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Profiles of Dementia Caregivers according to Psychosocial and Resource Variables. Importance of Kinship
- Cristina Huertas-Domingo, Andrés Losada-Baltar, Laura Gallego-Alberto, Inés García-Batalloso, Laura García-García, María Márquez-González
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- Journal:
- The Spanish Journal of Psychology / Volume 27 / 2024
- Published online by Cambridge University Press:
- 21 May 2024, e15
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The present study aims to analyze the existence of different profiles in family caregivers of people with dementia according to psychosocial and resource variables. In addition, it aims to study whether there is a greater representation of each kinship group in each of the profiles and if there are differences in emotional distress among such profiles considering the kinship with the care-recipient. Participants were 288 family dementia caregivers, divided into four kinship groups (wives, husbands, sons and daughters). Psychosocial (familism, dysfunctional thoughts and experiential avoidance), resource (leisure activities and social support) and outcomes (depressive, anxious and guilt symptomatology) variables were collected. A hierarchical cluster analysis using Ward’s method, an exploratory factor analysis of two fixed factors and contingency tables were performed. Five clusters were obtained: Low psychosocial vulnerability-High resources, Low psychosocial vulnerability-Low resources, Mixed, High psychosocial vulnerability-High resources, and High psychosocial vulnerability-Low resources. Results suggested that clusters associated with lower distress were the Low psychosocial vulnerability-High resources and the High psychosocial vulnerability-High resources. Clusters associated with higher distress were the Low psychosocial vulnerability-Low resources and Mixed. High levels of dysfunctional thoughts, familism and experiential avoidance do not always have a maladaptive function. This could depend on sociocultural and resource variables such as the kinship with the caregiver or perceived social support. The identification of profiles of family caregivers potentially needing protection and vulnerable to psychological distress could help to increase the effectiveness of interventions aimed at this population.
P126: Older adults’ psychological distress: exploring the role of implicit age stereotypes
- María Del Sequeros Perdroso-Chaparro, Isabel Cabrera, José A. Fernandes-Pires, Maria Marquez-González, Laura García-García, Inés García-Batalloso, Andrés Losada-Baltar
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, pp. 253-254
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Objective:
Self-perceptions of aging seem to be a key variable to understand physical and mental health (see the systematic review conducted by Tully-Wilson et al., 2021). Following Levy’s (2003) stereotype embodiment theory, negative attitudes towards aging originate as aging stereotypes (e.g., “older people are frail”; Warmoth et al., 2016) during childhood. They are internalized and reinforced in adulthood, both consciously and below conscious awareness, becoming aging self-stereotypes in old age and affecting self-perceptions of aging (Levy, 2003). Kordnat et al. (2016) developed an implicit association test (IAT; Greenwald et al., 1998) to assess implicit age stereotypes for specific life domains (health and family domains) across the life span and found positive stereotypes towards older people for family domain and negative for health domain. However, the associations between implicit age stereotypes and adults’ psychological distress have been scarcely analyzed. The aims of this communication are: a) to present the preliminary data of the validation of the implicit association test (IAT, Greenwald et al., 1998) to measure implicit aging stereotypes and b) to explore the relationship between implicit aging stereotypes and older adults’ psychological distress (loneliness, guilt associated with self-perception as a burden, and anxiety and depressive symptoms).
Methods:The IAT used is an adaptation of the IAT developed by Kordnat et al. (2016). The IAT explores the relationship between the categories of sickness/health and old/young age. The task has a target category that consists of: a) a set of 6 words of physical and mental sickness (e.g., frail, weak, sad, lonely) and 6 words of physical and mental health (e.g., healthy, energetic, happy, in company); and b) 6 photos of old people and 6 photos of young people.
Results:Preliminary results of the implicit aging stereotypes task associations with older adults’ psychological distress in 100 community dwelling older adults will be presented.
Conclusion:Findings will be discussed. The implicit (below awareness) assessment of the aging stereotypes with the IAT in older adults could provide a better understanding of the role of aging stereotypes in older adults’ psychological distress, avoiding the weaknesses of assessing the construct through self-report measures.
P80: Implicit emotional ambivalence and emotional distress in family carers of people with dementia: Exploratory study.
- Isabel Cabrera, Inés García-Batalloso, Laura Mérida-Herrera, Laura Gallego-Alberto, Vanessa Da Silva, Andrés Losada-Baltar, Isabel Bermejo-Gómez, María Márquez-González
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, p. 122
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Objective:
Caring for a relative with dementia is a chronic stress situation related to negative consequences such as elevated depressive and anxiety symptoms. A possible mediator variable explored to explain pathways from chronic stress to emotional distress is emotional ambivalence towards the care-recipient (the simultaneous experience of positive and negative feelings towards the care-recipient). Emotional ambivalence, measured with questionnaires, presents significant associations with depression and anxiety in family carers of people with dementia. However, the self-report of emotional ambivalence is susceptible to being influenced by social desirability. The aim of this study is to present preliminary results that analyze implicit ambivalence and its association with emotional distress in family carers of people with dementia.
