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Singh Solorzano C, Rowlands H, Ronaldson A, Kidd T, Steptoe A, Leigh E, Jahangiri M, Poole L. Caregiver burden in informal spousal caregivers predicts psychological and physical health in patients following coronary artery bypass graft surgery: a longitudinal clinical cohort study. J Behav Med 2024:10.1007/s10865-024-00512-3. [PMID: 39183251 DOI: 10.1007/s10865-024-00512-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 07/29/2024] [Indexed: 08/27/2024]
Abstract
Previous research has shown that informal caregiver burden can have deleterious effects on patient recovery; however, this relationship has yet to be investigated in patients undergoing coronary artery bypass graft (CABG) surgery. This study aimed to examine the impact of the change of caregiver burden from pre- to post-surgery on patients' mental and physical health after CABG surgery. Ninety patient-caregiver dyads were assessed one month before the surgery, two months and one year after the surgery. Caregivers completed the Oberst Burden Scale to measure caregiver burden. Patients completed the Beck Depression Inventory to measure depressive symptoms, a subscale of the Hospital Anxiety and Depression Scale to measure anxiety symptoms, the Short Form-12 health assessment to measure health-related quality of life, and the Coronary Revascularisation Outcomes Questionnaire to measure surgery symptoms. Hierarchical linear regression analyses were conducted to explore the association between change in caregiver burden and post-surgery patient outcomes. A greater increase in caregiver burden from pre- to two-months post-surgery significantly predicted higher patients' depressive symptoms (β = 0.179, p = 0.010), anxiety symptoms (β = 0.114, p = 0.017), reported post-surgery symptoms (β = 0.335, p = 0.008) and reduced physical health-related quality of life (β = -0.358, p = 0.003), after controlling for a wide range of covariates. These findings were not replicated at a one-year follow-up. These results provide insights into the impact of caregiver burden on patient distress following CABG surgery, supporting the idea of psychological support interventions for caregivers to increase patients' short-term recovery outcomes.
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Affiliation(s)
- Claudio Singh Solorzano
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, 25125, Italy.
| | - Hannah Rowlands
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, WC1E 7HB, UK
| | - Amy Ronaldson
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Tara Kidd
- School of Psychology, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, WC1E 7HB, UK
| | - Elizabeth Leigh
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, WC1E 7HB, UK
| | - Marjan Jahangiri
- Department of Cardiac Surgery, St George's Hospital, London, SW17 0QT, UK
| | - Lydia Poole
- Department of Psychological Interventions, School of Psychology, University of Surrey, Stag Hill Campus, Guildford, GU2 7XH, Surrey, UK
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Zambrano Garza E, Pauly T, Choi Y, Murphy RA, Linden W, Ashe MC, Madden KM, Jakobi JM, Gerstorf D, Hoppmann CA. Daily solitude and well-being associations in older dyads: Evidence from daily life assessments. Appl Psychol Health Well Being 2024; 16:356-375. [PMID: 37740540 DOI: 10.1111/aphw.12494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/04/2023] [Indexed: 09/24/2023]
Abstract
Older adults spend significant time by themselves, especially since COVID-19. Solitude has been associated with positive and negative outcomes. Partners need to balance social connectedness with time for one's own needs. This project examines how individual and partner solitude are associated with daily affect and relationship quality in dyads of older adults and a close other. One-hundred thirty-six older adults plus a close other rated their relationship quality and reported affect, solitude, and its characteristics (desired and bothersome) every evening for 10 days. Over and above overall associations, individual and partner effects emerged; when individual desired solitude was up, participants reported more positive affect and their partners less negative affect. When bothersome solitude was up, participants and their partners alike reported more negative affect and less positive affect. Desired solitude was associated with more support, whereas bothersome solitude was associated with less partner support. Findings provide further evidence on the potential benefits of solitude, highlighting the importance of considering the social context of what is often believed to be an individual-level phenomenon.
