Community Mental Health Journal

, Volume 47, Issue 2, pp 233–242 | Cite as

An Exploratory Factor Analysis of the Burden Assessment Scale with a Sample of African-American Families

  • Joseph Guada
  • Helen Land
  • Jina Han
Original Paper


It remains unclear if the factor structures of commonly used caregiver burden scales normed on white samples are similar with samples from different ethnic communities. Our study tests the factor structure of the Burden Assessment Scale (BAS) using Exploratory Factor Analysis (EFA) with data from low-income, African American families caring for a family member with schizophrenia. The EFA solution included a 2 factor structure of subjective burden and objective burden with strong loadings demonstrating a clear differentiation between the factors. Our results suggest that low income, African American families appear to experience caregiving burden as one major or broad component in their lives similar to other areas that demand ongoing coping and adaptation. Likewise, the factor structure found with this sample as compared to the factor structure found with white samples suggests differences in the perception of and/or the reporting of burden. Study limitations as well as implications for practice are provided.


Burden Assessment Scale Schizophrenia African Americana families Psychometric properties Ethnicity Caregiver burden 


  1. Awad, A. G., & Voruganti, L. N. P. (2008). The burden of schizophrenia on caregivers: A review. Pharmacoeconomics, 26(2), 149–162.PubMedCrossRefGoogle Scholar
  2. Baronet, A. (1999). Factors associated with caregiver burden in mental illness: A critical review of the research literature. Clinical Psychology Review, 19(7), 819–841.PubMedCrossRefGoogle Scholar
  3. Bauml, J., Frobose, T., Kraemer, S., Rentrop, M., & Pitschel-Walz, G. (2006). Psychoeducation: A basic psychotherapeutic intervention for patients with schizophrenia and their families. Schizophrenia Bulletin, 32(Suppl 1), S1–S9.PubMedCrossRefGoogle Scholar
  4. Berglund, N., Vahlne, J. O., & Edman, A. (2003). Family intervention in schizophrenia: Impact on family burden and attitude. Social Psychiatry and Psychiatric Epidemiology, 38, 116–121.PubMedCrossRefGoogle Scholar
  5. Biegel, D. E., Milligan, S. E., Putnam, P. L., & Song, L.-Y. (1994). Predictors of burden among lower socioeconomic status caregivers of persons with chronic mental illness. Community Mental Health Journal, 30(5), 473–494.PubMedCrossRefGoogle Scholar
  6. Bradley, G. M., Couchman, G. M., Perlesz, A., Nguyen, A. T., Singh, B., & Riess, C. (2006). Multiple-family group treatment for English- and Vietnamese-specking families living with schizophrenia. Psychiatric Services, 57(4), 521–530.PubMedCrossRefGoogle Scholar
  7. Caqueo-Urizar, A., & Gutierrez-Maldonado, J. (2006). Burden of care in families of patients with schizophrenia. Quality of Life Research, 15, 719–724.PubMedCrossRefGoogle Scholar
  8. Chien, W. T., Chan, S. W. C., & Morrissey, J. (2007). The perceived burden among Chinese family caregivers of people with schizophrenia. Journal of Clinical Nursing, 16, 1151–1161.PubMedCrossRefGoogle Scholar
  9. Choppelas, J., & Wilson, C. (2006). Caregiver burden and stress in African American, Asian, Hispanic and Caucasian American caregivers of older family members. Dissertation Abstracts, 66, 9-B.Google Scholar
  10. Connery, L., & Brekke, J. (1999). A home-based family intervention for ethnic minorities with a mentally ill member. Alcoholism Treatment Quarterly, 17(1/2), 149–167.CrossRefGoogle Scholar
  11. Cook, J. A., Lefley, H. P., Pickett, S. A., & Cohler, B. J. (1994). Age and family burden among patients of offspring with severe mental illness. American Journal of Orthopsychiatry, 64(3), 435–447.PubMedCrossRefGoogle Scholar
  12. DeVellis, R. F. (1991). Scale development: Theory & applications. Newbury Park, CA: Sage.Google Scholar
  13. Foldemo, A., Gullberg, M., Ghristina, E. K., & Bogren, L. (2005). Quality of life and burden in parents of outpatients with schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 40, 133–138.PubMedCrossRefGoogle Scholar
  14. Guarnaccia, P. J., & Parra, P. (1996). Ethnicity, social status, and families’ experiences of caring for a mentally ill family member. Community Mental Health Journal, 32(3), 243–260.PubMedCrossRefGoogle Scholar
  15. Hines, P. M., & Boyd-Franklin, N. (2005). African-American families. In M. McGoldrick, J. Giordano, & N. Garcia-Preto (Eds.), Ethnicity and family therapy (3rd ed., pp. 87–100). New York, NY: Guildford Press.Google Scholar
  16. Horwitz, A. V., & Reinhard, S. C. (1995). Ethnic differences in caregiving duties and burden among parents and siblings of persons with severe mental illnesses. Journal of Health and Social Behavior, 36(2), 138–150.PubMedCrossRefGoogle Scholar
  17. Ivarsson, A.-B., Sidenvall, B., & Carlsson, M. (2004). The factor structure of the Burden Assessment Scale and the perceived burden of caregivers for individuals with severe mental disorders. Scandinavian Journal of Caring Sciences, 18, 396–401.PubMedCrossRefGoogle Scholar
  18. Kealey, E. M. (2005). Variations in the experience of schizophrenia: A cross-cultural review. Journal of Social Work Research and Evaluation, 6(1), 47–56.Google Scholar
