Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Women with substance use disorders or substance use and mental disorders rely heavily on their families for emotional and instrumental support. While family caregivers often report gratifications of caregiving, this role can also negatively impact caregivers' well-being. This poster will report on a recent study that: (1) Assessed the degree to which caregivers of women with substance use or dual disorders experienced depressive symptomatology as compared to the general population; (2) Determined the important correlates of caregivers' depressive symptomatology including care recipient behavioral problems, substance use, or emotional disorders and caregiver physical health and social support. There has been little research on depressive symptomatology of this understudied population.

Methods

This NIDA funded study interviewed women clients in substance abuse treatment programs and also a principal family caregiver/significant other designated by each woman. Almost all (97.2%) of the women who met study eligibility criteria were contacted. Of these, 96.2% (N=87) agreed to participate and provided the name of a family member, and 95% of the family members (N=83) were interviewed. Over four-fifths (84.1%) of the study sample were African-American. More than half of the women (56.1%) were diagnosed as having a current dual disorder (substance use disorder plus anxiety, PTSD, depression, or dysthymia), whereas 43.9% were diagnosed as having only a current substance use disorder, as measured by the C-DIS. A stress-coping model was utilized to identify the impact of family caregiver stressors (e.g., care recipient behavioral, substance use, or emotional problems, caregiver physical health), resources (e.g., caregiver social support), and demographic variables hypothesized to impact caregiver depressive symptomatology. Bivariate correlation analyses were conducted using variables from the theoretical model followed by linear regression analyses utilizing predictors that were statistically significant at the bivariate level.

Results

The depressive symptomatology scale, as measured by the CES-D, had good internal consistency among the study sample (α= .85). Overall, the levels of depressive symptomatology were high with 39% of caregivers being at risk for clinical depression (> 16 on the CES-D). The regression model was statistically significant (p <.001), and accounted for 36% of the variance in caregivers' depressive symptomatology (R2= .36). The strongest predictor of depressive symptomatology was caregivers' perception of their physical health status (B=-1.28, p<.05); higher levels of depressive symptomatology were predicted by lower levels of self-perceived health. Higher levels of care recipients' emotional problems, as perceived by the caregiver, predicted higher levels of caregiver depressive symptomatology (B=2.09, p<.05).

Implications

Findings indicate that family caregivers of women with substance use disorders or with co-occurring disorders experience higher levels of depressive symptomatology compared to the general population. This finding suggests the need for interventions to assist caregivers in managing their caregiving role. The finding that self-perceived physical health predicts depressive symptomatology is consistent with previous research on depression and suggests the importance of evaluating and addressing this issue with caregivers. The finding that care recipients' emotional problems predicted higher levels of caregivers' depressive symptomatology suggests the need for interventions to assist caregivers in understanding and addressing care recipients' emotional problems.