Abstract 14087: Psychosocial Determinants of Health Predict Depressive Symptoms and Anxiety in Rural Caregivers

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jennifer L Smith ◽  
Misook L Chung ◽  
Jennifer Miller ◽  
Martha J Biddle ◽  
Donna Schuman ◽  
...  
Keyword(s):  
Social Support ◽  
Depressive Symptoms ◽  
Caregiver Burden ◽  
Perceived Stress ◽  
Brief Symptom Inventory ◽  
Determinants Of Health ◽  
Future Research ◽  
Cvd Risk ◽  
Rural Caregivers ◽  
Increased Risk

Introduction: Caregivers have an 82% increased risk of cardiovascular disease (CVD) compared to non-caregivers. Depressive symptoms (DS) and anxiety increase CVD risk, and these are worse in rural dwellers. Knowing predictors of DS and anxiety in rural caregivers of patients with chronic illness is important to reduce CVD risk. Purpose: To identify predictors of DS and anxiety in rural caregivers at risk for CVD using a social determinants of health (SDH) model. Method: In this cross-sectional study we measured multiple SDH. These variables included sociodemographic (i.e., age, gender, race, marital status, health insurance, education, financial status), behavioral (i.e., smoking and body mass index [BMI]), and psychosocial (i.e., caregiver burden measured by the Zarit Burden Interview, perceived stress by the Cohen Perceived Stress Scale, and social support by the Medical Outcomes Study Social Support Survey) factors. The outcomes of DS were measured by the Patient Health Questionnaire-9 and anxiety by the Brief Symptom Inventory – Anxiety subscale. Data were analyzed using two separate multiple regression models, one for DS and one for anxiety. As depression and anxiety are often comorbid, they were considered predictors in the appropriate models. Results: In the 262 participants (mean age 53±13, 78% female, 96% Caucasian, 70% were married), mean years of education were 14±2, 56.1% had enough money to make ends meet, and 55% had no insurance or Medicaid only. Significant predictors of worse DS were higher caregiver burden (β=0.05, p=0.004), higher perceived stress (β=2.04, p=0.001), and higher anxiety (β=3.79, p= <0.001). Predictors of worse anxiety, were younger age (β=-0.006, p=0.03), higher caregiver burden (β=0.006, p=0.009), lower social support (β=-0.004, p=0.05), and higher DS (β=0.08, p=<0.001). Conclusion: Predictors of DS and anxiety in these rural caregivers were psychosocial variables. Caregiver CVD Interventions could be optimized by including stress management, education about the psychological effects of caregiving, and social support components. Future research is needed on the role of DS and anxiety in CVD to better support rural caregivers at highest risk.

Depressive Symptoms and Diurnal Salivary Cortisol Patterns Among Female Caregivers of Stroke Survivors

2012 ◽  
Vol 14 (4) ◽  
pp. 396-404 ◽  
Author(s):  
Karen L. Saban ◽  
Herbert L. Mathews ◽  
Fred B. Bryant ◽  
Timothy E. O’Brien ◽  
Linda Witek Janusek
Keyword(s):  
Depressive Symptoms ◽  
Chronic Stress ◽  
Caregiver Burden ◽  
Perceived Stress ◽  
Salivary Cortisol ◽  
Allostatic Load ◽  
Depression Scale ◽  
Epidemiologic Studies ◽  
Stroke Survivors ◽  
Increased Risk

Informal caregivers of stroke survivors experience elevated chronic stress and are at risk of developing depressive symptoms. The cumulative effects of chronic stress can increase allostatic load and dysregulate biological processes, thus increasing risk of stress-related disease. Stress-induced alterations in the pattern of cortisol secretion vary with respect to stressor onset, intensity, and chronicity. Little is known about the psychoendocrine response to stress in female caregivers of stroke survivors. The purpose of this study was to examine perceived stress, caregiver burden, and the association between caregiver depressive symptoms and diurnal cortisol in 45 females caring for a significant other who experienced a stroke within the past year. Women completed the Center for Epidemiologic Studies Depression Scale (CES-D) and collected saliva for cortisol upon awakening, 30 min postawakening, noon, and bedtime for 2 consecutive days. Results revealed that women had high levels of perceived stress and caregiver burden. In women with CES-D scores ≥ 16, salivary cortisol levels were significantly lower across the day relative to women with CES-D scores < 16. This difference persisted after adjusting for age, number of caregiving hours per week, perceived social support, and quality of sleep. Younger age was associated with more depressive symptoms as well as lower levels of cortisol at awakening and 30 min postawakening. Results demonstrate that the burden of caregiving increases risk of depressive symptoms and hypocortisolism across the day. Hypocortisolism may contribute to increased risk of depressive symptoms as a result of the loss of glucocorticoid attenuation of stress-induced inflammation.

