Predicting depression in dementia caregivers: do religious/spiritual struggles play a role?

Objectives Using a stress process framework model, the goal of this study was to address the current gap in our understanding of the prevalence and predictive power of specific types of religious/spiritual struggles for mental health outcomes in informal dementia caregivers. Method A convenience sample of 156 informal dementia caregivers completed a scale measuring six domains of religious/spiritual struggles, as well as other measures of primary stressors, background/contextual variables, and mental health outcome (depression). Results Overall levels of religious/spiritual struggle were low, but 26 percent of the sample were classified as possible cases of clinically significant religious/spiritual struggle for at least one of the six domains. Of this group, 49 percent acknowledged struggles with ultimate meaning. Religious/spiritual struggles predicted greater self-reported depression over and above number of care recipient problem behaviors (primary stressor), caregiver sex, and caregiver personality (i.e. emotional stability). Although no individual domain of religious/spiritual struggle emerged as most salient, caregivers reported significantly more ultimate meaning struggles than demonic or interpersonal struggles. Conclusion Consistent with the stress process framework model, religious/spiritual struggles appeared to operate as a secondary stressor for informal dementia caregivers, adding predictive power to background/contextual factors and to primary stressors for the measured outcome of self-reported depression. One-fourth of the sample self-reported potentially clinically significant religious/spiritual struggles, with ultimate meaning struggles most commonly reported. Further research in this area may advance efforts to better equip both secular and religious professionals to provide evidence-based counsel to informal dementia caregivers.