Hostname: page-component-848d4c4894-mwx4w Total loading time: 0 Render date: 2024-06-15T05:28:16.346Z Has data issue: false hasContentIssue false
  • English
  • Français

Self-reassurance and self-efficacy for controlling upsetting thoughts predict depression, anxiety, and perceived stress in help-seeking female family caregivers

Published online by Cambridge University Press:  18 July 2019

Katherine Arenella  and
Ann M. Steffen
Katherine Arenella
Affiliation:
Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA
Ann M. Steffen*
Affiliation:
Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA
*
Correspondence should be addressed to: Ann M. Steffen, University of Missouri–St. Louis, Department of Psychological Sciences/325 Stadler Hall, One University Boulevard, St. Louis, MO, 63121, USA. Phone: +1 314 516 5382. Email: ann_steffen@umsl.edu.
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

Providing care for an older family member is a common experience for women and has been linked with increased depression, anxiety, and stress for some caregivers. This study aimed to investigate the role of self-reassurance and self-efficacy for controlling upsetting thoughts in mitigating the negative effects of caregiving stressors on mental health.

Design:

Measures were collected during a pre-intervention assessment for a larger study in the U.S.A. evaluating online interventions for intergenerational caregivers. Hierarchical linear regressions were used to examine the contribution of self-reassurance and self-efficacy for controlling upsetting thoughts on mental health outcomes, after controlling for caregiving-related contextual variables and stressors.

Setting:

Participants completed online questionnaires on a computer or tablet at their convenience.

Participants:

Participants were 150 help-seeking adult women providing health-care assistance to older relatives living in the community.

Measurements:

Measures were completed for the mental health outcomes of depression, anxiety, and stress. Measures also included contextual factors of caregiving and demographics. Cognitive impairment, caregiver assistance, role overload, percentage of care provided, family conflict, self-reassurance, and self-efficacy for controlling upsetting thoughts were also measured.

Results:

Regression models revealed that both self-reassurance and self-efficacy for controlling upsetting thoughts predicted depression, anxiety, and perceived stress after controlling for caregiving contextual factors and stressors.

Conclusions:

The results indicate that self-reassurance and self-efficacy for controlling upsetting thoughts are effective resources linked to mental health outcomes. Although results were obtained with cross-sectional data, these findings suggest the potential of targeting these resources in transdiagnostic interventions for family caregivers.

