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The relationships between coping strategies, social support and depression: an investigation among Turkish care-givers of patients with dementia

Published online by Cambridge University Press:  29 September 2015

KAHRAMAN KIRAL ,
ÜNSAL YETİM ,
AYNUR ÖZGE  and
ARZU AYDIN
KAHRAMAN KIRAL*
Affiliation:
Department of Psychology, Cag University, Yenice-Mersin, Turkey.
ÜNSAL YETİM
Affiliation:
Department of Psychology, Mersin University, Turkey.
AYNUR ÖZGE
Affiliation:
Department of Neurology, Mersin University, Turkey.
ARZU AYDIN
Affiliation:
Department of Psychology, Mersin University, Turkey.
*
Address for correspondence: Kahraman Kıral, Department of Psychology, A. Yasar Baybogan Campus, Cag University, Yenice-Mersin, Turkey E-mail: [email protected]
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Abstract

Caring for a patient with dementia is a stressful life event, and care-givers carry a heavy psychological burden. However, the extent to which care-givers are affected by the stressful aspects of care-giving may depend on a variety of factors. This study examined the relationships between cognitive emotion regulation strategies, social support and depression among Turkish dementia care-givers. Research questions explored whether different coping strategies and social support were related to levels of depression, as well as whether social support moderated this relationship. We used a hierarchical multiple regression analysis consisting of three blocks as the primary statistical technique to examine our expectations. In total, 141 dementia care-givers (108 women, 33 men) were recruited to the study. The mean age of the sample was 59.74 years old (standard deviation = 12.70). Hierarchical regression analysis indicated a significant negative main effect for positive refocusing strategies and significant positive main effects for catastrophising and blaming others. Social support moderated the relationships between catastrophising, rumination and symptoms of depression. Our results show that cognitive emotion regulation strategies and social support can play significant roles in alleviating care-giver depression. In the light of these results, it may be suggested that interventions focusing on the effects of positive refocusing, catastrophising and blaming others, as well as providing social support, may be helpful in alleviating depression in care-givers.

Keywords

copingsocial supportdementia care-givingdepression
Type
Articles
Information
Ageing & Society , Volume 37 , Issue 1 , January 2017 , pp. 167 - 187
Copyright
Copyright © Cambridge University Press 2015 

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References

Aguinis, H. 1995. Statistical power with moderated multiple regression in management research. Journal of Management, 12, 6, 1141–58.Google Scholar
Aiken, L. S. and West, S. G. 1991. Multiple Regression: Testing and Interpreting Interactions. Sage, Newbury Park, California.Google Scholar
American Psychiatric Association 2013. Diagnostic and Statistical Manual of Mental Disorders. Fifth edition, American Psychiatric Publishing, Arlington, Virginia.Google Scholar
Arai, Y., Zarit, S. H., Sugiura, M. and Washio, M. 2002. Patterns of outcome of caregiving for the impaired elderly: a longitudinal study in rural Japan. Aging & Mental Health, 6, 1, 39–46.Google Scholar
Au, A., Lau, K. M., Koo, S., Cheung, G., Pan, P. C. and Wong, M. K. 2009. The effects of informal social support on depressive symptoms and life satisfaction in dementia caregivers in Hong Kong. Hong Kong Journal of Psychiatry, 19, 57–64.Google Scholar
Au, A., Shardlow, S. M., Teng, Y., Tsien, T. and Chan, C. 2013. Coping strategies and social support-seeking behavior among Chinese caring for older people with dementia. Ageing & Society, 33, 8, 1422–41.Google Scholar
