How do care-related beliefs contribute to depression and anxiety in family caregivers of people with dementia? Testing a cognitive vulnerability-stress model.
Nicolas Wrede, Nils F Töpfer, Anne Katrin Risch, Gabriele Wilz
{"title":"How do care-related beliefs contribute to depression and anxiety in family caregivers of people with dementia? Testing a cognitive vulnerability-stress model.","authors":"Nicolas Wrede, Nils F Töpfer, Anne Katrin Risch, Gabriele Wilz","doi":"10.1080/13607863.2024.2386079","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Care-related beliefs are considered risk factors for decreased mental health in family caregivers of people with dementia. However, their exact role in the caregiver stress process remains unclear. Hence, we tested a cognitive vulnerability-stress model of depression and anxiety in family caregivers of people with dementia.</p><p><strong>Method: </strong>A cross-sectional study was conducted using baseline data from a caregiver intervention trial (N = 322). Within Bayesian moderated mediation analysis, we examined mediation of effects of objective demands (<i>severity of dementia, challenging behavior, caregiving intensity, caregiving duration</i>) on depression and anxiety via subjective caregiver burden and moderation by care-related beliefs in four domains (<i>dysfunctional caregiving standards, dysfunctional attitudes towards dementia, functional self-care-related beliefs, functional acceptance-related beliefs</i>).</p><p><strong>Results: </strong>The relation between objective demands and subjective burden was amplified by dysfunctional caregiving standards and dysfunctional attitudes towards dementia and mitigated by functional self-care-related beliefs. Further, functional acceptance-related beliefs attenuated the effect of subjective caregiver burden on depression.</p><p><strong>Conclusion: </strong>The study provides preliminary evidence for a cognitive vulnerability-stress model of depression and anxiety in family caregivers of people with dementia. The results indicate that the four-domain model of care-related beliefs is a valuable framework for future research and may serve as a heuristic model for cognitive-behavioral therapy in this population.</p>","PeriodicalId":55546,"journal":{"name":"Aging & Mental Health","volume":" ","pages":"282-290"},"PeriodicalIF":2.8000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Aging & Mental Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/13607863.2024.2386079","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/31 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: Care-related beliefs are considered risk factors for decreased mental health in family caregivers of people with dementia. However, their exact role in the caregiver stress process remains unclear. Hence, we tested a cognitive vulnerability-stress model of depression and anxiety in family caregivers of people with dementia.
Method: A cross-sectional study was conducted using baseline data from a caregiver intervention trial (N = 322). Within Bayesian moderated mediation analysis, we examined mediation of effects of objective demands (severity of dementia, challenging behavior, caregiving intensity, caregiving duration) on depression and anxiety via subjective caregiver burden and moderation by care-related beliefs in four domains (dysfunctional caregiving standards, dysfunctional attitudes towards dementia, functional self-care-related beliefs, functional acceptance-related beliefs).
Results: The relation between objective demands and subjective burden was amplified by dysfunctional caregiving standards and dysfunctional attitudes towards dementia and mitigated by functional self-care-related beliefs. Further, functional acceptance-related beliefs attenuated the effect of subjective caregiver burden on depression.
Conclusion: The study provides preliminary evidence for a cognitive vulnerability-stress model of depression and anxiety in family caregivers of people with dementia. The results indicate that the four-domain model of care-related beliefs is a valuable framework for future research and may serve as a heuristic model for cognitive-behavioral therapy in this population.
期刊介绍:
Aging & Mental Health provides a leading international forum for the rapidly expanding field which investigates the relationship between the aging process and mental health. The journal addresses the mental changes associated with normal and abnormal or pathological aging, as well as the psychological and psychiatric problems of the aging population. The journal also has a strong commitment to interdisciplinary and innovative approaches that explore new topics and methods.
Aging & Mental Health covers the biological, psychological and social aspects of aging as they relate to mental health. In particular it encourages an integrated approach for examining various biopsychosocial processes and etiological factors associated with psychological changes in the elderly. It also emphasizes the various strategies, therapies and services which may be directed at improving the mental health of the elderly and their families. In this way the journal promotes a strong alliance among the theoretical, experimental and applied sciences across a range of issues affecting mental health and aging. The emphasis of the journal is on rigorous quantitative, and qualitative, research and, high quality innovative studies on emerging topics.