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The Relationship Between Bedouin Mothers' Appraisal of Their Child's Schizophrenia, Their Expressed Emotions and Their Choice of Coping Strategies

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The Relationship Between Bedouin Mothers' Appraisal of Their Child's Schizophrenia, Their Expressed Emotions and Their Choice of Coping Strategies Review Article iMedPub Journals Acta Psychopathologica 2016 http://wwwimedpub.com ISSN 2469-6676 Vol. 2 No. 1: 2 DOI: 10.4172/2469-6676.100028 The Relationship between Bedouin Iris Manor Binyamini Mothers' Appraisal of their Child's Department of Special Education, Faculty of Education, University of Haifa, Schizophrenia, their Expressed Emotions Haifa, Israel and their Coping Strategies Corresponding author: Binyamini IM Abstract [email protected] Background: The way mothers in the Bedouin communities cope with the stress of caring for a child with schizophrenia merits investigation. Ph.D, Department of Special Education, Fac- ulty of Education, University of Haifa, Haifa, Aim: This study examined the relationships between Bedouin mothers' appraisal Israel. of their child's schizophrenia, their expressed emotions and their strategies for coping with the illness. Tel: 972-4-8249297 Method: Sixty Bedouin mothers of children with schizophrenia completed questionnaires regarding demographic variables, incident appraisal, measure of Citation: Binyamini IM. The Relationship expressed emotion, and their coping strategies. between Bedouin Mothers' Appraisal of their Child's Schizophrenia, their Expressed Results: Illness appraised as a loss correlated positively and significantly with Emotions and their Coping Strategies. Acta high levels of expressed emotions, but illness appraised as a challenge did not. Psychopathol. 2016, 2:1. Expressed emotions correlated negatively and significantly with use of problem- focused coping strategies, but not with emotion-focused coping strategies, and illness appraised as a challenge correlated significantly and positively with emotion-focused coping strategies. Conclusion: The study provides preliminary evidence regarding the relationship between Bedouin mothers' appraisal of their child's schizophrenia, their expressed emotions and their choice of coping strategies. Keywords: Bedouin; Mothers; Appraisal of their child's schizophrenia; Expressed emotions; Coping strategies Received: November 11, 2015; Accepted: January 11, 2016; Published: January 20, 2016 Introduction The Bedouin community in Israel has unique characteristics. This is a traditional tribal, patriarchal society, with norms such as having A Severe mental disorder such as the schizophrenia of a child in a large number of children, marriages between blood relatives, the family is a state of chronic stress on all family members. This living among clans of the extended family, and polygamous is a situation of continual crises, which harms not only the child marriages. Additionally, this community is characterized by a low suffering from schizophrenia, but the entire family system as well [1]. The child's caregiver, in particular, may feel a great deal of socioeconomic background, since half of the population is living distress due to the many roles involved in caring for the child, in recognized settlements, while the other half lives in scattered since schizophrenia is characterized by many ups and downs, dwellings without even basic living conditions [4]. According to times of deterioration and then remissions, which are not always Lazarus and Folkman [5], choosing a strategy for coping with predictable [2]. To date, limited research has been conducted stressful situations is influenced by the person's appraisal of the regarding the coping strategies of family members of people event. This, in turn, is influenced by the appraiser’s and other suffering from mental illness [3] and even less research has been family members’ personality characteristics, and in a community conducted among populations of a non-Western culture, such as with traditional characteristics, the appraisal of the event is the Bedouin community in Israel. probably influenced also by the community. © Under License of Creative Commons Attribution 3.0 License | This article is available from: www.psychopathology.imedpub.com 1 Acta Psychopathologica 2016 ISSN 2469-6676 Vol. 2 No. 1: 2 In addition to the appraisal of the event, this study examined questionnaires were translated into Arabic by two Arabic-speaking the mothers’ measure of expressed emotions (EE), which is a interpreters for the purposes of this study. The translations were global measure that include five components: emotional over then submitted for appraisal to an external judge – a doctoral involvement, critical comments, hostility, positive remarks and candidate studying the Arabic language, who selected the more warmth. Studies that examined the relationship between the accurate of the two versions. EE ratings and the coping strategies of family members found that the EE ratings were influenced by the family members' The demographic questionnaire appraisal of the situation as stressful, disturbing, uncontrollable The questionnaire gathered information regarding the mother’s or as resulting from the illness [6]. A continuous illness like