Beck, A. T. 1961. An inventory for measuring depression. Archives of General Psychiatry, 4, 6, 561–71.CrossRefGoogle ScholarPubMed
Beck, A. T. 1976. Cognitive Therapy and the Emotional Disorders. International Universities Press, New York.Google Scholar
Beeson, R. A. 2003. Loneliness and depression in spousal caregivers of those with Alzheimer's disease versus non-caregiving spouses. Archives of Psychiatric Nursing, 17, 3, 135–43.Google Scholar
Bozo, Ö., Toksabay, N. E. and Kürüm, O. 2009. Activities of daily living, depression, and social support among elderly Turkish people. Journal of Psychology, 143, 2, 193–205.Google Scholar
Brodaty, H. and Donkin, M. 2009. Family caregivers of people with dementia. Dialogues in Clinical Neurosciences, 11, 2, 217–28.CrossRefGoogle ScholarPubMed
Brown, P. J., Sloman, R., Brown, L. M. and Mitchell, R. 1995. Coping strategies of caregivers of family members with dementia. Australian and New Zealand Journal of Mental Health Nursing, 4, 2, 70–6.Google Scholar
Brunnström, H., Gustafson, L., Passant, U. and Englund, E. 2009. Prevalence of dementia subtypes: a 30-year survey of neuropathological reports. Archives of Gerontology and Geriatrics, 49, 1, 146–9.Google Scholar
Champoux, J. E. and Peters, W. S. 1987. Form, effect size, and power in moderated multiple regression. Journal of Occupational Psychology, 60, 3, 243–55.Google Scholar
Chappell, N. L. and Penning, M. 1996. Behavioural problems and distress among caregivers of people with dementia. Ageing & Society, 16, 1, 57–73.CrossRefGoogle Scholar
Cohen, J., Cohen, P., West, S. G. and Aiken, L. S. 2003. Applied Multiple Regression/Correlation Analysis for the Behavioral Science. Third edition, Erlbaum, Mahwah, New Jersey.Google Scholar
Cohen, S. 1992. Stress, social support and disorder. In Veiel, H. O. F. and Baumann, U. (eds), The Meaning and Measurement of Social Support. Hemisphere Press, New York, 109–24.Google Scholar
Cohen, S., Sherrod, D. R. and Clark, M. S. 1986. Social skills and the stress protective role of social support. Journal of Personality and Social Psychology, 50, 5, 963–73.Google Scholar
Cohen, S. and Wills, T. A. 1985. Stress, social support and the buffering hypothesis. Psychological Bulletin, 98, 2, 340–57.Google Scholar
De Labra, C., Millán-Calenti, J. C., Buján, A., Núñez-Naveira, L., Jensen, A. M., Peersen, M. C., Mojs, E., Samorski, W. and Maseda, A. 2015. Predictors of caregiving satisfaction in informal caregivers of people with dementia. Archives of Gerontology and Geriatrics, 60, 3, 380–8.Google Scholar
De Souza, L. C., Sarazin, M., Goetz, C. and Dubois, B. 2009. Clinical investigation in primary care. In Giannakopoulos, P. and Hof, P. R. (eds), Dementia in Clinical Practice. Frontiers of Neurology and Neuroscience. Krager, Basel, 1–11.Google Scholar
Dohrenwend, B. P. 2006. Inventorying stressful life events as risk factors for psychopathology: toward resolution of the problem of intracategory variable. Psychological Bulletin, 132, 3, 477–95.CrossRefGoogle Scholar
Drieling, T., van Calker, D. and Hecht, H. 2006. Stress, personality and depressive symptoms in a 6.5 year follow-up of subjects at familial risk for affective disorders and controls. Journal of Affective Disorders, 91, 2, 195–203.Google Scholar
Eker, D. and Arkar, H. 1995. Çok boyutlu algınan sosyal destek ölçeğinin faktor yapısı, geçerlik ve güvenirliği. Türk Psikoloji Dergisi, 10, 45–55.Google Scholar
Etters, L., Goodall, D. and Harrison, B. E. 2008. Caregiver burden among dementia patient caregivers: a review of the literature. Journal of the American Academy of Nurse Practitioners, 20, 8, 423–8.Google Scholar
