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P79: Correlates of anticipatory grief in family caregivers of persons with dementia
- Isabel Bermejo-Gómez, Laura Gallego-Alberto, Isabel Cabrera, Laura Mérida-Herrera, Isabel Lozano-Montoya, Javier Gómez-Pavón, 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, pp. 121-122
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Objective:
Anticipatory grief is frequently experienced by family caregivers of persons with dementia. It is defined as the feelings of pain and loss that appear in the caregiver prior to the death of the person cared for, and it is linked to negative consequences for the physical and psychological caregiver’s health. However, more research is needed about this construct. The purpose of this work was to explore the differences regarding gender and kinship in anticipatory grief in caregivers and to explore its associations with distress experienced by the caregivers.
Method:The sample consisted of 70 caregivers. The anticipatory grief was measured with the Caregiver Grief Scale (CGS; Meichsner et al., 2016). Also, frequency of problematic behaviours in the person with dementia and caregiver reactions to them (RMPBC; Teri et al., 1992), depressive symptomatology (CES-D; Radloff, 1977), guilt (CGQ; Losada et al., 2010), anxiety (Tension Sub-scale of POMS’s Questionnaire; Fernández et al., 2000), emotional ambivalence (CAS; Losada et al., 2017) and the experiential avoidance in caregiving (EACQ; Losada et al., 2014) were measured.
Independent-samples T-tests were conducted to study if there were differences in anticipatory grief according to the gender of the caregiver and the kinship with the person with dementia. Secondly, Pearson correlations were conducted to study the associations between anticipatory grief and emotional distress variables.
Results:The results showed no significative differences according to the gender of the caregiver in anticipatory grief. However, a longer caregiver ́s age and being a spouse caregiver was related to a greater anticipatory grief. Regarding the person cared for, behavioral problems and caregivers ́ reaction to them were associated with anticipatory grief. With regard to caregiver ́s emotional distress, significant and positive correlations were also obtained between anticipatory grief and its subscales with depressive symptomatology, guilt, anxiety, emotional ambivalence and experiential avoidance in caregiving.
Conclusions:The results suggest that anticipatory grief may have a relevant role in the well-being of dementia family caregivers. Therefore, it is necessary to consider this process in the assessment and intervention in this context with caregivers.
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.
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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- Article
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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.