Relationships Among Caregiver Burden, Psychological Flexibility Processes, and Depressive Symptoms in Family Caregivers of People with Dementia: Path Analyses

This study examined relationships among caregiver burden, depressive symptoms, and key processes related to psychological flexibility (experiential avoidance, cognitive fusion, values-driven actions, and mindfulness) in 157 family caregivers of individuals with dementia in the United States. Path analyses were used. Participants’ mean age was 59.5 years, ranging between 24 and 87 years. The model fit indices indicated excellent fit to the data. Caregiver burden had a direct effect on depressive symptoms (51.6 % of the total effect), while indirect effects accounted for 48.4%. The largest indirect effect was through values-driven action (14.6% of the total effect), followed by the paths through cognitive fusion → experiential avoidance (13.5%) and through mindfulness → cognitive fusion → experiential avoidance (8.7%). Targeting these key processes related to psychological flexibility with interventions such as acceptance and commitment therapy may help reduce the negative impact of caregiver burden on depressive symptoms in these caregivers.