Fauth, E., Hess, K., Piercy, K., Norton, M., Corcoran, C., Rabins, P., Lyketsos, C. and Tschanz, J. 2012. Caregivers’ relationship closeness with the person with dementia predicts both positive and negative outcomes for caregivers’ physical health and psychological well-being. Aging & Mental Health, 16, 6, 699–711.Google Scholar
Flynn, M., Kecmanovic, J. and Alloy, L. B. 2010. An examination of integrated cognitive-interpersonal vulnerability to depression: the role of rumination, perceived social support, and interpersonal stress generation. Cognitive Therapy and Research, 34, 5, 456–66.Google Scholar
Frazier, P. A., Tix, A. P. and Barron, K. E. 2004. Testing moderator and mediator effects in counseling psychology research. Journal of Counseling Psychology, 51, 1, 115–34.Google Scholar
Garnefski, N., Koopman, H., Kraaij, V. and Cate, R. 2009. Brief report: cognitive emotion regulation strategies and psychological adjustment in adolescents with a chronic disease. Journal of Adolescence, 32, 2, 449–54.Google Scholar
Garnefski, N. and Kraaij, V. 2006. Relationships between cognitive emotion regulation strategies and depressive symptoms: a comparative study of five specific samples. Personality and Individual Differences, 40, 8, 1659–69.Google Scholar
Garnefski, N., Kraaij, V. and Spinhoven, P. 2001. Negative life events, cognitive emotion regulation and emotional problems. Personality and Individual Differences, 30, 8, 1311–27.CrossRefGoogle Scholar
Garnefski, N., Kraaij, V. and Spinhoven, P. 2002. Manual for the Use of the Cognitive Emotion Regulation Questionnaire. DATEC, Leiderdorp, The Netherlands.Google Scholar
Garnefski, N., Teerds, J., Kraaij, V., Legerstee, J. and van den Kommer, T. 2004. Cognitive emotion regulation strategies and depressive symptoms: differences between males and females. Personality and Individual Differences, 36, 2, 267–76.Google Scholar
Grootegoed, E., Knijn, T. and Da Roit, B. 2010. Relatives as paid care-givers: how family carers experience payments for care. Ageing & Society, 30, 3, 467–89.CrossRefGoogle Scholar
Haeffel, G. J. and Mathew, A. R. 2010. Inside thoughts and outside influences: cognitive vulnerability moderates the effect of decreases in perceived social support on depressive symptoms. Journal of Social and Clinical Psychology, 29, 281–300.Google Scholar
Haley, W. E., Gitlin, L. N., Wisniewski, S. R., Feeney-Mahney, D., Coon, D. W, Winter, L., Corcoran, M., Schinfeld, S. and Ory, M. 2004. Well-being, appraisal, and coping in African-American and Caucasian dementia caregivers: findings from the REACH study. Ageing & Mental Health, 8, 4, 316–29.Google Scholar
Haley, W. E., Levine, E. G., Brown, S. L. and Bartolucci, A. A. 1987. Stress, appraisal, coping and social support as predictors of adaptational outcome among dementia caregivers. Psychology and Aging, 2, 4, 323–30.Google Scholar
Hayes, A. F. and Matthes, J. 2009. Computational procedures for probing interactions in OLS and logistic regression: SPSS and SAS implementations. Behavior Research Methods, 41, 3, 924–36.Google Scholar
Hayslip, B., Han, G. and Anderson, C. 2008. Predictors of Alzheimer's disease caregiver depression and burden: what noncaregiving adults can learn from active caregivers. Educational Gerontology, 34, 11, 945–69.Google Scholar
Hisli, N. 1989. Beck depresyon envanterinin üniversite öğrencileri için geçerliği ve güvenirliği. Psikoloji Dergisi, 7, 23, 3–13.Google Scholar
Holmbeck, G. N. 1997. Toward terminological, conceptual, and statistical clarity in the study of mediators and moderators: examples from the child-clinical and pediatric psychology literatures. Journal of Consulting and Clinical Psychology, 65, 4, 599–610.Google Scholar
Holmes, T. H. and Rahe, R. H. 1967. The Social Readjustment Rating Scale. Journal of Psychosomatic Research, 11, 2, 213–8.Google Scholar
