A safe haven: an attachment theory perspective on support seeking and caregiving in intimate relationships

This study used an attachment theoretical framework to investigate support-seeking and caregiving processes in intimate relationships. Dating couples (N = 93) were videotaped while one member of the couple (support seeker) disclosed a personal problem to his or her partner (caregiver). Results indicated that when support seekers rated their problem as more stressful, they engaged in more direct support-seeking behavior, which led their partners to respond with more helpful forms of caregiving. Responsive caregiving then led seekers to feel cared for and to experience improved mood. Evidence for individual differences was also obtained: Avoidant attachment predicted ineffective support seeking, and anxious attachment predicted poor caregiving. Finally, couples in better functioning relationships engaged in more supportive interactions, and participants' perceptions of their interaction were biased by relationship quality and attachment style.     

Predictors of caregiving in adult intimate relationships: an attachment theoretical perspective.

Romantic couples (N = 194) participated in an investigation of caregiving processes in adulthood. In Phase 1, couple members completed questionnaires designed to identify attachment style differences in caregiving behavior and to explore the underlying (personal and relationship) mechanisms that lead people with different attachment styles to be effective or ineffective caregivers. Results revealed that social support knowledge, prosocial orientation. interdependence, trust, and egoistic motivation mediated the link between attachment style and caregiving. In Phase 2, responsive caregiving was assessed behaviorally by exposing one member of the couple to a stressful laboratory situation and experimentally manipulating his or her need for support. Results revealed that attachment style and mediating mechanisms identified in Phase 1 also predicted observable support behavior in a specific episode in which a partner had a clear need for support.     

Attachment,caregiving, and relationship functioning in couples: Effects of self and partner

We examined the links among attachment, caregiving, and relationship functioning in both dating (Study 1) and married couples (Study 2), assessing both partners' perspectives. We found that (1) men and women generally evidenced caregiving characteristics similar to those of their parent% especially their same-sex parent; (2) individuals who reported giving more care to their partner evidenced less fearful-avoidant attachment (Studies 1 and 2) and less preoccupation with attachment (Study 2); and (3) individuals' own attachment models and their partner's attachment models and caregiving jointly predicted relationship functioning, but individuals' own attachment models remained strong predictors even after the partner's attachment and caregiving were taken into account. The results suggest that caregiving learned in childhood attachment relationships may be carried forward into adult romantic relationships, and they support the idea that attachment and caregiving are central components of romantic love.     

Self‐esteem and caregiving in romantic relationships: Self‐ and partner perceptions

Self‐esteem may be associated with romantic partners' experience of emotional support and caregiving. Using a sample of 6,385 heterosexual couples in committed relationships gathered from the RELATionship Evaluation (RELATE) data set (see www.relate‐institute.org ), structural equation modeling was used to compare two actor–partner interdependence models examining the associations between both partners' self‐esteem and perceptions of partner caregiving responsiveness (i.e., accessibility, responsiveness, and engagement). Male and female self‐esteem was significantly related to partners' caregiving responsiveness while controlling for family‐of‐origin attachment experiences and relationship stability. Female self‐esteem was also significantly associated with females' caregiving responsiveness. These findings yield important implications, demonstrating that higher self‐esteem may be associated with improved caregiving behaviors between romantic partners. Relevant implications and future research directions are discussed.     

The avoidance cocoon: Examining the interplay between attachment and caregiving in predicting relationship satisfaction

In the present research, we examined the hypothesis that low avoidance enables the activation of the caregiving system, and therefore, among people low in avoidance, caregiving would affect relationship satisfaction, whereas among people high in avoidance, caregiving would not affect relationship satisfaction. One‐hundred seventy‐nine Israeli adults, currently involved in romantic relationships, participated in Study 1, in which we examined whether attachment avoidance moderated the associations between caregiving and relationship satisfaction. In Study 2, we sought to replicate this finding in a sample of Israeli couples (N = 194). Finally, in Study 3 (N = 44), we examined links between attachment, caregiving, and relationship satisfaction over a period of 1 year among Israeli married couples. Results indicated that caregiving deactivation and/or hyperactivation predicted lower relationship satisfaction, yet only among people low in avoidance or among people whose partners were low in avoidance. Results are discussed in relation to the important interplay between behavioral systems on individual and dyadic levels. Copyright © 2014 John Wiley & Sons, Ltd.     

