The Influence of Caregiving on the Relation Between Marital Status and Psychological Health in a Grandparent Sample

Abstract

Grandparent caregivers report poorer psychological and physical health, but relationship status has been shown to influence burden. The current study investigated depressive symptoms of 3288 grandparents who completed the third wave of the National Survey of Families and Households. The study found that those who are unmarried were more likely to be grandparent caregivers, and female participants reported higher depressive symptoms. Marital status and caregiving status were comparable predictors of depression, but marital status did not buffer the effects of caregiving status on depression. Caregiving status accounted for a significant amount of depressive symptom variance for depression, comparable to marital status and gender. There was a significant difference in depressive symptoms of married and unmarried grandparent non-caregivers but with a significantly lower baseline depression rate than grandparent caregivers. Future research should examine whether making social support options available to unmarried grandparent caregivers who lack informal support from a spouse may improve outcomes.

Keywords

custodial grandparents marital status depression gender

Custodial grandparenting (e.g., serving as primary caregiver to one’s grandchildren) has been a rising phenomenon in the United States for the past 20+ years (Bryson, 2001; Kreider & Ellis, 2011). According to the latest American Community Survey data, there are approximately 7.2 million grandparents whose grandchildren live with them within the United States. Of these, roughly 17.7% report being responsible for raising their grandchildren (US Census, 2017). Custodial grandparents face the dual burden of caring for themselves and a child while aging. To examine the contributions of raising children on the aging process, researchers have investigated custodial grandparents’ physical and psychological health outcomes, with a focus on low-income grandmothers (Whitley et al., 2016). This research suggests grandparent caregivers generally experience more depressive symptoms and higher stress levels than non-caregiving grandparents (Blustein et al., 2004; Kelley et al., 2013; Musil et al., 2009, 2011; Waldrop & Weber, 2001). Of course, many grandparent caregivers may be as young as their 30s or as old as their 90s, increasing the complexity of the caregiving burden and their various responsibilities.

One way of ameliorating these poor mental health outcomes for grandparent caregivers is through support, and studies convey that married custodial grandmothers generally experience more support and better psychological outcomes than unmarried grandmothers (Bachman & Chase-Lansdale, 2005; Dowdell, 1995; Neely-Barnes et al., 2010). However, scant literature has examined marital status and depression in grandparent caregivers, and none have compared grandmothers and grandfathers. Thus, the purpose of the current study was to examine whether marital status (i.e., married or single) would moderate the relation between caregiver status and depressive symptoms. Moreover, given that few studies have examined grandfathers, the current study examined the association with the gender on each outcome.

Grandparent Caregivers and Depression

A large portion of research on custodial grandparents has focused on their psychological health outcomes and emotional well-being. Psychological and emotional health includes the ability to adapt to everyday stresses while fostering relationships with others (Ryff & Keyes, 1995; Whitley et al., 2016). For custodial grandparents, caretaking for grandchild(ren) and focusing on their own social integration are both important factors of their emotional well-being (Bachman & Chase-Lansdale, 2005; Furman & Buhrmester, 1985).

Overall, research suggests grandparent caregivers are more susceptible to increased depressive symptoms and higher stress levels compared with non-caregiving grandparents (Blustein et al., 2004; Kelley et al., 2013; Musil et al., 2009, 2011; Waldrop & Weber, 2001). For example, in a national survey, African American custodial grandmothers reported a 37% depression rate, which was significantly higher than non-custodial grandmothers (Fuller-Thomson & Minkler, 2000). Also, psychological health has commonly been tied to physical health, as grandmothers with poorer perceived physical health and limitations in activities of daily living also reported increased depression and lower self-esteem (Burnette, 1999; Dowdell, 1995; Neely-Barnes et al., 2010; Park, 2009; Pruchno & McKenney, 2002; Purcal, Brennan, Cass et al., 2014). Studies suggest that younger grandmothers experience higher depression levels than older grandmothers (Keene et al., 2012; Purcal et al., 2014; Whitley et al., 2016), likely due to early-life disruption and feelings of compromised personal fulfillment (Burton, 1996; Whitley et al., 2016).

