Relationship Quality Among Persons with Serious Mental Illness and Their Relatives: Rates and Correlates.

Abstract

Supportive family relationships for persons with serious mental illness (SMI) are correlated with positive functional, health and mental health outcomes and are essential to the recovery process. However, there has been a dearth of research on positive family dynamics. Using multivariate logistic regression with a U.S. community-recruited sample of persons with SMI (N = 523), we examined the extent to which demographics, clinical characteristics, and supportive and problematic relationship interactions were associated with relationship quality with reference relatives (RR). Secondarily, we tested whether the relationship between routine limit-setting practices by RR toward participants and relationship quality was significantly mediated by perceived emotional overinvolvement using Baron and Kenny's four step method. High levels of relationship quality were reported by two-thirds of the sample. Relationship quality was positively associated with frequency of contact between participants and RR, participants helping RR with activities of daily living, and caregiving provided by RR to participants. High relationship quality was negatively associated with RR being parents or other family members (compared to romantic partners), perceived emotional overinvolvement of RR, and psychological abuse by RR toward participants. Clinical and demographic characteristics were not associated with relationship quality. Perceived emotional overinvolvement was found to be a mediator between routine limit-setting practices and relationship quality. These results can help direct clinicians in targeting factors that will likely enhance the process of recovery.