Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA.
Fam Process. 2013 Dec;52(4):709-22. doi: 10.1111/famp.12032. Epub 2013 Jun 27.
Late-life depression (LLD) has detrimental effects on family caregivers that may be compounded when caregivers believe that depressive behaviors are volitional or within the patient's capacity to control. In this study we examined three person-centered caregiver attributions that place responsibility for LLD on the patient (i.e., character, controllability, and intention), and the impact of such attributions on levels of general caregiver burden and burden specific to patient depressive symptoms. Participants were 212 spouses and adult children of older adults enrolled in a depression treatment study. Over one third of caregivers endorsed character attributions, which significantly predicted greater levels of both general and depression-specific burden. Intention attributions were significantly associated with general burden, but not depression-specific burden. Contrary to our expectation, controllability attributions did not predict either type of burden. Our findings suggest that the assessment of family caregiver attributions for LLD may be useful in identifying caregivers at risk for burden and subsequent health effects, as well as those who may need education and support to provide effective care to a vulnerable population of older adults.
老年期抑郁症（LLD）会对家庭照顾者产生不利影响，如果照顾者认为抑郁行为是出于自愿或在患者的控制能力范围内，这种影响可能会更严重。在这项研究中，我们考察了三种以患者为中心的照顾者归因，即把 LLD 的责任归咎于患者的性格、可控制性和意图，以及这些归因对一般照顾者负担和与患者抑郁症状相关的负担水平的影响。参与者是参加抑郁症治疗研究的老年患者的 212 名配偶和成年子女。超过三分之一的照顾者认同性格归因，这显著预测了一般和与抑郁症状相关的负担水平更高。意图归因与一般负担显著相关，但与抑郁症状特异性负担无关。与我们的预期相反，可控制性归因并不能预测任何一种负担。我们的研究结果表明，评估家庭照顾者对 LLD 的归因可能有助于识别有负担和随后健康影响风险的照顾者，以及那些可能需要教育和支持以向弱势老年人群体提供有效护理的照顾者。