Hong, G.-R. S. and Kim, H. 2008. Family caregiver burden by relationship to care recipient with dementia in Korea. Geriatric Nursing, 29, 4, 267–74.Google Scholar
Huang, C. Y., Musil, C. M., Zauszniewski, J. A. and Wykle, M. L. 2006. Effects of social support and coping of family caregivers of older adults with dementia in Taiwan. International Journal of Aging & Human Development, 63, 1, 1–25.Google Scholar
Iavarone, A., Ziello, A. R., Pastore, F., Fasanaro, A. M. and Poderico, C. 2014. Caregiver burden and coping strategies in caregivers of patients with Alzheimers disease. Neuropsychiatric Disease and Treatment, 29, 10, 1407–13.Google Scholar
Kagitcibasi, C. 1996. Family and Human Development Across Cultures: A View from the Other Side. Erlbaum, Hillsdale, New Jersey.Google Scholar
Kim, H. 2013. What is the effect of a support program for female family caregivers of dementia on depression? International Journal of Bio-science and Bio-technology, 5, 5, 39–46.Google Scholar
Kim, H., Chang, M., Rose, K. and Kim, S. 2012. Predictors of caregiver burden in caregivers of individuals with dementia. Journal of Advanced Nursing, 68, 4, 846–55.CrossRefGoogle ScholarPubMed
Kneebone, I. I. and Martin, P. R. 2003. Coping and caregivers of people with dementia. British Journal of Health Psychology, 8, 1, 1–17.Google Scholar
Lazarus, R. and Folkman, S. 1984. Stress, Appraisal and Coping. Springer Publishing, New York.Google Scholar
Lee, Y. R. and Sung, K. T. 1997. Cultural differences in caregiving motivations for demented parents: Korean caregivers versus American caregivers. International Journal of Aging & Human Development, 44, 2, 115–27.Google Scholar
Martin, R. C. and Dahlen, E. R. 2005. Cognitive emotion regulation in the prediction of depression, anxiety, stress, and anger. Personality and Individual Differences, 39, 7, 1249–60.Google Scholar
McKhann, G. M., Knopman, D. S., Chertkow, H., Hyman, B. T., Jack, C. R., Kawas, C. H., Klunk, W. E., Koroshetz, W. J., Manly, J. J., Mayeux, R., Mohs, R. C., Morris, J. C., Rossor, M. N., Scheltens, P., Carrillo, M. C., Thies, B., Weintraub, S. and Phelps, C. H. 2011. The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's & Dementia, 7, 3, 263–9.Google Scholar
Min, J. A., Yu, J. J., Lee, C. U. and Chae, J. H. 2013. Cognitive emotion regulation strategies contributing to resilience in patients with depression and/or anxiety disorders. Comprehensive Psychiatry, 54, 8, 1190–7.Google Scholar
Möller-Leimkühler, A. M. and Wiesheu, A. 2012. Caregiver burden in chronic mental illness: the role of patient and caregiver characteristics. European Archives of Psychiatry and Clinical Neuroscience, 262, 2, 157–66.CrossRefGoogle ScholarPubMed
Moore, R. G. and Garland, A. 2003. Cognitive Therapy for Chronic and Persistent Depression. Wiley, Chichester, UK.Google Scholar
Muscatell, K. A., Slavich, G. M., Monreo, S. M. and Gotlib, I. H. 2009. Stressful life events, chronic difficulties, and the symptoms of clinical depression. Journal of Nervous and Mental Disease, 197, 3, 154–60.Google Scholar
Neundorfer, M. M. 1991. Coping and health outcomes in spouse caregivers of persons with dementia. Nursing Research, 40, 5, 260–5.CrossRefGoogle ScholarPubMed
Nolen-Hoeksema, S. and Davis, C. G. 1999. ‘Thanks for sharing that’: ruminators and their social support networks. Journal of Personality and Social Psychology, 77, 4, 801–14.Google Scholar
Nuck, B. and Suckow, J. 2006. Intergenerational relationships in cross-cultural comparison: how social networks frame intergenerational relations between mothers and grandmothers in Japan, Korea, China, Indonesia, Israel, Germany, and Turkey. Journal of Family Issues, 27, 8, 1159–85.CrossRefGoogle Scholar
