Coping strategies, distress and well-being of informal caregivers of people with borderline personality disorder

Abstract for empirical study:Informal carers of people with BPD experience high levels of burden and psychological distress and may be facing even greater stress in the context of COVID-19. There is a scarcity of research evidencing the influence of modifiable factors on carer outcomes to inform interventions. This study aimed to investigate (i) the relationship between social support, coping strategies and psychological distress and positive mental well-being in carers of people with BPD and also (ii) the relationship between coping strategies and change in carer stress due to COVID-19. 1207 carers completed the McLean Screening Instrument for BPD-Carer Version, the Brief COPE, the Multidimensional Scale of Perceived Social Support, the Kessler Psychological Distress scale, the WHO-5 Well-being Index, the Coronavirus Anxiety Scale, and measures of change in use of coping strategies and change in caregiver stress due to COVID-19. Data for 863 participants who met the inclusion criteria were analysed. Carers reported low positive mental well-being, high psychological distress and a mean increase in caregiving stress due to COVID-19. Perceived social support and coping strategies were significant unique predictors of psychological distress and positive mental well-being. Perceived social support and the coping strategy of positive reframing were the strongest predictors of higher positive mental well-being and lower psychological distress. Self-blame, behavioural disengagement and substance use were the strongest predictors of adverse outcomes. Change in use of planning was the strongest predictor of change in caregiving stress due to COVID-19.The findings suggest that interventions that assist informal carers to decrease the use of self-blame, behavioural disengagement and substance use and to develop quality social support and skills to positively reframe caregiving situations may support improved caregiver outcomes. Abstract for systematic review: This systematic review aimed to identify the relationship between coping strategies and psychological distress and well-being in carers of people with schizophrenia. Electronic searches were conducted in PsycINFO, Pubmed, Scopus and CINAHL Plus. Reference lists of included studies and related published reviews were subsequently manually searched. A total of 1984 papers were screened. Fourteen studies conducted between 1996 and 2020, comprising 1987 carers of people with schizophrenia, met the inclusion criteria. All studies identified had cross-sectional designs. The quality of the studies, variation in carer samples, and heterogeneity of questionnaires and scales used to measure coping, psychological distress and well-being limited the strength and clinical utility of conclusions. Based on cross-sectional designs, there is preliminary evidence that carer coping strategies are associated with carer psychological distress and well-being. Further research is required to identify whether coping strategies buffer the impact of caregiving stress on carer outcomes and which coping strategies are most useful. Recommendations are made to optimise the research and clinical utility of future studies