Transitions to Caregiving, Gender, and Psychological Well-Being: A Prospective U.S. National Study.

Guided by a life course perspective, this study examined the effects of transitioning into caregiving activity for a child, spouse, parent, other relative, or nonkin associate on nine dimensions of psychological well-being. Data came from adults ages 19-95, who were noncaregiver primary respondents in the National Survey of Families and Households in 1987-88 and who were followed up longitudinally in 1992-93 (N = 8,286). Results from multivariate regression models confirmed that the transition to caregiving for primary kin (i.e., a child, spouse, or biological parent) was associated with an increase in depressive symptoms. However in selected instances, caregiving was associated with beneficial effects (e.g., women who began to provide nonresidential care to a biological parent reported more purpose in life than noncaregiving women). Evidence regarding gender differences was inconsistent, varying across caregiving role relationship types. Key Words: caregiving, depression, gender, life course, psychological well-being, transition. The likelihood of becoming a caregiver for a family member or friend with a disabling mental or physical health condition during the adult life course is increasing for both women and men (Brody, 1990; Marks, 1996; Stone, Cafferata, & Sangl, 1987). As public awareness has grown about the prevalence and social significance of informal care provision during the last two decades, caregiving research has mushroomed-particularly research on geriatric caregiving for aging parents and spouses (see Biegel, Sales, & Schulz, 1991; Chappell, 1990; Gallagher-Thompson, Coon, Rivera, Powers, & Zeiss, 1998; Horowitz, 1985; Schulz, O'Brien, Brookwala, & Fleissner, 1995; Schulz, Visintainer, & Williamson, 1990, for reviews). Overall, most studies have concluded that caregiving is associated with an increased sense of burden and psychological distress (e.g., Anthony-Bergstone, Zarit, & Gatz, 1988; George & Gwyther, 1986; Hoyert & Seltzer, 1992; Schulz & Williamson, 1991; Strawbridge, Wallhagen, Shema, & Kaplan, 1997). Gender differences in the effects of caregiving have also been a prominent topic of research interest. Although there is not total consistency in results across studies, the predominance of evidence from research to date suggests that women experience more burden and psychological distress in the caregiving role than men (see Miller & Cafasso, 1992; Montgomery, 1992; Stoller, 1992, Yee & Schulz, 2000, for reviews). Informal caregiving is provided by a wide range of role partners-parents, spouses, adult children, adult children-in-law, other relatives, and nonkin (Barker & Mitteness, 1990; Cantor, 1979; Gerstel & Gallagher, 1993; Marks, 1996, 1998; Neal, Chapman, Ingersoll-Dayton, & Emlen, 1993; Stone et al., 1987). However, relatively few studies have differentiated and examined multiple role relationship types of caregiving (Neal et al. 1993; Seltzer & Li, 2000), even though existing research suggests role relationship type, like gender, is an important moderator of caregiving effects (Biegel et al., 1991). The most typical caregiving role relationship difference examined thus far is between spouse and filial caregivers. Overall, spousal caregivers have been found to experience more negative effects from caregiving than filial caregivers (Biegel et al., 1991; George & Gwyther, 1986; Seltzer & Li, 2000; Young & Kahana, 1989). Additionally, parents providing care for a child with a disability sometimes have been found to experience higher levels of stress in comparison to other types of caregivers (Biegel et al.); however, the evidence on this issue remains mixed (Neal et al., 1993). Only a few studies have explored differences between giving care to a parent and giving care to a parent-in-law, yielding inconsistent results. Spitze, Logan, Joseph, and Lee (1994) found more distress occurred when caring for a biological parent, Ingersoll-Dayton, Starrels, and Dowler (1996) found no differences in caregiver stress, and Peters-Davis, Moss, and Pruchno (1999) found only a few differences. …