Dynamic processes in health outcomes among caregivers of patients with spinal cord injuries.

The developmental trajectories of health outcomes in caregivers of patients with spinal cord injuries (SCIs) were studied as a function of caregiver and patient characteristics. Hierarchical linear modeling analysis examined (a) intraindividual developmental patterns of depressive behavior, anxiety, and physical symptoms over the 1st year of the caregiving career and (b) correlates of heterogeneity in the developmental patterns among 62 caregivers of persons with SCIs. Physical symptoms and anxiety were highly interdependent. Anxiety was a salient predictor of initial levels of and the rate of change in physical symptoms of caregivers. Physical symptoms and younger patient age were significantly predictive of initial levels of anxiety. Physical symptoms and positive affect predicted initial levels of depressive behavior among caregivers. Expressive support predicted the rate of change in anxiety and depressive behavior over time. These findings illustrate the value of studying caregiving as a developmental process.