The Relationship between Psychological Resilience and Caregiver Burden among Caregivers of Patients with Bipolar Disorder: The Mediating Role of Coping Styles

Background： As a high-disability psychiatric disorder, bipolar disorder (BD) subjects family caregivers to chronic multidimensional stress due to its relapsing nature. While resilience alleviates stress through cognitive regulation, high resilience may trigger excessive active coping strategies, leading to chronic allostatic load. Coping styles, as behavioral manifestations of resilience, demonstrate dual-edge effects: buffering acute stress versus exacerbating chronic exhaustion. Existing research neglects how BD-specific factors (e.g., aggression) dynamically modulate the "resilience-coping-burden" pathway. This study investigates the mediating mechanisms of coping styles to inform precision interventions. Methods： This descriptive cross-sectional study enrolled 176 family caregivers of hospitalized bipolar disorder patients from the psychiatric department of Renmin Hospital of Wuhan University between March 2024 and January 2025. Participants were assessed using the Connor-Davidson Resilience Scale (CD-RISC-25), Simplified Coping Style Questionnaire (SCSQ), and Zarit Burden Interview (ZBI-22). Data analysis included descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test, Spearman’s correlation, and mediation analysis via Hayes’ PROCESS macro (SPSS v19.0) with bias-corrected bootstrapping (10,000 resamples, 95% CI). Results： The mean psychological resilience total score was 61.90±15.79out of 11–100 points, the mean coping styles total score was 29.32±8.71 out of 3–47 points, and the mean caregiver burden total score was 23.76±13.26out of 0–71 points. The study revealed that psychological resilience total scores demonstrated a significant positive correlation with active coping strategies (r=0.53, p<0.001) and a negative association with total caregiver burden (r=−0.16, p<0.05). Passive coping positively correlated with personal burden (r=0.16), role burden (r=0.26), and total burden (r=0.21) (all p<0.05). The mediation model revealed: · Resilience → coping path coefficient a=0.223 (p<0.001) · Coping → burden path coefficient b=0.351 (p=0.005) · Direct effect c'=-0.189 (p=0.006), indirect effect ab=0.078 (95%CI [0.031,0.129]) · Proportion mediated: 70.7% Conclusions： Psychological resilience exerts dual effects on burden through coping styles - directly reducing burden while potentially increasing chronic stress via excessive active coping.Clinical interventions should integrate resilience enhancement with adaptive coping strategies.