The Effect of Resilience on the Relationship between Personality and Burden in Caregivers of Patient with Behavioral and Psychological Symptoms of Dementia (BPSD)
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Abstract
Objective: This study aimed to examine the association between mental resilience and the relationship between caregivers’ personality traits and caregiver burden among caregivers of patients with dementia, and to identify factors associated with caregiver burden.
Methods: A Cross-sectional descriptive study was conducted among 93 caregivers of patients with dementia. The instruments used included the Thai version of the International Personality Item Pool (IPIP) to assess personality traits, the Zarit Burden Interview to measure caregiver burden, and the 20-item Resilience Quotient (RQ) to assess mental resilience. Data were analyzed using descriptive statistics and multivariate analysis with multiple linear regression. Interaction analysis was conducted to examine the moderating role of resilience on the relationship between personality traits and caregiver burden. Linear marginal prediction was conducted to clarify the characteristics of the interaction.
Results: Among the 93 participants, caregiver burden was associated with neuroticism personality trait (ρ = .713, p < .001) and mental resilience (ρ = -.501, p < .001). Multivariate analysis revealed that neuroticism was positively associated with caregiver burden (b = 5.826, 95% CI 4.13, 7.52, p < .001), while the total resilience score (RQ) was negatively associated with caregiver burden (b = -4.447, 95% CI -6.19, -2.71, p < .001). Interaction analysis showed a significant interaction between neuroticism and resilience in predicting burden (interaction effect: b = 1.859, 95% CI 0.21, 3.51, p = .027). Specifically, among caregivers with low neuroticism, those with high resilience had lower predicted burden scores compared to those with low resilience.
Conclusion: A high level of resilience is associated with a lower likelihood of burden among caregivers with a low level of neuroticism, suggesting the role of resilience as a potential target for interventions aiming at preventing caregiver burden.
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References
Wang L, Zhou Y, Fang X, Qu G. Care burden on family caregivers of patients with dementia and affecting factors in China: A systematic review. Front Psychiatry 2022; 13: 1004552.
Balieiro Jr. AP, Sobreira EST, Pena MCS, Silva-Filho JH, Vale FDACD. Caregiver distress associated with behavioral and psychological symptoms in mild Alzheimer’s disease. Dement Neuropsychol 2010; 4: 238–44.
Deardorff WJ, Grossberg GT. Behavioral and psychological symptoms in Alzheimer’s dementia and vascular dementia. In: Handbook of Clinical Neurology [Internet]. Elsevier; 2019 [cited 2024 Apr 16]. Available from: https://linkinghub.elsevier.com/retrieve/pii/B9780444640123000022
Pinyopornpanish K, Soontornpun A, Wongpakaran T, Wongpakaran N, Tanprawate S, Pinyopornpanish K, et al. Impact of behavioral and psychological symptoms of Alzheimer’s disease on caregiver outcomes. Sci Rep 2022; 12: 14138.
Torrisi M, De Cola MC, Marra A, De Luca R, Bramanti P, Calabrò RS. Neuropsychiatric symptoms in dementia may predict caregiver burden: a Sicilian exploratory study. Psychogeriatrics 2017; 17: 103–7.
Sitironnarit K. Behavioral and psychological symptoms in dementia: Theory and treatment. J Psychiatr Assoc Thailand 2011; 56: 449–62.
Zhao QF, Tan L, Wang HF, Jiang T, Tan MS, Tan L, et al. The prevalence of neuropsychiatric symptoms in Alzheimer’s disease: Systematic review and meta-analysis. J Affect Disord 2016; 190: 264–71.
Rojanaudomsart A, Khowkagee J, Tantirit T. Clinical practice guidelines in dementia: Neurological Institute of Thailand. Bangkok: Department of Medical Services, Ministry of Public Health; 2021.
Allegri RF, Sarasola D, Serrano CM, Taragano FE, Arizaga RL, Butman J, et al. Neuropsychiatric symptoms as a predictor of caregiver burden in Alzheimer’s disease. Neuropsychiatr Dis Treat 2006; 2: 105-10.
Isik AT, Soysal P, Solmi M, Veronese N. Bidirectional relationship between caregiver burden and neuropsychiatric symptoms in patients with Alzheimer’s disease: A narrative review. Int J Geriatr Psychiatry 2019; 34: 1326–35.
