Correlates of Subjective Caregiver Strain in Caregivers of Youth Evaluated in a Pediatric Psychiatric Emergency Room
Although caregiver burden is relevant to the outcome for psychiatrically ill youth, most studies have focused on caregiver burden in the community or research settings. Therefore, we aimed at evaluating the subjective caregiver strain (SCS) at the time of presentation of youth to a pediatric psychia...
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| Veröffentlicht in: | Journal of child and adolescent psychopharmacology 2017-06, Vol.27 (5), p.451-461 |
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| creator | Molteni, Silvia Carbon, Maren Lops, Johnny Soto, Erin C Cervesi, Chiara Sheridan, Eva M Galling, Britta Saito, Ema Krakower, Scott Dicker, Robert Foley, Carmel Fornari, Victor Balottin, Umberto Correll, Christoph U |
| description | Although caregiver burden is relevant to the outcome for psychiatrically ill youth, most studies have focused on caregiver burden in the community or research settings. Therefore, we aimed at evaluating the subjective caregiver strain (SCS) at the time of presentation of youth to a pediatric psychiatric emergency room (PPER), assessing potential correlates to provide leads for improvements in formal support systems.
In this retrospective cohort study, the internalized, externalized, and total SCS were assessed in caregivers of youth |
| doi_str_mv | 10.1089/cap.2015.0028 |
| format | Article |
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In this retrospective cohort study, the internalized, externalized, and total SCS were assessed in caregivers of youth <18 years of age consecutively evaluated at a PPER during a 1 year period using the Caregiver Strain Questionnaire. Sociodemographic and a broad range of clinical data were collected during the PPER visit using a 12-page semistructured institutional evaluation form. The Appropriateness of Pediatric Psychiatric Emergency Room Contact scale, incorporating acuity, severity and harm potential, was used to rate appropriateness of the visit.
In caregivers of 444 youth, the internalized SCS was significantly higher than the externalized SCS (p < 0.001). Multivariable analyses indicated that higher total and externalized SCS were associated with disruptive behavior or substance abuse/dependent disorder diagnosis, presenting complaint of aggression, and discharge plan to the police. Higher total and internalized SCS were associated with lower child functioning, whereas total and internalized SCS were lower in adopted children. In addition, higher externalized SCS was associated with investigator-rated inappropriateness of the emergency visit, presenting complaint of defiance, and a lack of prior psychiatric ER visits.
High levels of CS in PPER highlight the necessity to adhere to existing guidelines regarding the inclusion of caregivers' perceptions into comprehensive psychiatric assessments. The particularly high strain in caregivers of children with externalizing disorders and in families with low-functioning youth may need to prompt PPER staff to provide efficient information on appropriate treatment options for these children and on support facilities for the parents.</description><identifier>ISSN: 1044-5463</identifier><identifier>EISSN: 1557-8992</identifier><identifier>DOI: 10.1089/cap.2015.0028</identifier><identifier>PMID: 26978127</identifier><language>eng</language><publisher>United States: Mary Ann Liebert, Inc</publisher><subject>Acuity ; Adolescent ; Age ; Aggression ; Aggressive behavior ; Caregivers ; Caregivers - psychology ; Child ; Child & adolescent psychiatry ; Child, Preschool ; Children ; Cohort Studies ; Drug abuse ; Emergency medical care ; Emergency medical services ; Emergency Service, Hospital ; Evaluation ; Female ; Guideline Adherence ; Guidelines ; Humans ; Internal-External Control ; Male ; Mental Disorders - epidemiology ; Mental Disorders - psychology ; Parents - psychology ; Police ; Practice Guidelines as Topic ; Retrospective Studies ; Stress ; Stress, Psychological - epidemiology ; Support systems ; Surveys and Questionnaires ; Teenagers</subject><ispartof>Journal of child and adolescent psychopharmacology, 2017-06, Vol.27 (5), p.451-461</ispartof><rights>(©) Copyright 2017, Mary Ann Liebert, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c321t-7710d91b7222da946349d2d552bac6e803c33a08fa13785e1238087357e528763</citedby><cites>FETCH-LOGICAL-c321t-7710d91b7222da946349d2d552bac6e803c33a08fa13785e1238087357e528763</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26978127$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Molteni, Silvia</creatorcontrib><creatorcontrib>Carbon, Maren</creatorcontrib><creatorcontrib>Lops, Johnny</creatorcontrib><creatorcontrib>Soto, Erin C</creatorcontrib><creatorcontrib>Cervesi, Chiara</creatorcontrib><creatorcontrib>Sheridan, Eva M</creatorcontrib><creatorcontrib>Galling, Britta</creatorcontrib><creatorcontrib>Saito, Ema</creatorcontrib><creatorcontrib>Krakower, Scott</creatorcontrib><creatorcontrib>Dicker, Robert</creatorcontrib><creatorcontrib>Foley, Carmel</creatorcontrib><creatorcontrib>Fornari, Victor</creatorcontrib><creatorcontrib>Balottin, Umberto</creatorcontrib><creatorcontrib>Correll, Christoph U</creatorcontrib><title>Correlates of Subjective Caregiver Strain in Caregivers of Youth Evaluated in a Pediatric Psychiatric Emergency Room</title><title>Journal of child and adolescent psychopharmacology</title><addtitle>J Child Adolesc Psychopharmacol</addtitle><description>Although caregiver burden is relevant to the outcome for psychiatrically ill youth, most studies have focused on caregiver burden in the community or research settings. Therefore, we aimed at evaluating the subjective caregiver strain (SCS) at the time of presentation of youth to a pediatric psychiatric emergency room (PPER), assessing potential correlates to provide leads for improvements in formal support systems.
