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Does Caregiving Cause Psychological Distress? The Case for Familial and Genetic Vulnerabilities in Female Twins



Informal caregiving can be deleterious to mental health, but research results are inconsistent and may reflect an interaction between caregiving and vulnerability to stress.


We examined psychological distress among 1,228 female caregiving and non-caregiving twins. By examining monozygotic and dizygotic twin pairs discordant for caregiving, we assessed the extent to which distress is directly related to caregiving or confounded by common genes and environmental exposures.


Caregiving was associated with distress as measured by mental health functioning, anxiety, perceived stress, and depression. The overall association between caregiving and distress was confounded by common genes and environment for mental health functioning, anxiety, and depression. Common environment also confounded the association of caregiving and perceived stress.


Vulnerability to distress is a factor in predicting caregivers' psychosocial functioning. Additional research is needed to explicate the mechanisms by which common genes and environment increase the risk of distress among informal caregivers.

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This research was supported by the National Institutes of Health grants RC2 HL103416 (D. Buchwald) and R01 AR051524 (N. Afari) and AG023629 (P. Vitaliano). We wish to thank the twins for taking part in the University of Washington Twin Registry and for their time and enthusiasm for this project.

Conflict of Interest

The authors have no conflict of interest to disclose.

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Correspondence to Peter P. Vitaliano Ph.D..

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Vitaliano, P.P., Strachan, E., Dansie, E. et al. Does Caregiving Cause Psychological Distress? The Case for Familial and Genetic Vulnerabilities in Female Twins. ann. behav. med. 47, 198–207 (2014).

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  • Twins
  • Caregiving
  • Psychological distress