The relationship between marital intimacy, perceived strain and depression in spouse caregivers of dementia sufferers
Abstract
This study explored the quality of marital relationship between dementia sufferers and their spouse caregivers. It assessed the quality of the relationship (level of intimacy) prior to the onset of dementia and also at the time of the study. Caregivers who experienced lower levels of marital intimacy, both currently and before the onset of dementia, were found to have higher levels of perceived strain and depression. The decline in intimacy following the onset of dementia was estimated from the difference between the levels of past and present intimacy. Caregivers who experienced a greater loss of intimacy had a higher level of depression, but did not show evidence of increased perceived strain. It is speculated that a poor premorbid relationship makes caregiving more stressful because of a greater difficulty in performing the caregiving role. In addition, it is suggested that a poor premorbid relationship or high loss of intimacy acts as a vulnerability factor, predisposing the caregiver to depression.
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Carer psychological morbidity, in particular depression, predicts care breakdown and institutionalisation, as well as elder abuse.
“carer psychological morbidity, in particular depression, predicts care breakdown and, therefore, institutionalisation,7,8 as well as elder abuse.9”
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“In addition, spousal caregivers reported higher levels of marital intimacy with people with dementia who showed fewer behavioural disabilities or disturbances (Morris et al., 1988).”
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“which is associated with care recipient (CR) institutionalisation (Morris et al., 1988) and possibly elder abuse (Shugarman et al.”
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“, 2003; Morris, Morris, & Britton, 1988), and loss of dyad intimacy is associated with increased caregiver depression (Morris et al., 1988).”
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de Vugt, M. E., Stevens, F. C. J., Aalten, P., Lousberg, R. L., Jaspers, N., Winkens, I., JOLLES, J., & Verhey, F. R. J. (2003) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.807 · Cited by 184 · see citing works
“In addition, the results confirm previous findings showing that, overall, caregivers experience a deterioration of their relationship (Horowitz and Shindelman, 1983; Morris et al., 1988; Wright, 1991), yet at the same time most felt closer to their spouse now than in the past.”
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“Morris, Morris, and Britton (1988a) found that spouses who reported a greater loss of closeness following the onset of dementia reported higher levels of depression.”
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Clare, L., Nelis, S. M., Whitaker, C. J., Martyr, A., Markova, I. S., Roth, I., Woods, B. T., & Morris, R. G. (2011) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0b013e318221ba23 · Cited by 78 · see citing works
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Adams, K. B., McClendon, M. J., & Smyth, K. A. (2008) · Dementia · doi:10.1177/1471301208093286 · Cited by 68 · see citing works
“Our findings add support to the studies of Lawrence et al. (1998) and Morris et al. (1988), both of which concluded that quality of relationship is a central feature in this process, an important perception that will be affected by perceptions of the pre-morbid relationship and by the loss of…”
MethodResultThe Emotional Toll of Spousal Morbidity and Mortality
Zivin, K., & Christakis, N. A. (2007) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e318050c9ae · Cited by 66 · see citing works
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“This supports the original findings of Bergmann et al. (1984), who showed that poor outcome was related to negative communication in the relationship and of Morris et al. (1988) who showed that carer strain was related to a poor pre-morbid relationship.”
ResultUnderstanding Stress in Informal Caregiving
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“Co-resident spouses tend to be the most vulnerable to increased stress, possibly due to intense emotional involvement with the patient on a consistent, daily basis [6].”
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“Among spouse caregivers, lower levels of marital intimacy predicted higher perceived caregiving stress.(14) However, the results of prior studies on relationship quality and BPSD‐related distress are not conclusive, with findings ranging from no significant association(15) to identifying it as a key factor in reducing…”
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“These results support previous research indicating that spouse caregivers (Morris et al., 1988), health problems (Pinquart & Sörensen, 2007), and perception of time (Sawyer et al., 2011) and of cost (Lai, 2012) are predictive of caregiver depression.”
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Personal Strengths and Health Related Quality of Life in Dementia Caregivers from Latin America
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“, 2017), while criticism and emotional over-involvement with the care recipient reflect poor relationship quality and predict caregivers’ strain levels (Morris et al., 1988; Fearon et al., 1998).”
BackgroundExperiences and Perspectives of Family Caregivers of the Person with Dementia
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“…et al., 1992) and they experience significantly higher levels of psychological morbidity, depression, stress, and burden than people who are not carers or who are caring for physically ill relatives (Brodaty et al., 1990; Eagles et al., 1987; Livingston et al., 1996; Morris et al., 1988).”
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Anxiety-depression and quality of life in dementia caregivers
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- Authors
- Morris, L. W., Morris, R. G., & Britton, P. G.
- Affiliations
- Royal Victoria Infirmary (GB)
- Corresponding author
- Morris, Lorna W.
- ORCID
- Morris, Robin G.
- Venue
- British Journal of Medical Psychology
- Publisher
- Wiley
- Published
- 1988-09
- Volume
- 61
- Issue
- 3
- Pages
- 231-236
- ISSN
- 0007-1129 (ISSN-L)
- OpenAlex
- W2071185686
- Cited by
- 138
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2022: 3 · 2021: 1 · 2020: 4 · 2019: 1 · 2018: 5 · 2017: 4 · 2016: 3 · 2015: 10 · 2014: 11 · 2013: 6 · 2012: 4
- FWCI
- 2.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- British Journal of Medical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Medical Research Council Canada
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Keywords
- marital intimacy, dementia, spousal caregivers, caregiver depression, perceived strain, caregiver stress, vulnerability factors
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Depressive Disorder, Female, Home Nursing, Humans, Male, Marriage, Middle Aged, Psychological Tests, Risk Factors, Dementia, Vascular
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