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Thought–feeling discrimination in people with dementia: adaptation and preliminary validation of the first dementia-specific measure

Published online by Cambridge University Press:  29 April 2019

Joshua Stott ,
Tim Cadman ,
Henry Potts ,
Katrina Scior ,
Janina Brede  and
Georgina Charlesworth
Joshua Stott*
Affiliation:
Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
Tim Cadman
Affiliation:
Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
Henry Potts
Affiliation:
UCL Institute of Health Informatics, University College London, London, UK
Katrina Scior
Affiliation:
Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
Janina Brede
Affiliation:
Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
Georgina Charlesworth
Affiliation:
Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
*
Correspondence should be addressed to: Joshua Stott, Research Department of Clinical, Educational and Health Psychology, University College London, London, WC1E 6BT, UK. Phone: +44 2076795950; Fax: +44 2079161989; Email: [email protected].
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Abstract

Objective:

There is emerging evidence that cognitive behavioral therapy (CBT) can be effective for treating anxiety and depression in people living with dementia (PLWD). Discriminating between thoughts and feelings is a critical element of CBT and also of relevance to emotional understanding more generally. The aim of the present study was the structured adaptation and preliminary validation of an existing measure of thought–feeling discrimination for use in PLWD.

Methods/Design:

The Behavior Thought Feeling Questionnaire (BTFQ) was adapted via expert and service-user consultation for use in PLWD. One hundred two PLWD and 77 people aged over 65 years who did not have measurable cognitive impairments completed the adapted measure along with two measures of emotional recognition and reasoning. The factor structure of this measure was examined and the measure reduced.

Results:

Factor analysis suggested a two-factor solution with thought and feeling items loading on separate factors. The behavior items were not included in scoring due to high cross-loading and ceiling effects, leaving a 14-item measure with two subscales. Thus, an adapted measure was created (named the BTFQ-D), which showed moderate convergent validity in the PLWD but not the older adult sample. Both thought and feeling subscales showed good internal consistency.

Conclusions:

The BTFQ-D showed preliminary validity as a measure of thought–feeling discrimination in PLWD. It may have utility in measuring readiness for CBT as part of clinical assessment. Further validation is required.

Keywords

agingcognitive behavioral therapy (CBT)anxietymood disordersclinical assessment
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 1: Issue Theme: Cultural Diversity in Psychogeriatrics , January 2020 , pp. 87 - 96
Copyright
© International Psychogeriatric Association 2019 

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Footnotes

*

Tim Cadman’s affiliation has been updated. A corrigendum detailing this change has also been published (doi:10.1017/S1041610219001340).