Stroke patients' well-being as a function of caregiving spouses' helpful and unhelpful actions

This study examined the perceptions that 55 older married stroke patients had about themselves and about the motivations of their caregiving spouses when they judged their spouses' actions to be helpful and when they judged them to be unhelpful. It also examined how these perceptions were related to patients' well-being (depression, positive affect, marital satisfaction). Patients had more negative perceptions of themselves and of their spouses when they judged the actions to be unhelpful than when they judged them to be helpful. The hypothesis that perceptions about unhelpful actions would be more strongly related to patients' well-being than would perceptions about helpful actions was only partially supported. Perceptions about unhelpful actions were related to patients' depression, but perceptions about helpful actions were related to positive affect. Both kinds of perceptions were related to marital satisfaction. Findings begin to explicate the complex relationship between perceived helpfulness of actions and well-being.     

Attachment orientation and reactions to anxiety expression in close relationships

This study examined perceptions, interpretations, and emotional reactions to a close partner's anxiety expression as mediators for the association between attachment orientation and caregiving effectiveness. One member of married or dating couples was exposed to a stressor and unobtrusively observed while interacting with his or her partner. Results revealed that anxious attachment was related to higher perceptions of partners' anxiety expression, feeling more personal distress, but not less effective caregiving. Avoidant attachment was related to lower perceptions of partners' anxiety expression and feeling more anger. Negative interpretations of partners' anxiety mediated the association between avoidant attachment and less effective caregiving. These findings suggest that attachment orientation is related to cognitive and emotional processes important for effective caregiving behavior.     

Attachment,caregiving, and marital satisfaction

This research tested the proposition that attachment and caregiving are central, interrelated components of adult love relationships. A sample of 229 married couples was used to assess the association between attachment and caregiving styles and the implications of these variables for marital satisfaction. There was evidence of partner matching in terms of dimensions of attachment (Comfort with closeness, Anxiety over relationships) and caregiving (Responsive care, Compulsive care). Secure attachment (high Comfort with closeness, low Anxiety over relationships) was associated with beneficial caregiving to the spouse (high Responsive care, low Compulsive care). These associations were modest in size, however, suggesting that attachment and caregiving are separate constructs; further, these constructs were related in different ways to retrospective reports of early parenting. Marital satisfaction was higher for securely attached spouses, and for those whose partners reported more beneficial caregiving. For husbands, however, the link between caregiving and satisfaction was restricted to short-term marriages, and to those high in Anxiety over relationships. Overall, the results support the role of attachment and caregiving in marriage, but suggest that variables such as gender have important moderating effects.     

A dyadic exploration of attachment and caregiving in long‐term couples

This cross‐sectional study explored associations between attachment style and caregiving patterns in 125 couples with children in the United Kingdom. The Actor–Partner Interdependence Model was used to model for both actor (own) and partner attachment effects on caregiving. Attachment was measured along the dimensions of avoidance and anxiety, and caregiving was measured along the dimensions of proximity, sensitivity, cooperation, and compulsion. Results indicated that different combinations of individual and partner attachment scores predicted different dimensions of caregiving. Own attachment scores best predicted caregiving proximity, cooperation, and compulsion, whereas own and partner attachment predicted caregiving sensitivity. The implications of the findings, limitations, and suggestions for future research are discussed.     

Views on Aging: How Caring for an Aging Parent Influences Adult Daughters’ Perspectives on Later Life

Approximately 24 million Americans provide informal (unpaid) care to a family member or friend who is disabled or ill. The most common informal caregiving relationship is that of an adult child providing assistance to an elderly parent. Women in midlife represent most of the unpaid caregivers for older adults, yet little is known about how providing care affects women’s beliefs about and desires for their own aging. The purpose of this study was to understand how being a caregiver affected adult daughters’ perspectives on their own late life. In-depth interviews were conducted with a diverse sample of 15 women between the ages of 50 and 65 who were providing care to an ill and disabled parent or parent-in-law. Analysis of the qualitative data revealed that caregivers were affected by the caregiving experience in five ways: gaining awareness, provoking fears, providing a comparison for current functioning, providing firsthand knowledge about aging, and providing an example of how to age. This study offers an alternative perspective on the well-documented negative consequences of caring for an older person, suggesting that caregiving encourages personal growth for adult daughters in midlife.     

Older spouses' perceptions of partners' chronic arthritis pain: implications for spousal responses, support provision, and caregiving experiences

This study of older patients with osteoarthritis and their spouses examined concordance between patients' and spouses' reports of patients' pain severity and the association of concordance with support and caregiving outcomes. Patients and spouses independently viewed videotapes of the patient performing simulated household tasks and provided ratings of patients' pain. Spousal overestimation of patients' pain was the most common type of nonconcordance. Spouses who were accurate in their perceptions of their partner's level of pain during a log-carrying task responded less negatively and provided emotional support that was more satisfying to patients. In addition, spouses who were accurate in their perceptions of their partner's pain during the log-carrying task reported less stress from providing support and assistance. Future research that uses such observational methods may be highly useful for understanding the effects of chronic illness on older couples.     

