Psychometric properties of the Valued Living Questionnaire Adapted to Dementia Caregiving.

OBJECTIVES: Caring for a relative with dementia is associated with physical and emotional health problems in caregivers. There are no studies analysing the role of personal values in the caregiver stress process. This study aims to analyse the psychometric properties of the Valued Living Questionnaire Adapted to Caregiving (VLQAC), and to explore the relationship between personal values and stressors, coping strategies and caregiver distress. METHOD: A total of 253 individual interviews with caregivers of relatives with dementia were conducted, and the following variables were assessed: personal values, stressors, cognitive fusion, emotional acceptance, depression, anxiety, and satisfaction with life. An exploratory factor analysis and hierarchical regression analyses were carried out. RESULTS: Two factors were obtained, Commitment to Own Values and Commitment to Family Values which explain 43.42% of variance, with reliability coefficients (Cronbach's alpha) of .76 and .61, respectively. Personal values had a significant effect on emotional distress (depression and anxiety) and satisfaction with life, even when controlling for socio-demographic variables, stressors and coping strategies. CONCLUSION: Results suggest that the personal values construct of dementia caregivers is two-dimensional. The personal values of the caregivers play an important role in accounting for distress and satisfaction with life in this population.

Stressors and anxiety in dementia caregiving: multiple mediation analysis of rumination, experiential avoidance, and leisure.

BACKGROUND: Despite the robust associations between stressors and anxiety in dementia caregiving, there is a lack of research examining which factors contribute to explain this relationship. This study was designed to test a multiple mediation model of behavioral and psychological symptoms of dementia (BPSD) and anxiety that proposes higher levels of rumination and experiential avoidance and lower levels of leisure satisfaction as potential mediating variables. METHODS: The sample consisted of 256 family caregivers. In order to test a simultaneously parallel multiple mediation model of the BPSD to anxiety pathway, a PROCESS method was used and bias-corrected and accelerated bootstrapping method was used to test confidence intervals. RESULTS: Higher levels of stressors significantly predicted anxiety. Greater stressors significantly predicted higher levels of rumination and experiential avoidance, and lower levels of leisure satisfaction. These three coping variables significantly predicted anxiety. Finally, rumination, experiential avoidance, and leisure satisfaction significantly mediated the link between stressors and anxiety. The explained variance for the final model was 47.09%. Significant contrasts were found between rumination and leisure satisfaction, with rumination being a significantly higher mediator. CONCLUSIONS: The results suggest that caregivers' experiential avoidance, rumination, and leisure satisfaction may function as mechanisms through which BPSD influence on caregivers' anxiety. Training caregivers in reducing their levels of experiential avoidance and rumination by techniques that foster their ability of acceptance of their negative internal experiences, and increase their level of leisure satisfaction, may be helpful to reduce their anxiety symptoms developed by stressors.

Moderating effect of self-efficacy on the relation between behavior problems in persons with dementia and the distress they cause in caregivers.

INTRODUCTION: Behavioral and psychological symptoms in dementia (BPSD) are the principal sources of stress in caregivers. The aim of the present work is to analyze the moderating effect of self-efficacy for managing BPSD on the distress these problems generate in family caregivers. METHOD: The participants were 231 family caregivers of people with dementia. We assessed the frequency and caregiver distress associated with three dimensions of BPSD (depressive, disruptive and memory problems). In addition, we assessed the moderating effect of self-efficacy for dealing with BPSD in the relationship between the dementia patient's frequency of BPSD and caregiver distress through hierarchical regression analyses, one for each of the dimensions of BPSD. RESULTS: We found a moderating effect of self-efficacy on the relation between the frequency of BPSD and the distress in caregivers for the dimensions of depressive and disruptive behaviors. Caregivers having to deal with a high frequency of behavior problems but with high levels of self-efficacy presented significantly lower levels of distress associated with depressive and disruptive behavior problems compared to those caregivers with low levels of self-efficacy. No differences in the effects of self-efficacy were found for distress levels of caregivers who dealt with low frequency of BPSD. Also, we did not find a moderating effect of self-efficacy on the relation between the frequency of memory problems and caregivers' distress. CONCLUSIONS: The results suggest that self-efficacy for managing BPSD attenuates the relation between the frequency of behavior problems ­ both disruptive and depressive ­ and the distress they cause in caregivers.

Anger and health in dementia caregivers: exploring the mediation effect of optimism.

Although previous studies indicate a negative association between caregivers' anger and health, the potential mechanisms linking this relationship are not yet fully understood. The aim of this study was to explore the potential mediating role of optimism in the relationship between anger and caregivers' physical health. Dementia caregivers (n = 108) were interviewed and filled out instruments assessing their anger (reaction), optimism and health (vitality). A mediational model was tested to determine whether optimism partially mediated the relationship between anger and vitality. Angry reaction was negatively associated with optimism and vitality; optimism was positively associated with vitality. Finally, the relationship between angry reaction and vitality decreased when optimism was entered simultaneously. A non-parametric bootstrap approach confirmed that optimism significantly mediated some of the relationship between angry reaction and vitality. These findings suggest that low optimism may help explain the association between caregivers' anger and reduced sense of vitality. The results provide a specific target for intervention with caregivers.

Spirituality and self-efficacy in dementia family caregiving: trust in God and in yourself.

BACKGROUND: Research indicates that spirituality and self-efficacy have been associated with higher levels of caregivers' well-being. However, these two concepts have rarely been examined simultaneously. The aim of this study was to analyze the combined effect of spirituality and self-efficacy on the caregiving stress process. METHODS: The study design was cross-sectional. Dementia family caregivers (n = 122) were assessed in relation to the following variables: stressors (time since caregiving began, daily hours caring, frequency of behavioral problems, patient's functional status); appraisal (caregiver's appraisal of behavioral problems), caregiver's personal resources (self-efficacy, spiritual meaning, social support), and outcomes (depression and anxiety). RESULTS: Participants were divided into four groups corresponding to four profiles defined by their scores on spiritual meaning and self-efficacy: LELS = Low self-efficacy and low spirituality; HELS = High self-efficacy and low spirituality; LEHS = Low self-efficacy and high spirituality; and HEHS = High self-efficacy and high spirituality. No differences were found between groups in stressors, appraisal, or personal resources. Caregivers in the HEHS group had significantly less depression compared to the LEHS group. Regression analysis showed that being a HEHS caregiver, low appraisal of behavioral problems and high social support were associated with low caregiver depression. Only high appraisal of behavioral problems was associated with high levels of anxiety. CONCLUSION: The results of this study suggest that spirituality and self-efficacy had an additive effect on caregivers' well-being. A high sense of spiritual meaning and a high self-efficacy, in combination, was associated with lower levels of depression in caregivers.

Survival and germination of Clostridium perfringens spores during heating and cooling of ground pork.

The effect of heating rate on the heat resistance, germination, and outgrowth of Clostridium perfringens spores during cooking of cured ground pork was investigated. Inoculated cured ground pork portions were heated from 20 to 75°C at a rate of 4, 8, or 12°C/h and then held at 75°C for 48 h. No significant differences (P > 0.05) in the heat resistance of C. perfringens spores were observed in cured ground pork heated at 4, 8, or 12°C/h. At heating rates of 8 and 12°C/h, no significant differences in the germination and outgrowth of spores were observed (P > 0.05). However, when pork was heated at 4°C/h, growth of C. perfringens occurred when the temperature of the product was between 44 and 56°C. In another set of experiments, the behavior of C. perfringens spores under temperature abuse conditions was studied in cured and noncured ground pork heated at 4°C/h and then cooled from 54.4 to 7.2°C within 20 h. Temperature abuse during cooling of noncured ground pork resulted in a 2.8-log CFU/g increase in C. perfringens. In cured ground pork, C. perfringens decreased by 1.1 log CFU/g during cooling from 54.4 to 36.3°C and then increased by 0.9 log CFU/g until the product reached 7.2°C. Even when the initial level of C. perfringens spores in cured ground pork was 5 log CFU/g, the final counts after abusive cooling did not exceed 3.4 log CFU/g. These results suggest that there is no risk associated with C. perfringens in cured pork products under the tested conditions.

Factores asociados a la consideración de ingresar a un familiar con demencia en una residencia / Factors associated with dementia caregivers’ preference for institutional care

Introducción: El número de personas con demencia en España es cada vez mayor y también aumenta la cantidad de cuidadores que consideran la institucionalización de sus familiares. El objetivo de este estudio es analizar las variables asociadas al deseo por parte del cuidador de institucionalizar a su familiar mayor con demencia.Pacientes y métodos: Se entrevistó a 243 cuidadores familiares de personas con demencia. Fueron evaluadas variables predisponentes (sociodemográficas y contextuales), estresores (relacionados con la demencia y el cuidado), valoración (de la situación y del rol de cuidador), recursos (personales y comunitarios) y el deseo de institucionalización. Resultados: Más de la mitad de los cuidadores (52,6%) manifestó en alguna medida estar considerando la institucionalización del familiar con demencia. Un análisis de regresión múltiple por pasos muestra que ser varón, tener un parentesco con el enfermo distinto del de cónyuge, así como haber valorado y utilizado en mayor grado los recursos formales comunitarios (residencia esporádica, centro de día y psicoestimulación) se asocian a una mayor consideración de institucionalización en los cuidadores. Conclusiones: La valoración y posterior utilización de recursos formales fuera del hogar parece servir para romper las barreras que impiden que los cuidadores valoren ingresar a su familiar en una residencia. La dificultad para plantearse la institucionalización es más evidente en los cónyuges, que tienen unos vínculos más fuertes con la persona con demencia, y especialmente en las cuidadoras, quienes probablemente se sienten más obligadas a continuar con el cuidado por su condición de mujeres (AU)

Introduction: The prevalence of dementia is growing in Spain, and so is the number of caregivers who are considering the institutionalization of their relatives. The purpose of this study is to identify which variables are associated with caregivers’ desire for institutionalization their dementia relatives. Patients and methods: Informal caregivers of 243 individuals suffering from dementia were interviewed. Predisposing variables (sociodemographic and contextual variables), stressors (dementia-related and caregiving-related aspects), appraisals (of circumstances and caregivers’ role), resources (personal and community-based resources) and the desire to institutionalize were evaluated. Results: Over half of the caregivers (52.6%) indicated that they had some desire to institutionalize their relatives with dementia. Stepwise regression analysis revealed that caregivers’ consideration to institutionalize was associated with being a male caregiver, not being the spouse of the dementia patient, and with a higher consideration and higher use of community-based formal resources (short-term nursing home use, adult day care centres and psycho-stimulation). Conclusions: Assessing and using formal resources outside their homes help caregivers overcome barriers that keep them from considering the institutionalization of their relatives. The difficulty in considering institutionalizing their relatives is more evident among spouses, who have stronger attachments with the dementia patients, especially among females, who probably feel obliged to continue developing caregiver roles because of their gender (AU)

[Factors associated with dementia caregivers' preference for institutional care]. / Factores asociados a la consideración de ingresar a un familiar con demencia en una residencia.

INTRODUCTION: The prevalence of dementia is growing in Spain, and so is the number of caregivers who are considering the institutionalization of their relatives. The purpose of this study is to identify which variables are associated with caregivers' desire for institutionalization their dementia relatives. PATIENTS AND METHODS: Informal caregivers of 243 individuals suffering from dementia were interviewed. Predisposing variables (sociodemographic and contextual variables), stressors (dementia-related and caregiving-related aspects), appraisals (of circumstances and caregivers' role), resources (personal and community-based resources) and the desire to institutionalize were evaluated. RESULTS: Over half of the caregivers (52.6%) indicated that they had some desire to institutionalize their relatives with dementia. Stepwise regression analysis revealed that caregivers' consideration to institutionalize was associated with being a male caregiver, not being the spouse of the dementia patient, and with a higher consideration and higher use of community-based formal resources (short-term nursing home use, adult day care centres and psycho-stimulation). CONCLUSIONS: Assessing and using formal resources outside their homes help caregivers overcome barriers that keep them from considering the institutionalization of their relatives. The difficulty in considering institutionalizing their relatives is more evident among spouses, who have stronger attachments with the dementia patients, especially among females, who probably feel obliged to continue developing caregiver roles because of their gender.

Variables modulating depression in dementia caregivers: a longitudinal study.

BACKGROUND: Dementia caregiving has been linked to negative consequences for mental health in caregivers. Although depression seems to be an enduring psychological consequence associated with caregiving, little is known about the longitudinal effects that modulating variables related to coping strategies have on caregiver's changes in depression over time. This study is aimed at investigating whether, in a one-year longitudinal study with 130 dementia caregivers, caregivers' depression scores co-vary with modulating variables such as self-efficacy for controlling upsetting thoughts, frequency of leisure activities, and cognitive reappraisal, after controlling for gender and caregivers' stressors (frequency of disruptive behaviors). METHODS: Linear mixed models analysis was used to analyze the associations between time-varying values for caregivers' stressors and modulating variables in predicting caregivers' depression. RESULTS: It was found that increases in caregivers' self-efficacy, frequency of leisure activities, and cognitive reappraisal significantly predicted decreases in caregivers' depression over time, even after controlling for gender and frequency of disruptive behaviors. In addition, increases in stressors were significantly related to increases in depression over time. CONCLUSIONS: The inclusion of modulating variables significantly contributed to the explanation of the variance in caregivers' depression, adding explanatory power to the variables usually included in the stress and coping model (gender and stressors).

Analysis of the moderating effect of self-efficacy domains in different points of the dementia caregiving process.

INTRODUCTION: Studies analyzing the moderator role of self-efficacy have centered their attention on the relationship between stressors and distress. However, drawing upon the stress and coping model, the moderator effects of self-efficacy may appear in the relationship between other key elements of the stress process. OBJECTIVES AND METHOD: The purpose of this study was to analyze, in a sample of 167 dementia family caregivers, (1) the moderating effect of self-efficacy for managing behavioral problems on the relationship between frequency of behavioral problems and burden; and (2) the moderating effect of self-efficacy for controlling upsetting thoughts on the relationship between burden and caregivers' distress (depression and anxiety). RESULTS: While no support has been found for the hypothesis that self-efficacy for managing behavioral problems moderates the relationship between frequency of behavioral problems and burden, our findings support the moderator role of self-efficacy for controlling upsetting thoughts in the relationship between burden and distress. No differences in distress measures are found between caregivers with high and low scores on self-efficacy for controlling upsetting thoughts when they report low levels of burden. However, when the levels of burden are high, caregivers with high self-efficacy for controlling upsetting thoughts report significantly lower levels of distress than caregivers with low self-efficacy for controlling upsetting thoughts. CONCLUSION: Self-efficacy for controlling upsetting thoughts may be particularly effective for caregivers who report high burden scores, attenuating the impact of burden on caregivers' distress (depression and anxiety).

Motives for caring: relationship to stress and coping dimensions.

BACKGROUND: Although research has highlighted the importance of including cultural factors in the analysis of caregiver stress, little is known about the effects of motives for caregiving on the stress and coping process. This study is aimed at analyzing the dimensional structure of the Cultural Justifications for Caregiving Scale - Revised (CJCS-R), and the effects of motives for caregiving on stressors, caregiver resources and outcome variables. METHODS: Dementia caregivers (N = 166) were interviewed and the following variables were assessed: motives for caregiving (CJCS-R), stressors (frequency of behavioral problems), resources (rumination, cognitive reappraisal), and outcomes (depression, anxiety and anger). RESULTS: A bidimensional structure was obtained for the CJCS-R, and the two factors were labeled Intrinsic and Extrinsic motives for caregiving. Participants were divided into four groups corresponding to four motivation profiles: HIHE = High Intrinsic Motives + High Extrinsic motives; LILE = Low Intrinsic Motives + Low Extrinsic Motives; HILE = High Intrinsic Motives + Low Extrinsic Motives; and LIHE = Low Intrinsic Motives + High Extrinsic Motives. No differences between groups were found in frequency of behavioral problems. Caregivers in the LIHE group had significantly worse consequences on caregiver resources and outcome variables compared to the other groups. CONCLUSIONS: The results support the usefulness of considering motives for caregiving as a multidimensional construct. Analyzing caregivers' motivation profiles may constitute a useful strategy for identifying caregivers at risk. Caregivers scoring simultaneously low on intrinsic motives and high on extrinsic motives may be at particular risk for negative caregiving outcomes.

Differential regulation of IgG-NMO autoantibodies on S100Beta protein and disability in relapsing neuromyelitis optica.

Neuromyelitis optica (NMO), an uncommon central nervous system (CNS) demyelinating disease, produces transverse myelitis and severe optic neuritis. IgG-NMO autoantibody, a specific immunoglobulin binding aquaporin-4 water channel protein, confirms that NMO is a different entity to multiple sclerosis. Parallel to cytokine down-regulations found in serum of relapsing-NMO (rNMO) patients, it has been reported that IgG-NMO may also confer a worse course of the disease in r-NMO Caribbean patients. In this study, we were interested in exploring the influence of IgG-NMO autoantibody on S100beta levels and clinical parameters from serum of r-NMO patients. Serum samples from 24 rNMO patients and 10 controls were evaluated. The reduction of S100beta observed in r-NMO patients was not significant compared to controls; and no differences were present regarding IgG-NMO immunoreactivity. At the same time, a significant correlation was also observed between IgG-NMO autoantibody serum detection and EDSS (Expanded Disability Status Scale) in rNMO. These results corroborate a differential regulation of IgG-NMO autoantibodies on the S100beta glial marker and on the disability present in rNMO patients.

Modification of dysfunctional thoughts about caregiving in dementia family caregivers: description and outcomes of an intervention programme.

UNLABELLED: Among the diverse group of interventions developed to help dementia family caregivers cognitive-behavioural approaches show especially promising results. OBJECTIVES: This study describes a cognitive-behavioural group intervention aimed principally at the modification of dysfunctional thoughts associated with caregiving (MDTC). The efficacy of the MDTC intervention in reducing caregivers' depressive symptomatology, together with the frequency and appraisal of problem behaviours, is compared to that of a waiting-list control group (WL). Furthermore, the potential mediating role of the dysfunctional thoughts in the relationship between this intervention and caregivers' depressive symptomatology is analyzed. Of the 74 dementia caregivers who were randomized to one of two conditions (MDTC and WL), 39 completed the post-intervention assessment. Statistical analyses were performed on an intention-to-treat basis, using last observation carried forward. The results reveal that the MDTC intervention is successful in reducing caregivers' level of depressive symptomatology and dysfunctional thoughts about caregiving, as well as in modifying their appraisal of their relative's problem behaviours. Furthermore, a mediating role for dysfunctional thoughts was found in the relationship between the MDTC intervention and levels of depressive symptomatology. The relevance of addressing dysfunctional thoughts and cognitive distortions in group interventions with caregivers is highlighted.

[Differential efficacy of two psychoeducational interventions for dementia family caregivers]. / Eficacia diferencial de dos intervenciones psicoeducativas para cuidadores de familiares con demencia.

INTRODUCTION AND OBJECTIVES: The aim of this work is to compare the effectiveness of two psychoeducational interventions for dementia caregivers: a cognitive behavioral one (PCC), aimed at the modification of dysfunctional thoughts about caregiving, and another one consisting in problem solving skills training (PSP) for caregivers, with the aim of modifying the behavioral problems of their relative. SUBJECTS AND METHODS: Seventy five caregivers were asked to participate in an intervention program, of whom 31 finally completed the study. Both group interventions are compared with a control group (CG). The caregiver groups were randomly assigned to each experimental condition. Pre, post intervention, and follow up assessments of the following variables have been made: depression, perceived stress, frequency of behavioral problems, perceived stress associated with the behavioral problems and dysfunctional thoughts about caregiving. RESULTS: Following the intervention, caregivers in the PCC program show significantly less perceived stress than the other two groups. In the same direction, a trend exists to a significant reduction of the stress associated with the behavioral problems. In the follow up assessment, caregivers of the PCC program significantly report less relative's behavioral problems than the other two groups. Caregivers of the PCC program have less dysfunctional thoughts than the other two groups, differences almost reaching significance. CONCLUSIONS: Benefits of a psychoeducational intervention vary as a function of the contents it includes. The importance of intervening on the caregiver dysfunctional thoughts for an adequate coping with caregiving is highlighted.

