Group-Based Trajectory Modeling of Caregiver Psychological Distress Over Time

Background Competing theories of adaptation and wear- and-tear describe psychological distress patterns among family caregivers. Purpose This study seeks to characterize psychological distress patterns in family caregivers and identify predictors. Methods One hundred three caregivers of care recipients with primary malignant brain tumors were interviewed within 1, 4, 8, and 12 months post-diagnosis regarding psychological distress; care recipients were interviewed regarding clinical/functional characteristics. Group-based trajectory modeling identified longitudinal distress patterns, and weighted logistic/multinomial regression models identified predictors of distress trajectories. Results Group-based trajectory modeling identified high-decreasing (51.1 % of caregivers) and consistently low (48.9 %) depressive symptom trajectories, high-decreasing (75.5 %) and low-decreasing (24.5 %) anxiety trajectories, and high (37.5 %), moderate (40.9 %), and low-decreasing (21.6 %) caregiver burden trajectories. High depressive symptoms were associated with high trajectories for both anxiety and burden, lower caregivers age, income, and social support, and lower care recipient functioning. Conclusions Our data support the adaptation hypothesis; interventions should target those at risk for persistent distress.