Attachment and spousal caregiving

A community sample of 362 married couples participated in a study of attachment and spousal caregiving, which combined qualitative and quantitative components. The qualitative component focused on actual experiences of caregiving, assessed by participants' semi‐structured accounts of a situation involving their role as caregiver for their spouse. Attachment styles and their underlying dimensions (comfort with closeness, anxiety over relationships) were related to the type of support provided, the coping strategies used in the situation, caregivers' feelings about the quality of their care, perceived effects on the couple bond, and the emotional tone of the accounts. The quantitative component tested a theoretical model of factors predicting willingness to provide care for the spouse if he or she should become dependent in later life. Measures of attachment and caregiving styles, attachment to spouse, and anticipated burden provided reliable prediction of willingness to care. The results support the conceptualization of attachment and caregiving as interrelated features of marital bonds, and they have important implications for patterns of family caregiving.     

Individual and gender differences in mindful parenting: The role of attachment and caregiving representations

The current study aimed to investigate the mediating role of caregiving representations in the association between attachment representations and mindful parenting. Additionally, this study explored differences between mothers and fathers in attachment and caregiving representations and in mindful parenting and tested whether the proposed model was invariant across genders. A sample of 439 parents (67% mothers) of school-aged children completed measures of attachment-related anxiety and avoidance, caregiving representations, and mindful parenting. Path analyses showed that attachment anxiety was associated with lower levels of mindful parenting through a lower perceived ability to recognize others' needs and more egoistic motivations to provide help. In turn, attachment avoidance was associated with lower levels of mindful parenting through a lower perceived ability to provide help and to evaluate others as worthy of help. The path model was invariant across genders, although fathers presented higher levels of avoidance, more egoistic motivations to provide help, lower perceived ability to recognize others' needs, and lower levels of mindful parenting than mothers. This study demonstrates that attachment representations play a critical role in parents' ability to be mindful in their relationship with their children, although through different caregiving pathways.     

Responsive behaviors in good times and in bad

Although self‐disclosure is a critical aspect of interactions between intimate partners, having a partner who is responsive to one’s needs after the disclosure is equally important. But what does responsiveness look like? Two observational coding systems for responsive behaviors (Study 1) were created to test the links between one partner’s behaviors and the other partner’s outcomes, on videotaped interactions of 79 U.S. dating couples disclosing positive and negative events with each other (Study 2). These systems were useful across both types of disclosure interactions, providing evidence for the importance of responsive behaviors in different contexts. Responsive behaviors were associated with postinteraction perceptions of responsiveness, which is important for understanding how the behavioral response impacts both the discloser and the relationship.     

Models of self and others and their relation to positive and negative caregiving responses

The burden of providing informal care to a family member can lead to caregiver depression and potentially harmful caregiving behavior. Given the interpersonal nature of caregiving, the relationship between caregivers and care recipients may impact caregiver responses. We applied attachment theory to understanding caregiver depression, and both potentially harmful and exemplary caregiving responses. We present data from 430 caregivers in the Family Relationships in Late Life (FRILL 2) Project, a multisite, longitudinal study of caregiving. Age, gender, and model of self were related to caregiving responses, suggesting that model of self may help identify caregivers at risk for poor responses.     

The burden of filial piety: A qualitative study on caregiving motivations amongst family caregivers of patients with cancer in Singapore

Objective. This study explores (1) the motivations and challenges facing family caregiving for cancer in Singapore and (2) suggests a possible framework to guide culturally sensitive future work on caregivers.

Design. Twenty caregivers of patients being treated for cancer at a public hospital in Singapore were interviewed. A semi-structured interview format and inductive thematic analysis were used to analyse the data. Caregivers were asked about their motivations for caregiving and the challenges they faced.

Results. Caregivers’ motivations grouped into three categories: personal value and fulfilment, giving care because of societal expectations such as filial piety, and practical need. Challenges were grouped into interpersonal challenges, disclosure and finding balance. Caregivers with different primary motivations varied in their responses to these challenges. More autonomous caregivers cited learning points and reprioritised more effectively than less autonomous caregivers, who reported more internal conflict and less control over their situation.

Conclusions. In Singapore and Asia, sociocultural values of family caregiving are not uniformly experienced as positive, and may be burdensome for caregivers who give care primarily for extrinsic motivations. As family caregiving needs increase, targeted psychosocial support for caregivers with less autonomous behavioural orientations may pre-empt caregiver burnout and burden.     

