Academic journal article Family Relations

A Caregiving Model of Coping with a Partner's Depression*

Academic journal article Family Relations

A Caregiving Model of Coping with a Partner's Depression*

Article excerpt


To test a caregiving model of depression in spouses, 31 married couples completed interview and questionnaire assessments of depressive symptoms and caregiving activities. Spouses living with a partner with depressive symptoms had more symptoms of depression themselves. However, this association was found to be fully mediated by spouses' perceived level of caregiving stress and burden. Results suggest that feelings of stress associated with caring for a depressed spouse may lead to depressive symptoms in the caregiving spouse and should be addressed in treatment.

Key Words: caregiving burden, depression, spouse.

Spouses of depressed individuals are at risk for increased depressive symptoms themselves (Benazon & Coyne, 2000; Coyne et al., 1987; Dudek et al., 2001). In treating depressed patients, particularly in the context of marital therapy, therapists need to be aware of how depressive symptoms in one spouse may produce increased symptoms in the other spouse. Several models have been proposed to explain this "contagion" effect of depression. In the present study, caregiver stress and burden was tested as a possible mediator of the relationship between depression levels in spouses.

Coyne (1976) posited that depression has detrimental effects on interpersonal relationships. In a meta-analysis of the empirical literature examining the interpersonal nature of depression, Joiner and Katz (1999) found substantial support for the contention that depressive symptoms and negative mood are contagious. For example, studies of college roommates found elevated depression in roommates of depressed students (Joiner, 1994), providing support for Coyne's interpersonal theory of depression that suggests that living with a depressed person could precipitate distress and psychiatric disturbance.

Although studies of college roommates have illuminated the potential effects of living with a depressed person, there are notable differences in the quality, duration, and commitment of marital relations in comparison with transient roommate relationships. If merely being in the presence of a depressed person is associated with depressive symptoms, then spouses whose lives are intertwined with their depressed partner's also should show more depressive symptoms, perhaps to an even greater degree than in other relationships. Findings support this speculation, such that studies of married couples also have found that living with a depressed individual is associated with higher levels of distress and depression, lending support to the contagious model of depression (Benazon, 2000). Specifically, couples in which one partner was depressed reported more dysphoric and uncomfortable feelings and negative well-being compared with nondepressed couples (Hautzinger, Linden, & Hoffman, 1982). Depressed spouses also appear to be less able to respond to a spouse's positive behavior with their own positive behavior (Johnson & Jacob, 2000). Further, Coyne et al. (1987) reported that 36%-40% of the spouses of individuals in a depressive episode had enough depressive symptoms themselves to meet standardized criteria to warrant a referral, compared with 17% of spouses of previously depressed individuals not in a depressive episode.

Caregiving and Depression

The relationship between caregiving burden and depression is well documented within the medical domain. A recent meta-analysis of 84 studies examining differences between caregivers and noncaregivers on a variety of physical and psychological health variables found the greatest difference between the groups on depression (Pinquart, Schiller, & Soerensen, 2003). Much of this literature examined caring for a family member with Alzheimer's disease or dementia. Compared with healthcare professionals and other family members, spouses are the most vulnerable group of caregivers because they have the most invested in the relationship (Pruchno & Resch, 1989), and Dura, Stukenberg, and Kiecolt-Glasner (1990) found that 30% of spousal caregivers experienced a depressive disorder during the years that they provided care. …

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