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Affiliation(s)
| | - Theresa Pauly
- Department of Gerontology, Simon Fraser University, Vancouver, Canada
| | - Yoonseok Choi
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Rachel A Murphy
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- Cancer Control Research, BC Cancer, Vancouver, Canada
| | - Wolfgang Linden
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Maureen C Ashe
- Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Kenneth M Madden
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Jennifer M Jakobi
- School of Health and Exercise Sciences, University of British Columbia, Okanagan, Canada
| | - Denis Gerstorf
- Department of Psychology, Humboldt University, Berlin, Germany
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3
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Wong JS, Hsieh N. Couple Analysis in the National Social Life, Health, and Aging Project. J Gerontol B Psychol Sci Soc Sci 2021; 76:S276-S286. [PMID: 34918155 PMCID: PMC8678438 DOI: 10.1093/geronb/gbab061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Marital and intimate partner relationships are some of the most important social ties that shape older adults' health and well-being. This paper provides analytic guidelines for the couple data in Round 2 (2010-2011) and Round 3 (2015-2016) of the National Social Life, Health, and Aging Project (NSHAP) to encourage more research on marriage and partnership in late life. METHOD First, we describe the recruitment of couples and outline how to identify partners in the data sets. Second, we provide descriptive information about the couple sample. Third, we offer guidance for analyzing the dyadic data cross-sectionally and longitudinally. RESULTS Round 2 interviewed all primary respondents and a sample of their current cohabiting partners and spouses (n = 955 couples). In Round 3, NSHAP reinterviewed the primary respondents and partners who participated in Round 2 (Cohort 1; n = 621 couples) and recruited a new sample of age-eligible adults along with any cohabiting romantic partners (Cohort 2; n = 766 couples). Couples can be identified using a household ID variable in Round 2 and a partner ID variable in Round 3. Demographic characteristics of the couple sample vary by round and cohort. DISCUSSION Researchers can use data from either round to conduct cross-sectional dyadic analyses to examine issues faced by older couples. A common strategy for couple analysis is the actor-partner interdependence model. With 2 rounds of couple-level data, researchers may consider using cross-lagged models in their research.
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Affiliation(s)
- Jaclyn S Wong
- Department of Sociology, University of South Carolina, Columbia, USA
| | - Ning Hsieh
- Department of Sociology, Michigan State University, East Lansing, USA
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Tracy EL, Berg CA, Kelly CS, Kent de Grey RG, Litchman ML, Allen NA, Helgeson VS. Daily stress spillover and crossover in couples coping with type 1 diabetes. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2021; 35:618-627. [PMID: 33661686 PMCID: PMC8324044 DOI: 10.1037/fam0000819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
In the context of a chronic illness such as Type 1 diabetes (T1D), managing general stressors may be linked to diabetes-specific stressors for persons with T1D, an intraindividual contagion phenomenon (i.e., spillover). Among those with romantic partners, stress may also be associated with the partner's stress (i.e., crossover). These intraindividual and interpersonal processes may be further strengthened or weakened in the presence of individual (e.g., sleep satisfaction) and interpersonal (e.g., relationship satisfaction) factors. This study examined spillover and crossover effects between daily general and diabetes-specific stressors and whether sleep satisfaction and relationship satisfaction moderated spillover and crossover effects among couples in which one person had T1D. Persons with T1D (n = 199; Mage = 46.82, 52.3% female) and their romantic partners (n = 199; Mage = 46.41, 47.2% female) reported general stressors and sleep satisfaction, and persons with T1D reported diabetes-specific stressors on 14 consecutive days. Both couple members completed a survey that assessed relationship satisfaction. Multilevel models revealed significant within-person and between-person stress spillover and crossover effects. When examining the moderating role of sleep satisfaction, however, persons with T1D with better sleep satisfaction did not experience spillover between one domain and the other. Furthermore, partners with higher relationship satisfaction did not experience crossover between the persons with T1D-specific stressors and their general stressors. These findings support the conceptualization of the link between general and diabetes-specific stressors as both an intraindividual and a dyadic process among couples coping with T1D. In addition, better sleep satisfaction can prevent spillover effects, and relationship satisfaction can prevent stress crossover effects. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Eunjin Lee Tracy