Keywords

stress process modelpositive psychologycarersdementiacoping resources
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 2: Issue Theme: Psychological Promoters of Well-Being in Older Adults , February 2020 , pp. 229 - 240
Copyright
© International Psychogeriatric Association 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aneshensel, C. S., Pearlin, L. I., Mullan, J. T., Zarit, S. H. and Whitlatch, C. J. (1995). Profiles in Caregiving: The Unexpected Career. San Diego, CA: Academic Press.Google Scholar
Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W. and Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10(2), 176–181. doi: 10.1037/1040-3590.10.2.176.CrossRefGoogle Scholar
Bott, N. T., Sheckter, C. C. and Milstein, A. S. (2017). Dementia care, women’s health, and gender equity: The value of well-timed caregiver support. JAMA Neurology, 74(7), 757–758. doi: 10.1001/jamaneurol.2017.0403CrossRefGoogle ScholarPubMed
Butterworth, P., Pymont, C., Rodgers, B., Windsor, T. D. and Anstey, K. J. (2010). Factors that explain the poorer mental health of caregivers: Results from a community survey of older Australians. Australian and New Zealand Journal of Psychiatry, 44, 616–624. doi:10.3109/00048671003620202CrossRefGoogle ScholarPubMed
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159. doi: 10.1037/0033-2909.112.1.155CrossRefGoogle ScholarPubMed
Crellin, N., Charlesworth, G. and Orrell, M. (2014a). Measuring family caregiver efficacy for managing behavioral and psychological symptoms in dementia: A psychometric evaluation. International Psychogeriatrics, 26, 93–103. doi: 10.1017/ S1041610213001646CrossRefGoogle Scholar
Crellin, N. E., Orrell, M., McDermott, O. and Charlesworth, G. (2014b). Self-efficacy and health—related quality of life in family caregivers of people with dementia: A systematic review. Aging & Mental Health, 18, 954–969. doi: 10.1080/13607863.2014.915921CrossRefGoogle ScholarPubMed
Crespo, M. and Fernández-Lansac, V. (2014). Factors associated with anger and anger expression in caregivers of elderly relatives. Aging & Mental Health, 18, 454–462. doi: 10.1080/13607863.2013.856857CrossRefGoogle ScholarPubMed
Crespo, M., López, J. and Zarit, S. H. (2005). Depression and anxiety in primary caregivers: A comparative study of caregivers of demented and nondemented older persons. International Journal Of Geriatric Psychiatry, 20, 591–592. doi: 10.1002/gps.1321CrossRefGoogle ScholarPubMed
Duara, R. et al. (2010). Diagnosis and staging of mild cognitive impairment, using a modification of the clinical dementia rating scale: The mCDR. International Journal of Geriatric Psychiatry, 25, 282–289.CrossRefGoogle ScholarPubMed
Gallagher-Thompson, D. and Coon, D. (2007). Evidence-based psychological treatments for distress in family caregivers of older adults. Psychology and Aging, 22, 37–51. doi: 10.1037/0882-7974.22.1.37CrossRefGoogle ScholarPubMed
George, N. R. and Steffen, A. (2014). Physical and mental health correlates of self-efficacy in dementia family caregivers. Journal of Women & Aging, 26, 319–331. doi:10.1080/08952841.2014.906873CrossRefGoogle ScholarPubMed
Gilbert, P., Baldwin, M. W., Irons, C., Baccus, J. R. and Palmer, M. (2006). Self-criticism and self-warmth: An imagery study exploring their relation to depression. Journal of Cognitive Psychotherapy, 20, 183–200. doi: 10.1891/jcop.20.2.183CrossRefGoogle Scholar
Gilbert, P., Clarke, M., Hempel, S., Miles, J. V. and Irons, C. (2004). Criticizing and reassuring oneself: An exploration of forms, styles and reasons in female students. British Journal of Clinical Psychology, 43, 31–50. doi: 10.1348/014466504772812959CrossRefGoogle ScholarPubMed
Grano, C., Lucidi, F. and Violani, C. (2017). The relationship between caregiving self-efficacy and depressive symptoms in family caregivers of patients with Alzheimer disease: A longitudinal study. International Psychogeriatrics, 29, 1095–1103. doi: 10.1017/S1041610217000059CrossRefGoogle ScholarPubMed
Irons, C., Gilbert, P., Baldwin, M. W., Baccus, J. R. and Palmer, M. (2006). Parental recall, attachment relating and self-attacking/self-reassurance: Their relationship with depression. British Journal of Clinical Psychology, 45, 297–308. doi: 10.1348/014466505X68230CrossRefGoogle ScholarPubMed
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A. and Jaffe, M. W. (1963). Studies of illness in the aged: The index of ADL: A standardized measure of biological and psychosocial function. JAMA, 185, 914–919.CrossRefGoogle ScholarPubMed
Keyes, C. M. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 43, 207–222. doi: 10.2307/3090197CrossRefGoogle ScholarPubMed
Keyes, C. M. (2007). Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health American Psychologist, 62, 95–108. doi:10.1037/0003-066X.62.2.95CrossRefGoogle ScholarPubMed
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179–186. doi:10.1093/geront/9.3_Part_1.179CrossRefGoogle ScholarPubMed
Lopez, J., Romero-Moreno, R., Marquez-González, M. and Losada, A. (2012). Spirituality and self-efficacy in dementia family caregiving: Trust in God and in yourself. International Psychogeriatrics, 24, 1943–1952. doi: 10.1017/S1041610212001287CrossRefGoogle ScholarPubMed
Lovibond, P. F. and Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33, 335–343. doi: 10.1016/0005-7967(94)00075-UCrossRefGoogle ScholarPubMed
Marziali, E. and Garcia, L. G. (2011). Dementia caregivers’ responses to 2 internet-based intervention programs. American Journal of Alzheimer’s Disease and Other Dementias, 26, 36–43. doi: 10.1177/1533317510387586CrossRefGoogle ScholarPubMed
