Department of Psychology, Universidad Rey Juan Carlos, Alcorcón, Spain.
Department of Psychiatry, University of California San Diego, La Jolla, CA.
Am J Geriatr Psychiatry. 2022 Feb;30(2):148-157. doi: 10.1016/j.jagp.2021.06.011. Epub 2021 Jun 24.
Caring for a relative with dementia is considered a chronically stressful role associated with negative consequences for psychological health such as higher levels of depression. However, the subjective experience of depressive symptomatology is complex as it relates to two unique domains: positive affect (PA) and negative affect (NA). The objective of this study was to analyze, through a longitudinal design, the associations of caregivers' cognitive (avoidance coping, personal mastery, and coping self-efficacy) and behavioral (frequency of pleasant events) coping strategies with depressive symptoms, PA, and NA.
A total of 111 caregivers of a spouse with dementia participated in this study. They were assessed yearly across 5 years. Mixed model regression analyses were conducted separately for depressive symptoms, PA, and NA, analyzing within and between-person associations of caregivers' age, gender, role overload, sleep quality, and coping variables previously mentioned.
The results showed that different coping strategies were associated with different components of depressive symptomatology. While avoidant coping was associated with NA and depressive symptoms but not PA at both within- and between-person levels, frequency of pleasant events was associated only with NA and depressive symptoms at the within-person level, showing no effect at the between-person level. Personal mastery and coping self-efficacy were found to be more transversal variables, being associated with most of the mood outcomes in both within and between-person effects.
Findings support the concept of depressive mood as a complex construct and highlights the importance of analyzing different coping strategies when trying to comprehend the caregiving stress process.
照顾痴呆症患者被认为是一种慢性压力大的角色,与心理健康的负面后果相关,如抑郁水平升高。然而,抑郁症状的主观体验是复杂的,因为它涉及两个独特的领域:积极情绪(PA)和消极情绪(NA)。本研究的目的是通过纵向设计分析照顾者的认知(回避应对、个人掌握和应对自我效能感)和行为(愉快事件频率)应对策略与抑郁症状、PA 和 NA 的关系。
共有 111 名配偶痴呆症患者的照顾者参加了这项研究。他们在 5 年内每年接受评估。分别对抑郁症状、PA 和 NA 进行混合模型回归分析,分析照顾者年龄、性别、角色超负荷、睡眠质量和前面提到的应对变量的个体内和个体间关联。
结果表明,不同的应对策略与抑郁症状的不同成分有关。回避应对与 NA 和抑郁症状相关,但在个体内和个体间水平均与 PA 无关,愉快事件频率仅与 NA 和抑郁症状相关,但在个体间水平没有影响。个人掌握和应对自我效能感被认为是更横向的变量,与大多数情绪结果在个体内和个体间效应中都有关联。
研究结果支持抑郁情绪是一种复杂结构的概念,并强调在试图理解照顾压力过程时分析不同应对策略的重要性。