Mechanisms linking benefit finding and psychological wellbeing in spousal dementia caregivers

Abstract

Background: Benefit finding has been linked to better psychological outcomes among caregivers; however, the mechanisms underlying the positive effects of benefit finding are unclear. We tested whether relationships between greater benefit finding and lower anxiety and depression in spousal dementia caregivers were mediated by loneliness, self-efficacy, coping style, and perceived caregiver burden. Methods: Spousal dementia caregivers (n = 253) completed the Positive Aspects of Caregiving scale, the Centre for Epidemiological Studies Depression, the Hospital Anxiety and Depression Scale, the De Jong Gierveld Loneliness scale, the Fortinsky dementia-specific caregiver self-efficacy scale, the Brief COPE Questionnaire and the Zarit Burden Interview. A multiple mediation model was tested using the PROCESS macro in SPSS. Findings: Benefit finding was associated with lower caregiver burden and loneliness, which in turn predicted lower levels of anxiety and depression. No direct pathways, or indirect pathways through self-efficacy or coping, were supported; though self-efficacy and use of dysfunctional coping strategies were significantly related to both benefit finding and psychological wellbeing. Discussion: Our findings indicate that benefit finding may enhance psychological wellbeing by impacting on appraisal processes rather than by promoting positive coping strategies. Caregiver intervention studies that target benefit finding should consider and examine cognitive adaptations as the mechanisms underlying intervention effects on depression and anxiety.