Grandparent Gender and Psychological Health

There is limited research on grandfather caregivers and the influence of gender on grandparents’ health outcomes. In general, women are about twice as likely as men to experience depression (Nolen-Hoeksema, 1990; Weissman et al., 1996), implying grandmother caregivers may be more susceptible to depression due to underlying gender differences in areas like stressful life events and reactivity to stress (Nolen-Hoeksema, 2001). Goldman et al. (1995) studied the effects of marital status on the health of older adults through a longitudinal survey. They discovered being single or divorced has a greater negative impact on the mortality and disability rate for men than women, but marital status did not have much implication in overall physical health. In terms of grandparents’ caregivers, grandfathers generally have better physical and psychological health than grandmothers (Kolomer & McCallion, 2005; Park, 2009), possibly due to a more detached parenting style and higher parental support (Smith & Hancock, 2010; Pruchno & Resch, 1989). In 1 study, 33 grandfather caregivers reported fewer depressive symptoms on the Center for Epidemiological Studies-Depression (CESD) scale compared with 33 grandmothers (Kolomer & McCallion, 2005).

Also, gender may influence how a grandparent internalizes or externalizes the stresses of a caregiver role. For example, Smith and Hancock (2010) determined that the psychological health of custodial grandmothers was influenced by their own physical health and the outcomes of the grandchild, while grandfathers’ health was more connected to economic issues. Park (2009) findings suggest marital status is more closely associated with grandfathers’ emotional health than grandmothers.

Marital Status and Depression

Research has suggested that grandparent caregivers’ psychological outcomes are closely tied to their caregiving burden, social support, and physical health. For example, grandmothers with less social support reported poorer psychological health (Bachman & Chase-Lansdale, 2005; Hayslip, Blumenthal, Garner et al., 2014; Kelley et al., 2000; Ruiz et al., 2003). Marital status may be a factor, as a partner serves as an available social support. After analyzing a two-wave national survey, researchers discovered higher levels of perceived marital support increased protective factors against mental illness (i.e., internalizing, fear, and bipolar disorder for both genders, and externalizing disorders for women; Feder et al., 2018). In terms of grandparent caregivers, unmarried custodial grandmothers reported higher stress and more depressive symptoms than married custodial grandmothers (Bachman & Chase-Lansdale, 2005; Conway et al., 2011; Dowdell, 1995; Neely-Barnes et al., 2010), due to decreased perceived family support and poorer perceived health (Dowdell, 1995). Marital status was also a significant predictor of life satisfaction, even after controlling for demographic variables (Landry-Meyer et al., 2005).

However, the influence of marital status has mixed results, with other studies finding the little-to-no effect of marital status on grandmothers’ psychological health (Musil et al., 2009; Neely-Barnes et al., 2010). In fact, Pruchno and McKenney (2000) discovered that married grandmother caregivers reported higher caregiver burden compared with widowed grandmothers, perhaps due to the additional burden of caring for a spouse. The moderation of marital status on the psychological health of caregiving versus non-caregiving grandparents has yet to be explored and would fill a gap in the literature to better explain the relation between grandparent caregiving and depression.

Theoretical Framework

The circumstances surrounding grandparent caregivers also are an important framework in which to examine the impact marital status may have on grandparent mental health. For example, Choi et al. (2016) proposed a theoretical model meant to encompass the causes and consequences of custodial grandparenting. This model includes the many stressors which often contribute to grandparents raising their grandchildren, such as dysfunctional adult children (e.g., substance abuse, child abuse/neglect, illness, etc.). Coping methods that can help in the transition to caregiving for their grandchildren include emotion regulation and problem-solving strategies. Raising grandchildren also has an impact on grandparents’ quality of life, including their psycho-social (e.g., mental health) and physical well-being. Social support and interventions may be able to buffer these outcomes whereby grandparent caregivers can reduce their risk of decreased well-being. Ultimately, this whole model is influenced by socioeconomic characteristics like gender and ethnicity. Thus, the current study contributes to the latter half of this model as being a grandparent raising grandchildren may lead to depressive problems but buffers like the social support found in being married can reduce the risk of poor outcomes. Moreover, these relations may differ between grandmothers and grandfathers.

Current Study

Previous studies have suggested that married grandmother caregivers fare better psychologically than unmarried grandmothers, with little research on grandfather caregivers (Blustein et al., 2004; Kelley et al., 2013; Musil et al., 2009, 2011; Waldrop & Weber, 2001). Research has also established that social support and physical health are linked to the psychological health of grandparent caregivers (Gerard et al., 2006; Kelley et al., 2000; Landry-Meyer et al., 2005; Park, 2009). However, there is a lack of research comparing the effects of marital status on caregiving versus non-caregiving grandparents’ psychological health. The current study investigated the influence of marital status on the relation between caregiving status and depressive symptoms in a national sample of grandparents.