Öngen, D. E. 2010. Cognitive emotion regulation in the prediction of depression and submissive behavior: Gender and grade level differences in Turkish adolescents. Procedia Social and Behavioral Sciences, 9, 1516–23.Google Scholar
Papastavrou, E., Kalokerinou, A., Papacostas, S. S., Tsangari, H. and Sourtzi, P. 2007. Caring for a relative with dementia: family caregiver burden. Journal of Advanced Nursing, 58, 5, 446–57.CrossRefGoogle ScholarPubMed
Razi, Z. 1993. The myth of the immutable English family. Past and Present: A Journal of Historical Studies, 140, 1, 3–44.Google Scholar
Salfi, J., Ploeg, J. and Black, M. E. 2005. Seeking to understand telephone support for dementia caregivers. Western Journal of Nursing Research, 27, 6, 701–21.CrossRefGoogle ScholarPubMed
Schroevers, M., Kraaij, V. and Garnefski, N. 2008. How do cancer patients manage unattainable personal goals and regulate their emotions? British Journal of Health Psychology, 13, 3, 551–62.Google Scholar
Schulz, R. and Martire, L. M. 2004. Family caregiving of persons with dementia: prevalence, health effects and support strategies. American Journal of Geriatric Psychiatry, 12, 3, 240–9.Google Scholar
Simpson, J. R. 2014. DSM-5 and neurocognitive disorders. Journal of the American Academy of Psychiatry and the Law, 42, 2, 318–23.Google Scholar
Skarupski, K. A., McCann, J. J., Bienias, J. L. and Evans, D. A. 2009. Race differences in emotional adaption of family caregivers. Aging & Mental Health, 13, 5, 715–24.CrossRefGoogle ScholarPubMed
Sun, F. 2014. Caregiving stress and coping: a thematic analysis of Chinese family caregivers of persons with dementia. Dementia, 13, 6, 803–18.Google Scholar
Swann, W. B. Jr., Wenzlaff, R. M., Krull, D. S. and Pelham, B. W. 1992. Allure of negative feedback: self-verification strivings among depressed persons. Journal of Abnormal Psychology, 101, 2, 293–306.Google Scholar
Takahashi, M., Tanaka, K. and Miyaoka, H. 2006. Depression and associated factors of informal caregivers versus professional caregivers of demented patients. Psychiatry and Clinical Neurosciences, 59, 4, 473–80.Google Scholar
Truzzi, A., Valente, L., Ulstein, I., Engelhardt, E., Laks, J. and Engedal, K. 2012. Burnout in familial caregivers of patients with dementia. Revista Brasileira de Psiquiatria, 34, 405–12.CrossRefGoogle ScholarPubMed
Vitaliano, P. P., Murphy, M., Young, H. M., Echeverria, D. and Borson, S. 2011. Does caring for a spouse with dementia promote cognitive decline? A hypothesis and proposed mechanism. Journal of the American Geriatrics Society, 59, 5, 900–8.Google Scholar
Watson, L. C., Lewis, C. L., Moore, C. G. and Jeste, D. V. 2011. Perception of depression among dementia caregivers: findings from CATIE-AD trial. International Journal of Geriatric Psychiatry, 26, 4, 397–402.Google Scholar
Wheaton, B. 1985. Models for stress-buffering functions of coping resources. Journal of Health and Social Behavior, 26, 4, 352–64.Google Scholar
Xiao, J., Yao, S., Zhu, X., Abela, J. R. Z., Chen, X., Duan, S. and Zhao, S. 2011. A prospective study of cognitive emotion regulation strategies and depressive symptoms in patients with essential hypertension. Clinical and Experimental Hypertension, 33, 1, 63–8.Google Scholar
Yadav, S. 2010. Perceived social support, hope, and quality of life of persons living with HIV/AIDS: a case study from Nepal. Quality of Life Research, 19, 2, 157–66.Google Scholar
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. 1980. Relatives of the impaired elderly: correlates of feelings of burden. The Gerontologist, 20, 6, 649–55.Google Scholar
Zimet, G. D., Dahlem, N. W., Zimet, S. G. and Farley, G. K. 1988. The multidimensional scale of perceived social support. Journal of Personality Assessment, 52, 1, 30–41.Google Scholar