Research Article
Structural Equation Modeling of Parkinson’s Caregiver Social
Support, Resilience, and Mental Health: A Strength-
Based Perspective
Carmen M. Tyler,
1
Richard S. Henry,
1
Paul B. Perrin ,
1,2
Jack Watson,
1
Teresita Villaseñor,
3,4
Sarah K. Lageman ,
5
Erin R. Smith ,
1
Genoveva Rizo Curiel,
4
Judith Avila,
4
Miriam E. Jimenez Maldonado,
3,4
and Jose A. Soto-Escageda
4
1
Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
2
Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
3
Hospital Civil Fray Antonio Alcalde, Guadalajara, Mexico
4
Department of Neurosciences, University of Guadalajara, Guadalajara, Mexico
5
Department of Neurology, Parkinson’s & Movement Disorders Center, Virginia Commonwealth University,
Richmond, VA, USA
Correspondence should be addressed to Paul B. Perrin; pperrin@vcu.edu
Received 26 November 2019; Revised 14 January 2020; Accepted 21 January 2020; Published 14 February 2020
Academic Editor: Jeff Bronstein
Copyright © 2020 Carmen M. Tyler et al. is is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Only scant literature has focused on social support in Parkinson’s disease (PD) caregivers, and no studies to date have examined
resilience in this population, despite both variables having been shown to be important in other caregiving populations. As a
result, the purpose of the current study was to construct and validate a theoretical structural equation model whereby social
support is associated with higher levels of resilience in PD caregivers and increased resilience is related to decreased mental health
symptoms. Two hundred fifty three PD caregivers from two clinics in the United States and Mexico completed self-report
measures of these constructs. Results suggested that the hypothesized pattern was robustly supported with the structural equation
model showing generally good fit indices. Higher levels of social support were associated with increased resilience, which in turn
was associated with reduced mental health symptoms. Resilience partially mediated social support’s effect on mitigating mental
health symptoms. e model explained 11% of the variance in resilience and 35% in mental health symptoms. ese findings have
implications for future research on the development and tailoring of interventions to improve social support, resilience, and
mental health in PD caregivers.
1.Introduction
Parkinson’s disease (PD) is a neurodegenerative disorder
that gradually erodes a person’s motor and cognitive
functions, resulting in increasing disability; PD trails only
Alzheimer’s disease in neurodegenerative disorder occur-
rence, and risk for developing PD increases with age [1]. As
people are living longer, the proportion of older people in
global populations is increasing and rates of those who will
develop PD are expected to rise accordingly [2], with
incidence rates similar across the Americas [3]. Continued
progression of PD requires increasing levels of assistance
from others for the individual with Parkinson’s disease
(IWPD) [4], with caregiving responsibilities usually being
undertaken by informal caregivers, often aging spouses or
other family members [5, 6].
Caregiving for a person with a neurodegenerative disease
has been shown to be a high-demand role which can ad-
versely affect the physical and mental health and wellbeing of
the caregiver (e.g., [7–10]). For example, providing higher
Hindawi
Neurology Research International
Volume 2020, Article ID 7906547, 8 pages
https://doi.org/10.1155/2020/7906547