Does gender moderate the associations of caregiving distress with engagement in healthy behaviors and self-management in rural caregivers?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.L Chung ◽  
J.L Miller ◽  
D.K Moser
Keyword(s):  
Gender Differences ◽  
Depressive Symptoms ◽  
Perceived Stress ◽  
Gender Effects ◽  
Self Management ◽  
Funding Source ◽  
Cvd Risk ◽  
Healthy Behaviors ◽  
Rural Caregivers ◽  
Low Levels

Abstract Introduction Caregivers are globally vulnerable populations facing a high risk of cardiovascular disease (CVD) development and mortality. Caregiving distress, defined as caregiver burden, stress, depressive symptoms, and anxiety, may contribute to a lack of engagement in healthy behaviors and self-management. Although gender differences in caregiving distress have been reported, there is limited evidence about whether gender moderates the associations between caregiving distress and engagement in healthy behaviors or self-management in rural caregivers. Purposes To compare gender differences in caregiving distress (i.e., burden, stress, depressive symptoms, and anxiety), and engagement in healthy behaviors and self-management; and to determine whether gender moderates the associations of caregiving distress with engagement in healthy behaviors and self-management. Methods Rural informal caregivers caring for patients with chronic disease and having at least two or more CVD risk factors completed baseline assessment in an ongoing randomized controlled trial of a CVD risk reduction intervention. Caregiving distress was assessed using the Zarit Burden Interview, the Perceived Stress Scale, the Patient Health Questionnaire-9, and the Brief Symptom Inventory-Anxiety. Engagement in healthy behaviors and self-management were assessed using the MOS-Specific Adherence Scale and the Patient Activation Measure, respectively. Independent t-tests and multiple regression modeling with the PROCESS macro was used. Results Of the 262 rural caregivers (mean age= 53.7 years; 78% female; 96% white), 55% of the caregivers reported having at least one or more types of CVD. Female caregivers reported significantly higher levels of burden, perceived stress, depressive symptoms, and anxiety than male caregivers, but they experienced similar levels of engagement in healthy behaviors and self-management. High levels of burden (SB=−0.454, P&lt;0.001), stress (SB=−0.456, P&lt;0.001), depressive symptoms (SB=−0.363, P&lt;0.001) and anxiety (SB=−0.365, P&lt;0.001) were significantly associated with low levels of engagement in healthy behaviors, but there were no gender moderation effects on these associations. High levels of burden (SB=−0.334, P&lt;0.001) were significantly associated with poor engagement in self-care, but this association was strong and significantly only for female caregivers. High levels of stress (SB=−0.384, P&lt;0.001) were also significantly associated with poor engagement in self-care for only female caregivers. Although depressive symptoms (SB=−0.325, P&lt;0.001) and anxiety (SB=−0.349, P&lt;0.001) were associated with low levels of self-management, there were no gender effects on these associations. Conclusions Significant gender effects on associations of caregiving distress with self-management suggest the need for designing interventions targeting caregiving burden and stress to reduce caregiving distress for women rural caregivers. Funding Acknowledgement Type of funding source: Other. Main funding source(s): National Institutes of Health

scholarly journals Adverse and Benevolent Childhood Experiences Predict Mental Health during the COVID-19 Pandemic

2020 ◽  
Author(s):  
Jenalee Doom ◽  
Kathryn Fox
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Depressive Symptoms ◽  
Perceived Stress ◽  
Well Being ◽  
Future Research ◽  
Childhood Experiences ◽  
Health Crisis ◽  
Current Stress ◽  
Adult Mental Health

Background. Adverse childhood experiences (ACEs) are associated with poorer adult mental health, and benevolent childhood experiences (BCEs) are associated with better adult mental health. Objective. To test whether ACEs and BCEs predict adult mental health beyond current stress and social support during the COVID-19 pandemic. Participants and Setting. We analyzed data from undergraduate and graduate students (N = 502) at an urban private university in the western United States. Methods. An online survey was conducted to assess ACEs and BCEs, current stress and social support, depressive and anxiety symptoms, perceived stress, and loneliness in May 2020. Results. Higher levels of ACEs were associated with higher levels of depressive symptoms, β = 0.45, p = .002. Higher levels of BCEs were associated with lower depressive symptoms, β = -0.39, p = .03, lower perceived stress, β = -0.26, p = .002, and less loneliness, β = -0.12, p = .04. These associations held while controlling for current stress, social support, and socioeconomic status. Conclusions. Childhood experiences are associated with mental health during the COVID-19 pandemic. BCEs should be considered an important promotive factor, independent of ACEs, for psychological well-being during a global public health crisis. BCEs should be included along with ACEs in future research and screening with distressed and vulnerable populations.

