Predictors of Depressive Symptomatology Among Lower Social Class Caregivers of Persons with Chronic Mental Illness

This study examined the predictors of depressive symptomatology among caregivers of persons with chronic mental illness. Data were collected through in-person interviews with family caregivers of 103 adults with chronic mental illness who were served by mental health case management agencies. The results indicated that insufficiency of overall social support was the most powerful predictor of caregiver depressive symptomatology. In addition, caregiver burden had a significant unique contribution to caregiver depressive symptomatology, with higher levels of burden associated with greater levels of caregiver depressive symptomatology. Higher levels of client behavioral problems and insufficient support from family members and mental health professionals related to the caregiving role were associated with higher levels of caregiver depressive symptomatology through their associations with care-giver burden. Caregiver race was not significantly related to caregiver burden or to caregiver depressive symptomatology after controlling for other variables. Over two-fifths of White caregivers and over one-quarter of Black caregivers were at risk for clinical depression. Implications for practice and research are discussed.

[1]  D. Biegel,et al.  Predictors of Caregiver Burden among Support Group Members of Persons with Chronic Mental Illness , 1994 .

[2]  L. Thompson,et al.  Prevalence of depression in family caregivers. , 1989, The Gerontologist.

[3]  C. Grella,et al.  Families of the seriously mentally ill and their satisfaction with services. , 1989, Hospital & community psychiatry.

[4]  Joel Fischer,et al.  Measures for Clinical Practice: A Sourcebook , 1987 .

[5]  W. Doll Family coping with the mentally ill: an unanticipated problem of deinstitutionalization. , 1976, Hospital & community psychiatry.

[6]  R. Pruchno,et al.  Husbands and wives as caregivers: antecedents of depression and burden. , 1989, The Gerontologist.

[7]  T. Kamarck,et al.  Measuring the Functional Components of Social Support , 1985 .

[8]  D. Biegel,et al.  A comparative analysis of family caregivers' perceived relationships with mental health professionals. , 1995, Psychiatric services.

[9]  R. G. Hunt,et al.  Social Class and Mental Illness , 1959 .

[10]  K. Brummel-smith,et al.  Decreasing the Burden in Families Caring for a Relative With a Dementing Illness , 1985, Journal of the American Geriatrics Society.

[11]  J. Jackson Life in Black America , 1991 .

[12]  J. House,et al.  Occupational stress and coronary heart disease: A review and theoretical integration. , 1974, Journal of health and social behavior.

[13]  J. Berry,et al.  Psychological, Social, and Health Consequences of Caring for a Relative with Senile Dementia , 1987, Journal of the American Geriatrics Society.

[14]  T. Peters,et al.  Caring for elderly dependents: effects on the carers' quality of life. , 1992, Age and ageing.

[15]  S. Thompson,et al.  The Caregivers of Stroke Patients: An Investigation of Factors Associated with Depression , 1990 .

[16]  S. Lovett,et al.  Dimensions of perceived social support in clinically depressed and nondepressed female caregivers. , 1991, Psychology and aging.

[17]  R. Schulz,et al.  Family Caregiving in Chronic Illness , 1990 .

[18]  P. Sainsbury,et al.  Mental illness and the family. , 1963, Lancet.

[19]  L. Radloff The CES-D Scale , 1977 .

[20]  S. Zarit,et al.  Relatives of the impaired elderly: correlates of feelings of burden. , 1980, The Gerontologist.

[21]  D. Kreisman,et al.  Family response to the mental illness of a relative: a review of the literature. , 1974, Schizophrenia bulletin.

[22]  I. Hughes,et al.  Psychological Well-Being in Families with a Member Suffering from Schizophrenia , 1992, British Journal of Psychiatry.

[23]  C. Eisdorfer,et al.  Depression in Family Members Caring for a Relative With Alzheimer's Disease , 1988, Journal of the American Geriatrics Society.

[24]  R. Schulz Theoretical perspectives on caregiving: Concepts, variables, and methods. , 1990 .

[25]  A. Hatfield Psychological costs of schizophrenia to the family. , 1978, Social work.

[26]  W. Haley,et al.  Stress, appraisal, coping, and social support as predictors of adaptational outcome among dementia caregivers. , 1987, Psychology and aging.

[27]  A. B. Hollingshead,et al.  Social Class and Mental Illness , 1964 .

[28]  J. Albini,et al.  Schizophrenics in the community : an experimental study in the prevention of hospitalization , 1968 .

[29]  L. Noelker,et al.  Longitudinal impact of interhousehold caregiving on adult children's mental health. , 1989, Psychology and aging.

[30]  H. Lefley Family burden and family stigma in major mental illness. , 1989, The American psychologist.

[31]  D. Monahan,et al.  The effect of a support and education program on stress and burden among family caregivers to frail elderly persons. , 1989, The Gerontologist.

[32]  J. Cook,et al.  Strength in Adversity: Blacks Bear Burden Better Than Whites , 1993 .

[33]  R. Schulz,et al.  A 2-year longitudinal study of depression among Alzheimer's caregivers. , 1991, Psychology and aging.

[34]  C. Cox,et al.  Minority Caregivers of Dementia Victims: A Comparison of Black and Hispanic Families , 1990 .

[35]  J. Becker,et al.  Coping resources and depression in the caregiving spouses of Alzheimer patients. , 1990, The British journal of medical psychology.

[36]  R. Lewine,et al.  How families evaluate mental health professionals, resources, and effects of illness. , 1982, Schizophrenia bulletin.

[37]  D. Cutler,et al.  Networks and the chronic patient , 1983 .

[38]  D. Biegel,et al.  Predictors of burden among lower socioeconomic status caregivers of persons with chronic mental illness , 1994, Community Mental Health Journal.

[39]  R. Turner,et al.  Schizophrenics in the community , 1967 .