Specifically, it was hypothesized that (1) grandparent caregivers would report more depressive symptoms, (2) those who were single would report more depressive symptoms than those who were married, (3) grandparent caregivers would be more likely to be single than non-caregiving grandparents, (4) and that females would be more likely to report higher depressive symptoms than males. It was further hypothesized that (5) caregiving status would account for a significant amount of variance in a model predicting the depressive symptoms of grandparents, above and beyond the contribution of age, gender, and marital status. Finally, (6) it was predicted that caregiving status would moderate the relation between marital status and depressive symptoms, such that for caregiving grandparents being married would be more protective from depressive symptoms than for non-caregiving grandparents. Of note, hypotheses 1–4 have been strongly affirmed in previous studies, but the current study sought to test them in a national sample.

Methods

Participants

The current study analyzed data from respondents of the third wave of the National Survey of Families and Households (NSFH), conducted via random sampling in 1987, collecting data from 13,017 participants in the United States who were each identified as a primary respondent, a focal child, or a spouse/partner (Bumpass & Sweet, 2003). The third wave of data was collected from 9230 participants of the original sample in 2001–2002 via phone interviews. Included were responses from the 3288 participants who reported they were currently married, separated due to marital difficulties, or divorced and that they were grandparents. Included were responses from the 3288 participants who reported they were currently married, separated due to marital difficulties, or divorced and that they were grandparents. Excluded were 603 participants who reported being widowed or never married, given that the focus is on relationships and thus these individuals likely belong to a different population. As such, caregiving status may not influence someone becoming widowed in the same way it would someone who is still married or got divorced. Thus, the inclusion of these cases could confound the results and they were therefore excluded. Of the participants included, 405 (12.3%) reported ever having been primarily responsible for their grandchild (grandparent caregiver) and 2883 (87.7%) that they had never been primarily responsible for their grandchildren (grandparent non-caregiver). The average age of grandparents was 63.15 (SD = 11.82) years, with a range of 35–96 years old, and 60.3% were female.

Measures

Depressive Symptoms

Depressive symptoms were assessed using a modified 12-item version of the CESD scale. The CESD is a 20-item measure of depressive symptoms within the past week, using a four-point Likert scale (Eaton et al., 2004). The NSFH included 12 of the 20 CESD items and implemented a seven-point scale based on the number of days per week the participants experienced each symptom. The possible total scores of the scale range from 0 to 84. The unmodified CESD has been found to have a Cronbach’s α of .923 to .928, indicating excellent internal consistency (Van Dam & Earleywine, 2011). Merchant et al. (2015) discovered the CESD scale, compromised of a four-factor structure of depression, interpersonal, somatic, and well-being, demonstrates convergent construct validity within the custodial grandparent population specifically through Confirmatory Factor Analysis and cross-validation utilizing two large custodial-grandparent samples. Within the current sample, participants reported a mean of 12.60 (SD = 14.99) on the CESD. In addition to the CESD, a one-item dichotomous question asking, “Have you felt depressed or sad much of the time in the last year?” was used within a series of hierarchical binomial logistic regressions. 16.4 % of our sample reported feeling depressed most of the time in the last year.

Caregiving Status

Caregiving Status was defined using the answers to two questions. The first question asked, “How many grandchildren do you have?” and the second asked, “For various reasons, grandparents sometimes take on the primary responsibility for raising a grandchild. Have you ever had the primary responsibility for (your grandchild/any of your grandchildren) for 6 months or more?” (Bumpass & Sweet, 2003). Grandparent caregivers were defined as those who reported having one or more grandchildren and having ever had primary responsibility for them for a period of 6 months or more. Non-caregiving grandparents were defined as those individuals with one or more grandchildren who denied ever having had primary responsibility for their care. The current sample included 405 grandparent caregivers and 2883 grandparent non-caregivers.

Marital Status

The NSFH categorizes marital status into five options: married, separated because of marital problems, divorced, widowed, and never married. In the current study, marital status was separated into those who were divorced or separated and those who were married, as being widowed or never married are not as likely to influence one’s caregiving status given that divorce or separation causes a significant strain on an individual’s mental health (Afifi et al., 2006). Those who were married made up 81.3% of the sample and those who were divorced or separated made up 18.7% of the sample.

