Emotional Regulation, Psychological Resilience, and Depressive Symptoms among Caregivers of Patients with Psychiatric Disorders

Document Type : Original Article

Authors

1 damietta university

2 Assist Prof. of Psychiatric Nursing and Mental Health -Faculty of Nursing - Port Said University

Abstract

Background: Caregivers of psychiatric patient are exposed to significant psychological burdens, with depression being a common consequence. Emotional regulation and psychological resilience are recognized as potential protective factors that may help caregivers manage these burdens and reduce depressive symptoms. Aim: To explore the relation between emotional regulation, psychological resilience, and depressive symptom among caregivers of patients with psychiatric disorders. Design: A descriptive, cross-sectional methodological approach characterized this research. Setting: The study was executed within the psychiatric outpatient clinics situated at Port Said Health Hospital, along with an affiliated Addiction Treatment facility. Subjects: A purposive sample of 384 individuals serving as caregivers for psychiatric patients. Data collection tools: Four distinct tools: a questionnaire designed to gather personal and clinical characteristics, the Emotional Regulation Questionnaire, the Psychological Resilience Scale, and An Arabic Version of Beck Depression among caregivers of psychiatric patients. Results: More than three-quarters (78.4%) of the psychiatric patients’ caregivers exhibited infrequent habitual engagement with emotional regulation strategies. Concurrently, over half (61.5%) of this caregiver cohort displayed an elevated degree of resilience, while more than one-third (38.3%) reported experiencing moderate depressive symptoms. Conclusion: The total scores for psychological resilience, emotional regulation and depressive symptoms were found to be negatively associated. Furthermore, a statistically significant positive connection has been observed between the total emotional regulation score and the total psychological resilience score. Recommendations: The study recommended that an educational program aimed at enhancing emotional regulation skills and employing resilient coping strategies may assist in alleviating depression symptoms.

