The Effects of Cognitive Behavioral Therapy on the Perceived Stress of Family Dementia Caregivers

Description
Dementia is a progressive, neurodegenerative disease for which there is no cure at the present time. Patients with dementia and age-related disorders experience neuropsychiatric symptoms such as delusions, hallucinations, and other difficult to handle behaviors (Peipert et al., 2018). Due…

Dementia is a progressive, neurodegenerative disease for which there is no cure at the present time. Patients with dementia and age-related disorders experience neuropsychiatric symptoms such as delusions, hallucinations, and other difficult to handle behaviors (Peipert et al., 2018). Due to the staggering cost of hiring in-home help or placing their loved ones in a memory care facility, many Americans choose to care for their loved one at home. Unfortunately, this undertaking can impact the caregiver’s emotional and mental health, financial situation, and social life (Peipert et al., 2018). Psychosocial interventions, ranging from social support to therapy, have been shown to be incredibly effective in improving dementia caregiver mental health. One such psychosocial intervention is Cognitive-Behavioral Therapy. Cognitive-Behavioral Therapy (CBT) helps the individual adapt more effective thinking patterns in order to improve their coping skills (Kwon et al., 2017). CBT combines cognitive theory and behavioral theory to explain how our thoughts and feelings directly impact the severity of a situation. In cognitive theory, it is our interpretation of the events that happen to us that is the root of our emotions, not the events themselves. The relationship between our interpretation and our emotions is known as the ABC model (Sorocco & Lauderdale, 2011). In this paper, several relevant studies researching the impacts of CBT on family dementia caregiver stress and burden are assessed and reviewed. A comprehensive, tentative CBT plan for family dementia caregivers is included and proposed.
Date Created
2024-05
Agent

Pain During Midlife: A Cross-National Analysis of Cohort Differences in Reports of Pain in the United States, Europe, South Korea, and Mexico

Description
Over the past several decades, middle-aged Americans have exhibited troubling trends of declining mental and physical health over successive cohorts. Interestingly, this trend has not been observed in peer nations in Europe, Asia, and Mexico. Later-born cohorts in other countries…

Over the past several decades, middle-aged Americans have exhibited troubling trends of declining mental and physical health over successive cohorts. Interestingly, this trend has not been observed in peer nations in Europe, Asia, and Mexico. Later-born cohorts in other countries typically report better midlife mental and physical health than their earlier-born counterparts. It is less clear the extent to which physical pain shows similar trends to what has been observed in the U.S. and comparison peer nations. The goal of the current study was to examine how self-reports of pain have historically changed during midlife and investigate whether differences emerge between the U.S. and peer nations. We used harmonized data on pain from nationally representative longitudinal panel surveys from the U.S., 13 European nations, South Korea, and Mexico to directly quantify similarities and differences in historical change in midlife pain. Our results supported the hypothesis that midlife pain is higher amongst later-born cohorts in the U.S. A similar pattern of historical increases in pain was observed in Continental and Nordic Europe. In England, Mediterranean Europe, South Korea, and Mexico, the opposite pattern was observed with historical declines in pain. Historical increases in reports of pain in the U.S. emerged more quickly for later-born cohorts at earlier stages of midlife. These results suggest there could be aspects of American midlife today that are exacerbating reports of pain, and these aspects may be shared in some European nations but absent or less influential in other peer nations. Our discussion focuses on potential explanations for this pattern, such as population level discrepancies in health, differential use of health care services, and the inter/intrapersonal costs of westernization, as well as how pain is conceptualized across nations.
Date Created
2023-12
Agent

Childhood Adversity in Adolescent Custodial Grandchildren: A Study of Daily Stressors, Emotional Dynamics, and the Efficacy of a Mobile Socio-Emotional Program

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Description
Guided by the Risky Families model and Daily Process methods, the present study examined how daily stressors are related to emotional well-being at the between- and within-person levels among adolescent grandchildren raised by grandmothers. This study also examined whether risk…

