Cortisol, family coping and burden in informal caregivers of addicts

Abstract

This study focuses on the prospective mediation role of family coping between burden and cortisol levels in informal caregivers of addicts as well as on the feasible use of two different ways to analyse the salivary cortisol levels. Participants were 120 Portuguese informal caregivers of addicts. The cortisol samples were collected at awakening, 45 minutes later and after a 30 minute presentation of images taken from the International Affective Picture System. Family coping and caregiver burden were measured using the Portuguese versions of the Caregiver Reaction Assessment, and the Family Crisis Oriented Personal Evaluation Scale. Cortisol samples were collected in salivettes and the results were computed in order to determine the Area Under the Curve scores (AUCg, AUCi). Results found family coping to be negatively correlated with burden and AUCg levels (i.e. overall intensity) and positively correlated with either AUCg and AUCi (i.e. change over time). The mediation model revealed that family coping was a partial mediator in the relationship between the burden and AUCg levels. Therefore, Family Coping appears to be an essential variable in understanding the stress response and should be considered in further studies and interventions. In addition, the use of two different formulas for calculating cortisol levels provided important new information concerning the relationship between cortisol, burden and family coping. It seems that burden has a more profound effect on the overall intensity of the neuroendocrine response to caregiver stress and not so much on the sensitivity of the system.

Este estudo centrou-se na utilização viável de duas maneiras diferentes para analisar os níveis de cortisol salivar e no papel moderador do coping familiar entre níveis de cortisol e sobrecarga em cuidadores informais de toxicodependentes. A amostra incluiu 120 cuidadores informais de toxicodependentes. As amostras foram recolhidas ao acordar, 45 minutos mais tarde e depois de uma apresentação de 30 minutos de imagens retiradas do IAPS (International Affective Picture System). O coping familiar e a sobrecarga foram avaliados usando as versões em português do Caregiver Reaction Assessment (CRA) e Family Crisis Oriented Personal Evaluation Scale (F-Copes) respetivamente. As amostras de cortisol foram recolhidas em salivettes e os resultados foram computados, a fim de determinar a área sob a curva (AUCg, AUCi). Os resultados encontraram que o coping familiar encontrou-se negativamente correlacionado com a carga e os níveis AUCg (i.e. intensidade global) e positivamente correlacionada com AUCg e AUCi (ou seja, a mudança ao longo do tempo). O modelo revelou que o coping familiar foi um mediador parcial na relação entre a sobrecarga e os níveis de AUCg. Assim, o uso de duas fórmulas diferentes para calcular os níveis de cortisol forneceu novas informações importantes sobre a relação entre o cortisol, sobrecarga e coping familiar. Parece que a sobrecarga tem um efeito mais profundo sobre a intensidade global da resposta neuroendócrina ao stress do cuidador e não tanto na sensibilidade do sistema.