Correlates of Depressive Symptoms Among African American Family Caregivers of Frail Elders

Background and Purpose: The purpose of this study is to examine the variances in caregiver's mental health (depressive symptoms) of African American female family caregivers of frail elders and to identify the predictors of depressive symptoms. With the stress process model (Pearlin, Mullan, Semple, & Skaff, 1990) this study conceptualized variances in the predictors of respondent's depressive symptoms. Sociodemographic factors (age, education, employment, marital status of caregiver and elders, rural vs. urban, household income), objective primary stressors (elder's health status, number of chronic illness, ADL, dependence, level of cognitive ability, duration of caregiving in years and hours per week, and number of children under 18), subjective primary stressors (perceived stress and caregiver burden), secondary stressors (social limitation, self-esteem, self efficacy, caregiving satisfaction, impact of caregiving, mastery and caregiving ideology), and coping factors (formal support use, informal support use, religious coping strategies, distress management and SF summary scores used to measure functional physical health status and mental health) were used as predictors. Methods: Data came from a larger cross-sectional study, the Black Rural and Urban Caregivers Mental Health and Functioning Study, of 521 Midwestern African American female primary caregivers of older African American adults (aged 65 and older). Investigators adapted Picot et al.'s (2001) reverse sampling methodology to obtain information from representative samples of urban and rural older African American adults used to recruit caregivers. The outcome measure for the current analysis is caregiver's depressive symptoms, which was measured with the 20-item Center for Epidemiologic Studies–Depression (CES-D) scale, designed to measure a person's current level of depressive symptoms, with an emphasis on the person's affect (Radloff, 1977). Higher scores reflect higher levels of caregivers' depressive symptoms. Results: Based on the hierarchical linear regression model to examine significant correlates of depression among caregivers, the final model with five factors (R square = .581) indicate that two variables among subjective primary stressors (perceived stress and caregiver burden), two variables among secondary stressors (self-esteem and caregiving satisfaction), three variables among coping factors (distress management, SF -12 physical health summary and SF-12 mental health summary) were significant correlates in explaining the variance of caregivers depression when other things being equal. Specifically, with standardized coefficients comparison, the SF-12 mental health status last six weeks had the strongest effect (β = -.40), followed by the caregiver's perceived stress (β = .25), caregiver burden from caregiving appraisal scale (β = .19), caregiver's self-esteem (β = -.18), the SF-12 physical health status last six weeks (β = -.12), caregiving satisfaction based on caregiving appraisal scale (β = .09), and utilization of distress management skills (β = .08). Conclusions and Implications: The results of this study will provide crucial information for professionals who want to develop effective caregiver support and intervention programs that target specific correlates of depression among African American family caregivers. The practical implication to assessment for utilizing the SF-12 will be discussed.