Planned Analysis

Researchers analyzed data using SPSS and Model 1 of SPSS’ Process Macro (Hayes, 2018). Hypotheses 1, 2, and 4, that grandparent caregivers, those who were single, and females would be more likely to report depressive symptoms than non-caregiving grandparents, those who were married and males, respectively, were investigated through correlation and t-tests in SPSS. Hypothesis 3, that grandparent caregivers were more likely to be single was analyzed in the same manner. Hypothesis 5, that caregiving status would account for a significant amount of variance in a model predicting the depressive symptoms of grandparents was investigated through a linear regression model with the dichotomous depression variable (H5A) and a hierarchical logistic regression model with the CESD measure of depression (H5B). Finally, a moderation analysis in PROCESS was implemented to investigate Hypothesis 6, investigating the moderation of caregiving status on the relationship between marital status and CESD depressive symptoms.

Results

Within the current sample, both gender and caregiving status were differentially related to depressive symptoms. Correlations and mean differences are reported in Tables 1 and 2. Our first hypothesis was that grandparent caregivers would report higher rates of depressive symptoms than grandparent non-caregivers. This was supported, with independent samples t-tests indicating a significant difference in CESD scores (t(3286) = 7.90, p < .001), with grandparent caregivers reporting more depressive symptoms (M = 17.38, SD = 17.83) than grandparent non-caregivers (M = 11.32, SD = 13.91), which remained significant when each gender was analyzed separately (Table 2). It was next hypothesized that those who were single would report more depressive symptoms than those who were married. This was supported, with divorced or separated grandparents (M = 16.23, SD = 17.80) reporting significantly higher levels of depressive symptoms on the CESD than those who were married (M = 10.56, SD = 13.00, t(3286) = 10.39, p < .001). Hypothesis 3 was also supported, with a chi-square test revealing grandparent caregivers were more likely to be single than grandparent non-caregivers (Table 2). Hypothesis 4 was supported by the results of an independent samples t-test, where females (M = 14.16, SD = 15.86) reported significantly higher depressive symptoms than males (M = 10.23.16, SD = 13.23; Table 2).

Table 1

Correlations Among Variables in Measurement Model.

	1	2	3	4	5
1. Age	1	−.07**	.00	−.01	−.04**
2. Marital status	-	1	−.04*	−.16**	.13**
3. Caregiving status	-	-	1	.14**	−.10**
4. Center for Epidemiologic Studies Depression	-	-	-	1	−.53**
5. Depressed affect last year	-	-	-	-	1

Correlations separated by gender
1. Age	1	−.10**	−.02	−.03	−.00
2. Marital status	−.09**	1	.05	−.17**	.17**
3. Caregiving status	−.02	.05	1	.10**	−.04
4. Center for Epidemiologic Studies Depression scale	−.03	−.17**	.10**	1	−.52**
5. Depressed affect last year	−.00	.17**	−.04	−.52**	1

Note. *p < .05. **p < .01. Caregiving status is coded as 0 = non-caregiving grandparent, 1 = caregiving grandparent. Marital status is coded as 0 = single, 1 = married.

Note. *p < .05. **p < .01. Males are shaded and appear below the diagonal, with females above. Caregiving status is coded as 0 = non-caregiving grandparent, 1 = caregiving grandparent. Marital status is coded as 0 = single, 1 = married.

Table 2

Mean Differences on Study Variables.

Mean differences by gender (t-tests and chi-squares)
	Grandfathers (N = 1364)		Grandmothers (N = 1924)
	M	SD	M	SD	t-test/chi-square
Age	42.96	11.24	43.37	12.47	−1.47
Caregiving status	0.10	0.30	0.15	0.36	20.76***
Marital status	0.85	0.35	0.76	0.43	89.16***
CESD	10.23	13.23	14.16	15.86	−11.26***
Depressed affect last year	1.88	0.32	1.81	0.40	75.80***

Mean differences by caregiving status (t-tests and chi-squares)
Age	39.89	11.05	39.84	11.93	−0.10
Gender	0.72	0.45	0.62	0.48	20.76***
Marital Status	0.77	0.42	0.82	0.39	5.53*
CESD	17.37	17.83	11.32	13.91	−7.25***
Depressed affect last year	1.73	0.44	1.85	0.36	41.66***

Mean differences by marital status (t-tests and chi-squares)
Age	41.15	10.91	44.48	9.50	−6.98***
Gender	0.55	0.50	0.74	0.44	−8.77***
Caregiving status	0.12	0.32	0.15	0.36	−2.19***
CESD	10.94	13.47	16.93	17.88	−9.31***
Depressed affect last year	1.13	0.34	1.23	0.42	−6.07***

Note. ***p < .001. Values reported are independent samples t-tests for age and CESD, and Pearson’s chi-squares for the dichotomous variables of caregiving status, marital status, and depressed affect in the last year. CESD = Center for Epidemiologic Studies Depression; SD = standard deviation.