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Main Subjects

References

Abd El-Ghafar, S., Abd El-Nabi, A., & Fathalla, H. (2018). Resilience, burden, and quality of life in Egyptian family caregivers of patients with schizophrenia. Egyptian Nursing Journal, 15(2), 196–204.
Almotairi, S. H. H., Madkhali, A. A. H., Almrashi, M. K. W., Almarashi, B. K. W., Al-Amari, T. J. H., & Almutairi, K. S. K. (2023). Geriatric Health Care And Nurses Roles. Journal of Survey in Fisheries Sciences, 10(6), 64-66.‏
Aman, R. A., Ng, C. J., & Hairi, N. N. (2020). The impact of caregiving on caregivers of older persons and its associated factors: A cross-sectional study. Singapore Medical Journal, 61(5), 238–244.
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.; DSM-5-TR). American Psychiatric Publishing.
Aprilianti, E. (2024). Integrating Islamic Psychological Principles in Enhancing Students' Academic Resilience. Nusantara Journal of Behavioral and Social Science, 3(2), 63-72.‏
Bagheriamiri, Z., Mirsepassi, Z. & Sayadi, L. Caregiver burden, attachment and cognitive emotion among the family caregivers of severe mental illness patients. BMC Psychol 12, 610 (2024). https://doi.org/10.1186/s40359-024-02111-y
Barcelata Eguiarte, B. E. (2021). Growing up in Adverse Family Contexts: Risks and Resources for Adolescent Development. Child and Adolescent Development in Risky Adverse Contexts: A Latin American Perspective, 133-160.‏
Beck, A., Steer, R., & Carbin, G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical psychology review, 8(1), 77-100.‏
Beck, A., Ward, C., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of general psychiatry, 4(6), 561-571.‏
Behrouian, M., Ramezani, T., Dehghan, M., Sabahi, A., & Ebrahimnejad Zarandi, B. (2021). The effect of the emotion regulation training on the resilience of caregivers of patients with schizophrenia: a parallel randomized controlled trial. BMC psychology, 9 (1), 1-8.
Bullard, B. M., Brown, C. L., Scheffer, J. A., Toledo, A. B., & Levenson, R. W. (2024). Emotion regulation strategies and mental health in dementia caregivers: The moderating role of gender. Dementia and Geriatric Cognitive Disorders, 53(3), 128–134.
Besey, Ö., & Aydın, R. (2020). Engelli çocuğa sahip ebeveynlerde bakım veren yükü ve depresyon durumlarının incelenmesi [Examination of caregiver burden and depression in parents of children with disabilities]. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 7(3), 302–309.
Cabello, R., Salguero, M., Fern´andez-Berrocal, P., & Gross, J. (2013). A Spanish adaptation of the emotion regulation questionnaire. European Journal of Psychological Assessment, 29 (4), 234–240.
Cham, C. Q., Ibrahim, N., Siau, C. S., Kalaman, C. R., Ho, M. C., Yahya, A. N., ... & Lee, K. W. (2022, November). Caregiver burden among caregivers of patients with mental illness: A systematic review and meta-analysis. In Healthcare (Vol. 10, No. 12, p. 2423). MDPI.‏
Cong, X., McGrath, J. M., Cusson, R. M., & Zhang, D. (2021). Pain and stress in the NICU: Caregiving and health outcomes. Pain Management Nursing, 22(1), 1–4.
Connor, K. M., & Davidson, J. R. (2003). Development of a new resilience scale: The Connor‐Davidson resilience scale (CD‐RISC). Depression and anxiety, 18(2), 76-82.
Deng, Q., Liu, S., Yang, Y., & Chen, Y. (2025). Mind matters: a comparative study of self-reported severity of depression and cognitive symptoms in China and the USA. BMC Public Health, 25(1), 1088
Di Lorenzo, R., Dardi, A., Serafini, V., Amorado, M. J., Ferri, P., & Filippini, T. (2024). Psychoeducational Intervention for Caregivers of Adolescents and Young Adults with Psychiatric Disorders: A 7-Year Systematic Review. Journal of Clinical Medicine, 13(23), 7010.
Erkuş, Ş., & Gümüş, A. B. (2024). Hope and psychological resilience in primary caregivers of patients with a chronic mental illness followed in a community mental health center. Archives of Psychiatric Nursing, 50, 87–93.
Fang, L., Dong, M., Fang, W., & Zheng, J. (2022). Relationships between care burden, resilience, and depressive symptoms among the main family caregivers of stroke patients: A cross-sectional study. Frontiers in Psychiatry, 13, 960830.
Garieb, G. (2012). Arabic version of depression inventory. Psychological Department, Faculty of Education, Al-Azhar University. Available at El-Angluo Library, Egypt.
Gooding, P. A., Harris, K., & Haddock, G. (2022). Psychological resilience to suicidal experiences in people with non-affective psychosis: A position paper. International Journal of Environmental Research and Public Health, 19(7), 3813. https://doi.org/10.3390/ijerph19073813
Gross, J., & John, O. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348-362
Güler, A., Gül, S., & Yıldırım, M. (2024). Social comparison, resilience, life satisfaction, depression, and anxiety among earthquake survivors in Turkey. International Journal of Disaster Risk Reduction, 105, 104426.‏
Henshall, C., Davey, Z., & Jackson, D. (2020). Nursing resilience interventions—A way forward in challenging healthcare territories. Journal of Clinical Nursing, 29(19–20), 3597–3599. https://doi.org/10.1111/jocn.15276
Hussien, M. S., Fahmy, A. M., Barakat, A. H. A., & Ibrahim, F. M. (2023). Emotional empathy, burden, and depression among family caregivers of patients with schizophrenia. Egyptian Journal of Health Care, 14(3), 1–16.
Khatib, P & El helw, A. (2007). Resiliency in families with a member with a psychological disorder. The American Journal of Family Therapy,34(4),285–300.