References

Ballard, C., Neill, D., O’brien, J., Mckeith, I., Ince, P. and Perry, R. (2000). Anxiety, depression and psychosis in vascular dementia: prevalence and associations. Journal of affective disorders, 59, 97–106.CrossRefGoogle ScholarPubMed
Banerjee, S. et al. (2011). Sertraline or mirtazapine for depression in dementia (HTA-SADD): a randomised, multicentre, double-blind, placebo-controlled trial. The Lancet, 378, 403–411.CrossRefGoogle ScholarPubMed
Dagnan, D., Chadwick, P. and Proudlove, J. (2000). Toward an assessment of suitability of people with mental retardation for cognitive therapy. Cognitive Therapy and Research, 24, 627–636.CrossRefGoogle Scholar
Dagnan, D., Chadwick, P., Stenfert Kroese, B., Dagnan, D. and Loumidis, K. (1997). Components of cognitive therapy with people with learning disabilities. In: Stenfert Kroese, B., Dagnan, D., and Loumidis, K. (Eds.), Cognitive Therapy for People with Learning Disabilities (pp. 110–123). London: Routledge.Google Scholar
Dagnan, D., Mellor, K. and Jefferson, C. (2009). Assessment of cognitive therapy skills for people with learning disabilities. Advances in Mental Health and Learning Disabilities, 3, 25–30.10.1108/17530180200900036CrossRefGoogle Scholar
Dening, K. H., Jones, L. and Sampson, E. L. (2012). Preferences for end-of-life care: a nominal group study of people with dementia and their family carers. Palliative medicine, 27, 409–417.CrossRefGoogle ScholarPubMed
Doherr, L., Reynolds, S., Wetherly, J. and Evans, E. H. (2005). Young children’s ability to engage in cognitive therapy tasks: associations with age and educational experience. Behavioural and Cognitive Psychotherapy, 33, 201–215.CrossRefGoogle Scholar
Emre, M. et al. (2007). Clinical diagnostic criteria for dementia associated with Parkinson’s disease. Movement Disorders, 22, 1689–1707.CrossRefGoogle ScholarPubMed
Enache, D., Winblad, B. and Aarsland, D. (2011). Depression in dementia: epidemiology, mechanisms, and treatment. Current Opinion in Psychiatry, 24, 461–472.CrossRefGoogle ScholarPubMed
Fabrigar, L. R., Wegener, D. T., Maccallum, R. C. and Strahan, E. J. (1999). Evaluating the use of exploratory factor analysis in psychological research. Psychological Methods, 4, 272.CrossRefGoogle Scholar
Field, A. (2013). Discovering Statistics Using IBM SPSS Statistics. UK: Sage.Google Scholar
Flavell, J. H. (1999). Cognitive development: children’s knowledge about the mind. Annual Review of Psychology, 50, 21–45.10.1146/annurev.psych.50.1.21CrossRefGoogle ScholarPubMed
Gibbons, L. E., et al. (2002). Anxiety symptoms as predictors of nursing home placement in patients with Alzheimer’s disease. Journal of Clinical Geropsychology, 8, 335–342.CrossRefGoogle Scholar
Greenberger, D. and Padesky, C. A. (1995). Mind Over Mood: A Cognitive Therapy Treatment Manual for Clients. New York, USA: Guilford Press.Google Scholar
Greenberger, D. and Padesky, C. A. (2015). Mind Over Mood: Change How You Feel by Changing the Way You Think. New York, NY: Guilford Publications.Google Scholar
Guss, R. et al. (2014). Clinical Psychology in the Early Stage Dementia Care Pathway, London: The British Psychological Society.Google Scholar
Harter, L. (2003). Assessment of the suitability of older adults with dementia for cognitive therapy. D.Clin.Psy Doctoral. Lancaster University.Google Scholar
Hebblethwaite, A., Jahoda, A. and Dagnan, D. (2011). Talking about real-life events: an investigation into the ability of people with intellectual disabilities to make links between their beliefs and emotions within dialogue. Journal of Applied Research in Intellectual Disabilities, 24, 543–553.CrossRefGoogle Scholar
Hofmann, R. J. (1978). Complexity and simplicity as objective indices descriptive of factor solutions. Multivariate Behavioral Research, 13, 247–250.CrossRefGoogle ScholarPubMed
Hsieh, S., Schubert, S., Hoon, C., Mioshi, E. and Hodges, J. R. (2013). Validation of the Addenbrooke’s Cognitive Examination III in frontotemporal dementia and Alzheimer’s disease. Dementia and Geriatric Cognitive Disorders, 36, 242–250.CrossRefGoogle ScholarPubMed
Join Dementia Research. (2016). Available at: https://www.joindementiaresearch.nihr.ac.uk/; last accessed 7 November 2016.Google Scholar
Kohler, C. G., Anselmo-Gallagher, G., Bilker, W., Karlawish, J., Gur, R. E. and Clark, C. M. (2005). Emotion-discrimination deficits in mild Alzheimer disease. American Journal of Geriatric Psychiatry, 13, 926–933.10.1097/00019442-200511000-00002CrossRefGoogle ScholarPubMed
Kohler, C. G., Bilker, W., Hagendoorn, M., Gur, R. E. and Gur, R. C. (2000). Emotion recognition deficit in schizophrenia: association with symptomatology and cognition. Biological Psychiatry, 48, 127–136.CrossRefGoogle ScholarPubMed
Law, E., et al. (2013). Does the Addenbrooke’s Cognitive Examination-revised add to the Mini-Mental State Examination in established Alzheimer disease? Results from a national dementia research register. International Journal Geriatric Psychiatry, 28, 351–355.CrossRefGoogle ScholarPubMed
Lickel, A., Maclean, W. E. JR., Blakeley-Smith, A. and Hepburn, S. (2012). Assessment of the prerequisite skills for cognitive behavioral therapy in children with and without autism spectrum disorders. Journal of Autism & Developmental Disorders, 42, 992–1000.CrossRefGoogle ScholarPubMed
Livingston, G. et al. (2017). Dementia prevention, intervention, and care. The Lancet, 3990(10113), 2673–2734.10.1016/S0140-6736(17)31363-6CrossRefGoogle Scholar
McKhann, G. M. et al. (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, 263–269.CrossRefGoogle Scholar
Mokkink, L. B. et al. (2010). The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. Journal of Clinical Epidemiology, 63, 737–745.CrossRefGoogle ScholarPubMed
Neary, D. et al. (1998). Frontotemporal lobar degeneration A consensus on clinical diagnostic criteria. Neurology, 51, 1546–1554.CrossRefGoogle ScholarPubMed
Oathamshaw, S. C., Barrowcliff, A. L. and Haddock, G. (2012). Cognitive-Behavioral Therapy for People with Intellectual Disabilities and Psychosis. In: Taylor, J., Lindsay, W., Hasings, R., and Hatton, C. (Eds.), Psychological Therapies for Adults with Intellectual Disabilities (pp. 157–172). John Wiley and Sons.CrossRefGoogle Scholar
Oathamshaw, S. C. and Haddock, G. (2006). Do people with intellectual disabilities and psychosis have the cognitive skills required to undertake cognitive behavioural therapy? Journal of Applied Research in Intellectual Disabilities, 19, 35–46.CrossRefGoogle Scholar
Orgeta, V., Qazi, A., Spector, A. E. and Orrell, M. (2014). Psychological treatments for depression and anxiety in dementia and mild cognitive impairment. Cochrane Database of Systematic Reviews, 1. doi: doi/10.1002/14651858.CD009125.pub2/pdfGoogle Scholar
Pearson, R. H. and Mundform, D. J. (2010). Recommended sample size for conducting exploratory factor analysis on dichotomous data. Journal of Modern Applied Statistical Methods, 9(2), 359–368.Google Scholar
Pettersson, E. and Turkheimer, E. (2010). Item selection, evaluation, and simple structure in personality data. Journal of Research in Personality, 44, 407–420.CrossRefGoogle ScholarPubMed
Quakley, S., Coker, S., Palmer, K. and Reynolds, S. (2003). Can children distinguish between thoughts and behaviours? Behavioural and Cognitive Psychotherapy, 31, 159–168.CrossRefGoogle Scholar
Quakley, S., Reynolds, S. and Coker, S. (2004). The effect of cues on young children’s abilities to discriminate among thoughts, feelings and behaviours. Behaviour Research and Therapy, 42, 343–356.CrossRefGoogle Scholar
Reed, J. and Clements, J. (1989). Assessing the understanding of emotional states in a population of adolescents and young adults with mental handicaps. Journal of Mental Deficiency Research, 33, 229–233.Google Scholar
Revelle, W. and Revelle, M. W. (2017). Psych: Procedures for Psychological, Psychometric, and Personality Research (Version 1.7.5). Retrieved from https://cran.r-project.org/package=psychGoogle Scholar
Román, G. C. et al. (1993). Vascular dementia Diagnostic criteria for research studies: report of the NINDS‐AIREN International Workshop. Neurology, 43, 250–250.CrossRefGoogle ScholarPubMed
Roth, A. D. and Pilling, S. (2008). Using an evidence-based methodology to identify the competences required to deliver effective cognitive and behavioural therapy for depression and anxiety disorders. Behavioural and Cognitive Psychotherapy, 36, 129–147.CrossRefGoogle Scholar
