Longitudinal effects of cognitive fusion in depressive and anxious symptoms of family caregivers of people with dementia.

IF 3.4 3区 心理学 Q1 PSYCHOLOGY, CLINICAL
Samara Barrera-Caballero , Rosa Romero-Moreno , María Márquez-González , Lucía Jiménez-Gonzalo , Cristina Huertas-Domingo , Javier Olazarán , Andrés Losada-Baltar
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Abstract

Family dementia caregiving has been commonly associated with psychological distress for caregivers. Cognitive fusion, that is, the tendency to become too entangled in thoughts, beliefs, or judgments (in the absence of objectivity) that may often lead to rigid thinking and impact psychological distress, is a transdiagnostic and central process of psychological inflexibility. Cross-sectional studies have shown that family caregivers of people with dementia who could present high levels of stress may be vulnerable to experiencing psychological symptoms such as depression and anxiety (even comorbidity) if they present this rigid way of thinking without seeing the objectivity of their thoughts, which could be related to aspects of the family member's dementia or helplessness in being a caregiver, for example. Specifically, studies in the caregiving field, as well as in other populations, suggest that cognitive fusion could play a mediating role in the relationship between stress and psychological symptoms. However, the predictive role of caregivers' cognitive fusion on psychological distress has not been analyzed in longitudinal studies. The objective of this study was to analyze the longitudinal effect of cognitive fusion in depressive and anxious symptoms after controlling for other relevant variables in a sample of Spanish family caregivers. Face to face assessments were conducted with a total of 176 Spanish family dementia caregivers. The study involved three assessments in a two-year period (baseline, 12 and 24 months). Linear mixed model analysis was used to analyze the associations between time-varying values of frequency and reaction to care-recipient behavioral problems, cognitive fusion, and caregivers' depressive and anxiety symptoms. Increases in cognitive fusion significantly predicted depressive and anxious symptoms (p < 0.01). In addition, reaction to care-recipients’ behavioral problems and being a female caregiver predicted increases in anxiety symptoms over time (p < 0.05). These results suggested that cognitive fusion may constitute a core dysfunctional mechanism involved in depressive and anxious symptoms. Psychological strategies aimed at reducing cognitive fusion and stress levels may be especially helpful for reducing caregivers' distress.

认知融合对痴呆症患者家庭照顾者抑郁和焦虑症状的纵向影响。
痴呆症家庭照护通常与照护者的心理困扰有关。认知融合,即(在缺乏客观性的情况下)过于纠结于思想、信念或判断的倾向,往往会导致思维僵化并影响心理困扰,是心理僵化的一个跨诊断和核心过程。横断面研究表明,如果痴呆症患者的家庭照顾者表现出这种僵化的思维方式,而没有看到其思维的客观性,那么他们可能会面临很大的压力,很容易出现抑郁和焦虑等心理症状(甚至是合并症),这可能与家庭成员的痴呆症或作为照顾者的无助感等方面有关。具体来说,护理领域以及其他人群的研究表明,认知融合可能在压力和心理症状之间的关系中起到中介作用。然而,护理人员的认知融合对心理困扰的预测作用尚未在纵向研究中得到分析。本研究的目的是以西班牙家庭照顾者为样本,在控制了其他相关变量后,分析认知融合对抑郁和焦虑症状的纵向影响。共对 176 名西班牙痴呆症家庭照护者进行了面对面评估。研究在两年内进行了三次评估(基线、12 个月和 24 个月)。研究采用线性混合模型分析法,对护理对象行为问题的频率和反应、认知融合度、护理者的抑郁和焦虑症状之间的时变值进行了分析。认知融合度的提高可显著预测抑郁和焦虑症状(p < 0.01)。此外,对受照护者行为问题的反应和女性照护者也会随着时间的推移预测焦虑症状的增加(p < 0.05)。这些结果表明,认知融合可能是抑郁和焦虑症状的核心失调机制。旨在降低认知融合和压力水平的心理策略可能特别有助于减轻照顾者的痛苦。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.50
自引率
18.00%
发文量
82
审稿时长
61 days
期刊介绍: The Journal of Contextual Behavioral Science is the official journal of the Association for Contextual Behavioral Science (ACBS). Contextual Behavioral Science is a systematic and pragmatic approach to the understanding of behavior, the solution of human problems, and the promotion of human growth and development. Contextual Behavioral Science uses functional principles and theories to analyze and modify action embedded in its historical and situational context. The goal is to predict and influence behavior, with precision, scope, and depth, across all behavioral domains and all levels of analysis, so as to help create a behavioral science that is more adequate to the challenge of the human condition.
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