Eficacia diferencial de dos intervenciones psicoeducativas para cuidadores de familiares con demencia / Differential efficacy of two psychoeducational interventions for dementia family caregivers

Introducción y objetivo. A través de este trabajo se comparan dos intervenciones psicoeducativas con cuidadores de personas con demencia, un programa cognitivoconductual (PCC) dirigido a la modificación de pensamientos disfuncionales para el cuidado y otro programa de solución de problemas (PSP) dirigido a entrenar a los cuidadores en el manejo de los comportamientos problemáticos de su familiar. Sujetos y métodos. Se ofreció la posibilidad de participar en un programa de intervención a 75 cuidadores, de los cuales completaron el estudio 31. Las dos intervenciones grupales se comparan, a su vez, con un grupo control. Cada grupo de cuidadores se asignó aleatoriamente a cada una de las condiciones experimentales. Se realizaron evaluaciones antes y después de la intervención y otra de seguimiento de las siguientes variables: depresión, estrés percibido, frecuencia de comportamientos problemáticos, estrés asociado a los comportamientos y pensamientos disfun cionales sobre el cuidado. Resultados. Tras la intervención, los cuidadores que participaron en la intervención PCC tenían significativamente menos estrés percibido que los otros dos grupos, así como una tendencia a la significación en el mismo sentido cuando se analizaba el estrés asociado a los comportamientos problemáticos. En la fase de seguimiento, los cuidadores que participaron en la intervención PCC informaron de una frecuencia significativamente menor de comportamientos problemáticos que los otros dos grupos, y de menos pensamientos disfuncionales que los otros dos grupos, diferencias que rozan la significación estadística. Conclusiones. Los beneficios de una intervención psicoeducativa varían en función de los contenidos que incluya. Se destaca la importancia de intervenir sobre pensamientos poco adaptativos para un adecuado afrontamiento del cuidado (AU)

Introduction and objectives. The aim of this work is to compare the effectiveness of two psychoeducational interventions for dementia caregivers: a cognitive-behavioral one (PCC), aimed at the modification of dysfunctional thoughts about caregiving, and another one consisting in problem-solving skills training (PSP) for caregivers, with the aim of modifying the behavioral problems of their relative. Subjects and methods. Seventy-five caregivers were asked to participate in an intervention program, of whom 31 finally completed the study. Both group interventions are compared with a control group (CG). The caregiver groups were randomly assigned to each experimental condition. Pre, post-intervention, and follow-up assessments of the following variables have been made: depression, perceived stress, frequency of behavioral problems, perceived stress associated with the behavioral problems and dysfunctional thoughts about caregiving. Results. Following the intervention, caregivers in the PCC program show significantly less perceived stress than the other two groups. In the same direction, a trend exists to a significant reduction of the stress associated with the behavioral problems. In the follow-up assessment, caregivers of the PCC program significantly report less relative’s behavioral problems than the other two groups. Caregivers of the PCC program have less dysfunctional thoughts than the other two groups, differences almost reaching significance. Conclusions. Benefits of a psychoeducational intervention vary as a function of the contents it includes. The importance of intervening on the caregiver dysfunctional thoughts for an adequate coping with caregiving is highlighted (AU)

Isolation of Arcobacter spp. from retail meats and cytotoxic effects of isolates against vero cells.

