Friendship support and depressive symptoms among aphasia caregivers: does caregiver type matter?

Background Despite the critical roles informal/family caregivers play in the treatment and long-term rehabilitation of individuals living with aphasia, there are few empirical studies on the mental health of aphasia caregivers. The broader social science literature has shown that friendship support is generally associated with better mental health. Further, its psychosocial impacts may vary by individuals’ relational contexts. However, it remains unclear whether the positive association between friendship support and mental health differs by caregiver types (e.g., spousal and adult child caregivers), particularly among aphasia caregivers.Aims To address these knowledge gaps and advance the Life Participation Approach to Aphasia (LPAA), we aim to (1) investigate the association between friendship support and depressive symptoms among aphasia caregivers; (2) examine whether this association varies across different aphasia caregiver types (i.e., adult child, spouse, other caregivers).Methods and Procedures Using purposive sampling strategies, we conducted a cross-sectional survey of aphasia caregivers (n = 77) on their caregiving experiences, friendship support, and health. Ordinary Least Squares regression (OLS) using robust standard errors was conducted to assess the association between friendship support and depressive symptoms of aphasia caregivers and whether this association differs by caregiver type (i.e., adult child, spouse, other caregivers). To contextualize the interaction effect, we conducted marginal effect analysis to predict average depressive symptoms at varying levels of friendship support among different types of caregivers.Outcomes and Results For aim 1, results from OLS with robust standard errors show that friendship support was negatively associated with depressive symptoms (β = -5.04, p = 0.00), holding all else constant. For aim 2, the association between perceived friendship support and depressive symptoms for spousal caregivers (β = 5.32, p = 0.00) and other caregivers (β = 7.87, p = 0.01) was significantly different from that of adult-child caregivers. Accounting for perceived caregiving burden and other statistical controls, a one SD increase in friendship support was associated with a significant reduction in depressive symptoms among adult child caregivers (Δy/Δx = -8.95, p = 0.00). Spousal caregivers experienced a smaller but significant reduction in depressive symptoms (Δy/Δx = -3.64, p = 0.02). The reduction in depressive symptoms was not statistically significant among other caregivers (Δy/Δx = -1.08, p = 0.71).Conclusions Adult child caregivers’ mental health seems to be the most sensitive to the increase of perceived friendship support among all caregiver types, accounting for perceived caregiving burden and other statistical controls. Findings have implications for tailored caregiver intervention guided by LPAA.