age, education, and employment, and marital status, number schizophrenia, which is the focus of the current study, creates a of children and place of residence. Information collected about state of chronic stress, which requires coping processes for the the adolescent’s child with schizophrenia included gender, the purposes of adjustment [5] both for the person with the illness number of years of illness and the number of hospitalizations in and for the surrounding family. This study is the first to examine the past year. the relationship between Bedouin mothers’ appraisal of an adult child’s schizophrenia, their EE, and their coping strategies. The incident appraisal questionnaire The questionnaire is abbreviated of Folkman and Lazarus [7]. Method The original questionnaire consists of three dimensions of the Participants initial appraisal: appraisal of loss, threat appraisal and appraisal of the challenge of the situation. Each of three dimensions has 12 The sample included 60 mothers of adult children with items, with an internal reliability between α=0.79 and 0.89 [8]. schizophrenia who were receiving treatment at a mental health For the purposes of this study, the threat appraisal dimension centre that caters to the Bedouin community. The average age was entirely removed, and the remaining two dimensions, of mothers was 52.5 (range 35-70) years; about half of the appraising the illness as a loss and as a challenge, respectively, mothers had never had any formal education (49%) and the rest were shortened to 8 items each. Appraisal of the illness as a loss had received either a primary school education (41%), or a high required participants to assess the degree of impact the child's school education (10%). More than half (66%) did not work, most illness had on different areas of their lives. Appraisal of the illness were married (92%), and others (8%) were widows. Some of as a challenge required participants to assess the degree to which the married women (35%) were in a polygamous marriage and they could envision positive change occurring in various areas of more than half (of the married women of the study population) their lives in the wake of the child's illness. Items are presented (60%) reported that they were married to relatives. The average on a 5-point Likert scale, where choosing 1 –‘not at all’, represents number of children they had was 7. Most of the mothers lived in a low rating for the listed item, whereas choosing 5 –‘to a great recognized settlements (towns) (69%) and the rest of the mothers extent’, represents a high rating for the listed item. In the present reported living in unrecognized, scattered Bedouin villages (31%). study, the reliability was α=0.81 for the loss items, and α=0.87 for Regarding the gender of the child with the illness, boys were the the challenge items. majority (72%) and the rest were girls (28%). The onset of the child's illness had occurred between6 months and3 years before Questionnaire for coping strategies the mothers completed the questionnaires (M=2.6, S.D=0.88), The questionnaire is an abbreviated version of the Carver, and the number of the child's hospitalizations in the past year Scheier and Weintraub's coping strategies questionnaire [9]. ranged from 1 to 4. The abbreviated version used in this study includes 28 items The criteria for choosing the mothers for participation were: that measure 15 coping strategies: active coping, positive view mothers who can read and write, so that they could fill out the and personal growth, planning, emotional support, instrumental questionnaires, mothers who agreed to participate in the study support, suppression of competing activities, acceptance of the and sign the informed consent form, mothers whose husbands situation, behavioural dissociation, emotional release, mental or heads of the family or tribe expressed his consent for their dissociation, denial, restraint, turning to religion, alcohol and participation in the study. drug abuse and humour. The mothers were asked to rate their With regard to the sample size, an appeal was made to every levels of use of each of the coping strategies in the period since Bedouin mother whose child received treatment in the mental the onset of the illness and throughout the time that the child health care center in the Bedouin community in the course spent living at home. Responses were indicated on a scale of 0-3, of 2014; the sample included all mothers who a) met the where 0 indicates ‘not at all’, and 3 ‘to a great extent’. The score participation criteria for the study b) filled out the questionnaires for each strategy was based on the sum of its two items. and returned them. 73 questionnaires were handed out, 60 were Measure of expressed emotion (EE) filled out and returned, and those 60 were included in the sample. questionnaire Measures This questionnaire was developed by Kreisman and Joy [10] to examine levels of negative emotional expression [10]. It was Translation of questionnaire developed as an abbreviated measure and includes 11 short, This study used four research questionnaires; all the simple statements, rated on a scale from 1 – ‘never’ to 3 – 2 This article is available from: www.psychopathology.imedpub.com Acta Psychopathologica 2016 ISSN 2469-6676 Vol. 2 No.
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