The Role of Compassion, Suffering, and Intrusive Thoughts in Dementia Caregiver Depression

Overview

Journal Aging Ment Health

Publisher Routledge

Specialty Geriatrics

Date 2016 Jun 5

PMID 27260874

Citations 8

Authors

Richard Schulz

Jyoti Savla

Sara J Czaja

Joan Monin

Affiliations

Soon will be listed here.

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.

Citing Articles

Patient-reported assessment of compassion in Spanish: a systematic review.

Soto-Rubio A, Picazo C, Gil-Julia B, Andreu-Vaillo Y, Perez-Marin M, Sinclair S Front Med (Lausanne). 2024; 11:1352694.

PMID: 39055694 PMC: 11270590. DOI: 10.3389/fmed.2024.1352694.

Rewriting the Story of Mid- and Late-Life Family Caregiving: Applying a Narrative Identity Framework.

Mroz E, Monin J, Gaugler J, Matta-Singh T, Fried T Gerontologist. 2023; 64(2).

PMID: 37018754 PMC: 10809219. DOI: 10.1093/geront/gnad040.

Compassion Fatigue and Perceived Social Support among Polish Nurses.

Pergol-Metko P, Staniszewska A, Metko S, Sienkiewicz Z, Czyzewski L Healthcare (Basel). 2023; 11(5).

PMID: 36900712 PMC: 10001227. DOI: 10.3390/healthcare11050706.

Depression among caregivers of patients with dementia: Associative factors and management approaches.

Huang S World J Psychiatry. 2022; 12(1):59-76.

PMID: 35111579 PMC: 8783169. DOI: 10.5498/wjp.v12.i1.59.

Well-being in dementia: a cross-sectional dyadic study of the impact of multiple dimensions of strain on persons living with dementia and their family care partners.

Miller L, Kaye J, Lyons K, Lee C, Whitlatch C, Caserta M Int Psychogeriatr. 2019; 31(5):617-626.

PMID: 30722800 PMC: 6579645. DOI: 10.1017/S104161021800203X.

References

Schulz R, McGinnis K, Zhang S, Martire L, Hebert R, Beach S . Dementia patient suffering and caregiver depression. Alzheimer Dis Assoc Disord. 2008; 22(2):170-6. PMC: 2782456. DOI: 10.1097/WAD.0b013e31816653cc. View

Goetz J, Keltner D, Simon-Thomas E . Compassion: an evolutionary analysis and empirical review. Psychol Bull. 2010; 136(3):351-74. PMC: 2864937. DOI: 10.1037/a0018807. View

Monin J, Schulz R, Martire L, Jennings J, Hagerty Lingler J, Greenberg M . Spouses' cardiovascular reactivity to their partners' suffering. J Gerontol B Psychol Sci Soc Sci. 2010; 65B(2):195-201. PMC: 2821945. DOI: 10.1093/geronb/gbp133. View

Czaja S, Loewenstein D, Schulz R, Nair S, Perdomo D . A videophone psychosocial intervention for dementia caregivers. Am J Geriatr Psychiatry. 2013; 21(11):1071-81. DOI: 10.1016/j.jagp.2013.02.019. View

Schulz R, Monin J, Czaja S, Lingler J, Beach S, Martire L . Measuring the experience and perception of suffering. Gerontologist. 2010; 50(6):774-84. PMC: 3003549. DOI: 10.1093/geront/gnq033. View

Feeney B, Collins N . Predictors of caregiving in adult intimate relationships: an attachment theoretical perspective. J Pers Soc Psychol. 2001; 80(6):972-94. View

Monin J, Schulz R . Interpersonal effects of suffering in older adult caregiving relationships. Psychol Aging. 2009; 24(3):681-95. PMC: 2765123. DOI: 10.1037/a0016355. View

Steffen A, McKibbin C, Zeiss A, Gallagher-Thompson D, Bandura A . The revised scale for caregiving self-efficacy: reliability and validity studies. J Gerontol B Psychol Sci Soc Sci. 2002; 57(1):P74-86. DOI: 10.1093/geronb/57.1.p74. View

Viana M, Gruber M, Shahly V, Alhamzawi A, Alonso J, Andrade L . Family burden related to mental and physical disorders in the world: results from the WHO World Mental Health (WMH) surveys. Braz J Psychiatry. 2013; 35(2):115-25. DOI: 10.1590/1516-4446-2012-0919. View

10.

Horowitz M . Stress-response syndromes: a review of posttraumatic and adjustment disorders. Hosp Community Psychiatry. 1986; 37(3):241-9. DOI: 10.1176/ps.37.3.241. View

11.

Katz S, Ford A, Moskowitz R, Jackson B, JAFFE M . STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. JAMA. 1963; 185:914-9. DOI: 10.1001/jama.1963.03060120024016. View

12.

Robinson-Whelen S, Tada Y, MacCallum R, McGuire L, Kiecolt-Glaser J . Long-term caregiving: what happens when it ends?. J Abnorm Psychol. 2001; 110(4):573-84. DOI: 10.1037//0021-843x.110.4.573. View

13.

Andresen E, Malmgren J, Carter W, Patrick D . Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994; 10(2):77-84. View

14.

Horowitz M, WILNER N, Alvarez W . Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979; 41(3):209-18. DOI: 10.1097/00006842-197905000-00004. View

15.

Bowlby J . Attachment and loss: retrospect and prospect. Am J Orthopsychiatry. 1982; 52(4):664-678. DOI: 10.1111/j.1939-0025.1982.tb01456.x. View

16.

Batson C, Fultz J, Schoenrade P . Distress and empathy: two qualitatively distinct vicarious emotions with different motivational consequences. J Pers. 1987; 55(1):19-39. DOI: 10.1111/j.1467-6494.1987.tb00426.x. View

17.

Lepore S . Expressive writing moderates the relation between intrusive thoughts and depressive symptoms. J Pers Soc Psychol. 1997; 73(5):1030-7. DOI: 10.1037//0022-3514.73.5.1030. View

18.

Folstein M, Folstein S, McHugh P . "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3):189-98. DOI: 10.1016/0022-3956(75)90026-6. View

19.

Monin J, Schulz R, Feeney B, Cook T . Attachment Insecurity and Perceived Partner Suffering as Predictors of Personal Distress. J Exp Soc Psychol. 2010; 46(6):1143-1147. PMC: 2968751. DOI: 10.1016/j.jesp.2010.05.009. View

20.

Feeney B, Collins N . Motivations for caregiving in adult intimate relationships: influences on caregiving behavior and relationship functioning. Pers Soc Psychol Bull. 2004; 29(8):950-68. DOI: 10.1177/0146167203252807. View