title: Emotional suppression, caregiving burden, mastery, coping strategies and mental health in spousal caregivers.
abstract: The main aim was to explore the multiple mediation effects of personal resources (mastery, engagement and disengagement coping strategies) between caregiving burden and depression in spousal caregivers, based on integrated stress process models. A further aim was to examine whether emotional suppression moderates the relationship between perceived burden and depression.
  
  
  
  Cross-sectional data were collected in 2010-2011 by structured interviews from a sample of 110 spousal caregivers. Coefficients strategy with bootstrapping tested the strength and significance of the conditional indirect effects of simultaneous multiple mediators; and the conditional effect of burden on depression at different emotional suppression values.
  
  
  
  Caregiving burden was indirectly associated with depression, through mastery and disengagement coping, but not through engagement coping. Mastery was negatively associated with depression, while disengagement coping was positively associated with depression. Emotional suppression and functional disability were positively associated with depressive symptoms. A significant burden-by-emotional suppression interaction was found for predicting depressive symptoms.
  
  
  
  The study supports the conditional indirect effect in which burden can affect depression by reducing the mastery and increasing the disengagement coping simultaneously. The study provides also initial support for the moderating effect of emotional suppression, which can increase the deleterious effects of burden on depression. Researchers and practitioners should be aware of these issues of family care in spousal caregivers.
authors.affiliation: a Nursing Department , Zefat Academic College , Zefat , Israel.
authors.forename: Rabia
authors.initials: R
authors.lastname: Khalaila
authors.affiliation: b Department of Gerontology, Faculty of Social welfare and Health Sciences , University of Haifa , Haifa , Israel.
authors.forename: Miri
authors.initials: M
authors.lastname: Cohen
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: burden; coping; depression; emotional suppression; multiple mediators