This study examined how 70 caregiving spouses of Alzheimer patients varied in their reports of depression and burden, and how these reports were associated with the nature and severity of patient behavior problems, in particular memory-related, depressive, and disruptive behaviors. Depression and burden were found to be overlapping, but separate constructs, with about half of the variance unshared. Caregivers were divided into subgroups according to high and low levels of depression and burden, with the three most common groups being low depression/low burden (46 percent), high depression/high burden (26 percent), and low depression/high burden (23 percent). Only 6 percent of caregivers reported high depression/low burden. The level of patient behavior problems varied significantly among the remaining depression/burden classifications. Caregivers in the high depression/high burden and low depression/high burden categories reported greater numbers of disruptive behaviors and greater reactivity to memory-related and disruptive behavior problems, compared to the low depression/low burden group. The implications of these findings as they pertain to further elaboration of individual differences in caregiving experiences and interventions are discussed
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References
1.
1. Cohen D, Eisdorfer C: Depression in family members caring for a relative with Alzheimer's disease. J Am Geriatr Soc, 1988;36:885-885
2.
2. Drinka TJK, Smith JC, Drinka PJ: Correlates of depression and burden for informal caregivers of patients in a geriatrics referral clinic. J Am Geriatr Soc, 1987;35:522-522
3.
3. Fiore J, Becker J, Coppel DB: Social network interactions: A buffer or a stress?Am J Comm Psychol, 1983; 11:423-423
4.
4. Gallagher D, Rose J, Rivera P, et al: Prevalence of depression in family caregivers. Gerontologist, 1989;29:449-449
5.
5. Pearlin LI, Turner H, Semple S: Coping and the mediation of caregiver stress. In Light E, Lebowitz B (Eds.): Alzheimer's disease treatment and family stress: Directions for research. (DHHS Pub. No. ADM 89-1569). Washington, DC, US Govt Printing Office, 1989:198-198
6.
6. Vitaliano PP, Maiuro RD, Ochs H, et al: A model of burden in caregivers of DAT patients. In Light E, Lebowitz B (Eds.): Alzheimer's disease treatment and family stress: Directions for research. (DHHS Pub. No. ADM 89-1569). Washington, DC, US Govt Printing Office, 1989:267-267
7.
7. George LK, Gwyther LP: Caregiver wellbeing: A multidimensional examination of family caregivers of demented adults. Gerontologist, 1986;26:253-253
8.
8. Ory MG, Williams TF, Emr M, et al: Families, informal supports, and Alzheimer's disease. Research on Aging, 1985;7:623-623
9.
9. Poulshock SW, Deimling GT: Families caring for elders in residence: Issues in the measurement of burden. J Gerontology, 1984;39:230-230
10.
10. Soldo BJ, Myllyuoma J: Caregivers who live with dependent elderly. Gerontologist, 1983;23:605-605
11.
11. Zarit SH, Reever KE, Bach-Peterson J: Relatives of the impaired elderly: Correlates of feelings of burden. Gerontologist, 1980;20:649-649
12.
12. Anthony-Bergstone CR, Zarit SH, Gatz M: Symptoms of psychological distress among caregivers of dementia patients. Psychol Aging, 1988;3:245-245
13.
13. Pruchno RA, Resch NL: Husbands and wives as caregivers: Antecedents of depression and burden. Gerontologist, 1989;29:159-159
14.
14. Stommel M, Given CW, Given BG: Depression as an overriding variable explaining caregiver burdens. J Aging and Health, 1990;2:81-81
15.
15. Pruchno RA, Resch NL: Aberrant behaviors and Alzheimer's disease: Mental health effects on spouse caregivers. J Gerontology: Social Sciences, 1989;44:S177-S177
16.
16. Miller B, McFall S, Montgomery A: The impact of elder health, caregiver involvement, and global stress on two dimensions of caregiver burden. J Gerontology: Social Sciences, 1991;46:S9-S9
17.
17. Barnes RF, Raskind MA, Scott M, et al: Problems of families caring for Alzheimer patients: Use of a support group. J Am Geriatr Soc, 1981;18:80-80
18.
18. Deimling GT, Bass DM: Symptoms of mental impairment among elderly adults and their effects on family caregivers. J Gerontol, 1986;41:779-779
19.
