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The Relative Contribution of Subjective Factors to Expressed Burden among Spousal Caregivers of Suspected Dementia Patients*

  • Norm O'Rourke (a1), Beth E. Haverkamp (a2), Holly Tuokko (a3), Sherri Hayden (a4) and B. Lynn Beattie (a4)...


Burden among caregivers has consistently been recognized as a function of both subjective and objective variables. In addition to concrete role demands, caregivers' perceptions and appraisal strongly contribute to perceived burden. At present, however, the relative contribution of objective and subjective factors remains unclear. This question was addressed among 70 spousal caregivers recruited within a dementia assessment clinic. Subsequent to adjustment for socially desirable responding, both groupings of variables significantly contribute to the prediction of burden scores. These findings are discussed in the context of the hopelessness theory of depression. Demographic similarity between these caregivers and a corresponding sample of randomly derived spousal caregivers recruited as part of the Canadian Study of Health and Aging (CSHA) suggest the results of this study may be generalized with greater confidence.

La perception des personnes-soutien de l'importance de leur fardeau dépend à la fois de facteurs objectifs et subjectifs. En plus des demandes réelles, d'autres facteurs influencent la perception de l'importance du fardeau. La contribution relative des facteurs objectifs et subjectifs reste cependant inconnue. Nous avons entrepris de clarifier cette question en interviewant 70 individus ayant la charge de leur(e) conjoint(e). Les participants furent recrutés dans une clinique d'évaluation des démences. Après avoir pris en considération la tendance des participants à donner les réponses socialement désirables, les deux groupes de facteurs semblent contribuer de façon significative à la prédiction de la perception du fardeau. La similitude des caractéristiques démographiques des participants comparativement à celles d'un échantillon aléatoire de participants de l'Etude sur la santé et le vieillissement au Canada, suggere que les résultats peuvent être généralisés avec plus de confiance.



