Friday, 14 January 2005 - 8:00 AM

This presentation is part of: Families Coping with Severe Mental Illness

Predictors of Burden in Families of Women with Co-Occurring Substance and Mental Disorders

Purpose

Families are the primary source of support to family members with co-occurring substance and mental disorders. There has been little research on the predictors of caregiver burden for this population. This paper examines the predictors of burden of family members/significant others of women with substance disorders compared with women with co-occurring substance and mental disorders (anxiety, PTSD, depression, dysthymia). Study subjects represent an understudied population.

Methods

This NIDA funded study interviewed women clients in one residential and one outpatient substance abuse treatment program and also a principal family caregiver/significant other designated by each woman. Almost all( 97.2%) of the women who met study eligibility criteria were contacted. Of these, 96.2% (N=87) agreed to participate and provided the name of a family member, and 95% of the family members (N=83) were interviewed. A stress-coping model was utilized to identify stressors and resources hypothesized to impact three types of caregiver burden-- worry, stigma and displeasure. Bivariate correlation analyses were conducted using variables from the theoretical model and caregiver and care recipient demographic variables, followed by linear regression analyses for each of three types of burden utilizing predictors that were statistically significant (p < .05) at the bivariate level. Client classification as having a current dual disorder or current substance abuse only disorder, as measured by the CDIS, was entered into all three regression equations.

Results

The burden scales had good reliability with coefficient alphas ranging from .79 to .90. The regression model for Worry was statistically significant (p <.001, R2= .38), with higher Worry predicted by more client behavioral problems, the family caregiver not being a spouse/significant other, greater client recent drug problems, and greater likelihood of the family member to ask for help with the client from people that they know. The regression model for Stigma was significant (p <.001, R2= .19), with higher Stigma predicted by greater client recent drug problems, the family member receiving less help from friends in dealing with problems of the client, and the family member having less overall social support. The regression model for Displeasure was significant ( p <.001, R2= .32), with higher Displeasure predicted by more behavioral problems and the family caregiver not being a spouse/significant other. Whether the client had a dual diagnosis was not a significant predictor of caregiver burden.

Implications

The finding that predictors varied by burden type was consistent with previous caregiving research, suggesting that interventions to address burden in this population should be tailored to specific types of burden. The finding that client behavioral problems was the strongest predictor of caregiver Worry and Displeasure was also consistent with previous caregiving research, suggesting the need for interventions to assist caregivers in understanding and addressing behavioral problems. The extent of client drug problems predicted caregiver Worry and Stigma, but having a dual diagnosis was not statistically significant, suggesting that future analyses might be needed to distinguish the impact of specific psychiatric diagnoses on caregiver burden.

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