Pain that sticks: The mental, physical, and immune health effects of negative emotional inertia and the role of childhood trauma in dementia spousal caregivers

About This Grant

Project Summary/Abstract Dementia spousal caregiving contributes to chronic diseases of aging that result from stress- associated increases in inflammation. Chronic stress in this population is characterized by negative emotions in response to disruptive behaviors, activities of daily life, and anticipatory grief associated with providing care for a person with dementia, among others. Negative emotions, however, are dynamic, altering over time in response to contextual change and internal emotion regulation processes. Negative emotions that resist change over time (i.e., negative emotional inertia) may pose additional threats to emotional and physical well-being. Indeed, research has shown that individuals reporting negative emotions that linger are at increased risk for poor emotional well-being and physiological dysregulation. Further, our team has shown that dementia spousal caregivers reporting traumatic childhoods show markedly increased pro-inflammatory cytokine production in response to a biological stressor relative to caregivers reporting less trauma in early life. As a result, the caregivers who experience negative emotional inertia and report relatively high levels of childhood trauma may exhibit the poorest self-rated health and immune dysregulation in pro- inflammatory cytokine production. Specific aims: (1) To evaluate the role of emotional inertia in caregiver self-reported health. (2) To assess the immune implications of emotional inertia in dementia spousal caregiving. (3) To assess whether childhood trauma is a risk factor for poor well-being experienced after high levels of emotional inertia. Study design: Within the funded RF1 parent grant, 140 dementia spousal caregivers will have a venous blood draw and report self-rated physical health at baseline and six months after baseline. Participants will also self-report affect throughout the day for two weeks with a smartphone via ecological momentary assessment. We will assess emotional inertia using dynamic structural equation modeling, defining emotional inertia as the within-person auto-regressive coefficient of negative emotion, as standard in the emotion dynamics literature. Blood assays will assess lipopolysaccharide (LPS)-induced cytokine (i.e., interleukin-1ß, interleukin-6, and tumor necrosis factor-α) production. This study will elucidate both the emotional dynamics and psychosocial risk factors that promote increased risk for poor emotional and physical well- being overall.