- Department of Psychiatry, University of Pittsburgh School of Medicine
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5
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Zhao X, Li D, Zhang Q, Liu H. Spousal concordance in frailty predicting mental and functional health decline: A four-year follow-up study of older couples in urban and rural China. J Clin Nurs 2021; 31:679-688. [PMID: 34216057 DOI: 10.1111/jocn.15927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/25/2021] [Accepted: 05/28/2021] [Indexed: 12/22/2022]
Abstract
AIMS AND OBJECTIVES To examine the joint effects of self and spousal frailty status on functional and mental health in Chinese older adults and determine whether such effects vary by urban versus rural residency. BACKGROUND Frailty is a clinical syndrome among old adults and would lead to adverse outcomes. However, studies on the interactive patterns of frailty status between spouses and the joint effects of such patterns on health outcomes are scarce. DESIGN Data were from the China Health and Retirement Longitudinal Study (CHARLS). A total of 2,581 married seniors who participated both 2011 and 2015 waves of the CHARLS were categorised into four groups: robust self-robust spouse (RR), robust self-frail spouse (RF), frail self-robust spouse (FR) and frail self-frail spouse (FF). METHODS Frailty was measured using the physical frailty phenotype scale. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CESD). Functional health was measured by difficulties in activities of daily living (ADL) and instrumental activities of daily living (IADL). The generalised estimating equation was used to estimate the effects of concordant frailty on mental and functional outcomes, stratified by rural/urban residency. This study followed the STROBE checklist. RESULTS The FF group reported higher levels of ADL/IADL difficulties and depressive symptoms at follow-up than the RR group; urban individuals in the RF group reported higher follow-up depression than the RR group; and rural individuals from the FR or RF groups reported more follow-up ADL/IADL difficulties than the RR group. CONCLUSION Frailty and subsequent health decline are interdependent in older couples, and the rural/urban context is important for understanding this interdependence in the older Chinese population. RELEVANCE TO CLINICAL PRACTICE Couples-based intervention strategies are needed to tackle situations in which one or both spouses are concurrently facing frailty.
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Affiliation(s)
- Xinyi Zhao
- School of Health Humanities, Peking University, Beijing, China
| | - Danyu Li
- Department of Sociology, Central South University, Changsha, China
| | - Quan Zhang
- National School of Development, Peking University, Beijing, China
| | - Huiying Liu
- Department of Sociology, Central South University, Changsha, China.,Social Survey and Opinion Research Centre, Central South University, Changsha, China
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Wilson SJ, Peng J, Andridge R, Jaremka LM, Fagundes CP, Malarkey WB, Belury MA, Kiecolt-Glaser JK. For better and worse? The roles of closeness, marital behavior, and age in spouses' cardiometabolic similarity. Psychoneuroendocrinology 2020; 120:104777. [PMID: 32623020 PMCID: PMC7849824 DOI: 10.1016/j.psyneuen.2020.104777] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 11/30/2022]
Abstract
Spouses share common risks for cardiometabolic diseases: a person's diabetes or hypertension raises the partner's odds of developing the same condition. The mechanisms responsible for this disease concordance remain poorly understood. To examine three factors that may modulate partners' cardiometabolic similarity-closeness, hostile marital behavior, and age-and to explore whether health behavior concordance plays a role, on two separate occasions 43 healthy couples ages 24-61 provided fasting glucose, metabolic data (fat and carbohydrate oxidation), and resting blood pressure before discussing one of their most severe marital disagreements. Accounting for the fixed effects of sex, age, study visit, and abdominal fat on cardiometabolic levels, we found that aspects of health behavior concordance were associated with greater similarity in glucose, diastolic blood pressure (DBP), and carbohydrate and fat metabolism. Independent of health behavior concordance, partners who felt closer and behaved in a less hostile way had more similar rates of fat oxidation; less hostile partners also shared greater overlap in carbohydrate oxidation. Likewise, fasting glucose and DBP were more similar within older couples compared to younger pairs, beyond the effects of health behavior concordance. In sum, our data captured preclinical similarities in cardiometabolic health among disease-free couples, which may form the basis for their long-term overlapping disease risks. Closer, less hostile, and older couples shared more similar fasting glucose, metabolic data, and blood pressure; importantly, health behavior concordance did not explain all associations. These novel data suggest that multiple paths may lead to couples' shared disease risks.
