BACKGROUND: Competing theories of adaptation and wear-and-tear describe 
psychological distress patterns among family caregivers.
PURPOSE: This study seeks to characterize psychological distress patterns in 
family caregivers and identify predictors.
METHODS: One hundred three caregivers of care recipients with primary malignant 
brain tumors were interviewed within 1, 4, 8, and 12 months post-diagnosis 
regarding psychological distress; care recipients were interviewed regarding 
clinical/functional characteristics. Group-based trajectory modeling identified 
longitudinal distress patterns, and weighted logistic/multinomial regression 
models identified predictors of distress trajectories.
RESULTS: Group-based trajectory modeling identified high-decreasing (51.1 % of 
caregivers) and consistently low (48.9 %) depressive symptom trajectories, 
high-decreasing (75.5 %) and low-decreasing (24.5 %) anxiety trajectories, and 
high (37.5 %), moderate (40.9 %), and low-decreasing (21.6 %) caregiver burden 
trajectories. High depressive symptoms were associated with high trajectories 
for both anxiety and burden, lower caregivers age, income, and social support, 
and lower care recipient functioning.
CONCLUSIONS: Our data support the adaptation hypothesis; interventions should 
target those at risk for persistent distress.