European Journal of Ageing

, Volume 12, Issue 3, pp 175–185 | Cite as

Parental disability, parent care, and offspring mental health outcomes

  • Douglas A. Wolf
  • Kerri M. Raissian
  • Emily Grundy
Original Investigation


Decades of research supports a widely held view that providing parent care is stressful, and that these stresses are associated with adverse mental health outcomes. However, some recent studies suggest an additional possibility, namely that “noncaregiver stress”—a consequence of having a parent with major care needs, but not being an active caregiver—may be a serious problem as well. This finding emerges in data which permit separate controls for parental needs for care and offspring provision of parent care. We extend these results using Generations and Gender Programme data from five countries—Bulgaria, France, Georgia, Romania, and Russia—for which the necessary variables can be comparably measured. Our outcome variable is a depression score based on a 7-item scale. In country-specific regressions, we find two instances of statistically significant associations of depression with the regular provision of personal care to a parent with care needs, i.e., the usual “caregiver stress” result. However, we also find two instances of statistically significant differences in respondents’ depressive symptoms that are associated with having a parent with care needs, i.e., instances of “noncaregiver stress.” We find limited evidence of gender-specific responses to both forms of stress. Our evidence supports both the typical caregiver stress response and the less-studied noncaregiver stress response, which suggests the need for additional research.


Informal care Caregiver stress Parent care Comparative study 



An earlier version of this paper was presented at the 1st GGP User Conference, May 23–24 2011, in Budapest. We have received helpful comments from conference participants, Aat Liefbroer, the editor, and two anonymous referees.