McEvoy, P. M., Nathan, P. and Norton, P. J. (2009). Efficacy of transdiagnostic treatments: A review of published outcome studies and future research directions. Journal of Cognitive Psychotherapy, 23, 20–33. doi: 10.1891/0889-8391.23.1.20CrossRefGoogle Scholar
Medrano, M., Rosario, R. L., Payano, A. N. and Capellán, N. R. (2014). Burden, anxiety and depression in caregivers of Alzheimer patients in the Dominican Republic. Dementia & Neuropsychologia, 8, 384–388. doi: 10.1590/S1980-57642014DN84000013CrossRefGoogle ScholarPubMed
Morris, J. C. (1993). The Clinical Dementia Rating (CDR): Current version and scoring rules. Neurology, 43, 2412–2414. doi: 10.1212/WNL.43.11.2412-aCrossRefGoogle ScholarPubMed
O’Bryant, S. E. et al. (2008). Staging dementia using Clinical Dementia Rating Scale Sum of Boxes Scores: A Texas Alzheimer’s Research Consortium study. Archives of Neurology, 65, 1091–1095. doi: 10.1001/archneur.65.8.1091CrossRefGoogle ScholarPubMed
Pearlin, L. I. and Bierman, A. (2013). Current issues and future directions in research into the stress process. In: Aneshensel, C. S., Phelan, J. C., Bierman, A., Aneshensel, C. S., Phelan, J. C. and Bierman, A. (Eds.), Handbook of the Sociology of Mental Health (2nd edn, pp. 325–340). New York: Springer Science + Business Media.CrossRefGoogle Scholar
Pearlin, L. I. (2010). The life course and the stress process: Some conceptual comparisons. The Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 65, 207–215. doi:10.1093/geronb/gbp106CrossRefGoogle Scholar
Pearlin, L. I., Mullan, J. T., Semple, S. J. and Skaff, M. M. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30, 583–594. doi: 10.1093/geront/30.5.583CrossRefGoogle ScholarPubMed
Pearlin, L. I., Schieman, S., Fazio, E. M. and Meersman, S. C. (2005). Stress, health, and the life course: Some conceptual perspectives. Journal of Health and Social Behavior, 46, 205–219. doi: 10.1177/002214650504600206CrossRefGoogle ScholarPubMed
Peñacoba, C., Losada, A., López, J. and Márquez-González, M. (2008). Confirmatory factor analysis of the Revised Scale for Caregiving Self-Efficacy in a sample of dementia caregivers. International Psychogeriatrics, 20, 1291–1293. doi: 10.1017/S104161020800759XCrossRefGoogle Scholar
Romero-Moreno, R., Losada, A., Mausbach, B. T., Márquez-González, M., Patterson, T. L. and López, J. (2011). Analysis of the moderating effect of self-efficacy domains in different points of the dementia caregiving process. Aging & Mental Health, 15, 221–231. doi: 10.1080/13607863.2010.505231CrossRefGoogle ScholarPubMed
Romero-Moreno, R., Márquez-González, M., Mausbach, B. T. and Losada, A. (2012). Variables modulating depression in dementia caregivers: A longitudinal study. International Psychogeriatrics, 24, 1316–1324. doi: 10.1017/S1041610211002237CrossRefGoogle ScholarPubMed
Roth, D. L., Brown, S. L., Rhodes, J. D. and Haley, W. E. (2018). Reduced mortality rates among caregivers: Does family caregiving provide a stress-buffering effect? Psychology and Aging, 33, 619–629. doi: 10.1037/pag0000224CrossRefGoogle ScholarPubMed
Schulz, R. and Monin, J. K. (2012). The costs and benefits of informal caregiving. In: Brown, S., Brown, R. and Penner, L.A. (Eds.), Moving Beyond Self-Interest: Perspectives from Evolutionary Biology, Neuroscience, and the Social Sciences (pp. 178–198). New York, NY: Oxford University Press.Google Scholar
Sin, N. L. and Lyubomirsky, S. (2009). Enhancing well-being and alleviating depression symptoms with positive psychology interventions: A practice friendly meat-analysis. Journal of Clinical Psychology, 65, 467–487. doi: 10.1002/jclp.20593CrossRefGoogle Scholar
Stansfeld, J., Stoner, C. R., Wenborn, J., Vernooij-Dassen, M., Moniz-Cook, E. and Orrell, M. (2017). Positive psychology outcome measures for family caregivers of people living with dementia: A systematic review. International Psychogeriatrics, 29, 1281–1296. doi:10.1017/S1041610217000655CrossRefGoogle ScholarPubMed
Steffen, A. M., Epstein, J., George, N. and MacDougall, M. (2016). The Sandwich Generation Diner: development of a web-based health intervention for intergenerational caregivers. JMIR Research Protocols, 5, e91. doi: 10.2196/resprot.5488.CrossRefGoogle ScholarPubMed
Steffen, A. M. et al. (2018). Validating the Revised Scale for Caregiving Self-Efficacy: A cross-national review. The Gerontologist. doi: 10.1093/geront/gny004CrossRefGoogle Scholar
Steffen, A. M., Gant, J. R. and Gallagher-Thompson, D. (2008). Reducing psychosocial distress in family caregivers. In: Gallagher-Thompson, D., Steffen, A.M., and Thompson, L.W. (Eds.), Handbook of Behavioral and Cognitive Therapies with Older Adults (pp. 102–117). New York, NY: Springer New York.CrossRefGoogle Scholar
Steffen, A. M., McKibbin, C., Zeiss, A. M., Gallagher-Thompson, D. and Bandura, A. (2002). The revised scale for caregiving self-efficacy: Reliability and validity studies. Journal of Gerontology: Psychological Sciences, 57B, 74–86.CrossRefGoogle Scholar
Travis, S. S., Bernard, M. A., McAuley, W. J., Thornton, M. and Kole, T. (2003). Development of the family caregiver medication administration hassles scale. The Gerontologist, 43, 360–368. doi: 10.1093/geront/43.3.360CrossRefGoogle ScholarPubMed
Wang, P., Yip, P. and Chang, Y. (2016). Self-efficacy and sleep quality as mediators of perceived stress and memory and behavior problems in the link to dementia caregivers’ depression in Taiwan. Clinical Gerontologist: The Journal of Aging and Mental Health, 39, 222–239. doi:10.1080/07317115.2015.1128503CrossRefGoogle Scholar
World Health Organization (2012). Dementia: A public health priority. Retrieved from www.who.int; last accessed 17 May 2019.Google Scholar