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Affiliation(s)
| | - Juan Peng
- College of Public Health, Division of Biostatistics, The Ohio State University, United States
| | - Rebecca Andridge
- College of Public Health, Division of Biostatistics, The Ohio State University, United States
| | - Lisa M Jaremka
- Department of Psychological and Brain Sciences, University of Delaware, United States
| | | | - William B Malarkey
- Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, United States; Department of Internal Medicine, OSUWMC, United States
| | - Martha A Belury
- Department of Human Sciences, The Ohio State University, United States
| | - Janice K Kiecolt-Glaser
- Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, United States; Department of Psychiatry and Behavioral Health, OSUWMC, United States
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7
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Nah S, Martire LM, Zhaoyang R. Perceived Patient Pain and Spousal Caregivers' Negative Affect: The Moderating Role of Spouse Confidence in Patients' Pain Management. J Aging Health 2020; 32:1282-1290. [PMID: 32482120 DOI: 10.1177/0898264320919631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: This study examined whether older patients' greater daily pain perceived by their spouses was associated with spouses' higher daily negative affect. We further investigated whether spouses' lower confidence in patients' ability to manage pain exacerbated the daily association between perceived patient pain and spouses' negative affect. Method: We used baseline interviews and a 22-day diary of knee osteoarthritis patients and their spouses (N = 144 couples). Multilevel models were estimated to test hypotheses. Results: Daily perceived patient pain was not associated with spouses' daily negative affect. However, spouse confidence significantly moderated the association. Only spouses with lower confidence in patients' pain management experienced higher negative affect on days when they perceived that patients' level of pain was higher than usual. Discussion: Findings suggest that spousal caregivers' lack of confidence in patients' pain management may be a risk factor for spouses' affective distress in daily life.
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Affiliation(s)
- Suyoung Nah
- The Pennsylvania State University, University Park, Pennsylvania
| | - Lynn M Martire
- The Pennsylvania State University, University Park, Pennsylvania
| | - Ruixue Zhaoyang
- The Pennsylvania State University, University Park, Pennsylvania
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8
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Polenick CA, Kales HC, Birditt KS. Perceptions of Purpose in Life Within Spousal Care Dyads: Associations With Emotional and Physical Caregiving Difficulties. Ann Behav Med 2019. [PMID: 29538622 DOI: 10.1093/abm/kax005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background Greater feelings of purpose in life are associated with better health and may reduce the negative impact of chronic stress. Yet little is known about how purpose in life may buffer the negative effects of caregiving, a common chronic stressor in middle and later life. Methods This cross-sectional study utilized a U.S. sample of 315 spousal caregivers and their partners with functional disability drawn from the 2011 National Health and Aging Trends Study and National Study of Caregiving to examine how both parties' perceptions of purpose in life are associated with caregivers' emotional and physical caregiving difficulties. We also evaluated whether care recipients' purpose in life moderates the association between caregivers' purpose in life and care-related difficulties. Finally, we considered whether these links differed by caregiver gender. Models controlled for caregivers' sociodemographics, care tasks, support resources, valued activity participation, and each care partner's health conditions. Results Caregivers' greater purpose in life was significantly linked to fewer physical caregiving difficulties. Caregivers' greater purpose in life was significantly associated with fewer emotional care-related difficulties among caregiving wives and when care recipients' purpose in life was low. Conclusions Although the associations between purpose in life and care-related difficulties are likely bidirectional, purpose in life may represent an important resource for combating the adverse consequences of caregiving. This study highlights the value of considering personal resources and their implications for caregivers' well-being within a dyadic context.
