How do care-related beliefs contribute to depression and anxiety in family caregivers of people with dementia? Testing a cognitive vulnerability-stress model.

IF 2.8 3区 医学 Q3 GERIATRICS & GERONTOLOGY
Nicolas Wrede, Nils F Töpfer, Anne Katrin Risch, Gabriele Wilz
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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.

与护理相关的信念如何导致痴呆症患者家庭护理者的抑郁和焦虑?测试认知脆弱性-压力模型。
目的:与护理相关的信念被认为是导致痴呆症患者家庭护理者心理健康下降的风险因素。然而,它们在照顾者压力过程中的确切作用仍不清楚。因此,我们对痴呆症患者家庭照顾者抑郁和焦虑的认知脆弱性-压力模型进行了测试:方法:我们利用一项照顾者干预试验的基线数据(N = 322)进行了一项横断面研究。在贝叶斯调节中介分析中,我们研究了客观需求(痴呆症严重程度、挑战性行为、护理强度、护理持续时间)对抑郁和焦虑的中介效应,这种中介效应是通过护理者的主观负担以及四个领域中与护理相关的信念(功能失调的护理标准、功能失调的痴呆症态度、功能失调的自我护理相关信念、功能失调的接受相关信念)来调节的:结果:客观要求与主观负担之间的关系因护理标准失调和对痴呆症的态度失调而增强,因功能性自我护理相关信念而减弱。此外,与功能接受相关的信念减轻了照顾者的主观负担对抑郁的影响:本研究为痴呆症患者家庭照顾者抑郁和焦虑的认知脆弱性-压力模型提供了初步证据。研究结果表明,护理相关信念的四域模型是未来研究的重要框架,可作为认知行为疗法的启发式模型用于该人群。
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来源期刊
Aging & Mental Health
Aging & Mental Health 医学-精神病学
CiteScore
7.00
自引率
2.90%
发文量
176
审稿时长
4-8 weeks
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.
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