Lane, A., Smith, B., & Johnson, C. (2022). Title of the article. Journal Name, Volume(Issue), pages.
Li, Q., Wang, Y., Zhang, H., & Chen, L. (2021). Psychological outcomes of informal caregiving: The role of emotion regulation and resilience. Journal of Affective Disorders, 295, 758–766. https://doi.org/10.1016/j.jad.2021.08.045
Liu, Y., Pan, H., Yang, R., Wang, X., Rao, J., Zhang, X., & Pan, C. (2021). The relationship between test anxiety and emotion regulation: the mediating effect of psychological resilience. Annals of general psychiatry, 20, 1-9.
Massarwe, A., & Cohen, N. (2023). Understanding the benefits of extrinsic emotion regulation in depression. Frontiers in Psychology, 14, 1120653.‏
Mayordomo, T., Viguer, P., Sales, A., Satorres, E., & Meléndez, J. C. (2021). Resilience and coping as predictors of well-being in adults. The Journal of Psychology, 155(3), 267–283.
McKenna, O., Fakolade, A., Cardwell, K., Langlois, N., Jiang, K., & Pilutti, L. A. (2022). Towards conceptual convergence: a systematic review of psychological resilience in family caregivers of persons living with chronic neurological conditions. Health Expectations, 25(1), 4-37.‏
Munie, B. M., Birhan, Z., Legas, G., Asnakew, S., Belete, A., Beyene, G. M., Shiferaw, K., Mulu, A. T., Kassie, Y. T., Aytenew, T. M., & Tedla, A. (2024). Predictors of depression among caregivers of patients with severe mental illness in Northwest Ethiopia, 2023: An explanatory sequential mixed-method study. Frontiers in Psychiatry, 15, 1422104.
Olderbak, S., Uusberg, A., MacCann, C., Pollak, K. M., & Gross, J. J. (2023). The process model of emotion regulation questionnaire: Assessing individual differences in strategy stage and orientation. Assessment, 30(7), 2090–2114.
Palacio, A., Vera, M., & García, A. (2020). Resilience in family caregivers: The role of education and coping strategies. International Journal of Behavioral Medicine, 27(5), 541–548.
Panzeri, A., Bottesi, G., Ghisi, M., Scalavicci, C., Spoto, A., & Vidotto, G. (2024). Emotional regulation, coping, and resilience in informal caregivers: A network analysis approach. Journal of Contextual Behavioral Science, 14(8), 709–717.
Park, B., Chiriboga, D. A., Chung, S., & Lee, S. (2020). Stress and depressive symptoms among caregivers of individuals with dementia in diverse ethnic groups. Aging & Mental Health, 24(7), 1107–1115.
Phillips, R., Durkin, M., Engward, H., Cable, G., & Iancu, M. (2023). The impact of caring for family members with mental illnesses on the caregiver: a scoping review. Health promotion international, 38(3), daac049.‏
Pinheiro, Gonçalves, R. A., M., & Cunha, O. (2024). Emotional Processing and Psychopathy Among Women: A Systematic Review. Deviant Behavior, 45(10), 1366-1390
Pirallahi, Z., Alavi, M., Akbari, M., & Aliyari, N. (2025). The effect of the mental health literacy promotion program on emotion regulation strategies of family caregivers of patients with chronic psychiatric disorders in Isfahan, Iran. Iranian Journal of Nursing and Midwifery Research, 30(1), 116–122. https://doi.org/10.4103/ijnmr.ijnmr_349_23
Pornoshadi, H., Moradi, Z., Veiskarami, H., & Parvizian, F. (2020). Comparison of decision-making styles, cognitive-emotional regulation, and social adjustment in mothers with autistic children and mothers with normal children. Iranian Journal of Psychiatric Nursing, 8(5), 34–41.
Preston, T., Carr, D. C., Hajcak, G., Sheffler, J., & Sachs-Ericsson, N. (2022). Cognitive reappraisal, emotional suppression, and depressive and anxiety symptoms in later life: The moderating role of gender. Aging & mental health, 26(12), 2390-2398.‏
Sruthi, M., Sreedevi, P. A., Sreejamol, M. G., Anjali, R., & Nair, V. (2022). Stress resilience among caregivers of patients with mental illness during COVID-19 pandemic. Indian Journal of Mental Health, 9(3), 246–251.
Su, X., Liu, Y., Li, J., & Chen, W. (2021). Investigation into the psychological resilience of family caregivers burdened with in-home treatment of patients with bipolar disorder. Journal of Psychiatric Research, 45(3), 123–130.
Treichel, C. A. D. S., Jardim, V. M. D. R., Kantorski, L. P., & Alves, P. F. (2020). Gender differences in the manifestation of burden among family caregivers of people with mental disorders. International Journal of Mental Health Nursing, 29(6), 1120-1130.‏
Waters, L., Algoe, S. B., Dutton, J., Emmons, R., Fredrickson, B. L., Heaphy, E., ... & Steger, M. (2022). Positive psychology in a pandemic: Buffering, bolstering, and building mental health. The Journal of Positive Psychology, 17(3), 303-323.‏
Wylie, M. S., Colasante, T., De France, K., Lin, L., & Hollenstein, T. (2023). Momentary emotion regulation strategy use and success: Testing the influences of emotion intensity and habitual strategy use. Emotion, 23(2), 375.
Xiang, Y., Dong, X., & Zhao, J. (2020). Effects of envy on depression: The mediating roles of psychological resilience and social support. Psychiatry Investigation, 17(6), 547–555.
Zhang, Y., Subramaniam, M., Lee, S. P., Abdin, E., Sagayadevan, V., Jeyagurunathan, A., Chang, S., Shafie, S. B., Abdul Rahman, R. F., Vaingankar, J. A., & Chong, S. A. (2018). Affiliate stigma and its association with quality of life among caregivers of relatives with mental illness in Singapore. Psychiatry Research, 265, 55–61.

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