Caregiver distress is prevalent in Parkinson’s disease (PD) and predictive of negative health outcomes for both people with PD and caregivers. To identify future intervention targets, it is important to better elucidate the specific processes, such as criticism, that perpetuate burden.
Objective:
Evaluate the frequency and impact of criticism and reactivity to criticism in PD caregiving dyads.
Methods:
Eighty-three people with PD and their caregivers independently completed measures of criticism and physical and emotional health.
Results:
Criticism in the caregiving relationship was reported by 71.1% (n = 59) of people with PD and 80.7% (n = 67) of caregivers. Both perceived criticism and emotional reactivity to criticism were significant predictors of caregiver distress, adjusting for PD motor and non-motor symptom severity. In contrast, criticism was not related to PD depression.
Conclusion:
Criticism in the PD caregiving relationship is a clear target for psychotherapeutic intervention and may improve caregiver health and quality of life.
CarterJHStewartBJArchboldPG, et al.Living with a person who has Parkinson’s disease: the Spouse’s perspective by stage of disease. Mov Disord. 1998;13(1):20–28. doi:10.1002/mds.870130108
3.
CarterJHStewartBJLyonsKSArchboldPG. Do motor and nonmotor symptoms in PD patients predict caregiver strain and depression?Mov Disord. 2008;23(9):1211–1216. doi:10.1002/mds.21686
4.
MosleyPEMoodieRDissanayakaN. Caregiver Burden in Parkinson disease: a critical review of recent literature. J Geriatr Psychiatry Neurol. 2017;30(5):235–252. doi:10.1177%2F0891988717720302
5.
PerepezkoKHinkleJTShepardMD, et al.Social role functioning in Parkinson’s disease: a mixed-methods systematic review. Int J Geriatr Psychiatry. 2019;34(8):1128–1138.
6.
BackerJH. Stressors, social support, coping, and health dysfunction in individuals with Parkinson’s disease. J Gerontol Nurs. 2000;26(11):6.
7.
GreeneSMGriffinWA. Symptom study in context: effects of marital quality on signs of Parkinson’s disease during patient-spouse interaction. Psychiatry. 1998;61(1):35–45.
8.
SingerE. Sociopsychological factors influencing response to levodopa therapy for Parkinson’s disease. Arch Phys Med Rehabil. 1976;57(1):328–334.
9.
ThommessenBAarslandDBraekhusAOksengaardAREngedalKLaakeK. The psychosocial burden on spouses of the elderly with stroke, dementia and Parkinson’s disease. Int J Geriatr Psychiatry. 2002;17(1):78–84.
10.
O’ReillyFFinnanFAllwrightSSmithGDBen-ShlomoY. The effects of caring for a spouse with Parkinson’s disease on social, psychological and physical well-being. Br J Gen Pract. 1996;46(410):507–512.
11.
SchragAHovrisAMorleyDQuinnNJahanshahiM. Caregiver-burden in Parkinson’s disease is closely associated with psychiatric symptoms, falls, and disability. Parkinsonism Relat Disord. 2006;12(1):35–41.
12.
TanjiHAndersonKEGruber-BaldiniAL, et al.Mutuality of the marital relationship in Parkinson’s disease. Mov Disord. 2008;23(13):1843–1849.
13.
KarlstedtMFereshtehnejadS-MAarslandDLökkJ. Mediating effect of mutuality on caregiver burden in Parkinson’s disease partners. Aging Ment Health. 2020;24(9):1421–1428.
14.
DobkinRRubinoJGaraMMarkMMenzaM. The relationship between caregiver burden and negative social exchanges in Parkinson’s disease. Mov Disord. 2013;28:E6–E7.
15.
MartinSC. Psychosocial challenges experienced by partners of people with Parkinson Disease. J Neurosci Nurs. 2015;47(4):211–222. doi:10.1097/JNN.0000000000000141
16.
NewsomJTNishishibaMMorganDLRookKS. The relative importance of three domains of positive and negative social exchanges: a longitudinal model with comparable measures. Psychol Aging. 2003;18(4):746.
17.
FinchJFOkunMAPoolGJRuehlmanLS. A comparison of the influence of conflictual and supportive social interactions on psychological distress. J Pers. 1999;67(4):581–621.
18.
NewsomJTRookKSNishishibaMSorkinDHMahanTL. Understanding the relative importance of positive and negative social exchanges: examining specific domains and appraisals. J Gerontol B Psychol Sci Soc Sci. 2005;60(6):P304–P312.
19.
RookKS. The negative side of social interaction: impact on psychological well-being. J Pers Soc Psychol. 1984;46(5):1097.
20.
Peterson-PostKMRhoadesGKStanleySMMarkmanHJ. Perceived criticism and marital adjustment predict depressive symptoms in a community sample. Behav Ther. 2014;45(4):564–575.
21.
MiklowitzDJWisniewskiSRMiyaharaSOttoMWSachsGS. Perceived criticism from family members as a predictor of the one-year course of bipolar disorder. Psychiatry Res. 2005;136(2):101–111.
22.
HooleyJMTeasdaleJD. Predictors of relapse in unipolar depressives: expressed emotion, marital distress, and perceived criticism. J Abnorm Psychol. 1989;98(3):229–235.
23.
BurnsJWPostKMSmithDA, et al.Spouse criticism and hostility during marital interaction: effects on pain intensity and behaviors among individuals with chronic low back pain. Pain. 2018;159(1):25–32.
24.
