Caregiving and illness beliefs in the course of psychotic illness

Objective: Informal caregivers play a central role in patient care, and caregiving can provide positive and negative experiences. Negative caregiving experiences are associated with distress. This study investigates associations between caregiving appraisals in psychosis, distress, and 3 key illness beliefs (consequences, cure-control, and timeline), and whether illness beliefs makes a contribution to the relation between negative caregiving appraisal and distress. Method: We employed a cross-sectional study design. Caregivers (n = 146), including Early Psychosis Services caregivers (n = 60), completed self-report measures of the impact of care and illness beliefs. Results: Negative caregiving appraisals and distress were strongly associated. Caregivers appraised caregiving negatively and reported greater distress when they perceived the illness as having severe consequences for themselves and the patient, and when they perceived it as a long-term illness. In contrast, they appraised caregiving positively when they perceived that both they and the patient could exert some control over the illness. Illness beliefs did not account for the strong relation between negative caregiving appraisals and distress. Caregivers of patients with longer illness histories reported higher levels of positive caregiving appraisals. Conclusion: Caregivers' cognitive representation of psychosis may play an important role in positive and negative appraisals about caregiving, even at an early stage of the illness. Implications for interventions with early psychosis caregivers are discussed.