UC Berkeley

Caring for a loved one with a neurodegenerative disease can be highly rewarding, but it can also have devastating effects on caregivers’ mental health. Research on vulnerability and resilience to the negative effects of caregiving has emerged over the past few decades, largely focusing on disease factors and caregiver demographics, resources, personality, and coping strategies. The extent to which caregivers’ own emotional functioning, specifically their empathy, relates to their mental health is poorly understood. Because caregiving encompasses a multitude of interpersonal experiences with the person in their care, and emotions play an important role in these interactions, caregiver empathy may be particularly important for their mental health. Thus far, no known studies have utilized laboratory measures of caregiver empathy in examination with caregiver mental health. The present study addressed these gaps by using laboratory measures of two kinds of empathy: cognitive empathy (understanding others’ emotions) and emotional empathy (sharing others’ emotions). In 78 caregivers, we examined cognitive empathy (i.e., accuracy in emotion recognition from films and continuous ratings of a person’s emotions) and emotional empathy (i.e., physiological, behavioral, and self-reported emotional experience to a film depicting suffering) in relation to caregiver mental health (validated questionnaires of depression and anxiety). Results revealed that greater emotional empathy in caregivers (i.e., greater report of negative and caring emotions in response to the film depicting suffering) was associated with worse caregiver mental health. This relationship remained stable when accounting for caregiver physiological and behavioral responses to the film, measures of caregiver cognitive empathy, measures of caregiver emotional reactivity, or a measure of cognitive empathy in the person with neurodegenerative disease. Measures of caregiver cognitive empathy were not related to caregiver mental health. The relationship between caregiver emotional empathy and caregiver mental health was not moderated by disease or caregiver factors known to make caregivers more vulnerable to negative mental health outcomes (i.e., frontotemporal dementia diagnosis, caregiver female gender). These findings identify emotional empathy as a potentially important vulnerability in caregivers of persons with neurodegenerative diseases. One implication of these findings is that, when facing a chronic stressor such as a caregiving, caregivers who are higher in emotional empathy may benefit from strategies that create emotional distance in response to their loved ones’ suffering.