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Aging Ment Health. 2017 Sep;21(9):997-1004. doi: 10.1080/13607863.2016.1191057. Epub 2016 Jun 3.

The role of compassion, suffering, and intrusive thoughts in dementia caregiver depression.

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a Department of Psychiatry and University Center for Social and Urban Research , University of Pittsburgh , Pittsburgh , PA , USA.
b Center for Gerontology , Virginia Tech , Blacksburg , VA , USA.
c Department of Psychiatry and Behavioral Sciences , University of Miami , Miami , FL , USA.
d Social and Behavioral Sciences Division , Yale School of Public Health , New Haven , CT , USA.



Exposure to suffering of a relative or friend increases the risk for psychological and physical morbidity. However, little is known about the mechanisms that account for this effect. We test a theoretical model that identifies intrusive thoughts as a mediator of the relation between perceived physical and psychological suffering of the care recipient and caregiver depression. We also assess the role of compassion as a moderator of the relation between perceived suffering and intrusive thoughts.


Hispanic and African American caregivers (N = 108) of persons with dementia were assessed three times within a one-year period. Using multilevel modeling, we assessed the mediating role of intrusive thoughts in the relation between perceived physical and psychological suffering and CG depression, and we tested moderated mediation to assess the role of caregiver compassion in the relation between perceived suffering and intrusive thoughts.


The effects of perceived physical suffering on depression were completely mediated through intrusive thoughts, and compassion moderated the relation between physical suffering and intrusive thoughts. Caregivers who had greater compassion reported more intrusive thoughts even when perceived physical suffering of the CR was low. For perceived psychological suffering, the effects of suffering on depression were partially mediated through intrusive thoughts.


Understanding the role of intrusive thoughts and compassion in familial relationships provides new insights into mechanisms driving caregiver well-being and presents new opportunities for intervention.


Family caregiving; compassion; depression; intrusive thoughts

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