion in the families of patients with schizophrenia and its influence on the course of illness. Soc Psychiatry Psychiatr Epidemiol 29:61–65PubMed
20.
Jackson H, Smith N, McGorry P (1990) Relationship between expressed emotion and family burden in psychotic disorders: an exploratory study. Acta Psychiatr Scand 82:243–249CrossRefPubMed
21.
Jones SL, Roth D, Jones PK (1995) Effect of demographic and behavioral variables on burden of caregivers of chronic mentally ill persons. Psychiatr Serv 46:141–145PubMed
22.
Krakowski M, Czobor P, Chou JCY (1999) Course of violence in patients with schizophrenia relationship to clinical symptoms. Schizophr Bull 25:505–517PubMed
23.
Lauber C, Eichenberger A, Luginbuhl P, Keller C, Rossler W (2003) Determinants of burden in caregivers of patients with exacerbating schizophrenia. Eur Psychiatry 18:285–289CrossRefPubMed
24.
Lazarus RS, Folkman S (1984) Stress, appraisal and coping. Springer, New York
25.
Loughland CM, Carr VC, Lewin T (2001) The NISAD Schizophrenia Research Register: Why do we need a schizophrenia database? Aust NZ J Psychiatry 35:660–669CrossRef
26.
Lovibond SH, Lovibond PF (1995) Manual for the depression anxiety stress scales, 2nd edn. Psychology Foundation, Sydney
27.
Magliano L, Fadden G, Economou M, Held T, Xavier M, Guarneri M, Malangone C, Marasco C, Maj M (2000) Family burden and coping strategies in schizophrenia: 1 year follow up data from the BIOMED study. Soc Psychiatry Psychiatr Epidemiol 35:109–115CrossRefPubMed
28.
McFarlane A, Schrader G, Bookless C, Browne D (2006) Prevalence of victimization, posttraumatic stress disorder and violent behaviour in the seriously mentally ill. Aust NZ J Psychiatry 40:1010–1015CrossRef
29.
Nijman H, Bowers L, Oud N, Jansen G (2005) Psychiatric nurses’ experiences with inpatient aggression. Aggressive Behav 31:217–227CrossRef
30.
Nolan KA, Volavka J, Czobor P, Sheitman B, Lindenmayer JK, Citrome LL, McEvoy J, Leiberman JA (2005) Aggression and psychopathology in treatment-resistant inpatients with schizophrenia and schizoaffective disorder. J Psychiatr Res 39:109–115CrossRefPubMed
31.
Oud N (2001) Testing the perceptions of prevalence of aggression scale (POPAS). Presented at the 2nd European congress on violence in clinical psychiatry, Stockholm. (See also, reference 29)
32.
Ozer EJ, Best SR, Lipsey TL, Weiss DS (2003) Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychol Bull 129:52–73CrossRefPubMed
33.
Quinn J, Barrowclough C, Tarrier N (2003) The Family Questionnaire (FQ): a scale for measuring symptom appraisal in relatives of schizophrenia patients. Acta Psychiartr Scand 108:290–296CrossRef
34.
Raja M, Azzoni A, Lubich L (1997) Aggressive and violent behavior in a population of psychiatric inpatients. Soc Psychiatry Psychiatr Epidemiol 32:428–434PubMed
35.
Richmond D (1983) Inquiry into health services for the psychiatrically ill and developmentally disabled. In: NSW Department of Health, Sydney
36.
Sellwood W, Barrowclough C, Tarrier N, Quinn J, Mainwaring J, Lewis S (2001) Needs based cognitive behavioural family intervention for carers of patients suffering from schizophrenia: 12 month follow up. Acta Psychiatric Scand 104:346–355CrossRef
37.
Serper MR, Goldberg BR, Herman KG, Richarme D, Chou J, Dill CA, Cancro R (2005) Predictors of aggression on the psychiatric inpatient service. Compr Psychiatry 46:121–127CrossRefPubMed
38.
Soyka M, Morhart-Klute V, Schoech H (2004) Delinquency and criminal offenses in former schizophrenic inpatients 7–12 years following discharge. Eur Arch Psychiatry Clin Neurosci 254:289–294PubMed
39.
Steadman HJ, Mulvey EP, Monahan J, Robbins PC, Appelbaum PS, Grisso T, Roth LH, Silver E (1998) Violence by people discharged from acute psychiatric inpatient facilities and by others in the same neighbourhood. Arch Gen Psychiatry 55:393–401CrossRefPubMed
40.
Steinert T (2002) Prediction of inpatient violence. Acta Psychiatr Scand 106:133–141CrossRef
41.
Steinert T, Wölfle M, Gebhardt RP (2000) Measurement of violence during in-patient treatment and association with psychopathology. Acta Psychiatr Scand 102:107–112CrossRefPubMed
42.
Vaddadi KS, Gilleard C, Fryer H (2002) Abuse of carers by relatives with severe mental illness. Int J Soc Psychiatry 48:149–155CrossRefPubMed
43.
Vaddadi KS, Soosai E, Gilleard CJ, Adlard S (1997) Mental illness, physical abuse and burden of care on relatives: a study of acute psychiatric admission patients. Acta Psychiatr Scand 95:313–317CrossRefPubMed
44.
Weiss D, Marmar C (1997) The impact of event scale—revised. In: Wilson J, Keane T (eds) Assessing psychological trauma and PTSD. Guildford, New York
45.
Wildgoose J, Briscoe M, Lloyd K (2003) Psychological and emotional problems in staff following assaults by patients. Psychiatric Bull 27:295–297CrossRef
Metadata
Title
Aggression and trauma experiences among carer-relatives of people with psychosis
Authors
Carmel M. Loughland
Gali Lawrence
Joanne Allen
Mick Hunter
Terry J. Lewin
Nico E. Oud
Vaughan J. Carr
Publication date
01-12-2009
Publisher
D. Steinkopff-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 12/2009
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-009-0025-5

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