Caregivers’ beliefs about dementia: findings from the IDEAL study

Abstract

Objective: Informal caregivers of people with dementia develop their own beliefs about the condition, referred to as Dementia Representations (DRs), as they try to make sense of the changes they are observing. The first aim of this study was to provide a profile of the types of DRs held by caregivers. The second aim was to examine the impact of caregivers’ DRs on their well-being, satisfaction with life (SwL) and caregiving stress.

Methods: Participants were 1264 informal caregivers of people in the mild-to-moderate stages of dementia from time-point 1 of the IDEAL cohort study.

Measures: DRs were measured using questionnaire items covering: Identity, Cause, Control, and Timeline.

Results: Almost half (49.2%) of caregivers used a diagnostic term to describe the person’s condition, although 93.4% of caregivers stated they were aware of the diagnosis. Higher well-being, SwL, and lower caregiving stress were associated with the use of an identity term relating to specific symptoms of dementia, attributing the cause to ageing or not knowing the cause, and believing the condition would stay the same. Lower well-being, SwL, and higher caregiving stress were associated with believing there was little that could be done to control the effects of the condition.

Conclusion: Healthcare professionals should assess and gain an understanding of caregivers’ DRs in order to provide more tailored information and support.     

Convergent validity of the Agnew Relationship Measure and the Working Alliance Inventory

The convergent validity of the Agnew Relationship Measure (ARM) and the Working Alliance Inventory (WAI) was assessed in samples drawn from 2 comparative clinical trials of time-limited psychotherapies for depression. In 1 sample, clients (n = 18) and therapists (n = 4) completed self-report versions of both measures after every session (n = 198). In the other sample, clients (n = 39) and therapists (n = 6) completed the ARM, and observers subsequently rated selected audiotaped sessions (n = 78) using the WAI. In both samples, the ARM's core alliance scales (Bond, Partnership, and Confidence) were correlated with the WAI's scales (Bond, Tasks, and Goals) strongly when assessed within client and therapist perspectives and, with some qualifications, moderately when assessed between client, therapist, and observer perspectives, supporting the assumption that the ARM and the WAI measure some of the same core constructs.     

A feminist therapy application of the boundary model with obese female binge eaters

Increasing empirical attention is being paid to understanding the etiology, course, and duration of binge eating disorder, and numerous types of treatment for this disorder are currently available. This article examines binge eating disorder and discusses problematic issues in its current treatments from a feminist therapy perspective. A model conceptualizing the regulation of food intake and binge eating is presented. Clinical applications of the model consistent with principles of feminist therapy are suggested.     

Group versus individual cognitive-behavioural treatment for obsessive-compulsive disorder: a controlled trial

The efficacy of group cognitive behaviour therapy (CBT) for obsessive-compulsive disorder (OCD) has received relatively little research attention compared with the large number of studies that have investigated individual CBT. The current study is the first controlled study to compare an identical CBT protocol, containing both cognitive and behavioural elements, delivered either individually or in a group. Participants were randomly assigned to either 10 weeks of individual CBT, 10 weeks of group CBT or a 10 week wait-list. Participants with significant rates of secondary comorbidity were included in the study to enhance the generalisability of results. Intention-to-treat and completer analyses were carried out and indicated no differences between the group and individual treatments on outcome measures. Large effect sizes were found for both conditions. Analysis of clinically significant change indicated that the individual treatment was associated with a more rapid response but that both treatments had equivalent rates of recovered participants by brief follow-up. The importance of further investigations of the efficacy of group CBT for OCD is discussed.     

The Diagnostic Power of the Stages of Critical Discussion in the Analysis and Evaluation of Problem-Solving Discussions

In this article, the pragma-dialectical model of a critical discussion is demonstrated to provide a useful instrument for discovering causes of an unsatisfactory development of problem-solving discussions. First a sketch is given of the development of a problem-solving discussion which, in the opinion of the participants themselves, developed in an unsatisfactory fashion. Then it is argued that this development can be traced back to flaws in the execution of the stages of a critical discussion.