The role of schemas in the experience of distress, burden, and wellbeing in parents and siblings of people with serious mental health difficulties

Background: Caregivers of people with serious mental health difficulties (SMHD), such as schizophrenia or bipolar disorder, face various psychological challenges. It is unclear if the mechanisms underlying these challenges differ between different groups of caregivers. This study examined whether the relationship between maladaptive schemas and distress, burden, and reduced wellbeing differed between parents and siblings of people with SMHD. Methods: 70 parents and 40 siblings completed an online survey that included measures of schemas (Young Schema Questionnaire-Short Form), depressive symptoms (Patient Health Questionnaire-9), anxiety symptoms (Generalised Anxiety Disorder Assessment-7), burden (Experience of Caregiving Inventory), and wellbeing (Ryff Scales of Psychological Wellbeing). Multivariate linear regression models with interaction effects were tested for each outcome of interest. Results: Compared to parents, siblings reported significantly higher scores in each schema domain, greater distress and burden, and reduced wellbeing. Univariate analyses revealed that Disconnection ((3=0.52 [0.17, 0.91], t(100)=2.90, p=.005) and the interaction between Caregiver Group and Disconnection ((3=-1.17 [-2.27,-0.13], t(100) =-2.49, p=.014) significantly predicted depressive symptoms. Schema domains predicted anxiety symptoms, burden, and wellbeing; there were no significant interaction effects in these models. Conclusion: Siblings seem to experience greater psychological challenges than parents. Maladaptive schemas were linked to greater psychological challenges in both groups and the relationship between schemas and distress, burden, and wellbeing was similar in parents and siblings. Further research is needed to determine if there are group differences at the individual schema level.