title: The need for closure in caregivers of people with psychosis.
abstract: OBJECTIVE
  The aim of the study was to determine how carer need for closure relates to expressed emotion. It also examined the links between carer need for closure and patient functioning including patient need for closure.
  
  
  METHODS
  In a cross-sectional study, 70 caregivers of patients with psychosis completed the Need for Closure Scale (NFCS), the Camberwell Family Interview (CFI) and measures of distress, burden, coping and social network. The NFCS was assessed in terms of its two primary dimensions: a need for simple structure (NFSS) and Decisiveness. Patients also completed measures of psychotic symptoms and affect, and in 50 matched caregiver patient dyads, direct comparisons were undertaken between caregiver and patient NFCS scores.
  
  
  RESULTS
  No links were found between caregiver NFC and EE in this predominately low EE sample. More decisive carers had higher levels of self esteem, were less distressed, and resorted less to avoidant coping. The need for simple structure was greater in carers who lacked a confidante. As predicted, patients reported significantly higher NFSS and lower Decisiveness scores than carers, but no relationship was observed between caregiver NFC and patient symptoms of psychosis.
  
  
  CONCLUSIONS
  Carers reporting confident decision making were also more likely to report adaptive functioning in terms of having lower levels of avoidant coping and distress, and higher levels of self esteem. The results suggest that this style of thinking might be a helpful way of coping with some of the difficulties involved in caring for someone with psychosis. D
authors.affiliation: Institute of Psychiatry at King's College London, London, United Kingdom. juliana.l.onwumere@kcl.ac.uk
authors.forename: Juliana
authors.initials: J
authors.lastname: Onwumere
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kuipers
authors.forename: Paul
authors.initials: P
authors.lastname: Bebbington
authors.forename: Graham
authors.initials: G
authors.lastname: Dunn
authors.forename: Daniel
authors.initials: D
authors.lastname: Freeman
authors.forename: David
authors.initials: D
authors.lastname: Fowler
authors.forename: Philippa
authors.initials: P
authors.lastname: Garety
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders