Caregiver Mental Health Problems Research Articles

Child temperament as a longitudinal predictor of mother–adolescent interaction quality: are effects independent of child and maternal mental health?

Adaptive parent–child interaction plays a major role in healthy child development. Caregiver mental health problems can negatively impact parent–child interaction. In turn, interactional quality is often studied as a predictor of child outcome. However, child characteristics supposedly shape parent–child interactions as well. Given associations between child and caregiver mental health and child temperament, this study aimed at differentiating their effects on dyadic interaction quality in adolescence. Child temperament and character at age 5 were investigated as longitudinal predictors of observed mother–adolescent interactional quality at age 14 in a community sample (N = 76). It was examined whether these effects were independent of maternal and child mental health and earlier dysfunctional interaction. Lower novelty seeking, higher reward dependence, and higher cooperativeness separately predicted higher dyadic interactional quality at age 14. Controlling regressions for dysfunctional interaction at age 5, which was a significant negative predictor of later interactional quality, cancelled out the effects of novelty seeking and cooperativeness. Past or concurrent maternal or child psychopathology did not explain variance in mother–adolescent interaction. Applying backward selection, a model including reward dependence and dysfunctional interaction at age 5 and concurrent maternal stress showed the best fit for explaining dyadic interaction quality. Results suggest that enduring rather than transient child features predict interactional quality in a community sample. Effects of temperament are not better explained by those of psychopathology, but a combination of child, maternal, and dyadic features predicted dyadic behaviour best. Selective prevention should target parenting in the context of challenging child characteristics specifically.

Can resilience change over time? Patterns and transitions in resilience among young children involved with the child welfare system.

This study examined transitions in resilience profiles and the role of caregiver risk and protective factors in resilience transition probabilities over 18 months among children involved with the child welfare system, using latent profile analysis and latent transition analysis. The sample included 486 children (48% female, baseline Mage = 3.49). There were three resilience profiles at Time 1 (19.9% low emotional behavioral, 26.1% low cognitive, 54.0% multidomain) and two profiles at Time 2 (18.9% low emotional behavioral, 81.1% multidomain). Caregiver mental health problems were negatively associated with membership in the multidomain resilience group at Time 1. Higher levels of cognitive stimulation were associated with initial and continued membership in the multidomain resilience group. Implications for resilient child development are discussed.

The Mediating Effect of Caregiving Relationship Quality on the Association Between Caregiving Stressors and Mental Health Problems Among Older Spousal Caregivers.

Providing care to a spouse can be especially challenging for older adults given their compounding stressors resulting from aging and caregiving. This cross-sectional study examines the relationships between caregiving stressors and caregiver mental health problems and the potential mediator (i.e., caregiving relationship quality) of these associations. A total of 431 Americans (≥65 years) were selected from the National Study of Caregiving. Path analysis shows that care assistance was positively associated with caregiver mental health problems, and this association was mediated by negative relationship quality (Indirect effect = .14, p = .016). Moreover, role overload was positively associated with caregiver mental health problems, which was mediated by negative relationship quality (indirect effect = .13, p = .002). Findings suggest that caregiving stressors can adversely affect mental health by exacerbating negative relationship quality. Interventions that limit negative exchanges and increase compassionate communications between older spousal caregivers and their care-receiving partners are needed.

Stress, worry, and health problems experienced by Black and Indigenous caregivers of girls with juvenile legal system involvement

Caregiver-child relationships are essential in preventing or reducing delinquent and illegal adolescent behaviors. Such relationships are particularly important for Black and Indigenous families, who are at disproportionate risk for involvement in the juvenile legal system due to structural racism. Research demonstrates substantial harm associated with being the child of an incarcerated caregiver – but what about caregivers of youth in the juvenile legal system? This study was the first to evaluate associations between daughter’s juvenile legal system involvement and caregiver mental and physical health problems. Surveys were conducted with 183 Black and Indigenous caregivers of adolescent girls with juvenile legal system involvement (from arrest to incarceration). Results demonstrated caregiver mental health and physical health were significantly impacted by parental stress and stressors specific to having an adolescent daughter with juvenile legal system involvement. Mental health problems were significantly associated with worry about daughter’s delinquent behaviors such as risky sexual behavior and fighting. Specific problems due to having a daughter with juvenile legal system involvement were evaluated; feeling depressed (91% of the sample) and feeling guilty (86% of the sample) were the most frequently reported. Feeling worried about daughter’s juvenile legal system involvement was 5.1 times more likely among female as compared to male caregivers and 4.3 times more likely among single as compared to partnered caregivers. Unique stressors associated with daughter’s juvenile legal system involvement are highlighted in this study, as are self-reported health effects of such experiences for caregivers. Family-focused approaches to prevent girls’ juvenile legal system involvement and respond to their involvement are indicated and should be prioritized in treatment.

MOVING UPSTREAM: PRIMARY AND SECONDARY PREVENTION STRATEGIES TO MITIGATE THE IMPACTS OF EXPOSURE TO ADVERSE EXPERIENCES IN EARLY CHILDHOOD

National surveys indicate worsening mental health symptoms among parents during the COVID-19 pandemic, exacerbated by stressors including caregiving burden, social isolation, and lack of financial resources. Low-income families and families from Black and Brown communities, where the pandemic’s economic and health effects are most acute, may be particularly vulnerable to emotional distress impacting caregivers. Caregiver stress and mental health problems are modifiable risk factors highly correlated to early childhood social-emotional development and increase vulnerability to disrupted attachment and maladaptive parenting. This Symposium presents emerging findings from 4 empirically based preventative interventions. Presenters describe promising new research findings from 4 initiatives with high-risk families that: 1) identify at birth and provide resources to families at elevated risk for maltreatment in a prospective clinical study emphasizing tolerability, feasibility, and engagement, for which the final phase is a randomized controlled trial; 2) promote caregiver-infant bonding in a clinical sample of depressed mothers, using methods validated in Circle of Security; 3) initiate a proof-of-concept and feasibility study using video feedback in primary care to screen and educate caregivers around parent-child interactions; and 4) implement a parent mindfulness training program in preschools for reduction of stress and mental health symptoms in parents, using a mixed-methods open-label design. Across 4 projects demonstrating new clinical research data, presenters share examples of preventative interventions showing feasibility, engagement, and effectiveness, with noteworthy benefits for underserved families via delivery in a range of clinical and nonclinical settings. Despite stressors exacerbated by the pandemic, these novel projects demonstrate with new research findings that high-risk families with infants and young children can be engaged in a range of psychosocial supports toward prevention of maltreatment, improvement in bonding with Circle of Security, assessment and tailored video feedback around parent-child interactions delivered in primary care, and mindfulness to improve caregiver mental health.

Disrupted mealtime interactions are associated with stress and internalizing symptoms in caregivers of school-age children

ABSTRACT Caregivers of children with feeding problems (FP) experience more stress and mental health concerns. This study examines the relationship between disruptive mealtime interactions and symptoms of FP with caregiver stress and mental health concerns. A community sample of 198 caregivers of school-age children completed an online survey about child mealtime problems, caregiver perceptions of the severity of their child’s FP, disrupted mealtime interactions severity, caregiver stress, and caregiver depression and anxiety (i.e., internalizing symptoms). Two-thirds of caregivers reported at least 1 mealtime problem. Child picky eating was commonly reported and occurred before and after age 6. Increase in disrupted mealtime interactions and mealtime problem severity was associated with higher ratings of caregiver stress and increased internalizing symptoms. Feeding is an interactive activity between caregivers and children. Caregiver’s perception of FP is important as negative attributions about child feeding behaviors lead to increased risks of caregiver mental health problems. Integrative care providers and psychologists are encouraged to evaluate caregivers’ feeding concerns in addition to traditional objective measures of child nutrition (e.g., growth charts), as the interactions between caregiver stress, internalizing symptoms, and child FP result in poor outcomes.

Characterizing Family Contextual Factors and Relationships with Child Behavior and Sleep Across the Buffering Toxic Stress Consortium.

The Buffering Toxic Stress (BTS) consortium included six sites in locations that varied widely in racial/ethnic composition and population density. Each site tested a promising parent-child intervention designed to supplement Early Head Start (EHS) services and prevent "toxic stress." To better understand family risk in a large and diverse EHS sample, studies gathered extensive data on family risk exposure, including demographic risk factors (single mother, unemployed, less than high school education or its equivalent, and neighborhood safety), income-to-needs ratio, household resource constraints, perceptions of economic hardship and pressure, caregiver mental health, and caregiver-reported dysfunctional parent-child interactions. Results presented here for all six sites offer context for the more targeted studies in this special issue. Average levels of family characteristics and child behavior varied by site. We also characterized associations between family characteristics, observer-rated child temperament, and child outcomes (i.e., caregiver-reported child behavior problems and behavioral sleep quality), controlling for child age; these relationships were similar across sites. Demographic risk and caregiver mental health problems were positively associated with child behavior problems, with low income-to-needs ratio and increased financial strain relating to behavioral problems in infancy and toddlerhood. Caregiver mental health problems, financial strain, and social and affect temperament dimensions were related to increased behavioral sleep problems. Dysfunctional parent-child interactions and household resource constraints did not demonstrate statistically significant associations. Findings suggest helpful targets to increase effectiveness of parent-child interventions in early childhood on behavior and sleep outcomes.

The characteristics of older homicide offenders: a systematic review

This systematic review was conducted to develop a broader understanding of the characteristics of older people who commit homicide. PubMed, Embase and PsycINFO were searched on 28 November 2018 for studies on homicides committed by people aged 55 years and over. Only articles published in English were included. Studies focusing on euthanasia and palliation were excluded. Fifteen articles met the inclusion criteria, with studies from the United States (n = 6), United Kingdom (n = 2), Australia, Canada, Finland, Italy, New Zealand, Switzerland and Turkey. The age range for ‘older offenders’ varied across the studies. Some studies examined the phenomena of sexual homicide and homicide-suicide. Offenders were more likely to be male, and the domestic setting for the offence was common. Social maladjustment, a care-giver role, personal physical and mental health problems and/or substance misuse issues were relevant to the offenders. Firearms-related homicides were common. Homicide committed by older people is rare but there may be a constellation of risk factors specific to this age group that needs further understanding. Our findings suggest that there is an increasing need for care of older offenders and a need for specialist forensic services for elderly offenders.

The perceived impact of COVID-19 and associated restrictions on young people with epilepsy in the UK: Young people and caregiver survey

PurposeTo garner the views of young people with epilepsy and caregivers regarding the impact of COVID-19 and subsequent restrictions in the UK. MehodsAn online survey was used to explore the views of young people with epilepsy (n = 71) and caregivers (n = 130) in June 2020. It included questions on the impact of the pandemic and associated restrictions on the child’s epilepsy and on child and parental wellbeing. ResultsOne in three young people and 29 % of caregivers reported that the young person’s seizures had increased during the pandemic (only 10 % of young people and 8% of caregivers reported a decrease). Half of young people reported that they were more reluctant to go to hospital. Thirty-one percent of young people and 20 % of parents reported difficulties getting epilepsy medication whilst a significant minority of young people (18 %) and caregivers (25 %) reported that the young person had investigations/assessments cancelled by their hospital. The majority of young people reported their sleep (72 %), mood (64 %) and levels of physical activity (53 %) had deteriorated. Caregivers experienced increases in stress (55 %) and anxiety (52 %). Epilepsy nurses were seen as the most helpful support ConclusionsResults indicate that the pandemic and associated restrictions have had a negative impact on young people with epilepsy. Perceived increases in seizures, reluctance to go to hospital and cancelled investigations are likely to impact on epilepsy management. The wider psychosocial impact is also likely to be significant with increases in child and caregiver mental health problems in an already vulnerable group.

Associations between caregiver mental health and young children’s behaviour in a rural Kenyan sample

ABSTRACT Background: Research shows that caregiver mental health problems have direct, significant effects on child behaviour. While these risks are amplified in low-resource settings, limited evidence exists from these places, especially sub-Saharan Africa. Objective: We measured associations between caregiver mental health and child behaviour in a rural Kenyan sample, hypothesizing that higher rates of caregiver mental health would be associated with increased child behavioural problems. We also sought to provide an overview of caregiver mental health symptoms in our sample. Method: Cross-sectional data were collected from caregivers of children ages 4–5 years old enrolled in a community-based early child development programme in western Kenya. 465 caregivers were recruited and assessed at baseline, and answered questions about child behaviour, mental health symptoms (depression, anxiety, stress), and help-seeking. A multivariate linear regression model was used to assess significance of each mental health factor. Results: Caregiver anxiety (p = 0.01) and parenting stress (p < 0.001) were significantly associated with child behavioural problems. 245 caregivers (52.9%) had high levels of symptoms of depression, anxiety, or both; furthermore, 101 caregivers (21.7%) scored above the cut-off for both of these scales. A high proportion of our sample (60.6%) reported seeking some formal or informal psychosocial support services; however, less than one-third of these caregivers were symptomatic (30.9%). Conclusion: Anxiety and stress were associated with poorer child behavioural outcomes. Our sample reflected a higher prevalence of caregiving adults with mental health symptomology than previous estimates from Kenya, with few high-symptom caregivers seeking support. We discuss further implications for programming and health services delivery.

Mental Health Issues among Caregivers of Young Children in Rural China: Prevalence, Risk Factors, and Links to Child Developmental Outcomes.

Previous research has found that there are high rates of mental health problems among caregivers in rural China and that caregiver mental health may be a significant predictor of developmental delays among infants and toddlers in these rural areas. In this paper, we use data from a survey of 986 caregiver-child pairs in rural China to examine the risk factors of caregiver mental health and measure the association between caregiver mental health and child development outcomes. To conduct the empirical analysis, we assess caregiver mental health using the Depression Anxiety Stress Scales-21 (DASS-21) questionnaire and measure child developmental outcomes using the Bayley Scales of Infant and Toddler Developmental Third Edition (Bayley-III). The results show that 32% of caregivers have depressive symptoms, 42% have anxiety symptoms, and 30% have symptoms of stress. The data also demonstrate that caregiver identity and age as well as different measures of socioeconomic status (SES) (characterized by caregiver education, father’s education, and household wealth) are all significantly linked to symptoms of caregiver mental health problems. The analysis shows that caregiver depression, anxiety, and/or stress are significantly associated with lower early childhood development (ECD) outcomes in all areas measured (cognition, language, social-emotion, and motor skills). The heterogeneous analysis demonstrates that there are differences in the effects of caregiver mental health problems on ECD among households are from families that are endowed with different levels of SES. On the basis of the findings the study concludes that policymakers should pay more attention to caregiver mental health problems in order to improve child developmental outcomes in rural China. The study cannot, however, draw casual conclusions and cannot rule out the possibility of recall bias when measuring caregiver mental health, which may limit the external validity of the findings.

HIV-related enacted stigma and increase frequency of depressive symptoms among Thai and Cambodian adolescents and young adults with perinatal HIV.

HIV-related enacted stigma and social problems may increase risk for depression and/or behavioral problems among adolescents and young adults with perinatal HIV(AYA-PHIV), yet few studies have explored stigma in AYA-PHIV residing in low-to-middle income regions, including Southeast Asia. We assessed HIV-related enacted stigma and social problems in AYA-PHIV who participated in the RESILIENCE study (clinicaltrials.gov identification: U19AI53741) in Thailand and Cambodia using specific questions during structured in-person interviews. Depression was measured by the Child Depression Inventory for children <15 years, or the Center for Epidemiologic Studies Depression Scales for youth ≥15 years); behavioral problems were measured by the Child Behavior Checklist (CBCL-caregiver report). Among 195 AYA-PHIV (median age 16.9 years), 25.6% reported a lifetime experience of enacted stigma, while 10.8% experienced social problems due to HIV infection. The frequency of depressive symptoms was nearly two-fold higher among AYA-PHIV with compared to those without HIV-related enacted stigma (34.7% vs. 16.0%, p = 0.005). Caregiver-reported behavioral problems were detected in 14.6% of all AYA-PHIV, with no differences between those with and without HIV-related enacted stigma. Low household income and caregiver mental health problems were independent risk factors for depressive symptoms; HIV-related enacted stigma was also associated with increased risk, warranting targeted services to support AYA-PHIV.

Using Mixed Methods to Identify the Primary Mental Health Problems and Needs of Children, Adolescents, and Their Caregivers during the Coronavirus (COVID-19) Pandemic.

Our understanding of child, adolescent, and caregiver mental health (MH) problems during the coronavirus pandemic, and which interventions are needed, may be advanced by consumer input. 133 general population caregivers reported top MH problems and needs for themselves and their children (Mage = 8.21; SD = 4.94), using standardized and idiographic measures. We applied linear regression models to quantitative data and thematic analysis to qualitative data. Caregivers’ COVID-era depression and anxiety symptom means fell within the clinical range, as did their children’s MH symptoms. Caregiver-reported child and adolescent symptoms were positively associated with number of children in the home. Caregiver and caregiver-reported child and adolescent symptoms were more pronounced in regions with more lenient COVID-19 restrictions. Among the kinds of help most urgently needed, MH services were ranked #1 for caregivers and adolescents, #2 for 6–12 year-olds, and #3 for 1–5 year-olds. Top problems identified for each age group highlight pressing pandemic-related intervention targets.Electronic supplementary materialThe online version of this article (10.1007/s10578-020-01089-z) contains supplementary material, which is available to authorized users.

The Association between Caregiver Substance Abuse and Mental Health Problems and Outcomes for Trauma-Exposed Youth.

Trauma-exposed youth with impaired caregivers (i.e., due to substance use and/or mental health problems) may be at particular risk for negative outcomes. This study utilized data from the National Child Traumatic Stress Network Core Data Set to examine the impact of caregiver impairment on youth outcomes. Trauma-exposed youth with an impaired caregiver due to either: substance use (n = 498), mental health problems (n = 231), or both substance use and mental health problems (n = 305) were compared to youth without a reported impaired caregiver (n = 2282) to determine if impaired caregiver status is independently associated with increased likelihood of negative behavioral and mental health outcomes and service utilization after accounting for demographics and exposure to traumatic events. Youth with impaired caregivers compared to those without were more likely to display PTSD, emotional and behavioral problems, suicidality, self-injury, and substance abuse and had higher rates of service utilization (p < 0.05). Differential patterns were observed based on the type of caregiver impairment. Findings support the importance of family-centered assessment and intervention approaches for youth affected by trauma.

Effect of Caregiver's Mental Health on Early Childhood Development across Different Rural Communities in China.

Previous research has found that there are high rates of developmental delays among infants and toddlers in rural areas of China. Caregiver mental health problems might be one significant predictor of developmental delays among infants and toddlers, as has been found in other areas of the world. One way that the mental health of caregivers could affect early childhood development is through its effect on parenting practices. In this study, we used data from four major subpopulations of rural China to measure the correlation of caregiver mental health problems with the developmental outcomes of infants and toddlers. To do so, the study used the Bayley Scales of Infant Development III (BSID III) to examine the rates of developmental delays among 2514 rural infants/toddlers aged 6–30 months old. The results of the testing demonstrate that 48% of the sample’s infants/toddlers have cognitive delays; 52% have language delays; 53% have social-emotional delays; and 30% have motor delays. The data collection team also assessed caregiver mental health by using the Depression Anxiety Stress Scales (DASS-21) questionnaire. According to the findings, 39% of caregivers in the sample have symptoms of at least one kind of mental health problem (depression, anxiety, or stress). We also found that most caregivers do not engage in positive parenting practices, while a significant share of caregivers engage in negative parenting practices. The statistical analysis found that showing signs of mental health problems is significantly and negatively associated with infant/toddler developmental outcomes. The study also found that caregivers who show signs of mental health problems are significantly less likely to engage in interactive parenting practices. The study confirms that society needs to pay more attention to caregiver mental health problems in order to improve infant/toddler developmental outcomes in rural China and increase human capital accumulation in China as a whole.

Contextualization of psychological treatments for government health systems in low-resource settings: group interpersonal psychotherapy for caregivers of children with nodding syndrome in Uganda

BackgroundEvidence for the effectiveness of psychological treatments in low- and middle-income countries is increasing. However, there is a lack of systematic approaches to guide implementation in government health systems. The objective of this study was to address this gap by employing the Replicating Effective Programs (REP) framework to guide contextualization of a psychological treatment in the Uganda public health system for caregivers of children affected by nodding syndrome, a neuropsychiatric disorder endemic to Sub-Saharan Africa associated with high morbidity and disability.MethodsTo contextualize a psychological treatment, we followed the four components of the REP framework: pre-conditions, pre-implementation, implementation, and maintenance and evolution. A three-step process involved reviewing health services available for nodding syndrome-affected families and current evidence for psychological treatments, qualitative formative research, and analysis and documentation of implementation activities. Stakeholders included members of affected communities, health care workers, therapists, local government leaders, and Ministry of Health officials. Detailed written, audio, and video documentation of the implementation activities was used for content analysis.ResultsDuring the pre-condition component of REP, we selected group interpersonal therapy (IPT-G) because of its feasibility, acceptability, effectiveness in the local setting, and availability of locally developed training materials. During the pre-implementation component, we adapted the training, logistics, and technical assistance strategies in conjunction with government and stakeholder working groups. Adaptations included content modification based on qualitative research with caregivers of children with nodding syndrome. During the implementation component, training was shortened for feasibility with government health workers. Peer-to-peer supervision was selected as a sustainable quality assurance method. IPT-G delivered by community health workers was evaluated for fidelity, patient outcomes, and other process-level variables. More than 90% of beneficiaries completed the treatment program, which was effective in reducing caregiver and child mental health problems. With the Ministry of Health, we conducted preparatory activities for the maintenance and evolution component for scale-up throughout the country.ConclusionsThe REP framework provides a systematic approach to guide contextualization of psychological treatments for delivery in low-resource public health systems. Specific recommendations are provided for REP’s application in global mental health.Trial registrationISRCTN11382067; 08/06/2016; retrospectively registered

Cumulative risk effect of household dysfunction for child maltreatment after intensive intervention of the child protection system in Japan: a longitudinal analysis

BackgroundBuilding an effective casework system for child maltreatment is a global issue. We estimated the effect of household dysfunction (i.e., interparental violence, caregiver mental health problems, and caregiver substance abuse) on child maltreatment to understand how to advance the current framework of child welfare.MethodsThe sample comprised 759 children (1- to 17-year-old; mean age was 10.6; 404 boys and 355 girls) placed in temporary custody units (one of the strongest intervention of the Japanese child protection system). Caseworkers from 180 units across 43 prefectures completed questionnaires on children and their family and were asked whether a child maltreatment report had been made after cancelation of custody in a 15-month follow-up period. The relations of household dysfunction and maltreatment reports were assessed using the Cox proportional hazard model.ResultsAbout half (48.4%) of the children had been placed in the unit because of maltreatment, and 88.3% had a history of victimization. Seventy-six cases had maltreatment reports after cancelation. We entered household dysfunction variables individually into the model, and each had a significant relationship with maltreatment reports (hazard ratios for interparental violence, caregiver mental health problem, and substance abuse were 1.69, 1.69, and 2.19, respectively) after covariate adjustment. When treating these three variables as cumulative risk score model of household dysfunction, the hazard ratio increased with increasing number of score (1.96 for score two; 2.35 for score three; score 0 as reference).ConclusionsGreater household dysfunction score is a risk of maltreatment after intensive intervention. It is imperative to construct systems facilitating cooperation between child and adult service sectors and to deliver seamless services to children and families. Our findings provide child protect services with risk-stratified interventions for children at victimization risk and promote adult-focused services to be proactive in prevention or intervention for adults with perpetration risk.

Factors associated with mental health services referrals for children investigated by child welfare

Although child welfare caseworkers are responsible for facilitating mental health services access for maltreated children, little is known about caseworkers’ decisions to refer children to services. We aimed to identify factors associated with caseworker referral of children to mental health services after a maltreatment investigation. We analyzed data from 1956 children 2–17 years old from the Second National Survey of Child and Adolescent Well-being. We examined associations of children’s predisposing, enabling, and need-related factors and caseworkers’ work environment characteristics with referral to mental health services. Caseworkers referred 21.0% of children to mental health services. In multivariable analyses controlling for potential covariates, factors associated with increased odds of caseworker referral included: older child age; child sexual abuse (versus neglect); child out-of-home placement; caregiver mental health problems; prior maltreatment reports; clinically significant child behavioral problems; and child welfare agency collaborative ties with mental health providers (all p < .05). Factors associated with decreased odds of caseworker referral included child Black race (versus White race) and lack of insurance (versus Private insurance) (all p < .05). In summary, children’s need for mental health services was positively associated with caseworker referral to services but certain predisposing and enabling factors and caseworker work environment characteristics also correlated with services referral. Interventions to reduce disparities in services referral by race and insurance type are critically needed. These may include child welfare agency implementation of policies for mental health screening, assessment, and services referral based on clinical need and establishment of child welfare-mental health agency collaborative ties.

Mediational Model of Multiple Sclerosis Impairments, Family Needs, and Caregiver Mental Health in Guadalajara, Mexico.

Individuals with multiple sclerosis (MS), especially those living in Latin America, often require assistance from family caregivers throughout the duration of the disease. Previous research suggests that family caregivers may experience positive and negative outcomes from providing care to individuals with MS, but few studies have examined the unmet needs of individuals providing care to family members with MS and how these unmet needs may mediate the relationship between MS symptoms and caregiver mental health. The current study examined the relationships among MS impairments (functional, neurological, cognitive, behavioral, and emotional), unmet family needs (household, informational, financial, social support, and health), and caregiver mental health (satisfaction with life, anxiety, burden, and depression) in a sample of 81 MS caregivers from Guadalajara, Mexico. A structural equation model demonstrated the mediational effect of unmet family needs on the relationship between MS impairments and caregiver mental health. These findings suggest that intervention research on MS caregivers in Latin America may consider focusing on caregiver mental health problems by addressing unmet family needs and teaching caregivers ways to manage the impairments of the individual with MS.

Risky wandering behaviors of persons with dementia predict family caregivers’ health outcomes

ABSTRACTObjectives: To examine the relationships between dementia persons' risky wandering behaviors and family caregivers’ physical and mental health.Methods: A secondary analysis was conducted using the original cross-sectional data from180 dyads. The Risky Wandering and Adverse Outcome model assessed behaviors of eloping and getting lost outside the house for dementia persons. Data were analyzed using descriptive statistics, Pearson's correlation coefficient and hierarchical regressions.Results: The mean age of caregivers was 56.01 years (SD = 13.8); 65% were female. Younger caregivers experienced greater physical fatigue and sleep disturbance. Presence of foreign helpers predicted a reduction in mental and physical fatigue of caregiver (β = −0.186, p < .05; β = 0.198, p < .05, respectively). Getting lost outside of the house influenced caregivers' mental fatigue (β = 0–0.215, p < .05); eloping behavior influenced caregivers' sleep disturbance (β = 0.231, p < .05). Care-receivers’ activities of daily living affected caregivers’ depressive symptoms (β = −0.179, p < .05).Conclusions: Dementia family caregiver physical and mental health problems have distinct predictors. Employing the Risky Wandering and Adverse Outcome model could inform policy makers regarding long-term care resources to improve dementia care.