19. Green JG, Smith R, Gardiner M, et al: Measuring behavioural disturbance of elderly demented patients in the community and its effects on relatives: A factor analytic study. Age & Ageing, 1982;11:122-122
20.
20. Niederehe G, Fruge E, Woods AM, et al: Caregiver stress in dementia: Clinical outcomes and family considerations. Paper presented at the 36th Annual Scientific Meeting of the Gerontological Society of America, San Francisco, CA 1983
21.
21. Haley WE, Levine EG, Brown SL, et al: Stress, appraisal, coping, and social support as predictors of adaptational outcome among dementia caregivers. Psychol Aging, 1987;2:323-323
22.
22. Reisberg B, Ferris SH, DeLeon MJ, et al: The global deterioration scale for assessment of primary degenerative dementia. Am J Psychiatry, 1982;13: 1136-1136
23.
23. Rubin EH, Morris JC, Storandt M, et al: Behavioral changes in patients with mild senile dementia of the Alzheimer's type. Psychiatry Res, 1987;21:55-55
24.
24. Teri L, Larson EB, Reifler BV: Behavioral disturbance in dementia of the Alzheimer's type. J Am Geriatr Soc, 1988;36:1-1
25.
25. Teri L, Hughes H, Larson E: Cognitive deterioration in Alzheimer's disease: Behavior and health factors. J Gerontology, 1990;45:P58-P58
26.
26. Haley WE, Pardo KM: Relationship of severity of dementia to caregiving stressors. Psychol Aging, 1989;4:389-389
27.
27. Reifler BV, Larson EB, Teri L: An outpatient geriatric psychiatry assessment and treatment service. Clin Geriatr Med, 1987;3:203-203
28.
28. Folstein MF, Folstein SE, McHugh PR: Mini-Mental state: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res, 1975;12:189-189
29.
29. Radloff LW: The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1977;1:385-385
30.
30. Radloff L, Teri L: Use of the Center for Epidemiological Studies-Depression Scale with older adults. Clinical Gerontologist, 1986;5:119-119
31.
31. Himmelfarb S, Murrell SA: Reliability and validity of five mental health scales in older persons. J Gerontology, 1983;38:333-333
32.
32. Deimling GT, Bass DM: Mental status among the aged: Effects on spouse and adultchild caregivers. Paper presented at the 37th Annual Scientific Meeting of the Gerontological Society of America, 1984
33.
33. Teri L, Truax P, Logsdon R, et al: Assessment of behavioral problems in dementia: The revised memory and behavior problems checklist. Psychol Aging, 1992;7:622-622
34.
34. Zarit SH, Orr NK, Zarit JM: The hidden victims of Alzheimer's disease: Families under stress. New York, New York University Press, 1985
35.
35. Pruchno RA, Kleban MH, Michaels JE, et al: Mental and physical health of caregiving spouses: Development of a causal model. J Gerontology: Psychological Sciences, 1990;45:P192-P192
36.
36. Schulz R, Williamson GM: A 2-year longitudinal study of depression among Alzheimer's caregivers. Psychol Aging, 1991;6:569-569
37.
37. Malonebeach EE, Zarit SH: Current research issues in caregiving to the elderly. Int. J Aging Human Dev, 1991;32:102-102
38.
38. Montgomery RJV, Stull DE, Borgatta E: Measurement and analysis of burden. Res on Aging, 1985;7:137-137
39.
39. Pfifer JF, Murrell SA: Etiologic factors in the onset of depressive symptoms in older adults. J Abnormal Psychol, 1986;95:282-282
40.
40. Vitaliano PP, Becker J, Russo J, et al: Expressed emotion in spouse caregivers of patients with Alzheimer's disease. J Applied Soc Sci, 1988-89;13:215-215
41.
41. Pagel MD, Becker J, Coppel DB: Loss of control, self blame, and depression: An investigation of spouse caregivers of Alzheimer's disease patients. J Abnormal Psychol, 1985;94:169-169
42.
42. Teri L, Logsdon R, Wagner A, et al: The caregiver role in behavioral treatment of depression in dementia patients. Paper presented at the NIMH Caregiver and Family Stress Workshop, Washington, DC, 1990
