Schizophrenia is the most severe chronic disabling psychiatric disorder that needs long term care in various aspects. Therefore, the family’s emotional atmosphere caused by the disease affects the condition of the patients’ caregivers. This study aimed to investigate the effect of emotional regulation training on stress, anxiety, and depression in caregivers of patients with schizophrenia. The study was a randomized controlled trial. Seventy caregivers of patients with schizophrenia randomly assigned to a group that received emotion regulation training and a control group. The intervention group was trained about emotion regulation during eight 90-min sessions. The participants completed the Depression, Anxiety and Stress Scales-21 questionnaire before and one month after the intervention. The results showed that stress, anxiety and depression scores significantly reduced in the intervention group compared to the control group. Emotional regulation training with cognitive methods has significantly reduced the anxiety, stress, and depression of caregivers of patients with schizophrenia.
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Abedi, Z., Alavi, M., Ghazavi, Z., Visentin, D., & Cleary, M. (2020). Improving coping styles in family caregivers of psychiatric inpatients using planned behavior problem-solving training. Journal of Nursing Research,28, e70. https://doi.org/10.1097/jnr.0000000000000320.
Aminikhoo, M., Eskandari, H., Falsafinejad, M., Borjali, A., & Pezeshk, S. (2016). Self and schizophrenia (A case study). Clinical Psychology Studies.
Applebaum, A. J., Panjwani, A. A., Buda, K., O’Toole, M. S., Hoyt, M. A., Garcia, A., Fresco, D.M., & Mennin, D.S. (2018). Emotion regulation therapy for cancer caregivers—an open trial of a mechanism-targeted approach to addressing caregiver distress, Translational Behavioral Medicine: iby104, https://doi.org/10.1093/tbm/iby104.
Awad, A. G., & Voruganti, L. N. P. (2008). The burden of schizophrenia on caregivers: A review. Pharmacoeconomics,26(2), 149–162.
Bahadori, M.H., Jahanbakhsh, M., Jamshidi, A., & Mobarake, K.A. (2012). The effect of meta-cognitive therapy on anxiety symptoms of social phobia disorder patients. Knowledge & Research in Applied Psychology 12.
Chen, L., Zhao, Y., Tang, J., Jin, G., Liu, Y., Zhao, X., et al. (2019). The burden, support and needs of primary family caregivers of people experiencing schizophrenia in Beijing communities: a qualitative study. BMC Psychiatry,19, 1–10. https://doi.org/10.1186/s12888-019-2052-4
Chien, W. T., & Lee, I. Y. M. (2010). The schizophrenia care management program for family caregivers of chinese patients with schizophrenia. Psychiatric Services,61, 317–320.
Compare, A., Zarbo, C., Shonin, E., Van Gordon, W., & Marconi, Ch. (2014). Emotional regulation and depression: A potential mediator between heart and mind: 1–10.
Goodarzi, N., Mohammadi Shahboulaghi, F., Rahgoi, A., & Biglarian, A. (2018). Prediction of depression, anxiety and stress in familial observers of patients with dementia based on family performance. Iranian Journal of Rehabilitation Research,4, 44–52.
Gratz, K. L., & Gunderson, J. G. (2006). Preliminary data on an acceptance-based emotion regulation group intervention for deliberate self-harm among women with borderline personality disorder. Behavior Therapy,37, 25–35. https://doi.org/10.1016/j.beth.2005.03.002.
Gupta, Sh., Isherwood, G., Jones, K., & Van Impe, K. (2015). Assessing health status in informal schizophrenia caregivers compared with health status in non-caregivers and caregivers of other conditions. BMC Psychiatry,15, 1–11. https://doi.org/10.1186/s12888-015-0547-1.
Haresabadi, M., Bibak, B., Hosein, Z., Bayati, M., Arki, M., & Akbari, H. (2012). Assessing burden of family caregivers of patients with schizophrenia admitted in Imam Reza Hospital-Bojnurd 2010. Journal of North Khorasan University of Medical Sciences.,4, 165–171.
Hudson, P. L., Thomas, K., Trauer, T., Remedios, C., & Clarke, D. (2011). Psychological and social profile of family caregivers on commencement of palliative care. Journal of Pain and Symptom Management,41, 522–534.
Jenaabadi, H. (2017). Effect of emotion regulation training on depression, anxiety, and stress among mothers of children with mental disorders. Journal of Research and Health,7, 663–671.
Kamil, S. H., & Velligan, D. I. (2019). Caregivers of individuals with schizophrenia: Who are they and what are their challenges? Current Opinion in Psychiatry,32, 157–163. https://doi.org/10.1097/YCO.0000000000000492.
Loevaas, M. E. S., Sund, A. M., Patras, J., Martinsen, K., Hjemdal, O., Neumer, S. P., et al. (2018). Emotion regulation and its relation to symptoms of anxiety and depression in children aged 8–12 years: Does parental gender play a differentiating role? BMC Psychology,6, 1–11.…
McKay, M., Wood, J. C., & Brantley, J. (2007). The dialectical behavior therapy skills workbook: Practical DBT exercises for learning mindfulness, interpersonal effectiveness, emotion regulation & distress tolerance. A New Harbinger Self-Help Workbook:. https://doi.org/10.1017/CBO9781107415324.004.