  1. Amirkhanyan A, Wolf DA (2003) Caregiver stress and noncaregiver stress: exploring the pathways of psychiatric morbidity. Gerontologist 43(6):817–827. doi: 10.1093/geront/43.6.817 CrossRefGoogle Scholar
  2. Amirkhanyan A, Wolf DA (2006) Parent care and the stress process: findings from panel data. J Gerontol B Psychol Sci Soc Sci 61(5):S248–S255. doi: 10.1093/geronb/61.5.S248 CrossRefGoogle Scholar
  3. Badurashvili I, Nadareishvili M (2012) Social impact of emigration and rural-urban migration in Central and Eastern Europe, Final Country Report: Georgia. European commission DG employment, social affairs and inclusion VT/2010/001Google Scholar
  4. Bobinac A, van Exel JA, Rutten FFH, Brouwer WBF (2010) Caring for and caring about: disentangling the caregiver effect and the family effect. J Health Econ 29:549–556. doi: 10.1016/j.jhealeco.2010.05.003 CrossRefGoogle Scholar
  5. Botev N (2012) Population ageing in Central and Eastern Europe and its demographic and social context. Eur J Ageing 9(1):69–79. doi: 10.1007/s10433-012-0217-9 CrossRefGoogle Scholar
  6. Brandt M, Haberkern K, Szydlik M (2009) Intergenerational help and care in Europe. Eur Sociol Rev 25(5):585–601. doi: 10.1093/esr/jcn076 CrossRefGoogle Scholar
  7. Brown SL, Smith DM, Schulz R, Kabeto MU, Ubel PA, Poulin M, Yi J, Kim C, Langa KM (2009) Caregiving behavior is associated with decreased mortality risk. Psychol Sci 20(4):488–494. doi: 10.1111/j.1467-9280.2009.02323.x CrossRefGoogle Scholar
  8. Burton LC, Newsom JT, Schulz R, Hirsch CH, German PS (1997) Preventive health behaviors among spousal caregivers. Prev Med 26(2):162–169. doi: 10.1006/pmed.1996.0129 CrossRefGoogle Scholar
  9. Cameron AC, Trivedi PK (2013) Regression analysis of count data, 2nd edn edn. Cambridge University Press, New YorkGoogle Scholar
  10. Chanturidze T, Ugulava T, Durán A, Ensor T, Richardson E (2009) Georgia: health system review. Health Syst Transit 11(8):1–116Google Scholar
  11. Christakis NA, Allison PD (2009) Inter-spousal mortality effects: caregiver burden across the spectrum of disabling disease. In: Cutler DM, Wise DA (eds) Health at older ages: the causes and consequences of declining disability among the elderly. University of Chicago Press, ChicagoGoogle Scholar
  12. Dilworth-Anderson P, Williams I, Gibson BE (2002) Issues of race, ethnicity, and culture in caregiving research: a 20-year review (1980–2000). Gerontologist 42(2):237–272CrossRefGoogle Scholar
  13. Eisenberger NI (2013) An empirical review of the neural underpinnings of receiving and giving social support: implications for health. Psychosom Med 75(6):545–556. doi: 10.1097/PSY.0b013e31829de2e7 CrossRefGoogle Scholar
  14. Fokkema T, Kveder A, Liefbroer AC (2014) Report and recommendations for sample and data adjustment procedures. GGP 212749 (January 2014)Google Scholar
  15. FreedmanVA Cornman JC, Carr D (2014) Is spousal caregiving associated with enhanced well-being? New evidence from the panel study of income dynamics. J Gerontol B Psychol Sci Soc Sci 69(6):861–869. doi: 10.1093/geronb/gbu004 CrossRefGoogle Scholar
  16. Gatz M, Bengston VL, Blum MJ (1990) Caregiving families. In: Birren JR, Schaie KW (eds) Handbook of the psychology of aging, 3rd edn edn. Academic Press, Inc, San DiegoGoogle Scholar
  17. Giarchi GG (1996) Caring for older Europeans: comparative studies in 29 countries. Ashgate Publishing Limited, AldershotGoogle Scholar
  18. Haberkern K, Szydlik M (2010) State care provision, societal opinion and children’s care of older parents in 11 European countries. Ageing Soc 30:299–323. doi: 10.1017/S0144686X09990316 CrossRefGoogle Scholar
  19. Hansen T, Slagsvold B (2011) An evaluation of the existing psychological instruments in the GGS and propositions for a new module. Generations and Gender Programme report Accessed 8 Jan 2014
  20. Hansen T, Slagsvold B (2013) The psychological effects of providing personal care to a partner: a multidimensional perspective. Health Psychol Res 1:e25. doi: 10.4081/hpr.2013.e25 CrossRefGoogle Scholar
  21. Hansen T, Slagsvold B, Ingebretsen R (2013) The strains and gains of caregiving: an examination of the effects of providing personal care to a parent on a range of indicators of psychological well-being. Soc Indic Res 114(2):323–343. doi: 10.1007/s11205-012-0148-z CrossRefGoogle Scholar
  22. Horvath I (2007) Focus migration: Romania. Hamburg Institute for International Economics Accessed 3 April 2014
  23. Hox JJ, de Leeuw E, Petric G, LozarManfreda K, Kogovsek T, Platinovsek R, Klobas J, Aassve A, Kveder A, Liefbroer AC, Hiekel N (2010) Report on the methodological evaluation of the GGS questionnaire. Work Package 6: Methodological Research, GGP 212749Google Scholar
  24. Janevic MR, Connell CM (2001) Racial, ethnic, and cultural differences in the dementia caregiving experience: recent findings. Gerontologist 41(3):334–347. doi: 10.1093/geront/41.3.334 CrossRefGoogle Scholar
  25. Kiecolt-Glaser JK, Glaser R, Gravenstein S, Malarkey WE, Sheridan J (1996) Chronic stress alters the immune response to influenza virus vaccine in older adults. Proc Natl Acad Sci 93(7):3043–3047. doi: 10.1073/pnas.93.7.3043 CrossRefGoogle Scholar
  26. Kinney JM, Parris Stephens MA (1989) Hassles and uplifts of giving care to a parent with dementia. Psychol Aging 4(4):402–408CrossRefGoogle Scholar
  27. Knight BG, Sayegh P (2010) Cultural values and caregiving: the updated sociocultural stress and coping model. J Gerontol B Psychol Sci Soc Sci 65(1):5–13. doi: 10.1093/geronb/gbp096 CrossRefGoogle Scholar
