Centre for Youth Mental Health - Research Publications

Permanent URI for this collection

http://hdl.handle.net/11343/250

Filters

2021 - 2022 2
2
Reset filters

Settings
Statistics
Citations
Author: Mallawaarachchi, Sumudu × Author: Bendall, Catherine × Start date: 2020 ×

Search Results

Now showing 1 - 2 of 2
  • Item
    No Preview Available
    A comparison of experiences of care and expressed emotion among caregivers of young people with first-episode psychosis or borderline personality disorder features
    Cotton, SM ; Betts, JK ; Eleftheriadis, D ; Filia, K ; Seigerman, M ; Rayner, VK ; McKechnie, B ; Hulbert, CA ; McCutcheon, L ; Jovev, M ; Bendall, S ; Burke, E ; McNab, C ; Mallawaarachchi, S ; Alvarez-Jimenez, M ; Chanen, AM ; Gleeson, JFM (SAGE PUBLICATIONS LTD, 2022-09-01)
    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.
  • Item
    Thumbnail Image
    A pilot trial of moderated online social therapy for family and friends of young people with borderline personality disorder features
    Gleeson, J ; Alvarez-Jimenez, M ; Betts, JK ; McCutcheon, L ; Jovev, M ; Lederman, R ; Herrman, H ; Cotton, SM ; Bendall, S ; McKechnie, B ; Burke, E ; Koval, P ; Smith, J ; D'Alfonso, S ; Mallawaarachchi, S ; Chanen, AM (WILEY, 2021-12)
    AIM: We evaluated the acceptability, usability and safety of Kindred, a novel online intervention for carers of young people with borderline personality disorder (BPD) using a pre-post pilot trial design. The secondary aim explored whether Kindred use was associated with clinical improvements for caregivers on measures of burden of caregiving, stress, expressed emotion, family communication, disability, coping and knowledge of BPD and for patients on measures of severity of BPD symptoms and level of functional impairment. METHODS: The trial site was the Helping Young People Early program for young people with BPD at Orygen in Melbourne, Australia. Informed consent was obtained from 20 adult carers (i.e., relatives or friends) and 10 young people aged 15-25 with BPD. Kindred, which was available for 3 months, incorporated online psychoeducation, carer-to-carer social networking and guidance from expert and peer moderators. Assessments were completed at baseline and 3 months follow-up. Multiple indicators of acceptability, usability and safety were utilized. RESULTS: Seventeen carers were enrolled in Kindred and eight young people completed baseline measures. A priori acceptability, usability and safety criteria were met. Carer burden, stress, expressed emotion, family communication, quality of life, functioning, coping and perceived knowledge of BPD improved at follow-up. Sixty-six percent of the young people (4/6) reported that they believed Kindred had improved their carers' understanding of BPD. CONCLUSION: Kindred was shown to be acceptable, usable and safe, with encouraging improvements in both carer and young person outcomes. Kindred warrants evaluation of its efficacy via an randomized controlled trial.