Gender bias in caregiving professions: The role of perceived warmth

One hypothesized reason for why a disproportionately low number of men enter caregiving fields is how such men are perceived. In two studies, drawing upon the Stereotype Content Model and the lack‐of‐fit model, we tested whether men would encounter more social (e.g., likeability bias) and economic (e.g., hiring or job opportunity bias) penalties than women in caregiving professions due to perceptions that men are less warm than women. In all three studies, we created job or employment materials in which the gender of the candidate or employee was manipulated. In Study 1, a female preschool teacher received higher warmth ratings than a male preschool teacher, which in turn predicted preference for the female teacher over the male teacher. In Study 2, a female social worker was rated more highly in warmth and job hireability than a male social worker; warmth also mediated the relationships between gender and both likeability and job hireability. In Study 3, a male preschool teacher was rated lower in warmth, likeability, job hireability, and job suitability than both a female preschool teacher and a preschool teacher with an unspecified gender. There were no differences between perceived competence of men and women in caregiving positions when competence was assessed. Implications for the factors that predict adverse reactions to and penalties against men in caregiving occupations, as well as interventions to combat the potential negative effects of such penalties on men's interest in caregiving careers, are discussed.     

Leisure activities, caregiving demands and catecholamine levels in dementia caregivers

This study examined whether satisfaction from leisure activities moderates the relationship between caregiving demands (i.e., hours per day spent caring for a spouse with dementia) and resting levels of the catecholamines norepinephrine (NE) and epinephrine (EPI). Spousal caregivers (n?=?107; mean age?=?73.95?±?8.12 years) were assessed in home for plasma levels of NE and EPI, amount of care provided, and leisure satisfaction. Regression was used to determine whether leisure satisfaction moderated the relationship between hours providing care per day and catecholamine levels. A significant interaction was found between hours caregiving and leisure satisfaction for NE, but not for EPI. Post?hoc regressions were conducted for both NE and EPI. At low leisure satisfaction, time spent caring for a spouse was positively associated with plasma NE (β?=?0.41; p?=?0.005) and EPI (β?=?0.44; p?=?0.003). In contrast, at high levels of satisfaction, time caregiving was not significantly associated with plasma NE (β?=?-0.08; p?=?0.57) or EPI (β?=?0.23; p?=?0.12). These findings suggest that leisure satisfaction may protect caregivers from increases in catecholamines, which have been implicated in cardiovascular risk. Further support for these findings may impact psychological treatments for distressed caregivers.     

Defining the caregiving system: Toward a theory of caregiving

The purpose of this paper is to present a preliminary framework for conceptualizing the caregiving behavioral system. Following Bowlby (1982), we propose that caregiving is organized within a goal-corrected behavioral system that is reciprocal to attachment. The set-goal of the system is to keep dependent offspring close or safe; its adaptive function is protection of the young. The caregiving system is designed to provide changing levels and forms of protection depending upon the developmental and individual requirements of the young. However, the evolutionary interests of the parent are not entirely overlapping with that of the child because the parent's evolutionary fitness depends on the fitness of all her offspring. Caregiving is one of several motivational systems in the parent. Depending upon circumstances, parents may select from a range of caregiving strategies, which are believed to correspond to the continuum of child attachment relationships (secure, avoidant, ambivalent). The adult caregiving system is believed to be guided by an internal representation or mental model of caregiving. This system has its roots in early attachment—caregiver experiences, but is distinct from them. We suggest that the caregiving representational system becomes consolidated initially in adolescence and undergoes change during the transition to parenthood and as a function of interaction with the child. Once this development is complete, situations of danger and safety should activate the caregiving behavioral system. Under normal circumstances, if the parent's own attachment system is aroused she would appeal to her own attachment figures rather than to the child. However, situations that engender feelings of helplessness in the mother (i.e., which cause her to perceive herself as unable to protect the child) may disorganize or disable the caregiving system on both the behavioral and representational levels.     

Interpersonal loss in the context of family caregiving: Implications of communal relationships theory

Abstract

Much is known about the emotional costs of providing care to an ill or disabled family member. However, surprisingly little attention has been devoted to investigating how caregiver distress is related to interpersonal loss (i.e., reactions to changes in the typical day-to-day support behaviors that formerly characterized the caregiver–care recipient relationship). Drawing on the theory of communal relationships (e.g., Clark & Mills, 1979, 1993), this study proposes that the magnitude of interpersonal loss that caregivers experience, as well as its contributions to depressed affect, both directly and indirectly (through impact of interpersonal loss on perceived caregiving burden) are likely to depend on the type of relationship that existed between caregiver and care recipient prior to the onset of illness or disability. In this context, several hypotheses and directions for further research are proposed. It is hoped that future researchers will incorporate loss measures into their research and consider how aspects of preexisting relationships influence associations among interpersonal loss and variables (e.g., burden, social support) known to predict caregiver well-being.