Predictors of Relapse from Patients and Caregivers’ Perspective in Chronic Illnesses

Author: Tayyeba Kiran

Supervisor: Dr. Saima Dawood

Degree: MS

Year: 2008-2010

University: Centre for Clinical Psychology, Punjab University, Lahore, Pakistan


The present study focused on the assessment of predictors of relapse from both patients as well caregivers- perspective in the individuals with Schizophrenia, Bipolar Disorder and Depression. The research consisted of two stages. In stage one Relapse Prediction Questionnaire (RPQ) was developed by the researcher. Suggestions were taken from clinical psychologists regarding the items in different subscales of the questionnaire. The RPQ was administered on both indoor and outdoor patients diagnosed with Schizophrenia (n = 50), Bipolar Disorder (n = 50) and Depression (n = 50) and their caregivers to assess Premorbid Personality Stressful Life Evens; Perceived Criticism; Patients- Negative Appraisal of Illness’ Adherence; Patients- Internal Locus of Control; Patients- External Locus of Control’ Expressed Emotions; Caregivers- Internal Locus of Control and Caregivers External Locus of Control. The sample included/ men and women patients in equal proportion (50% men & 50% women). Content validity was established by taking ratings from qualified clinical psychologists (n = 15) regarding the appropriateness of items. Reliability of the RPQ was determined on a sample of 30 patients, on whom the questionnaire was re-administered after a period of one week. Pearson Product Moment Correlations between test and retest scores of all the subscales of RPQ were significant (p= 0.01). In second stage, the focus was to see the differences between three psychiatric groups on different subscales of RPQ. ANOVA was conducted to determine the differences between three psychiatric groups: Schizophrenia, Bipolar Disorder and Depression t-test was run to see gender differences of patients and caregivers. Results of ANOVA indicated that three groups differed significantly on different subscales of RPQ: Scale for Stressful Life Event, Scale for Patients’ Negative Appraisal of Illness (PNAOI) Critical Comment (CC) subscale of EE, Hostility (HOS) subscale of EE, Scale for Caregivers’ Internal Locus of Control (ILC-C) Scale for Caregivers’ External Locus of Control (ELC-C), respectively. Results of t-test indicated significant differences between men and women patients on Scale for Perceived Criticism and Scale for Expressed Emotions and significant differences were obtained for men and women caregivers on Scale for Caregivers’ Internal Locus of Control and Scale for Caregivers’ External Locus of Control. Furthermore, comparison was also made between caregivers who were hopeful and those who were hopeless towards treatment which indicated that both groups have significant differences [t (148) = 3.728*, 2.677*, 4014* 3704*] on Scale for Expressed Emotions (EE), Scale for Perceived Criticism, Scale for Caregivers’ Internal Locus of Control and Scale for Caregivers’ External Locus of Control. Regression Analysis showed that duration of psychiatric illness and duration of providing care by the caregivers were significant predictors of Expressed Emotion. Furthermore, Patients’ Negative Appraisal of Illness, Patients’ External Locus of Control and Expressed Emotion were significant predictors of Perceived Criticism.

Keywords: Relapse, Expressed Emotions, Locus of Control, Caregivers, Reliability, Validity.

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