Note. *p < .05. ***p < .001. Gender is coded as 0 = male, 1 = female. Values reported are independent samples t-tests for age and CESD, and Pearson’s chi-squares for the dichotomous variables of gender, marital status, and depressed affect in the last year. CESD = Center for Epidemiologic Studies Depression.

The fifth hypothesis, that caregiving status would account for a significant amount of variance in a model predicting the depressive symptoms of grandparents above and beyond the contribution of age, gender, and marital status, was evaluated using hierarchical regression analyses. Specifically, the CESD scale of depressive symptoms outcome was analyzed using a two-step hierarchical linear regression (Hypothesis 5A). Step 1 included the independent variables of age, marital status, and gender, and accounted for 4.2% of the variance in depressive symptoms (R ² = .042). Step 2 of the model added caregiving status and accounted for 5.7% of the variance in depressive symptoms (R ² = .057). These variables significantly predicted depressive symptoms, F(4, 3275) =49.52, p < .001, and all variables in the model added significantly to the prediction, p < .01 (Table 3).

Table 3

Hierarchical Regression Analyses of Predictors of Grandparent’s Depressive Symptoms.

Hierarchical linear regression predicting Center for Epidemiologic Studies Depression scores
	B	SE B		R ²
Model 1
Age	0.050	0.024	.067**	.042
Gender	0.112	0.516	3.30***
Marital status	−0.138	0.649	−5.150***
Model 2
Age	0.052	0.023	.070**	.057
Gender	0.104	0.512	3.088***
Marital status	−0.134	0.645	−5.002***
Caregiving status	0.124	0.755	5.507***
Hierarchical logistic regression predicting depressed affect in the last year
Model 1
Age	−0.025***	0.005	.976	.049
Gender	0.555***	0.107	1.742
Marital status	0.508***	0.112	1.661
Model 2
Age	−0.025***	0.005	.975	.060
Gender	0.526***	0.108	1.693
Marital status	0.488***	0.113	1.628
Caregiving status	0.620***	0.129	1.860

Note. N = 3891. ***p < .001. Odds ratios (OR) for gender indicate how many more times females are at reporting depressed affect than males. Marital status is reverse contrasted, with ORs indicating how many more times single individuals endorse depressed affect than married individuals. Caregiving status ORs indicate how many more times caregiving grandparents are reporting depressed affect than non-caregiving grandparents.

Depressive symptoms using the dichotomous variable assessing whether sad or depressed affect was present in the last year were analyzed using a two-step hierarchical logistic regression (Hypothesis 5B). Step 1 included demographics of age, gender, and marital status, and accounted for a significant amount of the variance in depressed affect over the past year (Nagelkerke R ² = .049). Step 2 of the model added caregiving status, which significantly increased the variance explained in depressed affect (Nagelkerke R ² = .060). The logistic regression model was statistically significant, χ ²(4) =118.299, p < .001, and all variables in the model added significantly to the prediction (Table 3). Females were 1.69 times more likely to report depressed affect than males. Single individuals were 1.63 times more likely to report depressed affect than those who were married. Grandparent caregivers were 1.86 times more likely to report depressed affect than grandparent non-caregivers. Increasing age was associated with a decreased likelihood of reporting depressed affect (Table 3).

Finally, it was predicted that caregiving status would moderate the relation between marital status and depressive symptoms, such that for grandparent caregivers, being married would be more protective of depressive symptoms than for grandparent non-caregivers. This was tested using Model 1 of SPSS Process Macro (Hayes, 2018) with marital status as the IV, CESD as the DV, and caregiving status as the moderator, controlling for gender. No significant interaction was found (p = .3914, See Figure 1).

Figure 1

Non-significant moderation results.

