Does Caregiving Cause Psychological Distress? The Case for Familial and Genetic Vulnerabilities in Female Twins

Abstract

Background Informal caregiving can be deleterious to mental health, but research results are inconsistent and may reflect an interaction between caregiving and vulnerability to stress. Methods We examined psychological distress among 1,228 female caregiving and non-caregiving twins. By examining monozygotic and dizygotic twin pairs discordant for caregiving, we assessed the extent to which distress is directly related to caregiving or confounded by common genes and environmental exposures. Results Caregiving was associated with distress as measured by mental health functioning, anxiety, perceived stress, and depression. The overall association between caregiving and distress was confounded by common genes and environment for mental health functioning, anxiety, and depression. Common environment also confounded the association of caregiving and perceived stress. Conclusions Vulnerability to distress is a factor in predicting caregivers' psychosocial functioning. Additional research is needed to explicate the mechanisms by which common genes and environment increase the risk of distress among informal caregivers.

Mental health and morbidity of caregivers and co-residents of individuals with dementia: a quasi-experimental design

“…Our findings concur with an earlier USA study that showed that having a close family member, such as a spouse/elderly parent, with dementia or other serious disability can lead to stress or depressive symptoms regardless of whether or not the unaffected family member is providing care (Amirkhanyan and Wolf, 2003). Furthermore, even in these difficult circumstances, not everyone may be affected, and Vitaliano et al in a unique twin-study suggests that the relationship between caregiving and psychological distress may be determined by a vulnerability largely shaped by genetic and early life factors (Vitaliano et al, 2014). Results from the multi-level models in our study purport that 33% of the variation in mental health is due to household factors, which would explain why household stressors such as living with someone with dementia symptoms could have the same influence on both caregiving and non-caregiving household members.…”

Patient and Caregiver Determinants of Patient Quality of Life and Caregiver Strain in Left Ventricular Assist Device Therapy

“…Thus, characteristics associated with pre-implantation levels of strain may have particular value in identifying those at risk for prolonged exposure to elevated strain and its associated impact on morbidity and mortality. [9][10][11] Influence of HF Symptoms HF symptoms predicted both patient QOL and caregiver strain, demonstrating that the symptom experience (a hallmark of the HF syndrome) affects patients and caregivers alike. In patients, we observed that greater physical symptom burden was associated with worse pre-implantation QOL, a finding consistent with the existing literature.…”

“…8 Similarly, there is a call for more research on LVAD therapy caregivers, about whom little is known quantitatively but who likely experience considerable caregiver strain (often called "caregiver burden"), a subjective measure of stress related to caregiving that is a known predictor of increased morbidity and mortality. [8][9][10][11] More important, caregiver characteristics are known to influence patient outcomes and vice versa, in chronic illness in general and HF in particular, 12,13 supporting quantitative approaches in LVAD therapy that consider both patient and caregiver factors as predictors of patient and caregiver outcomes. Thus, the purpose of this analysis is to identify patient and caregiver determinants of patient QOL and caregiver strain in response to LVAD therapy.…”

Impacto psicológico de las demencias en las familias: propuesta de un modelo integrador

“…Así, cuidadores que han tenido problemas de salud mental de forma previa al cuidado tienen mayor probabilidad de recaer (Russo, Vitalino, Brewer, Katon y Becker, 1995), y el estado mental de los cuidadores en fases previas del proceso también predice el desarrollo de problemas posteriores (Joling et al, 2015). Factores genéticos, de personalidad o ambientales previos al cuidado contribuyen a predecir la ocurrencia de problemas psicológicos en el proceso de cuidado (Hooker, Monahan, Bowman, Frazier y Shifren, 1998;Vitaliano, Strachan, Dansie, Goldberg, y Buchwald, 2014). Entre estos factores se encuentran las habilidades sociales.…”