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Affiliation(s)
- Courtney A Polenick
- Department of Psychiatry, University of Michigan, Ann Arbor, MI.,Program for Positive Aging, University of Michigan, Ann Arbor, MI
| | - Helen C Kales
- Department of Psychiatry, University of Michigan, Ann Arbor, MI.,Program for Positive Aging, University of Michigan, Ann Arbor, MI.,Department of Veterans Affairs, HSR&D Center for Clinical Management Research (CCMR), Ann Arbor, MI.,Geriatric Research, Education and Clinical Center (GRECC), VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Kira S Birditt
- Institute for Social Research, University of Michigan, Ann Arbor, MI
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9
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Kiecolt-Glaser JK, Wilson SJ, Madison A. Marriage and Gut (Microbiome) Feelings: Tracing Novel Dyadic Pathways to Accelerated Aging. Psychosom Med 2019; 81:704-710. [PMID: 30308579 PMCID: PMC6458105 DOI: 10.1097/psy.0000000000000647] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Within a couple, partners influence each other's mental and physical health. This review focuses on how couples' relationships, the partners' individual and joint vulnerabilities, and their health behaviors influence health through changes in the gut microbiota, metabolism, and immune function. Couples' shared stressors and emotions and their intertwined lifestyles and routines serve to promote common disease risks in part through parallel changes in their gut microbiotas. Marital discord, stress, and depression have strong bidirectional links, fueling one another. Chronic marital stress and depression can elevate the risk for obesity, metabolic syndrome, and cardiovascular disease by altering resting energy expenditure, insulin production, and triglyceride responses after unhealthy meals. During stressful times, health behaviors typically suffer-and sleep disturbances, poor diets, and sedentary behavior all influence these metabolic pathways while also promoting gut dysbiosis. Dysbiosis increases intestinal permeability (gut leakiness), providing a mechanistic pathway from marital distress and depression to heightened inflammation and accelerated aging. Age-related changes in the gut microbiota's composition and gut leakiness foster immunosenescence, as well as the progression of inflamm-aging; these age-related risks may be altered by stress and depression, diet, sleep, exercise habits, and developmental shifts in emotion regulation strategies. Consideration of the strong mutual influences that partners have on each other's mood and health behaviors, as well as the biological pathways that underlie these influences, provides a new way to view marriage's health implications.
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Affiliation(s)
- Janice K. Kiecolt-Glaser
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine
- Department of Psychiatry & Behavioral Health, The Ohio State University College of Medicine
| | - Stephanie J. Wilson
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine
| | - Annelise Madison
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine
- Department of Psychology, The Ohio State University
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10
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Allen JY, Haley WE, Small BJ. Bereavement outcomes among spousal hospice caregivers: Relief, rumination, and perceived patient suffering. DEATH STUDIES 2019; 45:371-379. [PMID: 31402770 DOI: 10.1080/07481187.2019.1648331] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Witnessing end-of-life suffering of loved ones is an underappreciated stressor that may affect caregiver bereavement. We interviewed 61 spousal caregivers of hospice patients who died within the past 6-18 months. Higher rumination about suffering and lower feelings of relief was related to poorer well-being. Rumination by caregivers about end-of-life suffering was an important predictor of depression and complicated grief. Most caregivers viewed the death as at least in part a relief. One important focus of grief support may be to help caregivers find productive ways to avoid rumination and use other forms of coping and to acknowledge feelings of relief.
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Affiliation(s)
- Jessica Y Allen
- School of Aging Studies, University of South Florida, Tampa, FL, USA
- Department of Psychology, Now at Birmingham-Southern College, Birmingham, AL, USA
| | - William E Haley
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Brent J Small
- School of Aging Studies, University of South Florida, Tampa, FL, USA
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11
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Monin JK, Xu A, Mitchell HR, Buurman F, Riffin C. Recalling support provision decreases distress and anger in response to partner suffering. Aging Ment Health 2018; 22:587-594. [PMID: 28165759 PMCID: PMC5786490 DOI: 10.1080/13607863.2017.1286452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Thinking about a loved one's suffering can be emotionally stressful and have negative effects on a person's psychological and physical health over time. This study examined the hypotheses that when thinking about a partner's suffering (1) recalling past support provision to the suffering partner can decrease distress and anger and increase compassion, and (2) attachment orientation moderates these effects. METHOD Seventy-seven older adult spouses of individuals with chronic pain were video-recorded while they disclosed: (1) an instance of partner suffering and (2) an instance of partner suffering plus their support provision. Compassion for the partner and their own distress and anger were self-reported immediately after each account. Accounts were coded for statements of support. Attachment was assessed with the Experiences with Close Relationships measure. RESULTS As hypothesized, distress and anger were lower in the 'suffering with support' condition versus the 'suffering only' condition. There was no evidence that attachment orientation significantly moderated the effect of support recollection on emotional responses; however, more avoidant individuals reported less compassion and anger and used more words reflecting anger across conditions. More anxiously attached individuals reported greater compassion across conditions. CONCLUSION When thinking about a partner's suffering, there are attachment-related differences in emotional reactions. Yet, regardless of these differences, it may be adaptive for spouses to think about their role in providing support to their partner to decrease their own negative emotions.