Guided by the Risky Families model and Daily Process methods, the present study examined how daily stressors are related to emotional well-being at the between- and within-person levels among adolescent grandchildren raised by grandmothers. This study also examined whether risk (i.e., adverse childhood experiences/ACES) and resilience (i.e., socio-emotional skills) factors were linked to differences in daily well-being, stressor exposure, and emotional reactivity, and evaluated the efficacy of an online social intelligence training (SIT) program on daily stressor-emotion dynamics. Data came from a subsample (n = 188) of custodial adolescents who participated in an attention-controlled randomized clinical trial and completed 14-day daily surveys prior to and following intervention. Analyses were conducted with dynamic structural equation modeling. Daily stressors, on average, and experiencing above average stressors, were associated with higher negative emotions and lower positive emotions and social connection. Those with more ACEs, on average, reported higher daily stressors and worse well-being, whereas those with higher socio-emotional skills, on average, reported lower daily stressors and better well-being. At the within-person level, more ACEs were associated with higher daily negative emotions. Nonverbal processing was linked to higher daily positive emotions and social connection. Conversational skills were associated with higher daily positive emotions and social connection, and lower, more inert daily negative emotions. Neither ACEs nor socio-emotional skills were associated with within-person reactivity to stressors. Also, the SIT program did not demonstrate efficacy for any outcome. My discussion focused on how findings extend the literature on custodial adolescents by showing that daily stressors impact well-being, offer knowledge of how ACEs and socio-emotional skills shape daily stressor-emotion dynamics, and considers reasons why the online, self-guided SIT program failed to show efficacy on key outcomes.
Date Created
2023
Agent

Does Negative Emotion Differentiation Buffer the Effects of Daily Pain on Stress in Individuals with Chronic Pain?

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Description
Chronic pain is among the most prevalent health issues experienced by older adults and negatively impacts daily functioning and psychosocial well-being through mechanisms that include energy depletion, pain interference, and pain-related changes in negative affect. The capacities to be aware…

Chronic pain is among the most prevalent health issues experienced by older adults and negatively impacts daily functioning and psychosocial well-being through mechanisms that include energy depletion, pain interference, and pain-related changes in negative affect. The capacities to be aware of and regulate negative emotions play a critical role in the successful management of chronic pain. One dimension of negative emotion awareness, termed negative emotion differentiation (NED), is the ability to discriminate between negative affective experiences and recognize them as discrete categories. The ability to identify and distinguish between the various emotions that accompany pain flares and other stressors may enhance the precision of the individual’s regulatory efforts. In doing so, NED may be one possible resilience resource that can facilitate adaptive functioning in the context of chronic pain by buffering the effects of chronic pain flares on daily interpersonal stress. However, this has not yet been investigated. The current study aimed to examine the moderating effect of trait NED on the relationship between daily pain and same-day stress in 259 patients diagnosed with osteoarthritis (OA) or fibromyalgia syndrome (FMS). Individuals completed daily diaries each evening for 30 days reporting on average daily pain, negative emotions, interpersonal stress, and depressive symptoms. It was hypothesized that higher levels of NED would buffer the effects of daily pain on same-day stress. In exploratory analyses, it was evaluated whether the buffering effects were larger for individuals with FMS versus OA. Results of multilevel models revealed that, as expected, higher levels of trait NED predicted lower levels of same-day negative interpersonal events and perceived interpersonal stress. Trait NED also moderated the relationship between pain-related increases in same-day perceived interpersonal stress. Additionally, findings indicated that NED was similarly important for those with FMS and OA. Taken together, the current findings suggest that NED is an important resilience trait that can attenuate chronic pain-related increases in daily experiences of interpersonal stress.
Date Created
2022
Agent

How Childhood Trauma Shapes Future Health Prospects

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Description

I did a literature review on how childhood trauma causes health issues in the future. Based on the information gathered, I did a clinical proposal for trauma informed care to help address this problem.