In this retrospective cohort study, the internalized, externalized, and total SCS were assessed in caregivers of youth <18 years of age consecutively evaluated at a PPER during a 1 year period using the Caregiver Strain Questionnaire. Sociodemographic and a broad range of clinical data were collected during the PPER visit using a 12-page semistructured institutional evaluation form. The Appropriateness of Pediatric Psychiatric Emergency Room Contact scale, incorporating acuity, severity and harm potential, was used to rate appropriateness of the visit.
In caregivers of 444 youth, the internalized SCS was significantly higher than the externalized SCS (p < 0.001). Multivariable analyses indicated that higher total and externalized SCS were associated with disruptive behavior or substance abuse/dependent disorder diagnosis, presenting complaint of aggression, and discharge plan to the police. Higher total and internalized SCS were associated with lower child functioning, whereas total and internalized SCS were lower in adopted children. In addition, higher externalized SCS was associated with investigator-rated inappropriateness of the emergency visit, presenting complaint of defiance, and a lack of prior psychiatric ER visits.
High levels of CS in PPER highlight the necessity to adhere to existing guidelines regarding the inclusion of caregivers' perceptions into comprehensive psychiatric assessments. The particularly high strain in caregivers of children with externalizing disorders and in families with low-functioning youth may need to prompt PPER staff to provide efficient information on appropriate treatment options for these children and on support facilities for the parents.</description><subject>Acuity</subject><subject>Adolescent</subject><subject>Age</subject><subject>Aggression</subject><subject>Aggressive behavior</subject><subject>Caregivers</subject><subject>Caregivers - psychology</subject><subject>Child</subject><subject>Child & adolescent psychiatry</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Cohort Studies</subject><subject>Drug abuse</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Emergency Service, Hospital</subject><subject>Evaluation</subject><subject>Female</subject><subject>Guideline Adherence</subject><subject>Guidelines</subject><subject>Humans</subject><subject>Internal-External Control</subject><subject>Male</subject><subject>Mental Disorders - epidemiology</subject><subject>Mental Disorders - psychology</subject><subject>Parents - psychology</subject><subject>Police</subject><subject>Practice Guidelines as Topic</subject><subject>Retrospective Studies</subject><subject>Stress</subject><subject>Stress, Psychological - epidemiology</subject><subject>Support systems</subject><subject>Surveys and Questionnaires</subject><subject>Teenagers</subject><issn>1044-5463</issn><issn>1557-8992</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNpdkctLAzEQxoMoWqtHrxLw4mVrHs3rKKU-QLBYPXgKaXZat-w2NdkV-t-b2upBGJiP4TfDzHwIXVAyoESbG-_WA0aoGBDC9AHqUSFUoY1hh1mT4bAQQ8lP0GlKS0Iol0QeoxMmjdKUqR5qRyFGqF0LCYc5nnazJfi2-gI8chEWWUQ8baOrVjjHX-0Hfg9d-4HHX67ucn-5BRyeQFm5NlYeT9LGf-z1uIG4gJXf4JcQmjN0NHd1gvN97qO3u_Hr6KF4er5_HN0-FZ4z2hZKUVIaOlOMsdKZfMfQlKwUgs2cl6AJ95w7oueOcqUFUMY10YoLBYJpJXkfXe_mrmP47CC1tqmSh7p2KwhdslQzKSUj3GT06h-6DF1c5e0sNcRwprTRmSp2lI8hpQhzu45V4-LGUmK3dthsh93aYbd2ZP5yP7WbNVD-0b__59-dhoR-</recordid><startdate>201706</startdate><enddate>201706</enddate><creator>Molteni, Silvia</creator><creator>Carbon, Maren</creator><creator>Lops, Johnny</creator><creator>Soto, Erin C</creator><creator>Cervesi, Chiara</creator><creator>Sheridan, Eva M</creator><creator>Galling, Britta</creator><creator>Saito, Ema</creator><creator>Krakower, Scott</creator><creator>Dicker, Robert</creator><creator>Foley, Carmel</creator><creator>Fornari, Victor</creator><creator>Balottin, Umberto</creator><creator>Correll, Christoph U</creator><general>Mary Ann Liebert, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7RV</scope><scope>7TK</scope><scope>7TM</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>201706</creationdate><title>Correlates of Subjective Caregiver Strain in Caregivers of Youth Evaluated in a Pediatric Psychiatric Emergency Room</title><author>Molteni, Silvia ; Carbon, Maren ; Lops, Johnny ; Soto, Erin C ; Cervesi, Chiara ; Sheridan, Eva M ; Galling, Britta ; Saito, Ema ; Krakower, Scott ; Dicker, Robert ; Foley, Carmel ; Fornari, Victor ; Balottin, Umberto ; Correll, Christoph