BandRBarrowcloughCWeardenA. The impact of significant other expressed emotion on patient outcomes in chronic fatigue syndrome. Health Psychol. 2014;33(9):1092.
25.
DobkinRMannSWeintraubD, et al.Innovating Parkinson’s care: a randomized controlled trial of telemedicine depression treatment. Mov Disord. 2021. doi:10.1002/mds.28548
26.
Dalrymple-AlfordJMacAskillMNakasC, et al.The MoCA well-suited screen for cognitive impairment in Parkinson disease. Neurology. 2010;75(19):1717–1725.
27.
NasreddineZSPhillipsNABédirianV, et al.The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695–699.
28.
FirstMBWilliamsJBWKargRSSpitzerRL. Structured Clinical Interview for DSM-5, Clinician Version. American Psychiatric Association; 2016.
29.
HamiltonM. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56.
30.
MarshLMcDonaldWMCummingsJRavinaB. Provisional diagnostic criteria for depression in Parkinson’s disease: report of an NINDS/NIMH Work Group. Mov Disord. 2006;21(2):148–158.
31.
CousinsRDaviesADTurnbullCJPlayferJR. Assessing caregiving distress: a conceptual analysis and a brief scale. Br J Clin Psychol. 2002;41(4):387–403.
32.
WareJEJr.SherbourneCD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–483.
33.
VoshaarMAOten KloosterPMTaalEvan de LaarMA. Measurement properties of physical function scales validated for use in patients with rheumatoid arthritis: a systematic review of the literature. Health Qual Life Outcome. 2011;9(1):99.
34.
SpruytteNVan AudenhoveCLammertynFStormsG. The quality of the caregiving relationship in informal care for older adults with dementia and chronic psychiatric patients. Psychol Psychother. 2002;75(3):295–311.
35.
PinquartMSörensenS. Associations of stressors and uplifts of caregiving with caregiver burden and depressive mood: a meta-analysis. J Gerontol B Psychol Sci Soc Sci. 2003;58(2):P112–P128.
36.
BraunMMuraKPETER-WIGHTMHornungRScholzU. Toward a better understanding of psychological well-being in dementia caregivers: the link between marital communication and depression. Fam Process. 2010;49(2):185–203.
37.
BradburyTNBeachSRFinchamFDNelsonGM. Attributions and behavior in functional and dysfunctional marriages. J Consult Clin Psychol. 1996;64(3):569.
38.
CoyneJC. Toward an interactional description of depression. Psychiatry. 1976;39(1):28–40. doi:10.1080/00332747.1976.11023874
39.
StarrLRDavilaJ.Excessive reassurance seeking, depression, and interpersonal rejection: a meta-analytic review. J Abnorm Psychol. 2008;117(4):762.
40.
UebelackerLAWhismanMA. Relationship beliefs, attributions, and partner behaviors among depressed married women. Cognit Ther Res. 2005;29(2):143–154.
41.
DeRubeisRJStrunkDR. The Oxford Handbook of Mood Disorders. Oxford University Press; 2017.
42.
HallgrenMLundinATeeFYBurströmBForsellY.Somebody to lean on: social relationships predict post-treatment depression severity in adults. Psychiatry Res. 2017;249:261–267.
43.
KimJWKangHJBaeKY, et al.Social support deficit and depression treatment outcomes in patients with acute coronary syndrome: findings from the EsDEPACS study. Int J Psychiatry Med. 2019;54(1):39–52.
44.
OxmanTEHullJG. Social support and treatment response in older depressed primary care patients. J Gerontol B Psychol Sci Soc Sci. 2001;56(1):P35–P45.
45.
WangJMannFLloyd-EvansBMaRJohnsonS. Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry. 2018;18(1):1–16.
46.
BlanchardVLHawkinsAJBaldwinSAFawcettEB. Investigating the effects of marriage and relationship education on couples’ communication skills: a meta-analytic study. J Fam Psychol. 2009;23(2):203.
47.
BaucomKJSevierMEldridgeKADossBDChristensenA.Observed communication in couples two years after integrative and traditional behavioral couple therapy: outcome and link with five-year follow-up. J Consult Clin Psychol. 2011;79(5):565.
48.
MartireLMSchulzRHelgesonVSSmallBJSaghafiEM. Review and meta-analysis of couple-oriented interventions for chronic illness. Ann Behav Med. 2010;40(3):325–342.
PinquartMSörensenS. Spouses, adult children, and children-in-law as caregivers of older adults: a meta-analytic comparison. Psychol Aging. 2011;26(1):1.
51.
LinLNWuSC. Kinship moderates the association between a demented individual’s behavioral disturbance and a caregiver’s burden: findings from a national survey in Taiwan. Geriatr Gerontol Int. 2016;16(12):1272–1280.
52.
KimHChangMRoseKKimS. Predictors of caregiver burden in caregivers of individuals with dementia. J Adv Nurs. 2012;68(4):846–855.
53.
FriedemannM-LBuckwalterKC. Family caregiver role and burden related to gender and family relationships. J Fam Nurs. 2014;20(3):313–336.
54.
SavundranayagamMYMontgomeryRJKosloskiK. A dimensional analysis of caregiver burden among spouses and adult children. Gerontologist. 2011;51(3):321–331.
55.
SwinkelsJTilburgTVVerbakelEBroese van GroenouM. Explaining the gender gap in the caregiving burden of partner caregivers. J Gerontol B Psychol Sci Soc Sci. 2019;74(2):309–317.