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Affiliation(s)
- Joan K. Monin
- Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Annie Xu
- Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Hannah-Rose Mitchell
- Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | | | - Catherine Riffin
- Geriatrics Department, Yale School of Medicine, New Haven, CT, USA
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12
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Schulz R, Savla J, Czaja SJ, Monin J. The role of compassion, suffering, and intrusive thoughts in dementia caregiver depression. Aging Ment Health 2017; 21:997-1004. [PMID: 27260874 PMCID: PMC5786267 DOI: 10.1080/13607863.2016.1191057] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Exposure to suffering of a relative or friend increases the risk for psychological and physical morbidity. However, little is known about the mechanisms that account for this effect. We test a theoretical model that identifies intrusive thoughts as a mediator of the relation between perceived physical and psychological suffering of the care recipient and caregiver depression. We also assess the role of compassion as a moderator of the relation between perceived suffering and intrusive thoughts. METHODS Hispanic and African American caregivers (N = 108) of persons with dementia were assessed three times within a one-year period. Using multilevel modeling, we assessed the mediating role of intrusive thoughts in the relation between perceived physical and psychological suffering and CG depression, and we tested moderated mediation to assess the role of caregiver compassion in the relation between perceived suffering and intrusive thoughts. RESULTS The effects of perceived physical suffering on depression were completely mediated through intrusive thoughts, and compassion moderated the relation between physical suffering and intrusive thoughts. Caregivers who had greater compassion reported more intrusive thoughts even when perceived physical suffering of the CR was low. For perceived psychological suffering, the effects of suffering on depression were partially mediated through intrusive thoughts. DISCUSSION Understanding the role of intrusive thoughts and compassion in familial relationships provides new insights into mechanisms driving caregiver well-being and presents new opportunities for intervention.
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Affiliation(s)
- Richard Schulz
- Department of Psychiatry and University Center for Social and Urban Research, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jyoti Savla
- Center for Gerontology, Virginia Tech, Blacksburg, VA, USA
| | - Sara J. Czaja
- Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, FL, USA
| | - Joan Monin
- Social and Behavioral Sciences Division, Yale School of Public Health, New Haven, CT, USA
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13
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Monin JK, Poulin MJ, Brown SL, Langa KM. Spouses' daily feelings of appreciation and self-reported well-being. Health Psychol 2017; 36:1135-1139. [PMID: 28726476 DOI: 10.1037/hea0000527] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Research shows that active support provision is associated with greater well-being for spouses of individuals with chronic conditions. However, not all instances of support may be equally beneficial for spouses' well-being. The theory of communal responsiveness suggests that because spouses' well-being is interdependent, spouses benefit most from providing support when they believe their support increases their partner's happiness and is appreciated. Two studies tested this hypothesis. METHOD Study 1 was a 7-day ecological momentary assessment (EMA) study of 73 spouses of persons with dementia (74%) and other conditions. In Study 1, spouses self-reported active help, perceptions of how happy the help made the partner and how much the help improved the partner's well-being, and spouses' positive and negative affect at EMA time points. Study 2 was a 7-day daily assessment study of 43 spouses of persons with chronic pain in which spouses reported their emotional support provision, perceived partner appreciation, and their own physical symptoms. RESULTS Study 1 showed that active help was associated with more positive affect for spouses when they perceived the help increased their partner's happiness and improved their partner's well-being. Study 2 showed that emotional support provision was associated with fewer spouse reported physical symptoms when perceptions of partner appreciation were high. CONCLUSION Results suggest that interventions for spouses of individuals with chronic conditions take into account spouses' perceptions of their partners' positive emotional responses. Highlighting the positive consequences of helping may increase spouses' well-being. (PsycINFO Database Record
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Affiliation(s)
- Joan K Monin
- Department of Social and Behavioral Sciences, Yale School of Public Health
| | | | | | - Kenneth M Langa
- Department of Internal Medicine and Health Management and Policy, University of Michigan
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