Res Gerontol Nurs. 2024 Sep-Oct;17(5):227-236. doi: 10.3928/19404921-20240808-01. Epub 2024 Sep 1.
In dementia family caregiving, caregiver psychopathology has been frequently identified as a possible risk factor for the use of physically abusive, psychologically abusive, and neglectful behaviors toward care recipients. Yet, the mechanistic role of psychopathology in the use of these behaviors is not understood. The purpose of the current study is to determine the role of caregiver mental health in their daily risk of engaging in physically and psychologically aggressive and neglectful behaviors toward their care recipient with dementia.
We used an intensive longitudinal design to survey family caregivers daily over 21 days. Using generalized linear mixed models, we evaluated the differential impact of caregivers' ( = 453) experience of major depression and generalized anxiety disorders measured at baseline versus 9,513 daily ratings of depressive and anxiety symptom severity, and interactions across levels, on the daily odds of engaging in physically abusive, psychologically abusive, and neglectful behaviors.
Caregivers with clinically significant depression or anxiety at baseline had higher daily odds of engaging in each type of abusive and neglectful behavior. Worsened depressive symptoms (compared to individuals' average across all days) on a given day were associated with increased odds of engaging in psychologically and physically aggressive behaviors on the same day. Worsened anxiety symptoms on a given day were associated with increased odds of psychologically aggressive and neglectful behaviors.
A key finding was lack of a significant interaction effect between depression and anxiety disorders and mental health symptomology on the daily odds of engaging in abusive and neglectful behaviors. This finding indicates that daily depressive and anxiety symptoms are generalizable intervention targets across the family caregiver population and do not only increase risk among family caregivers with depressive and anxiety disorders. [(5), 227-236.].
在痴呆症家庭护理中，护理员的精神病理学经常被认为是对护理接受者实施身体虐待、心理虐待和忽视行为的一个可能风险因素。然而，精神病理学在这些行为中的作用机制尚不清楚。本研究的目的是确定护理员的心理健康状况在其日常对痴呆症护理接受者实施身体和心理攻击以及忽视行为的风险中的作用。
我们使用密集纵向设计，在 21 天内对家庭护理员进行每日调查。使用广义线性混合模型，我们评估了基线时和 9 次每日抑郁和焦虑症状严重程度评估中护理员（=453）的主要抑郁和广泛性焦虑症的经历（共 9133 次），以及跨水平的交互作用，对每日发生身体虐待、心理虐待和忽视行为的可能性的差异影响。
基线时患有临床显著抑郁或焦虑的护理员每日发生每种虐待和忽视行为的可能性更高。在给定的一天，与个体在所有日子的平均水平相比，抑郁症状恶化与当天发生心理和身体攻击行为的可能性增加有关。在给定的一天，焦虑症状恶化与发生心理攻击和忽视行为的可能性增加有关。
一个关键发现是，抑郁和焦虑障碍与心理健康症状之间缺乏对每日发生虐待和忽视行为的可能性的显著交互作用。这一发现表明，每日的抑郁和焦虑症状是整个家庭护理员群体中可普遍干预的目标，并且不仅会增加患有抑郁和焦虑障碍的家庭护理员的风险。[（5），227-236]。