scholarly journals Perceived stress and depressive symptoms not neuropsychiatric symptoms predict caregiver burden in Alzheimer’s disease: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Manee Pinyopornpanish ◽  
Kanokporn Pinyopornpanish ◽  
Atiwat Soontornpun ◽  
Surat Tanprawate ◽  
Angkana Nadsasarn ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Depressive Symptoms ◽  
Caregiver Burden ◽  
Perceived Stress ◽  
Neuropsychiatric Symptoms ◽  
Cross Sectional Study ◽  
Assessment Tools ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background Caregiver burden affects the caregiver’s health and is related to the quality of care received by patients. This study aimed to determine the extent to which caregivers feel burdened when caring for patients with Alzheimer’s Disease (AD) and to investigate the predictors for caregiving burden. Methods A cross-sectional study was conducted. One hundred two caregivers of patients with AD at Maharaj Nakorn Chiang Mai Hospital, a tertiary care hospital, were recruited. Assessment tools included the perceived stress scale (stress), PHQ-9 (depressive symptoms), Zarit Burden Interview-12 (burden), Clinical Dementia Rating (disease severity), Neuropsychiatric Inventory Questionnaires (neuropsychiatric symptoms), and Barthel Activities Daily Living Index (dependency). The mediation analysis model was used to determine any associations. Results A higher level of severity of neuropsychiatric symptoms (r = 0.37, p < 0.01), higher level of perceived stress (r = 0.57, p < 0.01), and higher level of depressive symptoms (r = 0.54, p < 0.01) were related to a higher level of caregiver burden. The direct effect of neuropsychiatric symptoms on caregiver burden was fully mediated by perceived stress and depressive symptoms (r = 0.13, p = 0.177), rendering an increase of 46% of variance in caregiver burden by this parallel mediation model. The significant indirect effect of neuropsychiatric symptoms by these two mediators was (r = 0.21, p = 0.001). Conclusion Caregiver burden is associated with patients’ neuropsychiatric symptoms indirectly through the caregiver’s depressive symptoms and perception of stress. Early detection and provision of appropriate interventions and skills to manage stress and depression could be useful in reducing and preventing caregiver burden.

scholarly journals Every Night and Every Morn: Effect of Variation in CLOCK Gene on Depression Depends on Exposure to Early and Recent Stress

2021 ◽  
Vol 12 ◽  
Author(s):  
Dorka Gyorik ◽  
Nora Eszlari ◽  
Zsofia Gal ◽  
Dora Torok ◽  
Daniel Baksa ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Linkage Disequilibrium ◽  
Life Events ◽  
Negative Life Events ◽  
Population Sample ◽  
Brief Symptom Inventory ◽  
Additive Models ◽  
Outcome Variable ◽  
Childhood Adversities ◽  
Increased Risk

The role of circadian dysregulation is increasingly acknowledged in the background of depressive symptoms, and is also a promising treatment target. Similarly, stress shows a complex relationship with the circadian system. The CLOCK gene, encoding a key element in circadian regulation has been implicated in previous candidate variant studies in depression with contradictory findings, and only a few such studies considered the interacting effects of stress. We investigated the effect of CLOCK variation with a linkage-disequilibrium-based clumping method, in interaction with childhood adversities and recent negative life events, on two phenotypes of depression, lifetime depression and current depressive symptoms in a general population sample.Methods: Participants in NewMood study completed questionnaires assessing childhood adversities and recent negative life events, the Brief Symptom Inventory to assess current depressive symptoms, provided data on lifetime depression, and were genotyped for 1054 SNPs in the CLOCK gene, 370 of which survived quality control and were entered into linear and logistic regression models with current depressive symptoms and lifetime depression as the outcome variable, and childhood adversities or recent life events as interaction variables followed by a linkage disequilibrium-based clumping process to identify clumps of SNPs with a significant main or interaction effect.Results: No significant clumps with a main effect were found. In interaction with recent life events a significant clump containing 94 SNPs with top SNP rs6825994 for dominant and rs6850524 for additive models on current depression was identified, while in interaction with childhood adversities on current depressive symptoms, two clumps, both containing 9 SNPs were found with top SNPs rs6828454 and rs711533.Conclusion: Our findings suggest that CLOCK contributes to depressive symptoms, but via mediating the effects of early adversities and recent stressors. Given the increasing burden on circadian rhythmicity in the modern lifestyle and our expanding insight into the contribution of circadian disruption in depression especially as a possible mediator of stress, our results may pave the way for identifying those who would be at an increased risk for depressogenic effects of circadian dysregulation in association with stress as well as new molecular targets for intervention in stress-related psychopathologies in mood disorders.

