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Depressive cognitive functioning among spousal caregivers of suspected dementia patients: application of the hopelessness theory of depression O’Rourke, Norm

Abstract

This study provides the first examination of the hopelessness theory of depression among an older adult population. Adapted from the theory of learned helplessness, hopelessness depression is hypothesized to exist as a specific depressive subtype within a heterogeneous grouping of affective disorders. Salient negative life events are hypothesized to trigger depressive attributional processes among predisposed persons. This entails the propensity to attribute responsibility for negative events to stable and global causes, leading to the generalized perception of hopelessness. Seventy spousal caregivers of suspected dementia patients were recruited within an outpatient geriatric assessment clinic. One-time interviews were conducted with caregivers at the time of their relative's assessment. Caregivers were grouped within a predetermined matrix on the basis of responses to two depression screening measures. Analyses were subsequently conducted to assess the degree of association between the construct of hopelessness and depressive attributional style. A second focus of this study was an examination of the relationship between hopelessness and caregiver burden. This analysis suggests the constrained cognitive processes associated with the construct of hopelessness are significantly related to burden among caregivers. It is hypothesized that caregiver burden may be a specific type of hopelessness depression within this population. The results of univariate and multivariate analyses indicated a strong and significant association between hopelessness and depressive attributional processes. In contrast, depressed persons who do not present as hopeless do not appear to attribute negative events to stable and global causes. These findings provide the first indication that hopelessness effectively differentiates cognitive functioning within this population of older adults. The construct of hopelessness also appears significantly related to expressed burden among spousal caregivers. The constrained cognitive set epitomized by hopeless ideation may reflect the despair perceived by those caregivers who are overwhelmed by this role. This association appears over and above objective variables related to patient impairment and duration of caregiving. The sample recruited for the current study was compared against a randomly derived grouping of spousal caregivers from the Canadian Study of Health and Aging (CSHA). Demographic similarity between samples would suggest that caregivers recruited for the current study are representative of Canadian caregivers. Based on this finding, results from the current study can be generalized with greater confidence.

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