Devon Carroll

Although caregiver burden is well documented in the literature on caregivers of adults with psychosis, recent studies also suggest elevated levels of caregiver burden among caregivers of youths with psychotic spectrum disorders and those of youths at clinical high risk for psychosis (CHR-P); however, no review has been conducted to assess the literature in this area. The authors aimed to map the range, extent, and nature of the available evidence on caregiver burden among caregivers of youths with psychotic disorders or youths classified as at CHR-P. A scoping review of six databases was conducted. Studies were included if they provided data or commentary on caregiver burden among individuals caring for youths with psychotic disorders or youths at CHR-P. Two reviewers were involved in the screening and data extraction process, in consultation with a third reviewer. From 6,651 abstracts and titles screened, 280 full-text articles were reviewed, and 11 were included in the analysis. Overall, the articles supported the experience of significant burden among caregivers of youths with psychotic disorders or youths at CHR-P and highlighted the emotional costs of caring. Three prominent themes emerged: characteristics of caregiver burden (types of burden, youth and caregiver characteristics, and caregiver group comparisons), possible predictors of caregiver burden (youth vs. caregiver factors), and potential opportunities for intervention. Caregivers of youths at CHR-P or youths diagnosed as having psychotic disorders are a vulnerable population and need services to support them throughout the caregiving trajectory.

Background: Despite similar or higher prevalence of binge eating disorder and binge eating, Black women are less likely to be assessed for eating disorders, less likely to seek and/or receive eating disorder treatment, and more likely to drop out of treatment compared to other women. Efforts to improve early detection and interventions for Black women are hindered by the lack of knowledge about pathways for eating disorder psychopathology in this understudied and underserved population. The aim of this study was to explore how culture influences eating behaviors among Black women in the United States.Methods: Seven Black women completed semi-structured, in-depth interviews. Interview transcripts were analyzed using reflexive thematic analysis.Results: Four main themes were derived from the qualitative data: 1) Childhood: Moments That Shape Us, 2) Crossroads: Navigating the Clash of Two Norms, 3) The Ripple Effect: The Power of Social Influence, and 4) Feeding Feelings: When Emotions Drive Eating.Conclusions: Eating disorder models can be strengthened to represent the experiences of Black women and should consider their ethnic heterogeneity such as African, African American, and Afro-Caribbean. Such knowledge can then be used to inform conceptual frameworks to transform assessments and interventions, leading to more treatment efficacy and a decrease in attrition.

Introduction: Caregiver burden is well characterized in adults with psychosis but less is known about the burden experienced by carers of children with psychosis. In this secondary analysis, we examined burden reported by caregivers of children with clinical high risk for psychosis and psychotic disorders to test an explanatory model for caregiver burden. Methods: Cross-sectional analyses examined burden experienced by caregivers of children with clinical high risk for psychosis and psychosis who were recruited from an outpatient psychiatric clinic. Caregiver burden was assessed with the Zarit Burden Inventory. Structural equation modelling was employed to examine a model assessing the simultaneous effects of factors related to burden among caregivers of children at clinical high risk for psychosis and diagnosed with psychotic disorders. Results: The study involved 85 caregivers of children aged 6-17. The latent variable for positive caregiving attributes, which included parenting confidence and communication, had a direct effect on caregiver burden, with greater levels of positive caregiving attributes associated with decreased burden. Direct effects of social support and the latent variable for primary/secondary stressors on burden were not observed. There was a significant indirect effect for social support through positive caregiving attributes to mitigate the effects of primary/secondary stressors on caregiver burden. Conclusion: The results provide preliminary evidence supporting the importance of social support, parenting confidence, and caregiver-child communication as key targets for intervention. Moreover, our findings suggest that despite stressors, such as suicidal behaviour and psychiatric hospitalisations, modifiable factors exist to serve as protective buffers against caregiver burden.

Background: Despite the existing research exploring caregiver burden in adult psychosis, few studies have examined the experience of providing care to children diagnosed with psychotic disorders (PDs) and those identified as having clinical high risk for psychosis (CHR-P). Aim: This study measured the level of burden in caregivers of children with PD and CHR-P and examined associated risk factors, including social support, caregiver–child relationship, severity of illness, and frequency of psychiatric hospitalizations. Methods: A total of 56 caregivers completed validated measures and provided demographic information. Measures included the Zarit Burden Interview, the Multidimensional Scale of Perceived Social Support, the Behavior Assessment System for Children, Third Edition, Parenting Relationship Questionnaire–Child and Adolescent Form (BASC-3 PRQ-CA), and the Clinical Global Impression–Severity scale. Results: The majority of caregivers were women (86%), mothers (84%), White (63%), married (66%), working full-time (50%), college-educated (79%), and whose mean age was 45.7 years ( SD = 8.09). Nearly half of the caregivers (45%) reported a high level of caregiver burden, 39% rated their burden in the mild to moderate range, and 16% reported little to no burden. There was no significant difference in mean burden between PD and CHR-P groups. Higher caregiver burden was associated with lower levels of social support ( r = −.408, p = .002), lower levels of parenting confidence ( r = −.514, p < .001), higher levels of relational frustration ( r = .612, p < .001), and higher severity of illness ( r = .316 p = .025). Conclusions: These findings underscore the critical unmet need for support for caregivers of children with PD and CHR-P. Applications to clinical practice are discussed.