Date Created
2022-05
Agent

Evaluating Social Intelligence Training: Personality as a Predictor

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Description

With the emergence of programs that focus on socio-emotional regulation through online intervention, our focus is to move beyond the current literature to look at how personality might help to identify those in need of such an intervention, while also…

With the emergence of programs that focus on socio-emotional regulation through online intervention, our focus is to move beyond the current literature to look at how personality might help to identify those in need of such an intervention, while also assessing if personality may moderate the overall efficacy of the treatment in middle-aged adults. In particular, our focus is on the established improvements that similar programs have shown to have on positive affect (PA), negative affect (NA), and emotional reactivity (ER). Through a randomized controlled trial, this research examines whether an online social intelligence training (SIT) program improves socio-emotional regulation compared to an attention-control (AC) condition. During the pre- and post-test phases of the study, participants (N = 230) completed a questionnaire, along with online surveys for 14-days that included measures of social connectedness, emotional awareness, and perspective-taking. Our analysis, while lacking significant findings in the way of PA and NA, shed light on how SIT programs can improve ER, while personality can simultaneously predict baseline levels of ER and moderate the efficacy of the program.

Date Created
2021-12
Agent

The Exploration of Neuroticism as a Mediating Mechanism Between Trauma & Alcohol Related Problems

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Description

Eysenck’s (1967) biological model of personality suggests traits relate to meaningful functioning and structural variations regarding cortical and limbic brain regions. Neuroticism denotes the tendency to experience negative affect (i.e. anxiety, worry, tension, irritability) more frequently than others do (Eysenck…

Eysenck’s (1967) biological model of personality suggests traits relate to meaningful functioning and structural variations regarding cortical and limbic brain regions. Neuroticism denotes the tendency to experience negative affect (i.e. anxiety, worry, tension, irritability) more frequently than others do (Eysenck 1956). Patock-Peckham & Lopez, 2010). Individuals higher on neuroticism have lower thresholds for a fight or flight response to stressors (Xin et al., 2017). Childhood trauma is associated with increased expression of neurotic traits in an alcohol dependent sample (Schwandt et al, 2013). However, to date, it remains unexplored in the existing literature as to whether or not neuroticism mediates any indirect links from facets of childhood trauma (e.g. emotional, sexual, physical, or neglect) or a supportive family on dysregulated drinking. Impaired control over alcohol use reflects drinking larger amounts and for greater periods than one originally intended (Heather et al., 1993). We fit a multiple-group structural equation model with 937 (465 women/472 men) university student volunteers on a model from trauma facets to alcohol use and problems with neuroticism and impaired control as potential mediators. Results: We found that higher levels of emotional abuse were directly linked to more neurotic symptoms among both cisgender sexes. In addition, we found that higher degrees of a supportive family were directly linked to less neuroticism among women only. Interestingly, neuroticism was directly linked to less alcohol use. Yet, when impaired control was a mediator of the neuroticism to alcohol use pathway, alcohol use increased. We also found that higher levels of supportive family were indirectly linked to less neuroticism and in turn, less impaired control over drinking among women only. However, higher levels of emotional abuse were indirectly linked to more alcohol-related problems through both more neuroticism and impaired control for both genders. Our results support that impaired control may be a key mediating mechanism to internalizing traits such as neuroticism in the alcohol use quantity/frequency pathway. Further, our results suggest that emotional abuse may be an important therapeutic target of intervention for those with comorbid internalizing and alcohol use disorders. NIH/NIAAA K01AA024160-01A1; Burton Family Foundation FP11815 to Julie Patock-Peckham.

Date Created
2021-12
Agent

The direct & indirect links from facets of childhood trauma to arousability, impaired control, alcohol use, & alcohol-related problems.

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Description

Hyper-arousal theory presumes that experiencing trauma can increase one’s sense of fight or flight responses or generalized sense of arousability (Riemann et al., 2010). While this theory has been examined in studies regarding insomnia (e.g. Schwandt et al., 2013) it…

