(PS4-D86) Patients' Perceptions of Close Relationships and Their Impact on Well-being and Mental Health

Background

Foundational theories in clinical psychology have highlighted the importance of close relationships in psychopathology. Interpersonal support has been identified as a key protective factor against mental illness (i.e., the buffering hypothesis; Cohen & Wills, 1985), while interpersonal stress is thought to contribute to the development of mental illness (i.e., the stress generation hypothesis; Hammen, 2006). To date, however, little is known about how people with mental illness believe close relationships impact their well-being. Such knowledge may aid us in developing novel frameworks that delineate how close relationships can protect against, or contribute to, psychopathology. The present study aims to summarize patients’ perceptions of the psychosocial benefits and detriments of their close relationships.

Method

Our sample included 276 adult patients enrolled in a partial hospital program; data collected from March 2022 to February 2023. The program provides treatment for adults typically presenting with comorbid mood, anxiety, personality, and/or psychotic-spectrum disorders. Upon admission, patients completed the Identities in Treatment Scale (ITS), an open-ended questionnaire that asks how various aspects of identity, including their close relationships, may have (a) contributed to mental health problems and/or (b) promoted well-being and resilience. Using a general inductive approach, two independent reviewers conducted thematic analyses of the ITS relationship item. Discrepancies in coding schemes were resolved by discussion and eventual consensus. 

Results

We identified 10 overarching themes in patients’ responses. Close relationships functioned as a source of strength for patients by (1) providing them with tangible support, (2) making them feel emotionally connected, (3) motivating them to improve, and/or (4) providing a sense of purpose. Close relationships also functioned as a source of stress as patients reported feeling (5) overly dependent on loved ones, (6) inadequate in their close relationships, (7) burdened by their responsibilities as caregivers themselves (8) loss or grief from lack of or suboptimal close relationships, (9) misunderstood by others close to them, and/or (10) uncared for or disconnected.

Discussion

Our findings underscore several prominent psychosocial themes that characterize the challenges and rewards of maintaining close relationships faced by those with acute mental illness. The proposed poster would elaborate on how such themes overlap with existing interpersonal theories and create potential avenues for novel frameworks. Future research on the etiology or ongoing pathology of mental disorders may benefit from considering interpersonal factors. Clinically, integrating these topics into psychotherapy may help clinicians identify important sources of stress and strength in their patients’ lives.