# Attachment Behaviors in Parent Child Dyads Coping with Early Stage Alzheimer's Disease and Related Dementias

> **NIH NIH R01** · YALE UNIVERSITY · 2022 · $742,358

## Abstract

Roughly 4 million adult children provide unpaid care to their parents with Alzheimer's disease and related
dementias (ADRD). Caring for a parent with ADRD can be stressful and negatively impact caregivers' health.
While research on spousal caregiving dyads shows that emotionally supportive communication between
spouses in the early stages of ADRD can protect caregivers' health, little is known about such interpersonal
processes in parent-child dyads. This needs to be addressed because adult child caregivers and their parents
face different interpersonal challenges (e.g., navigating a reversal of the parent-child role) than spousal dyads.
We have shown in our spousal caregiving work that mutual emotional support behaviors, defined as caregivers
and care-recipients providing and receiving communication of safety, feeling comfortable expressing
vulnerability and empathy, and giving and receiving tangible aid, decrease caregiving burden and protect
psychological health. Mutual emotional support behaviors are amenable to change, making them appropriate
targets for interventions. Our research is informed by attachment theory, which stipulates that the need for
emotional security is a fundamental need in the parent-child dyad across the lifespan, especially in times of
crisis. Our overarching hypothesis is that mutual emotional support behaviors can protect the health of adult
child caregivers and parents by reducing caregiver stress and negative coping strategies. We integrate our
hypotheses about mutual support into an existing dyadic caregiving stress model that shows how caregiver
and care-recipient characteristics, primary and secondary stressors, caregiver appraisals and coping all
influence both dyad members' health and relational functioning. To test our innovative model, we propose a
Stage 0 dyadic, longitudinal, and observational study of 200 dyads: older adults aged 60 and older with early
stage ADRD and one primary adult child caregiver. Both dyad members will be interviewed, using valid and
reliable self-report measures, and have videotaped discussions about dementia-related stressors at baseline
and a one-year follow-up. Mutual emotional support behaviors will be measured with an observational coding
system created by Co-I Feeney, and blood pressure will be monitored. Dyadic analysis will be performed with
mixed models and structural equation modeling. Aim 1 will examine whether mutual emotional support
behaviors are associated with lower caregiver demand appraisals, caregiver perceived stress, and caregiver
negative coping longitudinally. Aim 2 will examine whether mutual emotional support behaviors protect both
dyad members' health and relational functioning longitudinally and whether this is mediated by lower caregiver
demand appraisals, caregiver perceived stress, and caregiver negative coping. Aim 3 will examine mutual
emotional support behavior differences by sex as a biological variable and contextual factors (e.g., SES,
caregiver d...

## Key facts

- **NIH application ID:** 10329947
- **Project number:** 5R01AG058565-04
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** JOAN E. MONIN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $742,358
- **Award type:** 5
- **Project period:** 2019-02-15 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10329947

## Citation

> US National Institutes of Health, RePORTER application 10329947, Attachment Behaviors in Parent Child Dyads Coping with Early Stage Alzheimer's Disease and Related Dementias (5R01AG058565-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10329947. Licensed CC0.

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