Shdo, Suzanne M.

Abstract As a group, family caregivers of people with dementia (PWDs) have substantially elevated levels of depression and anxiety, compared to same-aged non-caregiving adults. However, there is striking variation in mental health among individual caregivers. Previous research on predictors of the sources of these individual differences has focused on characteristics of individual caregivers and PWDs (rather than on the caregiver-PWD relationship), self-report measures (rather than behavioral measures), and negative emotion (rather than positive emotion). We examined 185 caregiver-PWD dyads who had an unrehearsed 10-minute conversation about an area of conflict in the laboratory. Video recordings were coded for Behavioral Indicators of Positivity Resonance (BIPR), which derives from Positivity Resonance Theory and assesses dyad-level behavioral expressions of positive affect, mutual warmth, and synchrony. Caregivers reported their level of depression, anxiety, and emotional well-being and PWDs underwent a comprehensive neurological and neuropsychological evaluation. Pearson’s correlations revealed that greater dyad-level BIPR was associated with caregivers’ higher emotional well-being (r(181) = .19, p = .008), lower depression (r(179) = -.17, p = .025), and lower anxiety (r(180) = -.15, p = .045). Regression analyses revealed that these associations were still obtained after controlling for caregiver age and sex and PWD dementia severity, cognitive impairment, and neuropsychiatric behavior (emotional well-being ß = .18, p = .012; depression ß = -.15, p = .039; anxiety ß = -.15, p = .044). Future studies should determine whether interventions that increase co-experienced positive emotions among caregiver-PWD dyads help buffer caregivers from adverse mental health consequences.

Abstract Objectives There are striking differences among caregivers of people with dementia in their health and well-being during active caregiving and after caregiving has ended. A key factor influencing caregiver health is the emotional quality of the caregiver–care recipient relationship, which may be reflected in the emotional language caregivers use when describing this relationship. The present study assessed whether caregivers’ positive and negative language is associated with their current and future depression trajectories. Methods Active caregivers responded to an open-ended question about a recent time they felt connected to the care recipient. We summed the number of positive and negative emotion words and divided them by the total words in the response. We evaluated whether caregivers’ emotional language (a proxy for the emotional quality of the caregiver–care recipient relationship) was associated with their depression assessed both concurrently (N = 347 active caregivers) and longitudinally (N = 224 former caregivers). Results Neither positive nor negative emotional language significantly correlated with caregiver depression during active caregiving. Structural equation modeling revealed caregivers’ greater positive emotional language (accounting for baseline depression) was associated with less steep increases in depression after the care recipient’s death. Results were robust when accounting for negative emotional language and covariates. Negative emotional language was not significantly associated with changes in caregiver depression. Discussion Caregivers who use more positive words when describing their connection with the care recipient may be more resilient, underscoring the potential role of positive emotional qualities of the caregiving relationship in preserving caregivers’ mental health after caregiving ends.

Abstract There are striking differences among caregivers of people with dementia (PWDs) in how their health and well-being changes during active caregiving; however, less is known about these differences after caregiving has ended. One important factor influencing caregiver health is the emotional quality of the caregiver-PWD relationship. The present study evaluated caregivers’ emotional connection to the PWD (during caregiving) and associations with caregivers’ depression both concurrently (N = 326 active caregivers) and longitudinally (n = 91 former caregivers). Active caregivers described a recent time they felt connected to the PWD, and their responses were transcribed verbatim. Caregivers’ emotional connection to the PWD was operationalized by summing the number of positive and negative emotion words from the transcripts using text analysis software and dividing each figure by the total number of words in the response. Results indicated that neither positive nor negative emotional language was significantly correlated with caregivers’ concurrent depression. However, two-wave latent change score modeling revealed that caregivers’ greater positive emotional language (adjusting for caregivers’ baseline depression and negative emotional language) predicted steeper declines in depression (i.e., improvements in depression trajectories) after the death of the PWD (ß = -.11, SE(ß) = 0.04, p = .033). Negative emotional language was not significantly associated with changes in caregivers’ depression. This finding highlights positive emotion expressed by caregivers when describing their connection with the PWD as a potential resilience factor and underscores the important role that positive emotional qualities of the caregiving relationship play in improving caregivers’ mental health after caregiving ends.