Kim B, Noh GO, Kim K. Behavioural and psychological symptoms of dementia in patients with Alzheimer’s disease and family caregiver burden: a path analysis. BMC Geriatr 2021; 21: 160-72.
Putri YSE, Putra IGNE, Falahaini A, Wardani IY. Factors associated with caregiver burden in caregivers of older patients with dementia in Indonesia. Int J Environ Res Public Health 2022; 19: 12437.
Tulek Z, Baykal D, Erturk S, Bilgic B, Hanagasi H, Gurvit IH. Caregiver burden, quality of life and related factors in family caregivers of dementia patients in Turkey. Issues Ment Health Nurs 2020; 41: 741–9.
Nemcikova M, Katreniakova Z, Nagyova I. Social support, positive caregiving experience, and caregiver burden in informal caregivers of older adults with dementia. Front Public Health 2023; 11: 1104250.
Xu L, Liu Y, He H, Fields NL, Ivey DL, Kan C. Caregiving intensity and caregiver burden among caregivers of people with dementia: The moderating roles of social support. Arch Gerontol Geriatr 2021; 94: 104334.
Baharudin AD, Din NC, Subramaniam P, Razali R. The associations between behavioral-psychological symptoms of dementia (BPSD) and coping strategy, burden of care and personality style among low-income caregivers of patients with dementia. BMC Public Health 2019; 19: 447-59.
Chen YJ, Su JA, Chen JS, Liu CH, Griffiths MD, Tsai HC, et al. Examining the association between neuropsychiatric symptoms among people with dementia and caregiver mental health: are caregiver burden and affiliate stigma mediators?. BMC Geriatr 2023; 23: 27.
Jhang KM, Wang WF, Chang HF, Chang MC, Wu HH. Characteristics predicting a high caregiver burden in patients with vascular cognitive impairment: Using the Apriori Algorithm to delineate the caring scenario. Risk Manag Healthc Policy 2021; 14: 1335–51.
Carver CS, Connor-Smith J. Personality and Coping. Annu Rev Psychol 2010; 61: 679–704.
Costa McCrae. Revised NEO personality inventory : Professional manual. Psychol Assess Resourses 1992.
Costa PT, McCrae R. The NEO personality inventory manual. Psychol Assess Resourses 1985.
Soto J. The next Big Five Inventory (BFI-2): Developing and assessing a hierarchical model with 15 facets to enhance bandwidth, fidelity, and predictive power. J Pers Soc Psychol 2017; 1: 113-17.
Hooker K, Frazier LD, Monahan DJ. Personality and coping among caregivers of spouses with dementia. The Gerontologist 1994; 34: 386–92.
Melo G, Maroco J, Lima-Basto M, De Mendonça A. Personality of the caregiver influences the use of strategies to deal with the behavior of persons with dementia. Geriatr Nur 2017; 38: 63–9.
Feast A, Orrell M, Russell I, Charlesworth G, Moniz‐Cook E. The contribution of caregiver psychosocial factors to distress associated with behavioural and psychological symptoms in dementia. Int J Geriatr Psychiatry 2017; 32: 76–85.
Intasit S, Julkeeree S. Change bad to good RQ: Resilience quotient. Nonthaburi: Department of Mental Health; 2009.
Ruisoto P, Contador I, Fernández-Calvo B, Serra L, Jenaro C, Flores N, et al. Mediating effect of social support on the relationship between resilience and burden in caregivers of people with dementia. Arch Gerontol Geriatr 2020; 86: 103952.
Serra L, Contador I, Fernández‐Calvo B, Ruisoto P, Jenaro C, Flores N, et al. Resilience and social support as protective factors against abuse of patients with dementia: A study on family caregivers. Int J Geriatr Psychiatry 2018; 33: 1132–8.
Yomaboot P, Cooper AJ. Factor structure and psychometric properties of the International Personality Item Pool–NEO (IPIP-NEO) THAI version. J Somdet Chaopraya Inst Psychiat 2016; 10: 36–49.
Zarit SH, Reever KE, Bach-Peterson J. Relatives of the Impaired Elderly: Correlates of Feelings of Burden. Gerontologist 1980; 20: 649–55.
Silpakit O, Chomchuen R, Silpakit C. Psychometric study of the Thai version of Zarit Burden lnterview in psychiatric caregivers. J Ment Health Thai 2015; 23: 13-23.