A survey of Arcobacter spp. was conducted over a 12-month period in Guadalajara, Mexico. A total of 135 samples (45 lean ground beef samples, 45 lean ground pork samples, and 45 chicken samples, including drumsticks, gizzards, and ground or chopped breast) were collected from local butcheries. The samples were enriched in Johnson-Murano enrichment medium and then streaked onto Johnson-Murano agar plates. Typical colonies were subjected to microscopic and biochemical identification followed by polymerase chain reaction confirmation of the genus Arcobacter. All isolates confirmed to be Arcobacter isolates were then inoculated into Eagle's minimum essential medium to determine their cytotoxicity against Vero cells. Arcobacter spp. were detected in 28.8, 51.1, and 40.0% of beef, pork, and chicken samples, respectively. From these samples, 101 isolates were confirmed to be Arcobacter spp. by polymerase chain reaction. Overall, the species most frequently identified was A. butzleri, followed by A. skirrowii. A. cryaerophilus was isolated only from pork meat. Ninety-five (95%) of the Arcobacter isolates produced a virulence mechanism against Vero cells, and 38 of them induced cell elongation, indicating enterotoxin production. Eighteen isolates produced the formation of vacuoles, and 39 produced both vacuolization and elongation. The vacuolization effect may be related to a vacuolizing toxin. The production of a vacuolizing toxin by Arcobacter spp. has not previously been reported. Results obtained in this study indicate that Arcobacter spp. may show cytotoxic effects other than the recognized enterotoxin production.

Prevalencia de trastornos de ansiedad y depresión en una muestra de personas mayores residentes en la comunidad / Prevalence of ansiety and depression disorders in an elderly sample living in the community

El presente trabajo se plantea como un estudio sobre prevalencia de ansiedad y depresión en población mayor a partir de una muestra aleatoria compuesta por 97 pesonas mayores de 65 años residentes en Majadahonda. La evaluación se realizó a través de una entrevista estructurada basada en los criterios del DSM-IV para los trastronos de ansiedad y depresión. Se emplearon, además, autoinformes de depresión y ansiedad. Se encontró que los problemas emocionales, en general, y los de ansiedad, particularmente, suponen un importante problema entre las personas mayores, y se halló una tasa de prevalencia de 14,4 por ciento para el conjunto de trastornos emocionales y, específicamente, 11,3 por ciento para los transtornos de ansiedad, en los que destaca el trastorno de ansiedad generalizada, con una tasa del 7,2 por ciento. Asimismo, los resultados muestran una importante presencia de problemas subclínicos emocionales entre las personas mayores, así como un gran solapamiento entre ansiedad y depresión, especialmente del trastorno de ansiedad generalizada con la depresión, cuya tasa de comorbilidad es del 57,1 por ciento (AU)

Programa psicoeducativo de tratamiento de la preocupación patológica en personas mayores. Un estudio piloto / Psycho-educational program for treatment of pathological worrying in elderly persons

OBJETIVO: El presente trabajo surge a partir de la constatación empírica de la importancia de los trastornos de ansiedad y la preocupación entre las personas mayores. Tiene como objetivo valorar la viabilidad de un programa psicoeducativo para el tratamiento en grupo de la preocupación clínica en las personas mayores. SUJETOS: El programa se aplicó a un grupo de siete personas mayores residentes en la comunidad que presentaban niveles de preocupación clínica elevados. MÉTODO: A lo largo de siete sesiones semanales de una hora de duración se aplicó un paquete de técnicas cognitivo-conductuales (relajación, parada de pensamiento con distracción y cuestionamiento racional) y se organizaron discusiones acerca de distintas cuestiones en torno a la preocupación que ayudaran a determinar con mayor exactitud los contenidos que debe tener un programa de esta naturaleza. RESULTADOS Y CONCLUSIONES: El principal resultado del programa es una disminución de la tendencia a la preocupación medida a través del Inventario de Preocupación Penn. Se analizan los aspectos más importantes de cara a la implantación de un programa psicoeducativo para el tratamiento de las preocupaciones en las personas mayores: la bondad de las técnicas cognitivas de cuestionamiento racional, una duración extensa del programa, el empleo de una directividad intermedia que dé lugar a la expresión de emociones e intercambios comunicativos entre las personas mayores y la compensación de la dificultad de abstracción en estas personas mediante el empleo de instrucciones y herramientas de reflexión más concretas y con mayor base en la realidad (AU)