Discussion

The purpose of the current study was to investigate whether the caregiving status of grandparents (those who had assumed the primary responsibility of a grandchild versus grandparents who had not assumed the primary responsibility of a grandchild) significantly affected the relation between marital status and depressive symptoms. It also examined interactions between various predictors of depressive symptoms including caregiving status, marital status, age, and gender. This study builds upon previous literature demonstrating a correlation between grandparent caregivers’ marital status and psychological outcomes, with those who are married showing increased positive psychological outcomes compared with those who are unmarried (Bachman & Chase-Lansdale, 2005; Conway et al., 2011; Dowdell, 1995; Neely-Barnes et al., 2010). However, these studies failed to test this relation in a non-caregiving comparison group or to account for the influence of grandparents’ gender. The present study also is a significant addition to the literature through its use of a large, nationally representative sample.

The current study supported hypotheses 1–4, as results determined that grandparent caregivers, those who were single, and females reported significantly more depressive symptoms than non-caregiving grandparents, those who were married, and males, respectively. Additionally, grandparent caregivers were more likely to be single than non-caregiving grandparents. The finding that grandparent caregivers experience more depressive symptoms than non-caregiving grandparents is meaningful as it is a replication of several prior studies in a large national sample, supporting the generalizability of these findings (Blustein et al., 2004; Kelley et al., 2013; Musil et al., 2009, 2011; Waldrop & Weber, 2001).

Additionally, the literature has consistently suggested that females report higher depression levels than males, which supports our finding that grandmothers (caregiving and non-caregiving) exhibited higher depressive symptoms than grandfathers (caregiving and non-caregiving; Blustein et al., 2004; Park, 2009). According to the current study, caregiving grandfathers’ depressive levels were lower than caregiving grandmothers for the CESD scale and dichotomous variable. When studying differences in gender outcomes with the second wave of data from the National Survey of Families and Households, Park (2009) also discovered grandfathers exhibited lower depressive symptoms. Interestingly, in terms of physical health, marital status was only significant for custodial grandfathers and not for grandmothers (Park, 2009). Another study discovered that the psychological health of married custodial grandmothers was influenced by her own physical health and the outcomes of the grandchild, whereas married grandfathers’ psychological health was more concerned with economic issues (Smith & Hancock, 2010). Future studies should compare the overlapping influence of physical health, psychological health, and social support on caregiving grandmothers and grandfather’s internalization and externalization of stresses from a caregiving role.

Regarding the regressions, all variables (age, gender, marital status, caregiving status) were significantly associated with both measures of depression. The hierarchical logistic regression determined caregiving status accounted for the greatest variance for reporting being sad/depressed in the last year or not, followed by gender, and marital status. The hierarchical linear regression determined marital status and caregiving status, respectively, accounted for the greatest variance at comparable levels, followed by gender for reported CESD symptoms. Age, although significant, accounted for much lower variance in both regressions. These findings indicate that although it was not a moderating variable in the current study, caregiving status accounted for a significant amount of variance for depression in grandparents, one that is comparable to marital status and gender.

One potential criticism of the present study is that the R-square change in the regressions was not extremely large nor was the overall amount of variance explained. It is possible that this is due, at least in part, to different cell sizes for the groups and some groups having rather large standard deviations. If anything, we believe that this led to a conservative bias, as the magnitude of differences in the present study were quite striking. First looking at the regression model, although the R-squared value is only 0.015, this is a 35% increase in the variance explained when compared with age, gender, and marital status combined, all of which we know can be meaningful predictors of depression in late life (and, indeed, all three were significant in the present study). Further, looking at the raw averages, grandparent caregiver depression scores (17.37) are very meaningfully larger than the average for grandparent non-caregivers (11.32). Using the pooled standard deviation, this difference is a medium effect size difference (d = .39). Perhaps even more strikingly, the depressive symptom score for grandparent caregivers was 53% higher than for non-caregivers. Therefore, it is likely that the regression models are underestimating the magnitude of these relations. The literature would benefit from future studies that can further clarify these regression findings, perhaps with more evenly sized groups and lower standard deviations, in order to better judge the magnitude of these effects.

The role of caregiving status and marital status on depression has been supported by previous literature. Generally, grandparent caregivers experience higher depression than non-caregiving grandparents (Blustein et al., 2004; Fuller-Thomson & Minkler, 2000; Kelley et al., 2013; Musil et al., 2009), and unmarried older adults experience higher depression levels than married older adults (Feder et al., 2018). Confounding variables influencing depression include caregiver burden (Whitlatch et al., 1997), measures of formal and informal support (Gerard et al., 2006; Hayslip et al., 2015; Kresak et al., 2014; Musil et al., 2009), and physical health (Dowdell, 1995; Park, 2009), which have also been discovered to affect grandparent caregiver’s depression levels.

