Advisor(s)

Olivio Clay

Committee Member(s)

Carolyn Pickering
Deborah Ejem
Micheal Crowe
Nataliya Ivankova

Document Type

Dissertation

Date of Award

2-2-2026

Degree Name

Doctor of Philosophy (PhD)

School

College of Arts and Sciences

Department

Psychology

Abstract

Providing care for an individual with Alzheimer’s Disease and Related Dementias (ADRD) is considered the most stressful type of family caregiving that impacts caregivers’ health. More than one in five ADRD family caregivers report their overall health as poor to fair. These adverse health outcomes are often exacerbated when caregivers’ emotional, informational, and practical needs remain unmet throughout the caregiving trajectory. Numerous studies have shown that the ways in which caregivers cope to caregiving-related stressors significantly shape their health outcomes. Despite this evidence, a clear and consistent understanding of caregivers’ own appraisals of their unmet needs, coping strategies and mental health outcomes remain lacking. Guided by prior research and the stress process model, this dissertation investigates how unmet needs and daily coping strategies impact three common indicators of caregiver health outcomes: depressive symptoms, anxiety, and perceived stress. The dissertation includes three studies: two intensive longitudinal analyses and one qualitative study. Paper 1 examines the prevalence and types of self-reported unmet needs across multiple domains and their associations with depressive symptoms, anxiety, and perceived stress. It also assesses whether healthcare access moderates the association between unmet needs and caregiver health outcomes. Paper 2 applies a Dynamic Structural Equation Modeling (DSEM) to test the how daily use of problem-focused, emotion-focused and dysfunctional coping predicts next-day health outcomes. Paper 3 provides a qualitative descriptive analysis of the specific daily coping strategies employed by family caregivers of people with dementia. These three methodological approaches provide an ecologically valid understanding of how unmet needs and coping strategies dynamically influence caregiver health and well-being in everyday life.

Keywords

coping strategies;dementia caregiving;health outcomes;intensive longitudinal design;unmet needs

ProQuest Publication Number

32284801

ISBN

9798273398641

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