Methods:54 caregivers participated in the study (mean age = 61.2, SD = 12.92, 81.5% women). To explore implicit emotional ambivalence, we adapted a sequential priming paradigm developed to measure implicit ambivalence about significant others (Zayas & Shoda, 2015). Two priming stimuli were used: a) neutral (e.g., RRR) and b) valenced prime (i.e., the name of the care-recipient). The targets were positive and negative words that participants have to categorize as positive or negative.
Results:A facilitation-inhibition indexes for positive and negative targets were calculated by subtracting the mean reaction time (RT) for valenced prime from the mean RT for neutral primes. Positive values show a facilitation effect of the valenced prime (i.e., the name of the care-recipient), and negative values inhibition. Participants were classified depending on their results of this indexes: a) positive (facilitation of positive information, inhibition of negative information), b) negative (facilitation of negative information, inhibition of positive information), c) flat (inhibition of positive and negative information), and d) ambivalence (facilitation of positive and negative information). ANOVAS were performed to explore differences between groups in emotional distress. The preliminary results showed that the ambivalence group might present more depressive symptoms compared with the positive group.
Conclusion:This is the first study that analyzed implicit ambivalence in family carers of people with dementia. The preliminary results show the relevance of exploring implicit processes to explain emotional distress in this population.
FC31: Profiles of dementia caregivers according to psychosocial variables. Importance of kinship.
- Cristina Huertas-Domingo, Andrés Losada-Baltar, Laura Gallego-Alberto, Inés García-Batalloso, Laura García-García, María Márquez
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, p. 94
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Objectives:
Caring for a family member with dementia may have important negative psychological consequences on caregivers. The present study aims to analyze the existence of different profiles in family caregivers of people with dementia according to the levels manifested in different psychosocial variables, which are grouped into psychosocial variables (dysfunctional thoughts, familism, experiential avoidance) and resources (leisure and social support). In addition, it aims to study whether there are differences among those profiles in the levels of distress (depressive, anxious and guilt symptomatology) depending on the relationship of kinship with the cared-for person.
Methods:288 family caregivers of people with dementia divided into four kinship groups (wives, husbands, sons and daughters) participated. Face-to-face interviews were conducted assessing sociodemographic variables, familism (family obligations), dysfunctional thoughts, experiential avoidance, leisure activities, perceived social support and depressive, anxious and guilt symptomatology. A hierarchical cluster analysis was performed using Ward's method and contingency tables were run between the clusters obtained and the variable of kinship and distress variables.
Results:Five clusters were obtained: Low psychosocial vulnerability-High resources (mostly daughters), Low psychosocial vulnerability-Low resources (mostly daughters), Mixed (mostly sons), High psychosocial vulnerability-High resources (mostly husbands) and High psychosocial vulnerability-Low resources (mostly wives). Although with nuances, the clusters associated with lower distress are the Low psychosocial vulnerability-High resources profile and the High psychosocial vulnerability-High resources profile, and with higher distress the Low psychosocial vulnerability-Low resources profile and the Mixed profile.
Conclusions:High levels of dysfunctional thoughts, familism and experiential avoidance are not always associated with greater psychological distress. In fact, profile 2 (Low psychosocial vulnerability-Low resources), in which most caregiving daughters are distributed, seems to be particularly vulnerable to presenting higher levels of emotional. Therefore, the identification of profiles of potential protection and vulnerability to psychological distress in family caregivers could help to increase the effectiveness of interventions aimed at this population.
P117: The role of hyperarousal for understanding the association among sleep problems and emotional symptoms in family caregivers of people with dementia. A network analysis approach.
- Lucía Jiménez-Gonzalo, Inés García-Batalloso, María Márquez-González, Isabel Cabrera, Javier Olazarán, Andrés Losada-Baltar
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, p. 132
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Objective:
Caregiving for a family member with dementia is a highly stressful situation that may last up to several years, and has been associated with symptoms of depression, anxiety, and sleep problems. These disorders frequently co-occur, with previous studies suggesting a bidirectional relationship between sleep and psychiatric disorders (i.e., anxiety and depression). Several models have highlighted the role of hyperarousal for understanding sleep disorders; however, there is little evidence about how sleep problems, depression and anxiety are linked together. Network analysis (NA) could help exploring the mechanisms underlying the associations between anxiety, depression, and sleep disturbances.
Methods:Participants were 368 family caregivers of a person with dementia. The depression-anxiety-sleep symptoms network was composed of 26 items. All the analyses were done using R (version 4.1.1).
Results:Symptoms of tension, shakiness, restlessness, nervousness, and anxiety were strongly connected with the symptom feeling depressed. Symptoms of insomnia were connected to trouble focusing, which was linked to feeling that everything is an effort and apathy. The strongest nodes in the network were shakiness, tension, restlessness, nervousness, and restless sleep. Tension was the node with the most predictive power, while restless sleep was the node with the highest betweenness. Central stability coefficient showed adequate indices.