Finally, contrary to the hypothesis, caregiving status did not moderate the relation between marital status and depression. In other words, the difference in depression levels between married and unmarried grandparent caregivers was not significantly different from the difference in depression levels between married and unmarried non-caregiving grandparents. The data conveys that although divorced/separated grandparent caregivers experienced significantly higher depressive symptoms than married grandparent caregivers, the same was true for non-caregiving grandparents. However, the depression levels for unmarried and married grandparent caregivers were significantly higher than the comparable groupings for non-caregiving grandparents. Even though males tend to have significantly lower baseline depression levels (Nolen-Hoeksema, 1990; Weissman et al., 1996), grandfather caregivers reported comparable symptoms to non-caregiving grandmothers, suggesting an increased baseline depressive symptom level regardless of gender differences.

Limitations

Researchers analyzed data from Wave 3 of the National Survey of Families in Households published in 2003. The data were collected via national random sampling, allowing it to overcome participant bias of convenience sampling. However, the data set also must be put in the context of its limitations. The questions were self-report and therefore susceptible to subjective interpretation and desirability bias. Depressive symptoms were self-perceived measures, and they were not objectively examined by professionals. However, the study does utilize commonly used and validated measures of the constructs being assessed. The survey data were collected in 2003, which may not be generalizable to the situations and demographics of custodial grandparents today. However, given that it is a large, nationally representative sample of this hard-to-recruit population it is still a meaningful addition to the literature. The items included for the CESD scale were an adapted version, as they quantified depression levels of number of days per week one felt depressed and only included 12 of the 20 items from the original scale. Therefore, researchers could not use cut-off scores as indicators of depression. Additionally, the data used were correlational and relationships between marital status, gender, caregiving status, and depressive symptoms cannot be directionally traced, as researchers only analyzed one wave of cross-sectional data. Future research should incorporate longitudinal studies of social support. In terms of generalizability of the sample, the study included both male and female grandparent caregivers, which adds to a body of literature that heavily focuses on grandmother caregivers.

Implications

Considering the generally high depressive level of grandparent caregivers, the current study suggests the need for future studies investigating informal and formal social support, especially for unmarried grandparent caregivers. The finding of lower levels of depressive symptoms for married than unmarried grandparent caregivers are perhaps attributable to lower caregiver burden (Dowdell, 1995; Musil et al., 2009; Strozier, 2012), more resources (Bachman & Chase-Lansdale, 2005; Landry-Meyer et al., 2005; Strawbridge et al., 1997), and better physical health (Bachman & Chase-Lansdale, 2005; Burnette, 1999; Hayslip, Blumenthal, Garner et al., 2015; Wei et al., 2012; Utz et al., 2002).

Future studies would do well to expand upon the current study in various ways. First, a longitudinal design would enable the determination of causation of whether being married functionally reduces the risk of developing depressive problems. Second, studies examining whether social support interventions may aid single and widowed caregivers are warranted. Finally, future studies should endeavor to include grandfathers when examining caregiving.

In summary, the present study significantly adds to the literature by replicating several studies in a large nationally representative sample as well as extending it through examining statistical predictors of depression in custodial grandparents. Future research delving further into the reasons for the observed differences, as well as looking at these differences over time, is warranted.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iDs

Melanie A. Stearns

Danielle K. Nadorff

Author Biographies

Angela M. Provenzano graduated with her B.S. in psychology from Mississippi State University in 2019. She is currently studying to become an occupational therapist at the Ohio State University.

Melanie A. Stearns graduated with her B.S. from the University of Kentucky, and will earn her Ph.D. in Clinical Psychology from Mississippi State University in 2020. Her research interests are focused on the family environment and how it affects children of all ages. Her three primary foci are parental influences on child behavior, child behaviors, and sleep problems in the context of parent-child gender differences.

Danielle K. Nadorff obtained her Ph.D. in Lifespan Developmental Psychology from West Virginia University in 2011. Her program of research is primarily focused on custodial grandchildren (children whose primary caregivers are their grandparents) and their grandparents. In particular, she investigates the physical, social, mental, emotional, and behavioral outcomes for these custodial grandchildren, as well as examining how they compare to children raised in foster care. More broadly, she also has interest in depressive symptoms, stress, and coping on both ends of the lifespan: both early childhood and late life.

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