  28. Lawton MP, Moss M, Kleban MH, Glicksman A, Rovine M (1991) A two-factor model of caregiving appraisal and psychological well-being. J Gerontol 46(4):181–189. doi: 10.1037/0882-7974.15.2.259 CrossRefGoogle Scholar
  29. Lee C (1999) Health, stress and coping among women caregivers. J Health Psychol 4(1):27–40. doi: 10.1177/135910539900400104 CrossRefGoogle Scholar
  30. Mamolo M,Scherbov S (2009) Population projections for forty-four European Countries: the ongoing population ageing. Vienna Institute of Demography, European Demographic Research Papers., Accessed 19 Mar 2014
  31. Matud MP (2004) Gender differences in stress and coping styles. Personal Individ Differ 37(7):1401–1415. doi: 10.1016/j.paid.2004.01.010 CrossRefGoogle Scholar
  32. Minagawa Y (2013) Inequalities in health life expectancy in Eastern Europe. Popul Dev Rev 39(4):649–671. doi: 10.1111/j.1728-4457.2013.00632.x CrossRefGoogle Scholar
  33. Nozhenko M (2010) Focus migration, Country profile no. 20, Russian Federation. Hamburg Institute for International Economics. Accessed 21 Jan 2015
  34. O’Reilly D, Connolly S, Rosato M, Patterson C (2008) Is caring associated with an increased risk of mortality? A longitudinal study. Soc Sci Med 67(8):1282–1290. doi: 10.1016/j.socscimed.2008.06.025 CrossRefGoogle Scholar
  35. OECD (2012) International migration outlook, country notes: recent changes in migration movements and policies, Bulgaria. OECD Publishing, Paris. doi: 10.1787/migr_outlook-2012-en Google Scholar
  36. Pearlin LI, Lieberman MA, Menaghan EG, Mullan JT (1990) Caregiving and the stress process: an overview of concepts and their measures. Gerontologist 30(5):583–594. doi: 10.1093/geront/30.5.583 CrossRefGoogle Scholar
  37. Piccinelli M, Wilkinson G (2000) Gender differences in depression. Br J Psychiatry 177:486–492. doi: 10.1192/bjp.177.6.486 CrossRefGoogle Scholar
  38. Pinquart M, Sörensen S (2005) Caregiving distress and psychological health of caregivers. In: Oxington KV (ed) Psychology of stress. Nova Biomedical Books, New York, pp 165–206Google Scholar
  39. Pinquart M, Sörensen S (2007) Correlates of physical health of informal caregivers: a meta-analysis. J Gerontol Series B Psychol Sci Soc Sci 62(2):126–137. doi: 10.1093/geronb/62.2.P126 CrossRefGoogle Scholar
  40. Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1(3):385–401. doi: 10.1177/014662167700100306 CrossRefGoogle Scholar
  41. Ramsay S, Grundy E, O’Reilly D (2013) The relationship between informal caregiving and mortality: an analysis using the ONS longitudinal study of England and Wales. J Epidemiol Commun Health 67:655–660. doi: 10.1136/jech-2012-202237 CrossRefGoogle Scholar
  42. Raschick M, Ingersoll-Dayton B (2004) The costs and rewards of caregiving among aging spouses and adult children. Fam Relat 53(3):317–325. doi: 10.1111/j.0022-2445.2004.0008.x CrossRefGoogle Scholar
  43. Reidel SE, Fredman L, Langenberg P (1998) Associations among caregiving difficulties, burden, and rewards in caregivers to older post-rehabilitation parents. J Gerontol B Psychol Sci Soc Sci 53(3):165–174CrossRefGoogle Scholar
  44. Rose D, Harrison E (2010) From derivation to validation: evidence from the UK and beyond. In: Rose D, Harrison H (eds) Social Class in Europe: an introduction to the European socio-economic classifcation. Rutledge, New YorkGoogle Scholar
  45. Schmaus BJS, Laubmeier KK, Boquiren VM, Herzer M, Zakowski SG (2008) Gender and stress: differential psychophysiological reactivity to stress reexposure in the laboratory. Int J Psychophysiol 69:101–106. doi: 10.1016/j.ijpshcho.2008.03.006 CrossRefGoogle Scholar
  46. Schmid T, Brandt M, Haberkern K (2012) Gendered support to older parents: do welfare states matter? Eur J Ageing 9(1):39–50. doi: 10.1007/s10433-011-0197-1 CrossRefGoogle Scholar
  47. Schulz R, Visintainer P, Williamson GM (1990) Psychiatric and physical morbidity effects of caregiving. J Gerontol B Psychol Sci Soc Sci 45(5):181–191Google Scholar
  48. Schulz R, Hebert RS, Dew MA, Brown SL, Scheier MF, Beach SR, Czaja SJ, Martire LM, Coon D, Langa KM, Gitlin LN, Stevens AB, Nichols L (2007) Patient suffering and caregiver compassion: new opportunities for research, practice, and policy. Gerontologist 47(1):4–13. doi: 10.1093/geront/47.1.4 CrossRefGoogle Scholar
  49. Torti F, Gwyther LP, Reed SD, Friedman JY, Schulman KA (2004) A multinational review of recent trends and reports in dementia caregiver burden. Alzheimer Dis Assoc Disorders 18(2):99–109. doi: 10.1097/01.wad.0000126902.37908.b2 CrossRefGoogle Scholar
  50. Velkoff VA, Kinsella K (1993) Aging in Eastern Europe and the Former Soviet Union, U.S. Census Bureau. Government Printing Office, Washington, DCGoogle Scholar
  51. Vikat A, Speder Z, Beets G, Billari FC, Buhler C, Desequelles A, Fokkema T, Hoem JM, MacDonald A, Neyer G, Pailhe A, Pinnelli A, Solaz A (2007) Generations and gender survey (GGS): towards a better understanding of relationships and processes in the life course. Demogr Res 17(14):389–440CrossRefGoogle Scholar
  52. Wethington E (2000) Contagion of stress. Adv Group Process 17:229–253CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Douglas A. Wolf
    • 1
  • Kerri M. Raissian
    • 2
  • Emily Grundy
    • 3
  1. 1.Syracuse UniversitySyracuseUSA
  2. 2.University of ConnecticutWest HartfordUSA
  3. 3.London School of EconomicsLondonUK

Personalised recommendations