title: Personal mastery is associated with reduced sympathetic arousal in stressed Alzheimer caregivers.
abstract: OBJECTIVE
  Spousal caregivers of Alzheimer's disease patients are at increased risk for cardiovascular disease, possibly via sympathetic response to stressors and subsequent catecholamine surge. Personal mastery (i.e., belief that one can manage life's obstacles) may decrease psychological and physiological response to stressors. This study examines the relationship between mastery and sympathetic arousal in elderly caregivers, as measured by norepinephrine (NE) reactivity to an acute psychological stressor.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Data were collected by a research nurse in each caregiver's home.
  
  
  METHODS
  Sixty-nine elderly spousal Alzheimer caregivers (mean age: 72.8 years) who were not taking beta-blocking medication.
  
  
  METHODS
  After assessment for mastery and objective caregiving stressors, caregivers underwent an experimental speech task designed to induce sympathetic arousal.
  
  
  METHODS
  Mastery was assessed using Pearlin's Personal Mastery scale and Alzheimer patient functioning was assessed using the Clinical Dementia Rating Scale, Problem Behaviors Scale, and Activities of Daily Living Scale. Plasma NE assays were conducted using pre- and postspeech blood draws.
  
  
  RESULTS
  Multiple regression analyses revealed that mastery was significantly and negatively associated with NE reactivity (B = -9.86, t (61) = -2.03, p = 0.046) independent of factors theoretically and empirically linked to NE reactivity.
  
  
  CONCLUSIONS
  Caregivers with higher mastery had less NE reactivity to the stressor task. Mastery may exert a protective influence that mitigates the physiological effects of acute stress, and may be an important target for psychosocial interventions in order to reduce sympathetic arousal and cardiovascular stress among dementia caregivers.
authors: Department of Psychiatry, University of California at San Diego, La Jolla, CA 92093-0680, USA.
authors: Susan K
authors: SK
authors: Roepke
authors: Brent T
authors: BT
authors: Mausbach
authors: Kirstin
authors: K
authors: Aschbacher
authors: Michael G
authors: MG
authors: Ziegler
authors: Joel E
authors: JE
authors: Dimsdale
authors: Paul J
authors: PJ
authors: Mills
authors: Roland
authors: R
authors: von Känel
authors: Sonia
authors: S
authors: Ancoli-Israel
authors: Thomas L
authors: TL
authors: Patterson
authors: Igor
authors: I
authors: Grant
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D009638:Norepinephrine