The dyadic effects of personality traits on depression in advanced lung cancer patients and caregivers: The mediating role of acceptance of illness

Abstract

Objective: This study aimed to explore the intrapersonal and interpersonal effects of three personality traits-neuroticism, extraversion and conscientiousness-on depression and examine whether acceptance of illness mediates the actor and partner effects in advanced lung cancer patients and caregivers using the Actor-Partner Interdependence Mediation Model (APIMeM).Methods: A total of 304 dyads of advanced lung cancer patients and caregivers were studied. Personality traits, acceptance of illness and depression were measured using 44-item Big Five Inventory, the Acceptance of Illness (AIS) scale and the Patient Health Questionnaire (PHQ-9). Results:The APIMeMs suggested that there were significant actor-actor effects of the three personality traits on depression through their own acceptance of illness.Additionally, significant actor-partner effects of neuroticism and extraversion on depression were also found. Specifically, patients' neuroticism was negatively related to their own acceptance of illness, which increased caregivers' depression, and caregivers' higher extraversion was related to their own higher acceptance of illness, which reduced patients' depression. Furthermore, a significant partner-actor effect was only found in the neuroticism model. Patients' neuroticism was negatively related to caregivers' acceptance of illness, which increased caregivers' depression. Conclusion:The three personality traits had both interpersonal and intrapersonal effects on depression in advanced lung cancer patient-caregiver dyads, and acceptance of illness played an important mediating role in these relationships.

Caregiver activation of relatives of patients with advanced cancer

“…In other research, the associations between the caregiver role of relatives and their symptoms of depression, anxiety, and stress have been described too. Often, these are described as complex and possibly cyclic because negative emotions may act as a blockade to activation (Elliott et al, 2010 ; Hibbard et al, 2007 ; Lau et al, 2010 ; O'Rourke, 2009 ; Wang et al, 2021 ). Relatives who feel prepared and are competent to meet the patient's demands, have been described to report emotional satisfaction and good well‐being as a result of being able to help their loved one through a challenging situation (Otis‐Green & Juarez, 2012 ).…”

The relationship between patient‐family caregiver congruence/incongruence in acceptance of illness and family caregivers' anticipatory grief

“…Illness acceptance is a positive cognitive appraisal referring to approval of the fact that the patient is ill, recognition of the need to adapt to the illness condition, and perception of coping with aversive consequences 11 . Existing evidence indicates that both patients and family caregivers need to undergo the process of illness acceptance 12 . Higher illness acceptance increased patients' ability to adapt to the illness condition and improve medication adherence, thereby lessening their AG 13,14 .…”

“…Higher illness acceptance increased patients' ability to adapt to the illness condition and improve medication adherence, thereby lessening their AG 13,14 . Higher illness acceptance in caregivers helped relieve anxiety and ineffective resistance to the disease, thus reducing negative emotional reactions 12,15 . Most prior research has focused on family caregivers' AG from the caregivers' perspective; few studies have considered patients' perspectives and their interactions and individual differences in AG generation.…”

“…13,14 Higher illness acceptance in caregivers helped relieve anxiety and ineffective resistance to the disease, thus reducing negative emotional reactions. 12,15 Most prior research has focused on family caregivers' AG from the caregivers' perspective; few studies have considered patients' perspectives and their interactions and individual differences in AG generation. Due to individual perceptions and differences in roles, patients and their caregivers may have different viewpoints on the patient's disease, leading to different levels of illness acceptance between them.…”

“…11 Existing evidence indicates that both patients and family caregivers need to undergo the process of illness acceptance. 12 Higher illness acceptance increased patients' ability to adapt to the illness condition and improve medication adherence, thereby lessening their AG. 13,14 Higher illness acceptance in caregivers helped relieve anxiety and ineffective resistance to the disease, thus reducing negative emotional reactions.…”