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Attachment Behaviors in Parent Child Dyads Coping with Early Stage Alzheimer's Disease and Related Dementias

应对早期阿尔茨海默病和相关痴呆症的亲子二人组的依恋行为

基本信息

批准号：
10329947
负责人：
JOAN E. MONIN
金额：
$ 74.24万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-02-15 至 2023-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10329947
关键词：
Address Adopted Adult Adult Children Affect Alzheimer&apos s Disease Alzheimer&apos s disease related dementia American Behavior Biological Blood Pressure Caregivers Caring Characteristics Child Clinical Code Communication Coping Skills Daughter Dementia Dementia caregivers Elderly Emotional Empathy Engineering Equation Face Family Family member Feeling Future Health Intervention Interview Investigation Literature Longevity Longitudinal observational study Measures Mediating Medicine Mental Health Methodology Modeling Monitor Outcome Parents Patient Self-Report Personal Communication Personal Satisfaction Persons Process Recommendation Recording of previous events Reporting Research Rest Risk Role Safety Security Sex Differences Son Spouses Stress Testing Time United States National Academy of Sciences United States National Institutes of Health Videotape Work aged base care giving burden care recipients caregiver depression caregiver stress caregiving contextual factors coping dementia caregiving follow-up human old age (65+)indexing innovation instrumental activity of daily living interest member multi-component intervention perceived stress physical conditioning primary caregiver stressor theories therapy design tool

项目摘要

Roughly 4 million adult children provide unpaid care to their parents with Alzheimer's disease and related dementias (ADRD). Caring for a parent with ADRD can be stressful and negatively impact caregivers' health. While research on spousal caregiving dyads shows that emotionally supportive communication between spouses in the early stages of ADRD can protect caregivers' health, little is known about such interpersonal processes in parent-child dyads. This needs to be addressed because adult child caregivers and their parents face different interpersonal challenges (e.g., navigating a reversal of the parent-child role) than spousal dyads. We have shown in our spousal caregiving work that mutual emotional support behaviors, defined as caregivers and care-recipients providing and receiving communication of safety, feeling comfortable expressing vulnerability and empathy, and giving and receiving tangible aid, decrease caregiving burden and protect psychological health. Mutual emotional support behaviors are amenable to change, making them appropriate targets for interventions. Our research is informed by attachment theory, which stipulates that the need for emotional security is a fundamental need in the parent-child dyad across the lifespan, especially in times of crisis. Our overarching hypothesis is that mutual emotional support behaviors can protect the health of adult child caregivers and parents by reducing caregiver stress and negative coping strategies. We integrate our hypotheses about mutual support into an existing dyadic caregiving stress model that shows how caregiver and care-recipient characteristics, primary and secondary stressors, caregiver appraisals and coping all influence both dyad members' health and relational functioning. To test our innovative model, we propose a Stage 0 dyadic, longitudinal, and observational study of 200 dyads: older adults aged 60 and older with early stage ADRD and one primary adult child caregiver. Both dyad members will be interviewed, using valid and reliable self-report measures, and have videotaped discussions about dementia-related stressors at baseline and a one-year follow-up. Mutual emotional support behaviors will be measured with an observational coding system created by Co-I Feeney, and blood pressure will be monitored. Dyadic analysis will be performed with mixed models and structural equation modeling. Aim 1 will examine whether mutual emotional support behaviors are associated with lower caregiver demand appraisals, caregiver perceived stress, and caregiver negative coping longitudinally. Aim 2 will examine whether mutual emotional support behaviors protect both dyad members' health and relational functioning longitudinally and whether this is mediated by lower caregiver demand appraisals, caregiver perceived stress, and caregiver negative coping. Aim 3 will examine mutual emotional support behavior differences by sex as a biological variable and contextual factors (e.g., SES, caregiver depression, relationship history). This will lead to a Stage 1 application to create an attachment- based intervention tool to protect the health of parents with ADRD and their adult child primary caregivers.

大约有400万成年子女无偿照顾患有阿尔茨海默病或相关疾病的父母