scholarly journals Low-Income, African American, Adolescent Mothers’ Depressive Symptoms, Perceived Stress, and Social Support

2016 ◽  
Vol 25 (7) ◽  
pp. 2306-2314 ◽  
Author(s):  
Christie Campbell-Grossman ◽  
Diane Brage Hudson ◽  
Kevin A. Kupzyk ◽  
Sara E. Brown ◽  
Kathleen M. Hanna ◽  
...  
Keyword(s):  
Social Support ◽  
African American ◽  
Depressive Symptoms ◽  
Perceived Stress ◽  
Adolescent Mothers ◽  
Low Income ◽  
African American Adolescent

A Systematic Review of Caregiver Burden following Stroke

2009 ◽  
Vol 4 (4) ◽  
pp. 285-292 ◽  
Author(s):  
H. Rigby ◽  
G. Gubitz ◽  
S. Phillips
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Systematic Review ◽  
Caregiver Burden ◽  
Search Strategy ◽  
Patient Characteristics ◽  
Future Research ◽  
Reference Sections ◽  
Caregiver Mental Health ◽  
Significant Health

Caregiver burden following stroke is increasingly recognised as a significant health care concern. A growing number of studies have evaluated the patient, caregiver, and social support factors that contribute to increased caregiver burden. We conducted a systematic review of this literature to guide future research. A search of the MEDLINE, PsyclNFO, CINAHL, and EMBASE databases (up to July 2008) and reference sections of published studies using a structured search strategy yielded 24 relevant articles. Studies were included if they evaluated predictors and/or correlates of caregiver burden in the setting of stroke. The prevalence of caregiver burden was 25–54% and remained elevated for an indefinite period following stroke. In studies that evaluated independent baseline predictors of subsequent caregiver burden, none of the factors reported were consistent across studies. In studies that assessed concurrent factors independently contributing to caregiver burden in the poststroke period, patient characteristics and social support factors were inconsistently reported. Several studies identified caregiver mental health and the amount of time and effort required of the caregiver as significant determinants of caregiver burden. Our findings highlight the need for more research to identify caregivers in need of support and guide the development and implementation of appropriate interventions to offset caregiver burden.

Informal Support, Health, and Burden Among Parents of Adult Children With Autism

2018 ◽  
Vol 59 (6) ◽  
pp. 1112-1121 ◽  
Author(s):  
Christina N Marsack ◽  
Faith P Hopp
Keyword(s):  
Social Support ◽  
Time Dependence ◽  
Caregiver Burden ◽  
Adult Children ◽  
Autism Spectrum ◽  
Future Research ◽  
Caregiver Support ◽  
Informal Social Support ◽  
Caregiver Health ◽  
The Relationship

Abstract Background and Objectives Many adults with autism spectrum disorders require lifelong reliance on caregiver support. As these caregivers age and experience health challenges, social support can be critical. This study seeks to understand if caregiver health moderates the relationship between informal social support and caregiver burden. Research Design and Methods A total of 320 parents (age 50+ years) of adult children diagnosed with ASD were recruited from autism organizations and support groups and completed a web-based survey. Separate moderation analyses were used to determine if caregiver health was moderating the relationship between informal social support and composite caregiver burden, as well as the separate domains of developmental, time dependence, emotional burden, and impact of caregiving on finances. For each analysis, perceptions of available informal social support were the independent variable, composite and domains of caregiver burden were dependent variables, and parents’ self-reported general health was the moderating variable. Results Caregiver health had a statistically significant moderating effect when predicting the relationships between informal social support and composite caregiver burden, as well as time dependence burden and impact of caregiving on finances. Discussion and Implications Increased attention should be focused on supporting the current and future needs of both aging caregivers and their adult children with ASD. Future research on the dynamics of social support, health, and burden is also urgently needed to address the growing number of aging caregivers of adults diagnosed with ASD.

scholarly journals Do positive or negative stressful events predict the development of new brain lesions in people with multiple sclerosis?