U</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c321t-7710d91b7222da946349d2d552bac6e803c33a08fa13785e1238087357e528763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Acuity</topic><topic>Adolescent</topic><topic>Age</topic><topic>Aggression</topic><topic>Aggressive behavior</topic><topic>Caregivers</topic><topic>Caregivers - 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Academic</collection><jtitle>Journal of child and adolescent psychopharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Molteni, Silvia</au><au>Carbon, Maren</au><au>Lops, Johnny</au><au>Soto, Erin C</au><au>Cervesi, Chiara</au><au>Sheridan, Eva M</au><au>Galling, Britta</au><au>Saito, Ema</au><au>Krakower, Scott</au><au>Dicker, Robert</au><au>Foley, Carmel</au><au>Fornari, Victor</au><au>Balottin, Umberto</au><au>Correll, Christoph U</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Correlates of Subjective Caregiver Strain in Caregivers of Youth Evaluated in a Pediatric Psychiatric Emergency Room</atitle><jtitle>Journal of child and adolescent psychopharmacology</jtitle><addtitle>J Child Adolesc Psychopharmacol</addtitle><date>2017-06</date><risdate>2017</risdate><volume>27</volume><issue>5</issue><spage>451</spage><epage>461</epage><pages>451-461</pages><issn>1044-5463</issn><eissn>1557-8992</eissn><abstract>Although caregiver burden is relevant to the outcome for psychiatrically ill youth, most studies have focused on caregiver burden in the community or research settings. Therefore, we aimed at evaluating the subjective caregiver strain (SCS) at the time of presentation of youth to a pediatric psychiatric emergency room (PPER), assessing potential correlates to provide leads for improvements in formal support systems.
In this retrospective cohort study, the internalized, externalized, and total SCS were assessed in caregivers of youth <18 years of age consecutively evaluated at a PPER during a 1 year period using the Caregiver Strain Questionnaire. Sociodemographic and a broad range of clinical data were collected during the PPER visit using a 12-page semistructured institutional evaluation form. The Appropriateness of Pediatric Psychiatric Emergency Room Contact scale, incorporating acuity, severity and harm potential, was used to rate appropriateness of the visit.
In caregivers of 444 youth, the internalized SCS was significantly higher than the externalized SCS (p < 0.001). Multivariable analyses indicated that higher total and externalized SCS were associated with disruptive behavior or substance abuse/dependent disorder diagnosis, presenting complaint of aggression, and discharge plan to the police. Higher total and internalized SCS were associated with lower child functioning, whereas total and internalized SCS were lower in adopted children. In addition, higher externalized SCS was associated with investigator-rated inappropriateness of the emergency visit, presenting complaint of defiance, and a lack of prior psychiatric ER visits.
High levels of CS in PPER highlight the necessity to adhere to existing guidelines regarding the inclusion of caregivers' perceptions into comprehensive psychiatric assessments. The particularly high strain in caregivers of children with externalizing disorders and in families with low-functioning youth may need to prompt PPER staff to provide efficient information on appropriate treatment options for these children and on support facilities for the parents.</abstract><cop>United States</cop><pub>Mary Ann Liebert, Inc</pub><pmid>26978127</pmid><doi>10.1089/cap.2015.0028</doi><tpages>11</tpages></addata></record> |
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| ispartof | Journal of child and adolescent psychopharmacology, 2017-06, Vol.27 (5), p.451-461 |
| issn | 1044-5463 1557-8992 |
| language | eng |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Acuity Adolescent Age Aggression Aggressive behavior Caregivers Caregivers - psychology Child Child & adolescent psychiatry Child, Preschool Children Cohort Studies Drug abuse Emergency medical care Emergency medical services Emergency Service, Hospital Evaluation Female Guideline Adherence Guidelines Humans Internal-External Control Male Mental Disorders - epidemiology Mental Disorders - psychology Parents - psychology Police Practice Guidelines as Topic Retrospective Studies Stress Stress, Psychological - epidemiology Support systems Surveys and Questionnaires Teenagers |
| title | Correlates of Subjective Caregiver Strain in Caregivers of Youth Evaluated in a Pediatric Psychiatric Emergency Room |
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