Examining the mediating effect of psychosocial resources on the relationship between ambivalent feelings and depression among Israeli Arab family caregivers of people with dementia

OBJECTIVES: Providing care for family members of individuals with dementia can be accompanied by a myriad of emotions, usually involving negative as well as positive feelings, or "ambivalent feelings." Recent studies conducted among family caregivers of people with dementia have shown ambivalent feelings to be associated with serious psychological consequences, such as increased depression. However, little is known about the path leading from ambivalent feelings to depression. Thus, the aim of this study was to examine the interplay of ambivalent feelings and depression with family caregivers' psychosocial resources-that is, their coping strategies and social support.

METHODS: A cross-sectional study using face-to-face interviews (via structured questionnaire) was conducted with 175 Israeli Arab family caregivers (adult children and spouses) of elderly people with Alzheimer's disease (87.4% female; 72% adult children; mean age = 54.28).

RESULTS: Overall, the participants reported a mild level of depression (mean = 7.93; SD = 4.30; range 0-15) and a moderate level of ambivalent feelings (mean = 1.63; SD = 1.04; range 0-3). Additionally, as expected, ambivalent feelings made a unique-although modest-contribution, adding an additional 6% ( p < 0.001) to the explanation of depression ( R 2 = 0.56, p<0.001). Whereas, neither problem-focused coping nor emotion-focused coping played a significant role in mediating the relationship between ambivalent feelings and depression, social support did mediate the relationship between these variables.

CONCLUSIONS: Our findings show that strengthening and expanding social networks among Israeli caregivers of people with Alzheimer's disease can minimize the impact of experiences of emotional feelings on depression.