Indirect effects of caregiver guilt on depressive symptoms through psychological flexibility processes in family caregivers of people with dementia.

Abstract

Objectives: Guilt is a common emotion among family caregivers of individuals with dementia and a significant predictor of depressive symptoms. This study explored the relationships among caregiver guilt, key psychological flexibility processes (cognitive fusion, experiential avoidance, and values-driven action), and depressive symptoms in these caregivers.

Methods: A cross-sectional study design was employed, with data collected from 191 family caregivers of individuals with dementia in the United States. Structural equation modeling was used to analyze the data.

Results: The model demonstrated excellent fit. Caregiver guilt directly explained 50.4% of its effect on depressive symptoms, with indirect effects accounting for 49.6%. The largest indirect effect was through values-driven action alone (11.5%), followed by experiential avoidance alone (10.3%), cognitive fusion → experiential avoidance (7.6%), and cognitive fusion → experiential avoidance → values-driven action (6.1%).

Conclusion: The findings highlight the significant partial mediating roles of key psychological flexibility processes in the relationship between caregiver guilt and depressive symptoms. Interventions targeting these processes in the context of guilt-related thoughts may help healthcare providers support caregivers by reducing the negative impact of caregiver guilt on depressive symptoms.