Self-efficacy in controlling upsetting thoughts, but not positive gains, mediates the effects of benefit-finding group intervention for Alzheimer family caregivers

Sheung-Tak CHENG, Wai Chi CHAN, Helene H. FUNG, Linda C. W. LAM

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1 Citation (Scopus)

Abstract

This study aimed to examine the therapeutic mechanism of the benefit-finding therapeutic (BFT) intervention that used cognitive reappraisal and alternative thinking to construct positive aspects of caregiving (PAC), in a cluster-randomized controlled trial for Alzheimer caregivers. Forty two caregivers received BFT, whereas 87 received psychoeducation as control. Depressive symptoms and global burden were outcomes measured at baseline, postintervention, and 4-and 10-month follow-up. Mediators considered included PAC (measured by benefit word count to a qualitative measure) and three self-efficacies—controlling upsetting thoughts (SECUT), responding to disruptive behaviors, and obtaining respite. Using mixed-effects regression, we demonstrated that benefit-finding increased caregivers’ PAC and SE-CUT, but that only SE-CUT uniquely predicted depressive symptoms and global burden longitudinally. Path analyses with bootstrapped confidence intervals, using full informationmaximumlikelihood estimation to retain the whole sample with partialmissing data, showed that SE-CUT change from baseline to postintervention mediated intervention effects on depressive symptoms, but not global burden, at both follow-ups. No mediation effects were found for PAC and the other self-efficacies. The BFT effect on depressive symptoms was partly accounted for by improvement in SE-CUT. The therapeutic mechanism for the effect on burden remained unknown. The study sheds light on the importance of actively promoting positive caregiver functioning. Copyright © 2021 American Psychological Association.
Original languageEnglish
Pages (from-to)766-775
JournalPsychology and Aging
Volume37
Issue number6
Early online dateNov 2021
DOIs
Publication statusPublished - Sep 2022

Citation

Cheng, S.-T., Chan, W. C., Fung, H. H., & Lam, L. C. W. (2022). Self-efficacy in controlling upsetting thoughts, but not positive gains, mediates the effects of benefit-finding group intervention for Alzheimer family caregivers. Psychology and Aging, 37(6), 766-775. doi: 10.1037/pag0000654

Keywords

  • Alzheimer’s disease
  • Caregiving
  • Depression
  • Positive aspects of caregiving
  • Self-efficacy

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