Department of Biological and Health Psychology, Autonomous University of Madrid.
Department of Psychology, King Juan Carlos University.
Psychol Aging. 2020 Feb;35(1):41-54. doi: 10.1037/pag0000412.
Caregiver distress is a complex, multicausal phenomenon. Most of the available interventions for caregivers are protocolized or manualized. A case formulation approach may be more appropriate, as it provides the opportunity for assessing and treating specific dysfunctional mechanisms explaining each caregiver's needs and causes of distress, through the design of an individualized modular intervention. In the present study, a randomized controlled study has been done in which a functional analysis-guided modular intervention (FAMI) was developed. The FAMI was compared with two manualized intervention (cognitive-behavioral therapy and acceptance and commitment therapy) which have received preliminary support, and a control group (waiting list). Mixed-effect models and clinical significance analyses were performed. Results suggest that all the interventions were effective in reducing depressive and anxious symptomatology at postintervention assessment, with large effect sizes, and with reductions in depression being maintained at follow-up. Regarding anxiety, long-term effects have been found only for the FAMI intervention. Results also suggest positive effects associated with the FAMI intervention in the long term with regards to comorbidity between depressive and anxious symptomatology. FAMI presents great potential for reducing dementia caregivers' levels of distress, being especially effective in maintaining therapeutic effects in the long term. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
照料者困扰是一种复杂的、多因的现象。大多数现有的照料者干预措施都是规范化或手册化的。病例形成方法可能更合适，因为它提供了机会，通过设计个体化的模块化干预，评估和治疗解释每个照料者需求和困扰原因的特定功能失调机制。在本研究中，进行了一项随机对照研究，开发了一种功能分析指导的模块化干预（FAMI）。将 FAMI 与两种已初步得到支持的手册化干预（认知行为疗法和接受与承诺疗法）以及对照组（等待名单）进行了比较。采用混合效应模型和临床意义分析。结果表明，所有干预措施在干预后评估时都能有效降低抑郁和焦虑症状，具有较大的效应量，并且在随访中抑郁症状也有所减轻。关于焦虑，仅发现 FAMI 干预具有长期效果。结果还表明，FAMI 干预与抑郁和焦虑症状之间的共病存在长期的积极影响。FAMI 具有降低痴呆症照料者困扰水平的巨大潜力，尤其是在长期内保持治疗效果方面。（PsycINFO 数据库记录（c）2020 APA，保留所有权利）。
