Psychological flexibility, emotion regulation and coping in stroke caregivers

Abstract

Evidence suggests stroke caregivers experienced reduced mental health outcomes compared to non-caregivers. Despite this, some caregivers report no difficulties. Several demographic and psychological variables have been suggested as explanations for this difference, yet the picture remains unclear. This thesis aimed to better understand the role of three psychological variables (coping, psychological flexibility and emotion regulation) in stroke caregiver outcomes.

Firstly, a systematic review aimed to identify evidence of an association between coping style and depressive symptoms in stroke caregivers. Eleven studies matched inclusion criteria. Results indicated little evidence for an association between problem-focused coping and depression scores. However, some aspects of emotion-focused coping were associated with increased self-reported symptoms of depression. Many studies within this review were of poor quality, leading to an increased risk of bias. Higher-quality research is needed to understand the relationship between coping and depression. Secondly, a cross-sectional study (N=63) investigated the role of psychological flexibility, emotion regulation and coping on caregiver distress and quality of life. Results of a regression analysis indicated that psychological flexibility and emotion regulation significantly predicted distress and quality of life. Emotionally-avoidant coping predicted distress but not quality of life. Problem-focused and active-emotional coping did not significantly predict distress. A conditional process analysis confirmed that emotion regulation mediated the relationship between distress and quality of life. Psychological flexibility moderated the direct (but not indirect) relationship between distress and quality of life. This thesis highlights the important role psychological flexibility, emotion regulation and aspects of emotion-focused coping play in caregiver outcomes. Further research is needed to explore these variables and to develop suitable interventions for caregivers.