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Abraham, I.V. (1991). The Geriatric Depression Scale and Hopelessness Index: Longitudinal psychometric data on frail nursing home residents. Perceptual and Motor Skills, 72, 875880.
Abramson, L.Y., Metalsky, G.I., & Alloy, L.B. (1989). Hopelessness depression: A theory-based subtype of depression. Psychological Bulletin, 96, 358372.
Alloy, L.B., Abramson, L.Y., Metalsky, G.I., & Hartlage, S. (1988). The hopelessness theory of depression: Attributional aspects. British Journal of Clinical Psychology, 27, 521.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Baumgarten, M. (1989). The health of persons giving care to the demented elderly: A critical review of the literature. Journal of Clinical Epidemiology, 42, 11371148.
Beck, A.T., & Steer, R.A. (1988). Beck Hopelessness Scale Manual. San Antonio, TX: Harcourt Brace Jovanovich.
Beck, A.T., & Weishaar, M.E. (1989). Cognitive therapy. In Freeman, A., Simon, K.M., Beutler, L.E., & Arkowitz, H. (Eds.), Comprehensive handbook of cognitive therapy. New York: Plenum.
Beck, A.T., Weissman, M.E., Lester, D., & Trexler, L. (1974). The measurement of pessimism: The Hopelessness Scale. Journal of Consulting and Clinical Psychology, 42, 861865.
Canadian Study of Health and Aging Working Group. (1994a). Canadian Study of Health and Aging: Study methods and prevalence of dementia. Canadian Medical Association Journal, 150, 899913.
Canadian Study of Health and Aging Working Group. (1994b). Patterns of caring for people with dementia in Canada. Canadian Journal on Aging, 13(A), 470487.
Dura, J.R., & Kiecolt-Glaser, J.K. (1990). Sample bias in caregiving research. Journal of Gerontology, 45, P200–P204.
Edmonds, V.H. (1967). Marital conventionalization: Definition and measurement. Journal of Marriage and the Family, 29, 681688.
Fiore, J., Coppel, D.B., Becker, J., & Cox, G.B. (1986). Social support as a multi-faceted concept: Examination of important dimensions for adjustment. American Journal of Community Psychology, 14, 93111.
Gallagher, D., Rappaport, M., Benedict, A., Lovett, S., & Silven, D. (1985). Reliability of selected interview and self-report measures with family caregivers. Paper presented at the annual meeting of the Gerontological Society of America, New Orleans, LA.
Gilley, D.W. (1993). Behavioral and affective disturbances in Alzheimer's disease. In Parks, R.W., Zee, R.F., & Wilson, R.S. (Eds.), Neuropsychology of Alzheimer's disease and other dementias. New York: Oxford University Press.
Haaga, D.A.F., & Beck, A.T. (1995). Perspectives on depressive realism: Implications for cognitive theory of depression. Behaviour Research and Therapy, 33, 4148.
Hadjistavropoulos, T., Taylor, S., Tuokko, H., & Beattie, B.L. (1994). Neuropsychological deficits, caregivers' perceptions of deficits, and caregiver burden. Journal of the American Geriatrics Society, 42, 308314.
Hooker, K., Frazier, L.D., & Monahan, D.J. (1994). Personality and coping among caregivers of spouses with dementia. The Gerontologist, 34, 386392.
Katzman, R., & Jackson, J.E. (1991). Alzheimer disease: Basic clinical advances. Journal of the American Geriatrics Society, 39, 516525.
Koch, R.E. (1985). The revision of the learned helplessness attributional style questionnaire for an older population (Doctoral dissertation, University of Wisconsin Madison, 1984). Dissertation Abstracts International, 46, 1520A.
Lazarus, R.S., & Folkman, S. (1984). Coping and adaptation. In Gentry, W.D. (Ed.), Handbook of behavioral medicine. New York: Guilford Press.
Linden, W., Paulhus, D.L., & Dobson, K.S. (1986). Effects of response styles on the report of psychological and somatic distress. Journal of Consulting and Clinical Psychology, 54, 309313.
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E.M. (1984). Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA work group under the auspices of the Department of Health and Human Services task force on Alzheimer's disease. Neurology, 34, 939944.
O'Rourke, N. (1995). Depressive cognitive functioning among spousal caregivers of suspected dementia patients: Application of the hopelessness theory of depression. Unpublished master's thesis, University of British Columbia.
O'Rourke, N., Haverkamp, B.E., Rae, S., Tuokko, H., Hayden, S., & Beattie, B.L. (1996). Response biases as a confound to expressed burden among spousal caregivers of suspected dementia patients. Psychology and Aging, 11, 377380.
O'Rourke, N., Tuokko, H., Hayden, S., & Beattie, B.L. (in press). Early identification of dementia: Predictive validity of the Clock Test. Archives of Clinical Neu ropsychology.
Parks, C.W., & Hollon, S.D. (1988). Cognitive assessment. In Hersen, M. & Bellack, A.S. (Eds.), Behavioral assessment: A practical handbook. New York: Pergamon Press.
Paulhus, D.L. (1991). Measurement and control of response bias. In Robinson, J.P., Shaver, P.R., & Wrightsman, L.S. (Eds.), Measures of personality and social psychological attitudes. San Diego, CA: Academic Press.
Pearlin, L.I., Mullan, J.T., Semple, S.J., & Skaff, M.M. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30, 583594.
Russo, J., Vitaliano, P.P., Brewer, D.D., Katon, W., & Becker, J. (1995). Psychiatric disorders in spouse caregivers of care recipients with Alzheimer's disease and matched controls: A diathesis-stress model of psychopathology. Journal of Abnormal Psychology, 104, 197204.
SPSS Inc. (1988). SPSS-X user's guide (3rd ed.). Chicago, IL: Author.
Tabachnick, B.G., & Fidell, L.S. (1989). Using multivariate statistics. New York: Harper Collins.
Teng, E.L., & Chui, H.C. (1987). The Modified Mini-Mental State (3MS) Examination. Journal of Clinical Psychiatry, 48, 314318.
Tuokko, H., Crockett, D., Beattie, B.L., Horton, A., & Wong, M. (1986, February). The use of rating scales to assess psychosocial functioning in demented patients. Paper presented at the annual meeting of the International Neuropsychological Society, Denver, CO.
Tuokko, H., Kristjansson, B., & Miller, J.A. (1995). The neuropsychological detection of dementia: An overview of the neuropsychological components of the Canadian Study of Health and Aging. Journal of Clinical and Experimental Neuropsychology, 17, 325373.
Vitaliano, P.P., Young, H.M., & Russo, J. (1991). Burden: A review of measures used among caregivers of individuals with dementia. The Gerontologist, 31, 6775.
Weiss, R.L., & Cerreto, M.C. (1980). The Marital Status Inventory: Development of a measure of dissolution potential. American Journal of Family Therapy, 8, 8085.
Williamson, G.M., & Schulz, R. (1990). Relationship orientation, quality of prior relationship, and distress among caregivers of Alzheimer's patients. Psychology and Aging, 4, 502509.
Willson, V.L., & Reynolds, C.R. (1982). Methodological and statistical problems in determining membership in clinical populations. Clinical Neuropsychology, 4, 134138.
Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V., Adey, M., & Leirer, V.O. (1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 3749.
Zarit, S.H. (1990, June). Conceptual and methodological issues in family caregiving research. Paper presented at the meeting of the Invitational Conference on Family Caregiving Research, Toronto, ON.
Zarit, S.H., & Zarit, J.M. (1990). The Memory and Behavior Problems Checklist and the Burden Interview. Unpublished manuscript, Pennsylvania State University, Gerontology Center, University Park, PA.
Zee, R.F. (1993). Neuropsychological functioning in Alzheimer's disease. In Parks, R.W., Zee, R.F., & Wilson, R.S. (Eds.), Neuropsychology of Alzheimer's disease and other dementias. New York: Oxford University Press.



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