2013 ◽  
Vol 44 (2) ◽  
pp. 349-359 ◽  
Author(s):  
M. N. Burns ◽  
E. Nawacki ◽  
M. J. Kwasny ◽  
D. Pelletier ◽  
D. C. Mohr
Keyword(s):  
Multiple Sclerosis ◽  
Depressive Symptoms ◽  
Life Events ◽  
Perceived Stress ◽  
Stressful Life Events ◽  
Brain Lesions ◽  
Stressful Events ◽  
Stressful Life ◽  
Increased Risk ◽  
Mri Scans

BackgroundStressful life events have long been suspected to contribute to multiple sclerosis (MS) disease activity. The few studies examining the relationship between stressful events and neuroimaging markers have been small and inconsistent. This study examined whether different types of stressful events and perceived stress could predict the development of brain lesions.MethodThis was a secondary analysis of 121 patients with MS followed for 48 weeks during a randomized controlled trial comparing stress management therapy for MS (SMT-MS) to a waitlist control (WLC). Patients underwent magnetic resonance imaging (MRI) scans every 8 weeks. Every month, patients completed an interview measure assessing stressful life events and self-report measures of perceived stress, anxiety and depressive symptoms, which were used to predict the presence of gadolinium-enhancing (Gd+) and T2 lesions on MRI scans 29–62 days later. Participants classified stressful events as positive or negative. Negative events were considered ‘major’ if they involved physical threat or threat to the patient's family structure, and ‘moderate’ otherwise.ResultsPositive stressful events predicted decreased risk for subsequent Gd+ lesions in the control group [odds ratio (OR) 0.53 for each additional positive stressful event, 95% confidence interval (CI) 0.30–0.91] and less risk for new or enlarging T2 lesions regardless of group assignment (OR 0.74, 95% CI 0.55–0.99). Across groups, major negative stressful events predicted Gd+ lesions (OR 1.77, 95% CI 1.18–2.64) and new or enlarging T2 lesions (OR 1.57, 95% CI 1.11–2.23) whereas moderate negative stressful events, perceived stress, anxiety and depressive symptoms did not.ConclusionsMajor negative stressful events predict increased risk for Gd+ and T2 lesions whereas positive stressful events predict decreased risk.

scholarly journals A Systematic Review of Amenable Resilience Factors that Moderate and/or Mediate the Relationship between Childhood Adversity and Mental Health in Young People

2017 ◽  
Author(s):  
Jessica Fritz ◽  
Anne de Graaff ◽  
Helen Caisley ◽  
Anne-Laura Van Harmelen ◽  
Paul O. Wilkinson
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Systematic Review ◽  
Young People ◽  
Empirical Support ◽  
Childhood Adversity ◽  
Future Research ◽  
Increased Risk ◽  
Resilience Factors ◽  
The Relationship

THIS IS A PRE-PRINT OF AN ARTICLE PUBLISHED IN "FRONTIERS IN PSYCHIATRY - SPECIAL ISSUE: RESILIENCE, LIFE EVENTS, TRAJECTORIES AND THE BRAIN (9: 230)". THE FINAL AUTHENTICATED VERSION IS AVAILABLE ONLINE AT: https://doi.org/10.3389/fpsyt.2018.00230Background: Up to half of Western children and adolescents experience at least one type of childhood adversity. Individuals with a history of childhood adversity have an increased risk of psychopathology. Resilience enhancing factors reduce the risk of psychopathology following childhood adversity. A comprehensive overview of empirically supported resilience factors is critically important for interventions aimed to increase resilience in young people. Moreover, such an overview may aid the development of novel resilience theories. Therefore, we conducted the first systematic review of social, emotional, cognitive and/ or behavioural resilience factors after childhood adversity.Methods: We systematically searched Web of Science, PsycINFO and Scopus (e.g. including MEDLINE) for English, Dutch and German literature. We included cohort studies that examined whether a resilience factor was a moderator and/ or a mediator for the relationship between childhood adversity and psychopathology in young people (mean age 13-24). Therefore, studies were included if the resilience factor was assessed prior to psychopathology, and childhood adversity was assessed no later than the resilience factor. Study data extraction was based on the STROBE report and study quality was assessed with an adapted version of Downs and Black’s scale. The preregistered protocol can be found at: http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016051978.Results: The search identified 1969 studies, of which 22 were included (eight nationalities, study sample n range: 59-6780). We found empirical support for 13 of 25 individual-level (e.g. high self-esteem, low rumination), six of 12 family-level (e.g. high family cohesion, high parental involvement), and one of five community-level resilience factors (i.e. high social support), to benefit mental health in young people exposed to childhood adversity. Single versus multiple resilience factor models supported the notion that resilience factors should not be studied in isolation, and that interrelations between resilience factors should be taken into account when predicting psychopathology after childhood adversity.Conclusions: Interventions that improve individual, family, and/ or social support resilience factors may reduce the risk of psychopathology following childhood adversity. Future research should scrutinize whether resilience factors function as a complex interrelated system that benefits mental health resilience after childhood adversity.

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