Caring for a patient with schizophrenia often results in high levels of perceived burden and poorer overall mental health. Using a sample of 176 caregivers of patients with schizophrenia, the present study examined how two components of burden (objective and subjective) interacted with interdependence and ethnicity to influence relatives' overall mental health. In line with study hypotheses, and with the stress-appraisal-coping model developed by Lazurus and Folkman (1984), we found that subjective burden mediated the relationship between objective burden and mental health. In other words, subjective appraisals of caregiving appeared to partially underlie the association between the concrete costs of caregiving and psychological outcomes in schizophrenia caregivers. Also as hypothesized, we found that interdependence, or the perceived interconnectedness of individuals within a group, moderated the relationship between objective burden and subjective burden. In other words, when levels of interdependence were high, the objective components of burden appeared to have a weaker relationship with subjective burden. When interdependence was low, on the other hand, objective burden was more likely to be associated with subjective burden. This finding suggests that helping caregivers to value harmony and connection with others over individual self-interests may reduce the likelihood that objective stressors (which are often inevitable in schizophrenia) will result in subjective distress. On the basis of prior research, we also tested several hypotheses regarding the role of ethnicity and its association with burden, interdependence, and mental health. However, contrary to expectations, no ethnic patterns were observed.
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