Wood Kristie A, Suizzo Marie-Anne, Monin Joan K, Crasta Dev, Lum Hillary D
Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Department of Educational Psychology, The University of Texas at Austin, Austin, CO, USA.
Aging Ment Health. 2025 May 30:1-9. doi: 10.1080/13607863.2025.2508757.
Responsiveness is the cornerstone of relationship satisfaction, and parents with dementia may become increasingly unresponsive due to cognitive impairment. During a child's development, their parent's responsiveness-ability to perceive and tend to their core concerns, significantly impacts the child's attachment and self-image. Given increasing dementia prevalence and its impact on caregivers' mental health, understanding unresponsiveness may enhance caregiver support.
This grounded theory study aimed to develop a conceptual model of how unresponsiveness from parents with dementia manifests from the perspective of their adult child caregivers. Twelve caregivers of parents with dementia participated in semi-structured video interviews.
Participants experienced intense emotional pain, traumatizing relational shifts, and invalidation. Reactions to unresponsiveness included positive coping strategies (e.g. self-care), empathy for parents, and defense strategies (e.g. withdrawal due to perceiving unresponsiveness as threatening). Unresponsiveness was often interpreted as a reflection of participant self-worth, damaging their self-image.
A conceptual model illustrates the dynamic interplay of experiences, reactions, and meanings given to unresponsiveness. Novel findings suggest perceptions of unresponsiveness from parents with dementia may lead to disorganized attachment patterns and compromised self-images in adult child caregivers. The conceptual model may enhance caregiver support by helping clinicians normalize and address these experiences.
反应性是关系满意度的基石，而患有痴呆症的父母可能会因认知障碍而反应越来越迟钝。在孩子的成长过程中，他们父母的反应性——感知并关注其核心问题的能力——会显著影响孩子的依恋关系和自我形象。鉴于痴呆症患病率不断上升及其对照顾者心理健康的影响，了解反应迟钝可能会加强对照顾者的支持。
这项扎根理论研究旨在从成年子女照顾者的角度，建立一个关于痴呆症父母反应迟钝如何表现的概念模型。12名痴呆症患者的照顾者参与了半结构化视频访谈。
参与者经历了强烈的情感痛苦、创伤性的关系转变和被忽视的感觉。对反应迟钝的反应包括积极的应对策略（如自我照顾）、对父母的同理心以及防御策略（如因将反应迟钝视为威胁而退缩）。反应迟钝常常被视为对参与者自我价值的反映，损害了他们的自我形象。
一个概念模型阐明了对反应迟钝的体验、反应和意义之间的动态相互作用。新的研究结果表明，痴呆症父母的反应迟钝可能会导致成年子女照顾者出现混乱的依恋模式和受损的自我形象。该概念模型可以通过帮助临床医生使这些经历正常化并加以应对，从而加强对照顾者的支持。
