Relationships between Negative Exchanges and Depressive Symptoms in Older Couples: The Moderating Roles of Care and Gender

Background and Purpose: Marital relationships have a significant influence on older adults’ well-being. Many studies on general populations of older adults found that negative social exchanges from one spouse are associated with his or her partner’s psychological well-being and distress. In caregiving situations (e.g., illness or disability), negative exchanges between spouses are especially significant. However, few studies have examined to what extent negative social exchanges between spouses have more harmful effects on caregiving couples when compared to non-caregiving couples. This study examines the extent to which the effect of negative exchanges between spouses is stronger for caregiving couples than for non-caregiving couples. This investigation uses dyadic analyses to compare three different groups consisting of (a) couples who do not provide or receive care, (b) couples in which husbands receive care from their wives, and (c) couples in which wives receive care from their husbands. We tested for gender differences in the effect of negative exchanges on depressive symptoms among caregivers and care recipients.

Methods: The sample, taken from the 2012 and 2014 Health and Retirement Study, consisted of 3,564 couples, in which at least one of the spouses was aged 51 and over. Structural equation modeling was used to test the moderating effects of care and gender. After checking the measurement invariance, we constrained the factor loadings of each latent construct to be equal across the three subgroups and estimated the paths between the constructs separately for couples with no caregiving/receiving, couples with care-receiving husbands, and couples with care-receiving wives. Unconstrained model was compared to the model that constrained the path coefficients to be equal across the groups to determine whether they were significantly different. The chi-square difference test was used to determine whether differences were statistically significant. Sociodemographic and health characteristics were included as control variables.

Results: Analyses indicated that there were significant differences in the magnitude of paths between negative exchanges and depressive symptoms across the subgroups. Among wives, negative exchanges with spouses were more significant for caregiving wives (b=1.389, p<0.001) than for wives in non–caregiving relationships (b=0.742, p<0.001) or care-receiving wives (b=0.650, p>0.10). The difference in the magnitude of the path coefficient was significant at the level of 0.05 ((χ²(2)=7.45, p<.05). Among husbands, there was a stronger relationship between negative exchanges and depressive symptoms for care-receiving husbands (b=1.103, p<0.001) than for caregiving husbands (b=0.249, p=0.070) or husbands in non-caregiving relationships (b=0.519, p<0.001). A chi-square test indicated  significant differences in the magnitude of coefficients among husbands (χ²(2)=9.20, p<.05). We also found gender differences in the effect of negative exchanges on depressive symptoms among caregivers ((χ²(1)=17.20, p<.001), but not among care recipients (χ²(1)=0.77, p=.38).

Conclusions and Implications: This study provides evidence that the adverse effects on mental health of negative exchanges between spouses is greater for caregiving wives and care-receiving husbands. To reduce depressive symptoms in caregiving couples, interventions that facilitate supportive interactions between care recipients and caregivers may be effective, especially for couples where wives provide care to husbands.