Hyper-arousal theory presumes that experiencing trauma can increase one’s sense of fight or flight responses or generalized sense of arousability (Riemann et al., 2010). While this theory has been examined in studies regarding insomnia (e.g. Schwandt et al., 2013) it has yet to be examine with dysregulated drinking outcomes such as impaired control over alcohol use. Impaired control over alcohol use (IC) reflects drinking beyond one’s own self-proscribed limits for one’s own drinking behaviors (Heather et al., 1993). According to multiple review papers on the topic (Leeman et al., 2012; 2014), IC is an understudied topic regarding alcohol use disorders (AUDs). Thus, we sought to explore a pathway from facets of childhood trauma (emotional, physical, & sexual abuse, & neglect) versus a supportive family to arousability to drinking outcomes (i.e. IC, alcohol use, & alcohol-related problems). Method: We fit a multiple-group structural equation model with 835 (368 women/ 467 men) university student volunteers. As our model failed the overall invariance test, χ2Δ (20 df) = 55.788, p < .001, we allowed our hypothesized model to moderate on sex. Results: The direct link from sexual abuse to both IC and alcohol-related-problems was stronger for men than women. Emotional abuse was directly linked to higher levels of arousability among women, whereas an emotionally supportive family was related to lesser degrees of arousability among men. Impaired control mediated the indirect link between higher levels of arousability and alcohol use for both sexes. Impaired control also mediated the indirect link between physical neglect and alcohol-related problems among both sexes. Higher levels of emotional abuse were indirectly linked to both more alcohol use & problems through increased arousability and in turn, more IC among women. Higher levels of sexual abuse were indirectly linked to more alcohol problems through higher degrees of impaired control among men. Conclusions: We found evidence in favor of the Hyper-arousability Theory regarding dysregulated drinking with a direct link between arousability and IC. While physical neglect appears to affect both sexes drinking behaviors, emotional abuse may play a stronger role for women than men, while sexual abuse may play a stronger role among men.

Date Created
2021-12
Agent

Prospective Relations between Subjective Social Status and Depressive Symptoms in a Middle-Aged Community Sample: Exploring Biopsychosocial Mechanisms

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Description
Subjective social status (SSS) is a marker of perceived social rank that has been linked with depressive symptoms over and above objective socioeconomic status (SES), but longitudinal studies are limited. SSS has been theorized to capture perceived relative versus absolute…

Subjective social status (SSS) is a marker of perceived social rank that has been linked with depressive symptoms over and above objective socioeconomic status (SES), but longitudinal studies are limited. SSS has been theorized to capture perceived relative versus absolute deprivation and the corresponding psychosocial processes underlying status-based disparities in health. The literature suggests that upward social comparisons inherent in appraising SSS may confer psychosocial risk, which may in turn increase risk for depressive symptoms and stress-related inflammation involved in the pathogenesis of depression. However, no studies have examined whether interpersonal and biological factors simultaneously contribute to the inverse relation between SSS and depressive symptoms. This study examined whether (1) lower SSS was longitudinally associated with increased depressive mood symptoms, independent of income, and (2) whether higher social strain and lower social support simultaneously mediated the SSS— depressive mood symptoms relation directly and indirectly through higher interleukin-6 (IL-6). This study utilized secondary data from a representative community sample of 804 middle-aged adults taking part in a study of healthy aging between 2007 and 2012. Plasma levels of IL-6 and self-reported SSS, social support, and social strain were assessed at baseline, followed by an assessment of depressive mood symptoms by phone interview on average 20 months later. Results from multiple regression analysis revealed that lower SSS predicted higher depressive symptoms at follow-up after adjustment for sociodemographic characteristics and baseline depressive mood symptoms. Path analysis indicated that social strain significantly mediated the relation between SSS and depressive mood symptoms, but not after adjustment for baseline mood symptoms. Lower social support mediated the relation between lower SSS and higher depressive symptoms, but relations were non-significant in adjusted models. Contrary to predictions, paths including IL-6 were not significant. Lower SSS may represent a robust risk factor for subsequent depressive mood symptoms above and beyond income, in line with the conceptualization of SSS as a measure of relative deprivation. Further research examining biopsychosocial mechanisms would elucidate the implications of perceived low status and inform intervention efforts aimed at reducing the global burden of depressive symptoms.
Date Created
2021
Agent

An In-Depth Exploration of Overcoming Adversity in Midlife: A Mixed-Methods Approach

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Description

Midlife is a unique period of development during which individuals are simultaneously engaging in multiple roles. Despite this, there is a surprisingly small amount of research on this period of the life course. In order to examine sources of adversity…

Midlife is a unique period of development during which individuals are simultaneously engaging in multiple roles. Despite this, there is a surprisingly small amount of research on this period of the life course. In order to examine sources of adversity during this period, we analyzed interviews with individuals in midlife about their greatest challenge. The most common themes for types of adversity included relationships, health, and work, reflecting the unique combination of roles in midlife.

Date Created
2021-05
Agent
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