Cummings J, Mega M, Rosenberg-Thompson S, Carusi D. A., Gornbein J. The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia. Neurology 1994; 44: 2308–14.
Cummings JL. The Neuropsychiatric Inventory: Assessing psychopathology in dementia patients. Neurology 1997; 48: 10–6.
Jitapunkuls S. Disability among Thai elderly living in Klong Toey Slum. J Med Assoc Thai 1994; 77: 231-8.
Faul F, Erdfelder E, Lang A, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods 2007; 39: 175–91.
Faul F, Erdfelder E, Buchner A, Lang A. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. In: Behavior Research Methods 2009; 41: 1149–60.
Huang LC, Lin SH, Tseng HH, Chen KC, Yang YK. The integrated model of glutamate and dopamine hypothesis for schizophrenia: Prediction and personalized medicine for prevent potential treatment-resistant patients. Med Hypotheses 2020; 143: 110159.
Jang Y, Clay OJ, Roth DL, Haley WE, Mittelman MS. Neuroticism and longitudinal change in caregiver depression: Impact of a spouse-caregiver intervention program. The Gerontologist 2004; 44: 311–7.
Melo G, Maroco J, De Mendonça A. Influence of personality on caregiver’s burden, depression and distress related to the BPSD. Int J Geriatr Psychiatry 2011; 26: 1275–82.
Hu Y, Fei J, Yue J, Gao R, Song Q, Zhao X, et al. Emotional abuse and neglect, depression: A moderated mediation model of neuroticism and psychological resilience. Psychiatry Investig 2025; 22 :389–96.
Campbell P, Wright J, Oyebode J, Job D, Crome P, Bentham P, et al. Determinants of burden in those who care for someone with dementia. Int J Geriatr Psychiatry 2008; 23: 1078–85.
Shurgot GR, Knight BG. Influence of neuroticism, ethnicity, familism, and social support on perceived burden in dementia caregivers: Pilot test of the transactional stress and social support model. J Gerontol Ser B 2005; 60: 331–4.
De Vugt ME, Stevens F, Aalten P, Lousberg R, Jaspers N, Verhey FRJ. A prospective study of the effects of behavioral symptoms on the institutionalization of patients with dementia. Int Psychogeriatr 2005; 17: 577–89.
Ito S, Morishita C, Masuya J, Ono M, Honyashiki M, Higashi S, et al. Moderating and mediating effects of resilience together with neuroticism on depressive symptoms in adult volunteers. Neuropsychiatr Dis Treat 2022; 18: 1751–61.
Dias R, Santos RL, Sousa MF, Nogueira MM, Torres B, Belfort T, et al. Resilience of caregivers of people with dementia: a systematic review of biological and psychosocial determinants. Trends Psychiatry Psychother 2015; 37: 12–9.
Gilsenan J, Gorman C, Shevlin M. Explaining caregiver burden in a large sample of UK dementia caregivers: The role of contextual factors, behavioural problems, psychological resilience, and anticipatory grief. Aging Ment Health 2023; 27: 1274–81.
Nieto M, Visier ME, Silvestre IN, Navarro B, Serrano JP, Martínez‐Vizcaíno V. Relation between resilience and personality traits: The role of hopelessness and age. Scand J Psychol 2023; 64: 53–9.
Scott CB. Alzheimer’s Disease Caregiver Burden: Does Resilience Matter?. J Hum Behav Soc Environ 2013; 23: 879–92.
Van Der Lee J, Bakker TJEM, Duivenvoorden HJ, Dröes RM. Do determinants of burden and emotional distress in dementia caregivers change over time?. Aging Ment Health 2017; 21: 232–40.
Kocabaş D, Karaçar Y, Barçin NE. The effect of psychological resilience and self‐efficacy on caregiver burden: A cross‐sectional study among caregivers of people with Alzheimer’s disease. Nurs Open 2025; 12: 70288.
Prince EJ, Siegel DJ, Carroll CP, Sher KJ, Bienvenu OJ. A longitudinal study of personality traits, anxiety, and depressive disorders in young adults. Anxiety, Stress, & Coping 2020; 34: 299–307.
Karsten J, Penninx BWJH, Riese H, Ormel J, Nolen WA, Hartman CA. The state effect of depressive and anxiety disorders on big five personality traits. J Psychiatr Res 2012; 46: 644–50.
