Self-Compassion and Emotion Dysregulation Mediate the Effect of Stress Appraisals on Elder Abuse and Neglect Behaviors in Dementia Family Caregiving.

Abstract

The purpose of this paper is to evaluate the mechanistic process by which family caregivers' situational stress-appraisals of behavioral symptoms (BSD) increases the likelihood of a caregiver engaging in abusive and neglectful behaviors towards their care recipient with dementia. We test the hypotheses that (1) the effect of daily BSD stress-appraisals on elder abuse and neglect (EAN) is mediated by the caregivers' emotion dysregulation (2) and the mediation path is moderated by self-compassion. This study employed a multi-time series design in which participants (N=453) completed traditional longitudinal surveys at enrollment followed by 21 sequential days of diary surveys (n=9,513). The hypothesized moderated mediation path was evaluated through a multilevel structural equation model. Hypotheses were supported. At the within-person level daily BSD stress appraisal has a significant direct effect on daily EAN. At the between-person level the path was no longer significant implying a full mediation of emotion dysregulation. The main effect of self-compassion, and the interaction term (emotion dysregulation x self-compassion), were also statistically significant indicating the path between emotion dysregulation and EAN is moderated by self-compassion. This study significantly advances the field by empirically showing a mechanistic pathway for a theoretical explanation of EAN. These findings represent a breakthrough for the field and identify modifiable intervention targets for future behavioral interventions to prevent EAN. Emotion (dys)regulation and self-compassion are modifiable traits and skills that can be learned, with robust evidence-bases of efficacious interventions that can be adapted for context to dementia family caregiving.