Conclusion:Hyperarousal symptoms (e.g., tension, restlessness) were the most strongly connected symptoms and showed close connection with symptoms of depression. The strength of these nodes suggests a prominent role of hyperarousal to maintaining, or even fueling, anxiety and depressive symptoms. Besides, our results invite the hypothesis that sleep problems may trigger symptoms specific to depression via fatigue or energy loss. Even though this study is limited by its cross-sectional design, it is the first to examine the network structure of the associations between symptoms of depression, anxiety, and sleep problems in a sample of informal caregivers, and to explore the role of hyperarousal in this network. Future studies should explore the temporal association between symptoms and the network dynamics, including response to the potential treatments.
P108: Relational aspects in dementia family caregiving: exploring caregivers ́ self-perceived caring style and its correlates in the caregiving stress and coping process
- Maria Marquez-González, Isabel Cabrera, Laura Mérida-Herrera, Inés García-Batalloso, Laura Gallego-Alberto, Andrés Losada-Baltar
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, pp. 127-128
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Most research in dementia family caregiving field has been guided by the stress and coping model, which holds a caregiver-centered perspective look at the family caregiving scenario. This individualistic approach of mainstream caregiving research does not allow to explain the relational aspects and variables related to the interaction between caregivers and the person with dementia (PWD), which have been underexplored until today. However, more systemic and dyad-centered approaches are needed to enrich our understanding of this chronic stress scenario. How caregivers perceive their way of caring for the PWD may exert a central role in the stress and coping model, and it may be potentially related to characteristics of the PWD (problematic behaviors and functional capacity), and caregivers´ distress and coping variables. This study aimed to develop and test a valid and reliable instrument to measure caregivers´ self-perceived caring style and explore these potential associations.
This communication will present preliminary evidence from family dementia caregivers who volunteered to participate and were interviewed to assess sociodemographic data, stressors, psychological outcomes (anxiety and depression) and the following interaction-related variables: self-perceived caregiving interaction style, expressed emotion and quality of the relationship in the dyad (past and present). A sample of 100 participants is expected, as the project is currently going on.
The Caregivers´ Self-Perceived Caring Style Scale (SPCSS) has been developed to measure 6 potential aspects of caregivers’ way of caring for the PWD: calmness, tenderness/lovingness, acceptance/validation, control/structure, overprotection, hostility, and communication facilitation. Preliminary reliability and validity analyses support good psychometric properties of the scale, as well as significant correlations between the different styles of caring and characteristics of the PWD, caregivers´ gender and kinship with the PWD, depression and anxiety symptoms, quality of the dyad relationship and expressed emotion. Implications for caregiving research and for the development of effective interventions to alleviate caregivers´ distress will be discussed.
P109: The role of family caregivers’ emotional complexity in their relationship with the person with dementia and their emotional well-being and distress.
- Inés García-Batalloso, Isabel Cabrera, Laura Mérida-Herrera, Andrés Losada-Baltar, Javier Olazarán, María Márquez-González
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, p. 128
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Objective:
Research in informal dementia caregiving has focused on the negative outcomes it implies as a chronic stress situation, even though positive feelings derived from the caregiving experience are also reported. This co-occurrence of positive and negative experiences is a form of emotional complexity that has barely been explored in caregivers although it could be relevant for understanding caregivers' vulnerability to distress. To explore this emotional complexity, profiles of caregivers according to their levels of positive and negative affect were created and compared with regard to their reported anxiety, ambivalence feelings, experiential avoidance, quality of the actual relationship, thoughts of institutionalizing the person with dementia (PWD), and social support.
Methods:363 primary family caregivers were distributed in groups based on their reported depressive feelings and positive emotions related to caregiving and the PWD. Four groups were identified: (1) flat (low negative affect, low positive affect), (2) negative (high negative affect, low positive affect), (3) positive (low negative affect, high positive affect), (4) mixed (high negative affect, high positive affect). ANOVAS were performed to explore differences between groups.
Results:Caregivers in the positive and mixed profiles reported better actual relationships with the PWD and higher experiential avoidance. Caregivers with both negative and mixed profile showed higher anxiety than the other profiles, and the negative profile also reported higher thoughts about institutionalizing the care-recipient and more ambivalence. Caregivers in the positive group reported the highest social support.
Conclusion:The obtained findings converge in the idea that caregivers ́ positive emotions towards the PWD are closely related to the quality of the relationship, and may be involved in a delayed decision to institutionalize her/him. The presence of negative affect (depressive feelings) is associated with anxiety symptoms, even when positive emotions are reported, supporting the high prevalence of anxiety-depressive comorbidity in this population. Finally, the negative profile (low positive and high negative affect) is the one that reports more ambivalence. Taken together, these findings suggest that caregiving for PWD should be considered an emotionally complex situation with positive affect derived from the caregiving being key in understanding caregivers’ well-being and distress.