Adult attachment and psychological well-being in cancer caregivers: The mediational role of spouses' motives for caregiving

Objective: Caring for a spouse with cancer can be challenging on many levels. How caregivers adjust to this challenge may be influenced both by their personal orientation to the relationship and by their motives for providing care. In this study we examined the prediction of caregiver well-being from the relationship qualities specified by attachment theory and from motives specified by self-determination theory. Design: Cross-sectional data reported here are from the American Cancer Society's Quality of Life Survey for Caregivers. Main Outcome Measures: Three measures were included as indicators of the caregiver's psychological adjustment: benefit finding in cancer caregiving experience, life satisfaction, and depressive symptoms. Results: In structural equation models, among both husband (n = 154) and wife (n = 160) caregivers, attachment security (assessed with respect to the spouse) related positively to autonomous motives for and finding benefit in caregiving; attachment anxiety related to introjected motives for caregiving and more depression. Among husbands (but not wives), autonomous motives also related to less depression, and introjected motives related to less life satisfaction and more depression. Among wives (but not husbands), autonomous motives related to greater benefit finding. Conclusion: Variations in attachment orientations and in reasons for providing care are important elements in understanding the psychological well-being of cancer caregivers.