Mojarrad, K. A. H., Ghanbari, H., Abadi, B., Modares, A., & Gharavi, M. (2012). The efficacy of group psycho educational interventions in promoting quality of life and quality of relationships on family of patients with bipolar disorders. Journal of Research In Behavioural Sciences,10, 114–123.
Moskowitz, J. T., Cheung, E. O., Snowberg, K. E., Verstaen, A., Merrilees, J., Salsman, J. M., et al. (2019). Randomized controlled trial of a facilitated online positive emotion regulation intervention for dementia caregivers. Health Psychology,38, 391–402. https://doi.org/10.1037/hea0000680.
Navidian, A., Pahlavanzadeh, S., & Yazdani, M. (2010). The effectiveness of family training on family caregivers of inpatients with mental disorders. Iranian Journal of Psychiatry and Clinical Psychology,16, 99–106.
Normann, N., Van Emmerik, A. A. P., & Morina, N. (2014). The efficacy of metacognitive therapy for anxiety and depression: A meta-analytic review. Depression and Anxiety,31(5), 402–411.
O’Toole, M. S., Mennin, D. S., Applebaum, A., Weber, B., Rose, H., Fresco, D. M. & Zachariae, R. (2019). A randomized controlled trial of emotion regulation therapy for psychologically distressed caregivers of cancer patients, JNCI Cancer Spectrum: pkz074. https://doi.org/10.1093/jncics/pkz074.
Pahlavanzadeh, S., Navidian, A., & Yazdani, M. (2010). The effect of psycho-education on depression, anxiety and stress in family caregivers of patients with mental disorders. Journal of Kermanshah University of Meducak Sciences (Journal of Kermanshah University Medical Sciences).,14, 228–236.
Rocca, P., & R.A.A.C.F.A.G.S,. (2014). Schizophrenia today: Epidemiology, diagnosis, course and models of care. Journal of Psychopathology,20, 223–243.
Rodríguez-Snchez, E., Pérez-Pẽaranda, A., Losada-Baltar, A., Pérez-Arechaederra, D., Gámez-Marcos, M.Á., Patino-Alonso, M.C., & García-Ortiz, L. (2011). Relationships between quality of life and family function in caregiver., BMC Family Practice, 12: 19.
Seshadri, K., Sivakumar, T., & Jagannathan, A. (2019). The family support movement and schizophrenia in India. Current Psychiatry Reports,21, 95. https://doi.org/10.1007/s11920-019-1081-5.
Shaheri, K., Moradi Baglooei, M., Sarichloo, M., & Alipour, M. (2017). Examining the effect of metacognitive group therapy on anxiety among caregivers of hospitalized patients with schizophrenia. Journal of Psychiatric Nursing,5, 34–42.
Sharma, R., Sharma, S. C., & Pradhan, S. N. (2017). Assessing caregiver burden in caregivers of patients with schizophrenia and bipolar affective disorder in kathmandu medical college. Journal of Nepal Health Research Council,15, 258–263. https://doi.org/10.3126/jnhrc.v15i3.18851.
Sobhi-Gharamaleki, N., Porzoor, P., Aghajani, S., & Narimani, M. (2015). Effectiveness of emotion regulation training on reduction of anxiety, stress and depression symptoms among university students. Iran. Iranian Journal of Health Education & Promotion,3, 5–14.
Stanley, S., Balakrishnan, S., & Ilangovan, S. (2017). Psychological distress, perceived burden and quality of life in caregivers of persons with schizophrenia. Journal of Mental Health,26, 134–141. https://doi.org/10.1080/09638237.2016.1276537.
Yu, Y., Tang, B. W., Liu, Z. W., Chen, Y. M., Zhang, X. Y., & Xiao, S. (2018). Who cares for the schizophrenia individuals in rural China—A profile of primary family caregivers. Comprehensive Psychiatry,84, 47–53. https://doi.org/10.1016/j.comppsych.
We would thank all caregivers of patients with schizophrenia who participated in this study as well as psychiatric wards that cooperated in the research.
Conflict of interest
The authors declare that they have no conflict of interests.
The Kerman University of Medical Sciences Ethics Committee approved the study (IR.KMU.REC.1395.566, IRCT2017061733997N2). The researcher gave explanations to the samples on their optional presence and that they can leave the study whenever they want. We also assured the participants that the collected information was confidential and would be used only for the research.
Written informed consent was received from the caregivers of the patients.
Human and Animal Rights
The study protocol was in accordance with ethical standards of Kerman University of Medical Sciences on human experimentation.
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Behrouian, M., Ramezani, T., Dehghan, M. et al. The Effect of Emotion Regulation Training on Stress, Anxiety, and Depression in Family Caregivers of Patients with Schizophrenia: A Randomized Controlled Trial. Community Ment Health J (2020). https://doi.org/10.1007/s10597-020-00574-y
- Emotion regulation