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The Role of Stressors and Psychosocial Variables in the Stress Process: A Study of Chronic Caregiver Stress

From the Department of Medicine (K.V., N.S., S.L.), Dorothy Crowfoot Hodgkin Laboratories, and the Department of Experimental Psychology (K.V., S.A.), University of Bristol, Clifton, Bristol, United Kingdom.

Address reprint requests to: Kav Vedhara, PhD, MRC HSRC, Department of Social Medicine, University of Bristol, Canynge Hall, Clifton, Bristol, BS8 2PR, United Kingdom. Email: K.Vedhara @bris.ac.uk

OBJECTIVE: An investigation was conducted 1) to examine the relative importance of stressor types (ie, daily hassles, caregiving-specific stressors, and life events) on the stress response, 2) to assess the stability of relationships between psychosocial variables and stress over a 6-month period, and 3) to explore how the nature and magnitude of the contributions made by stressors and psychosocial factors to the stress process varied according to the qualitative characteristics of the stress response (ie, anxiety, depression, and stress).

METHODS: Fifty spousal caregivers of patients with dementia were recruited and asked to participate in a detailed psychosocial evaluation at 3-month intervals; the evaluation involved measurement of stressor frequency, psychosocial variables, and indices of the stress response (ie, anxiety, depression, and stress).

RESULTS: The data revealed that the effects of stressors and psychosocial factors on the stress response were considerable (accounting for 49–63% of the variance in stress response measures). Furthermore, there was some evidence of stability in the effects of the stressor and mediator variables on the stress response. Specifically, the contributions of life events and caregiver difficulties were largely consistent at both 3 and 6 months, and the psychosocial factor of "reactive coping and self-appraisal" influenced all three stress response indices at both 3 and 6 months.

CONCLUSIONS: There is some evidence of stability in the effects of stressors and psychosocial variables on the stress process over a 6-month period. However, it would also seem that the nature of the stress process differs according to the qualitative characteristics of the stress response.

Key Words: chronic stress • anxiety • life events • hassles • psychosocial variables • depression

Abbreviations: HIV = human immunodeficiency virus.

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