Salmon, D. P. and Bondi, M. W. (2009). Neuropsychological assessment of dementia. Annual Review of Psychology, 60, 257.CrossRefGoogle ScholarPubMed
Sams, K., Collins, S. and Reynolds, S. (2006). Cognitive therapy abilities in people with learning disabilities. Journal of Applied Research in Intellectual Disabilities, 19, 25–33.10.1111/j.1468-3148.2006.00303.xCrossRefGoogle Scholar
Seignourel, P. J., Kunik, M. E., Snow, L., Wilson, N. and Stanley, M. (2008). Anxiety in dementia: a critical review. Clinical Psychology Review, 28, 1071–1082.CrossRefGoogle ScholarPubMed
Shimokawa, A. et al. (2001). Influence of deteriorating ability of emotional comprehension on interpersonal behavior in Alzheimer-type dementia. Brain and Cognition, 47, 423–433.CrossRefGoogle ScholarPubMed
Smith, S. et al. (2005). Measurement of health-related quality of life for people with dementia: development of a new instrument (DEMQOL) and an evaluation of current methodology. Health Technology Assessment (Winchester, England), 9, 1–93.Google ScholarPubMed
Spector, A. et al. (2015). Cognitive-behavioural therapy for anxiety in dementia: pilot randomised controlled trial. British Journal of Psychiatry, 206, 509–516.CrossRefGoogle ScholarPubMed
Stanley, M. A. et al. (2013). The Peaceful Mind program: a pilot test of a cognitive–behavioral therapy-based intervention for anxious patients with Dementia. The American Journal of Geriatric Psychiatry, 21, 696–708.CrossRefGoogle ScholarPubMed
Stewart, A. L., Thrasher, A. D., Goldberg, J. and Shea, J. A. (2012). A framework for understanding modifications to measures for diverse populations. Journal of Aging and Health, 24, 992–1017.CrossRefGoogle ScholarPubMed
Stott, J., Charlesworth, G. and Scior, K. (2017a). Measures of readiness for cognitive behavioural therapy in people with intellectual disability: a systematic review. Research in Developmental Disabilities, 60, 37–51.CrossRefGoogle ScholarPubMed
Stott, J., Orrell, M. and Charlesworth, G. (2017b). The interpretability of the Hospital Anxiety and Depression Scale in carers of people with dementia: clinical and research implications. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 13, P1238–P1239.CrossRefGoogle Scholar
Stott, J., Scior, K., Mandy, W. and Charlesworth, G. (2017c). Dementia screening accuracy is robust to premorbid IQ variation: evidence from the Addenbrooke’s Cognitive Examination-III and the test of premorbid function. Journal of Alzheimer’s Disease, 57, 1293–1302.CrossRefGoogle ScholarPubMed
Stott, J., Spector, A., Orrell, M., Scior, K., Sweeney, J. and Charlesworth, G. (2016). Limited validity of the Hospital Anxiety and Depression Scale (HADS) in dementia: evidence from a confirmatory factor analysis. International Journal of Geriatric Psychiatry, 32(7), 805–813.CrossRefGoogle ScholarPubMed
Stott, J., Sweeney, J. M., Koschalka, L., O’Connor, L. and Mwale, A. (2017d). People with dementia as peer workers, challenges, and benefits: a thematic analysis and nominal groups study. International Psychogeriatrics, 29, 1185–1192.CrossRefGoogle ScholarPubMed
Van De Ven, A. H. and Delbecq, A. L. (1972). The nominal group as a research instrument for exploratory health studies. American Journal of Public Health, 62, 337–342.CrossRefGoogle Scholar
Vereenooghe, L., Gega, L., Reynolds, S. and Langdon, P. E. (2016). Using computers to teach people with intellectual disabilities to perform some of the tasks used within cognitive behavioural therapy: a randomised experiment. Behaviour Research and Therapy, 76, 13–23.CrossRefGoogle ScholarPubMed
Verhoeven, K. J., Simonsen, K. L. and Mcintyre, L. M. (2005). Implementing false discovery rate control: increasing your power. Oikos, 108, 643–647.CrossRefGoogle Scholar
Wells, C. S. and Wollack, J. A. (2003). An instructor’s guide to understanding test reliability. Testing & Evaluation Services. University of Wisconsin. Retrieved from https://testing.wisc.edu/Reliability.pdfGoogle Scholar
Zigmond, A. S. and Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefGoogle ScholarPubMed
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