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New Grants Fund YSPH Research for Adult Caregivers and Those with Depression

February 26, 2019
by Colin Poitras

Yale School of Public Health Associate Professor Joan Monin has received a $3.9 million grant to study how certain kinds of emotional support may reduce stress and protect the health of parents with early stage Alzheimer’s disease and their adult child caregivers.

More than five million Americans age 65 and over have Alzheimer’s disease and related dementias or ADRD, with much of the caretaking responsibility resting on adult children.

“Caring for a parent with ADRD has unique challenges that can negatively impact health,” said Monin, Ph.D. “While research has shown that emotionally supportive communication between spouses dealing with early stage ADRD can be helpful, little is known about how these interpersonal processes work when the relationship involves a parent and a child.”

Monin is one of two faculty in the school’s Department of Social and Behavioral Sciences to recently receive sizeable research grants.

Assistant Professor Katie Wang, Ph.D., received a 5-year, $886,000 Mentored Research Scientist Development Award from the National Institute on Drug Abuse (NIDA). The grant will allow Wang to explore how mental health stigma can be a potential risk factor for substance use among adults with depression.

Major depressive disorder is one of the most prevalent psychiatric conditions and substance use represents a significant public health concern and research priority for NIDA. While mental health stigma in the form of negative attitudes and beliefs has been identified as a major barrier to treatment seeking and recovery, its role as a potential risk factor for substance use remains under-examined.

Associate Professor John Pachankis, Ph.D., will serve as Wang’s primary mentor with additional support from Yale Foundations Fund Professor of Psychiatry Rajita Sinha and other professional colleagues from around the country.

“Working under the guidance of my excellent mentorship team, I plan to utilize a combination of physiological and daily diary measures to explore whether mental illness sigma might drive emotional regulation difficulties, which could in turn, contribute to increased reliance on substance use as a coping strategy,” said Wang.

“It is my hope that results from this project will lead to future substance abuse prevention interventions geared toward people with depression and other mental illnesses, who we know are at elevated risk for developing substance abuse problems,” Wang added.

Professor Trace Kershaw, department chair, said Wang’s research explores multiple important issues in public health.

“Dr. Wang’s work is important and innovative because it extends the work in three areas that are critical for social and behavioral sciences: stigma, mental health and substance use,” said Kershaw. “By integrating these three areas, she can truly impact health inequities.”

Monin also hopes her research will lead to new intervention strategies.

Adult caregivers and their parents dealing with early stage ADRD face unique interpersonal challenges not experienced in spousal relationships, such as navigating a reversal of the parent-child role, she said.

Her study will look at whether mutual emotional supports that have shown to be effective in spousal relationships - such as communicating about personal safety, expressing vulnerability and giving and receiving tangible aid - may decrease the caregiving burden and protect the psychological health of both the caregiver and the recipient of care.

Monin’s research is based on the concepts of attachment theory, which stipulate that the need for emotional security is a fundamental need in the parent-child relationship across the lifespan and especially in times of crisis.

“The intent of this study is to identify important relationship processes that are affecting the health of parents with early stage ADRD and their adult child caregivers and to create an attachment-based intervention tool,” said Monin.

The 5-year grant was awarded by the National Institute on Aging. Joining Monin on the study are Professor of Geriatric Medicine Dr. Richard Marottoli, M.D., M.P.H.; and Senior Research Scientist Peter Van Ness, Ph.D., M.P.H, from the Yale School of Medicine. Van Ness is co-director of the Biostatistics Core of the Yale Program on Aging.

Submitted by Colin Poitras on February 26, 2019