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Perceived Control, Coping, and Expressed Burden among Spouses of Suspected Dementia Patients: Analysis of the Goodness-of-Fit Hypothesis

  • Norm O'Rourke (a1) and Philippe Cappeliez (a2)


The goodness-of-fit hypothesis contends that distress results due to incongruence between choice of coping strategies and perceived ability to change stressful stimuli. Goal-directed or active coping responses are believed to be most efficacious when the individual believes s/he can change or control perceived threats (i.e., problem-focused coping). Instances in which stressors must be accepted, however, would dictate reliance upon strategies to regulate distress (i.e., emotion-focused coping). Inconsistent support for this facet of Lazarus and Folkman's cognitive phenomenological model was obtained in this study of spouses of suspected dementia patients. The distinction between emotion- and problem-focused coping appears less germane than overall coping efforts relative to perceived control and caregiver burden. In addition, perceived ability to control dementia-related stressors appears to be somewhat independent of coping by caregivers. These findings are discussed in terms of the unique and chronic demands faced by spouses of persons with dementia.

L'hypothèse de l'adéquation (goodness-of-fit) avance que la détresse résulte de l'inadéquation entre le choix de stratégies d'adaptation et la capacité subjective de changer les stimuli sources de stress. Les réponses dirigées vers des buts ou d'adaptation active sont considérées comme les plus efficaces dans les circonstances où l'individu croit qu'il peut changer ou contrôler les menaces perçues (par exemple, la stratégie de résolution de problème). Par contre, lorsque les situations stressantes doivent être acceptées, les stratégies de régulation de la détresse seraient de mise (par exemple, les stratégies centrées sur les émotions). Cette étude avec des conjoints de patients présumés déments n'apporte qu'un soutien empirique inconsistant à cette facette de la théorie cognitivo-phénoménologique de Lazarus et Folkman. Cette distinction entre adaptation centrée d'un côté sur les émotions et de l'autre sur les problèmes apparaît moins pertinente que l'effort global d'adaptation relatif au contrôle perçu et au fardeau de l'aidant naturel. De plus, la capacité perçue de contrôler les situations stressantes reliées à la démence apparaît être plutôt indépendante de l'adaptation de l'aidant naturel. Ces résultats sont discutés en termes des demandes uniques et chroniques auxquelles sont confrontés les conjoints de personnes affligées par la démence.


Corresponding author

Requests for offprints should be sent to: / Les demandes de tirés-a-part doivent être adressées à : Norm O'Rourke, Ph.D., Gerontology Research Centre, Simon Fraser University at Harbour Centre, #2800 - 515 West Hastings Street, Vancouver, BC, V6B 5K3. (


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*This article was written with the support of a Social Sciences and Humanities Research Council of Canada (SSHRC) Doctoral Fellowship awarded to the first author.



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