  19. Kung, W. W. (2003). The illness, stigma, culture, or immigration? Burdens on Chinese American caregivers of patients with schizophrenia. Families in Society: The Journal of Contemporary Human Services, 84(4), 547–557.Google Scholar
  20. Lauber, C., Eichenberger, A., Luginbuhl, P., Keller, C., & Rossler, W. (2003). Determinants of burden in caregivers of patients with exacerbating schizophrenia. European Psychiatry, 18, 285–289.PubMedCrossRefGoogle Scholar
  21. Magliano, L., Fiorillo, A., De Rosa, C., Malangone, C., & Maj, M. (2005). Family burden in long-term diseases: A comparative study in schizophrenia vs. physical disorders. Social Science and Medicine, 61, 313–322.PubMedCrossRefGoogle Scholar
  22. Magliano, L., Fiorillo, A., De Rosa, C., & N. M. H. P. W. Group. (2006). Family burden and social network in schizophrenia vs. physical diseases: Preliminary results from an Italian national study. Acta Psychiatrica Scandinavica, 113(Suppl. 429), 60–63.CrossRefGoogle Scholar
  23. Matias-Carrelo, L. E., Chavez, L. M., Negron, G., Canino, G., Aguilar-Gaxiola, S., & Hoppe, S. (2003). The Spanish translation and cultural adaptation of five mental health outcome measures. Culture, Medicine and Psychiatry, 27, 291–313.PubMedCrossRefGoogle Scholar
  24. Mechanic, D. (2008). Mental health and social policy: Beyond managed care (5th ed.). Boston: Allyn & Bacon.Google Scholar
  25. Mueser, K. T., Sengupta, A., Schooler, N. R., Bellack, A. S., Xie, H., Glick, I. D., et al. (2001). Family treatment and medication dosage reduction in schizophrenia: Effects on patient social functioning, family attitudes, and burden. Journal of Consulting and Clinical Psychology, 69(1), 3–12.PubMedCrossRefGoogle Scholar
  26. NAMI. (2003). Family to family: Recent studies of family-to-family. Retrieved 12/22/2006, from
  27. NIMH. (2008). National Institute of Mental Health Strategic Plan. District of Columbia: National Institute of Mental Healtho. Document Number.Google Scholar
  28. Pearlin, L., Aneshensel, C., & LeBlanc, A. (1997). The forms and mechanisms of stress proliferation: The case of AIDS caregivers. Journal of Health and Social Behavior, 38(3), 223–236.PubMedCrossRefGoogle Scholar
  29. Pearlin, L., Mullan, J., Semple, S., & Skaff, M. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30, 538–594.Google Scholar
  30. Perlick, D. A., Rosenheck, R. A., Kaczynski, R., Swartz, M. S., Canive, J. M., & Lieberman, J. A. (2006). Components and correlates of family burden in schizophrenia. Psychiatric Services, 57, 1117–1125.PubMedCrossRefGoogle Scholar
  31. Pickett, S. A., Vraniak, D. A., Cook, J. A., & Cohler, B. J. (1993). Strength in adversity: Blacks bear burden better than whites. Professional Psychology: Research and Practice, 24(4), 460–467.CrossRefGoogle Scholar
  32. Reinhard, S. C., Gubman, G. D., Horwitz, A. V., & Minsky, S. (1994). Burden Assessment Scale for families of the seriously mentally ill. Evaluation and program planning, 17(3), 261–269.CrossRefGoogle Scholar
  33. Rosenfarb, I., Bellack, A., & Aziz, N. (2006a). Family interactions and the course of schizophrenia in African American and White patients. Journal of Abnormal Psychology, 115(1), 112–120.PubMedCrossRefGoogle Scholar
  34. Rosenfarb, I., Bellack, A., & Aziz, N. (2006b). A sociocultural stress, appraisal, and coping model of subjective burden and family attitudes toward patients with schizophrenia. Journal of Abnormal Psychology, 115(1), 157–165.PubMedCrossRefGoogle Scholar
  35. Song, L., Biegel, D. E., & Milligan, S. E. (1997). Predictors of depressive symptomatology among lower social class caregivers of persons with chronic mental illness. Community Mental Health Journal, 33(4), 269–286.PubMedCrossRefGoogle Scholar
  36. Stueve, A., Vine, P., & Struening, E. L. (1997). Perceived burden among caregivers of adults with serious mental illness: Comparison of black, hispanic, and white families. American Journal of Orthopsychiatry, 67(2), 199–209.PubMedCrossRefGoogle Scholar
  37. Thornton, M. C. (1998). Indigenous resources and strategies of resistance: Informal caregiving and racial socialization in black communities. In H. I. McCubbin, E. A. Thompson, A. I. Thompson, & J. A. Futrell (Eds.), Resiliency in ethnic minority families: African-American families (Vol. 3, pp. 49–66). Thousand Oaks, CA: Sage.Google Scholar
  38. USDHHS. (2001). Mental health: Culture, race, and ethnicity-a supplement to mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.Google Scholar
  39. Williams, D. R., & Fenton, D. T. (1999). The mental health of African Americans: Findings, questions, and directions. In I. L. Livingston (Ed.), Handbook of black American health—the mosaic of conditions, issues, policies, and prospects (pp. 253–268). Westport, CN: Greenwood Press.Google Scholar
  40. Wolthaus, J. E. D., Dingemans, P. M. A. J., Schene, A. H., Linszen, D. H., Wiersma, D., Van Den Bosch, R. J., et al. (2002). Caregiver burden in recent-onset schizophrenia and spectrum disorders: The influence of symptoms and personality traits. The Journal of Nervous and Mental Disease, 190(4), 241–247.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.The Ohio State University, College of Social WorkColumbusUSA
  2. 2.University of Southern California, School of Social WorkLos AngelesUSA

Personalised recommendations