title: Group-based trajectory modeling of caregiver psychological distress over time.
abstract: BACKGROUND
  Competing theories of adaptation and wear-and-tear describe psychological distress patterns among family caregivers.
  
  
  OBJECTIVE
  This study seeks to characterize psychological distress patterns in family caregivers and identify predictors.
  
  
  METHODS
  One hundred three caregivers of care recipients with primary malignant brain tumors were interviewed within 1, 4, 8, and 12 months post-diagnosis regarding psychological distress; care recipients were interviewed regarding clinical/functional characteristics. Group-based trajectory modeling identified longitudinal distress patterns, and weighted logistic/multinomial regression models identified predictors of distress trajectories.
  
  
  RESULTS
  Group-based trajectory modeling identified high-decreasing (51.1 % of caregivers) and consistently low (48.9 %) depressive symptom trajectories, high-decreasing (75.5 %) and low-decreasing (24.5 %) anxiety trajectories, and high (37.5 %), moderate (40.9 %), and low-decreasing (21.6 %) caregiver burden trajectories. High depressive symptoms were associated with high trajectories for both anxiety and burden, lower caregivers age, income, and social support, and lower care recipient functioning.
  
  
  CONCLUSIONS
  Our data support the adaptation hypothesis; interventions should target those at risk for persistent distress.
authors.affiliation: Department of Acute and Tertiary Care School of Nursing, University of Pittsburgh, Pittsburgh, PA 15217, USA. cjk28@pitt.edu
authors.forename: Chien-Wen J
authors.initials: CW
authors.lastname: Choi
authors.forename: Roslyn A
authors.initials: RA
authors.lastname: Stone
authors.forename: Kevin H
authors.initials: KH
authors.lastname: Kim
authors.forename: Dianxu
authors.initials: D
authors.lastname: Ren
authors.forename: Richard
authors.initials: R
authors.lastname: Schulz
authors.forename: Charles W
authors.initials: CW
authors.lastname: Given
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Given
authors.forename: Paula R
authors.initials: PR
authors.lastname: Sherwood
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D001932:Brain Neoplasms / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires