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Race and ethnic group disparities in emotional distress among older adults during the COVID-19 pandemic
- Authors:
- BUI Cindy N., et al
- Journal article citation:
- Gerontologist, 61(2), 2021, pp.262-272.
- Publisher:
- Oxford University Press
Background and Objectives: Framed within Conservation of Resources theory, this study addressed race–ethnic differences in the relationships between emotional distress and current and expected coronavirus disease 2019 (COVID-19) pandemic stressors. Research Design and Methods: The study employed data from the Household Pulse Survey, a large national survey collecting weekly data to understand the experiences of Americans during the COVID-19 pandemic (age 55 and above; N = 94,550). Emotional distress included depression and anxiety symptoms. COVID-19 stressors included current and expected income, housing, health care, and food insecurities. Results: Older persons of color reported higher rates of stressors and emotional distress than their White counterparts. In relation to current stressors, older Black persons responded with less emotional distress and older Latino persons responded with more emotional distress than older White persons. In addition, older persons of color were more likely to expect future resource losses related to COVID-19, and the association between these expectations and emotional distress varied by race–ethnic group. Discussion and Implications: The findings reflected the disproportionate negative impact of COVID-19 stressors on emotional distress among older persons of color, providing a baseline for future studies to further examine the impacts of the pandemic among diverse older adult populations. (Edited publisher abstract)
Differences in caregivers' psychological distress and associated factors by care recipients' gender and kinship
- Authors:
- IWATA Norboru, HORIGHUCHI Kazuko
- Journal article citation:
- Aging and Mental Health, 20(12), 2016, pp.1277-1285.
- Publisher:
- Taylor and Francis
Objectives: This study examined the level of psychological distress of Japanese caregivers according to various combinations of the gender of care recipients and the kinship of caregivers (spouse, son, daughter, or daughter-in-law). It also explored the associated factors that could exacerbate or alleviate psychological distress. Methods: The study utilized a cross-sectional descriptive design and implemented a self-administered questionnaire survey with a two-stage stratified sample of community-dwelling caregivers of frail elderly persons throughout Japan. A total of 1279 caregiving families were surveyed, and 1020 questionnaires were completed by primary caregivers (response rate: 79.8%), with 945 respondents providing data on the Japanese version of the Kessler 6 psychological distress scale (K6). Results: Caregivers' K6 scores varied significantly by care recipients' gender and their relationship with the caregiver. K6 scores were significantly higher among daughters-in-law caring for fathers-in-law than among daughters-in-law caring for mothers-in-law, wives caring for husbands, or daughters or sons caring for mothers. ‘Negative influence of caregiving’ and ‘anxious about continuing caregiving’ were factors that commonly exacerbated caregivers' psychological distress. Further analyses involving interactions indicated that the effects of ‘anxious about continuing caregiving’ and ‘personal growth through caregiving’ on the psychological distress of daughters-in-law varied by care recipients' gender as did the effects of an alleviating factor, ‘keeping their own pace’, on daughters. Conclusions: Psychological distress levels among family caregivers, as well as exacerbating and alleviating factors, varied depending on the gender and kinship of care recipients. (Edited publisher abstract)
Do improvements in emotional distress correlate with becoming more mindful? A study of older adults
- Authors:
- SPLEVINS Kate, SMITH Alistair, SIMPSON Jane
- Journal article citation:
- Aging and Mental Health, 13(3), May 2009, pp.328-335.
- Publisher:
- Taylor and Francis
The study aimed (1) to investigate changes in older adults' emotional wellbeing (specifically depression, anxiety and stress levels) and mindful ability following a mindfulness-based cognitive therapy (MBCT) course; (2) to explore correlations between mindfulness (measured as an overall ability and as individual components; observe, describe, act with awareness and accept without judgement) and changes in depression, anxiety and stress levels. Twenty-two participants took an eight-week MBCT course. Levels of depression, anxiety and stress were recorded pre- and post-intervention, as was mindfulness ability (measured both as an overall ability and as individual components). Significant improvements in emotional wellbeing and mindfulness were reported post-MBCT, with large to moderate effect sizes. Increased mindfulness was moderately and significantly associated with improved emotional wellbeing. Increases on all four components of mindfulness were positively associated with greater emotional wellbeing, however only act with awareness and accept without judgement were significantly correlated (with reduced depression). Older adults in the sample reported higher scores on observe and act with awareness than other populations.
Assessment of the efficacy of a stress management program for informal caregivers of dependent older adults
- Authors:
- LOPEZ Javier, CRESPO Maria, ZARIT Steven H.
- Journal article citation:
- Gerontologist, 47(2), April 2007, pp.205-214.
- Publisher:
- Oxford University Press
The majority of dependent older adults receive care at home from a family member. Caregiving places enormous demands on these caregivers and the negative consequences associated with caregiving are well documented. This Spanish study compared the effectiveness of two active interventions to a waiting-list control condition to improve emotional well-being in family caregivers. The study randomized distressed caregivers (N = 91) of physically impaired older adults to one of three conditions: traditional weekly sessions, minimal-therapist-contact sessions, or a waiting-list control group. These manual-guided interventions took place over a 2-month period. Caregivers in the traditional weekly sessions experienced the highest reduction in depressive and anxious symptoms. Compared with control participants, caregivers in the traditional weekly sessions had lower post treatment levels of depression and anxiety. They had also lower levels of depression than did caregivers in the minimal-therapist-contact intervention. These data suggest that traditional weekly sessions may be effective in reducing caregiver anxiety and depression. They further suggest that traditional weekly sessions are better than no intervention, and they are also better than a minimal-therapist-contact intervention.
On becoming depressed or anxious in late life: similar vulnerability factors but different effects of stressful life events
- Authors:
- de BEURS Edwin, et al
- Journal article citation:
- British Journal of Psychiatry, 179, November 2001, pp.426-431.
- Publisher:
- Cambridge University Press
This research aimed to delineate risk factors for the decline of mental health in older persons, compares risk profiles for developing symptoms of pure depression, pure anxiety and both anxiety and depression in a prospective design. Self-report data on depression and anxiety were collected from community-dwelling older respondents on two occasions, 3 years apart. After 3 years 9% of the subjects had scored beyond the thresholds for symptoms. Vulnerability for depression and anxiety was quite similar, but life events differed: onset of depression was predicted by death of a partner or other relatives; onset of anxiety was best predicted by having a partner who developed a major illness. No support for moderator effects between vulnerability factors and stress was found; the effects were purely additive. Concludes that depression and anxiety have many risk factors in common, but specific risk factors also were found, especially in subjects developing both depression and anxiety.
In search of a marital distress model of depression in older marriages
- Authors:
- HARPER J.M., SANDBERG J.G.
- Journal article citation:
- Aging and Mental Health, 4(3), August 2000, pp.210-222.
- Publisher:
- Taylor and Francis
In an effort to investigate and describe the interpersonal nature of depression, data on levels of depression, stress, health and marital distress in 535 married couples was analysed. Specifically, the results showed that marital distress was significantly associated with levels of depression for both partners and that wives' distress was also significantly related to husbands' depression. Results also showed, with a few exceptions, that levels of stress and/or health in either partner were directly and indirectly associated with depression for husbands and wives. Implications for clinical practice with and future research on later life couples experiencing depression are discussed.
A pilot randomized trial of two cognitive rehabilitation interventions for mild cognitive impairment: caregiver outcomes
- Authors:
- VUC Andrea V., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(12), 2017, pp.e180-e187.
- Publisher:
- Wiley
This study aims to provide effect size estimates of the impact of two cognitive rehabilitation interventions provided to patients with mild cognitive impairment: computerised brain fitness exercise and memory support system on support partners' outcomes of depression, anxiety, quality of life, and partner burden. Methods: A randomised controlled pilot trial was performed. Results: At 6 months, the partners from both treatment groups showed stable to improved depression scores, while partners in an untreated control group showed worsening depression over 6 months. There were no statistically significant differences on anxiety, quality of life, or burden outcomes in this small pilot trial; however, effect sizes were moderate, suggesting that the sample sizes in this pilot study were not adequate to detect statistical significance. Conclusion: Either form of cognitive rehabilitation may help partners' mood, compared with providing no treatment. However, effect size estimates related to other partner outcomes (i.e., burden, quality of life, and anxiety) suggest that follow-up efficacy trials will need sample sizes of at least 30–100 people per group to accurately determine significance. (Publisher abstract)
in the face of fear: how fear and anxiety affect our health and society, and what we can do about it
- Author:
- HALLIWELL Ed
- Publisher:
- Mental Health Foundation
- Publication year:
- 2009
- Pagination:
- 55p.
- Place of publication:
- London
Research suggests that we are becoming more fearful as a nation. A survey indicated that people perceive our world as having become more frightening and frightened. The Government’s Psychiatric Morbidity Surveys, published in February 2009, show significant increases in anxiety disorders between 1993 and 2007. The Mental Health Foundation believes these trends are linked. The more fearful people feel in the general population, the more people will be tipped over into diagnosable anxiety disorders. Key findings from the survey show that fear is a feature of nearly all mental health problems. It is also strongly linked to poor physical health and unhealthy lifestyle choices such as smoking and poor diet. Thirty seven per cent of people in a survey say they get frightened or anxious more often than they used to, compared to 28% who disagree, and 77% of people believe people in general are more frightened and anxious than they used to be. Younger people also consistently report greater fear than older people. This report recommends a mental health promotion strategy that addresses fear and anxiety. We need to target the whole population with education and awareness-raising to improve people’s ability to recognise and manage feelings and thoughts and how they affect behaviour.
Panic disorder in older adults: evidence from the national epidemiologic survey on alcohol and related conditions
- Author:
- CHOU Kee-Lee
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(8), August 2010, pp.822-832.
- Publisher:
- Wiley
Panic disorder is significantly associated with higher medical and psychiatric comorbidities, yet there is a lack of research in this area. This study investigated the association of panic disorder with childhood parental loss and recent stressful life events; the co-existence of panic disorder with major depressive disorder and alcohol dependence; and the impact of panic disorder on health-related quality of life. Data from 13,420 adults, aged 55 years and older, from the National Epidemiologic Survey on Alcohol and Related Conditions (2001–2002) was used. Panic disorder was assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule. Findings indicated that the current and lifetime prevalence rates of panic disorder were 1.17 and 3.72%, respectively. Panic disorder was more common among low income groups, and those who had reported more recent stressful life events. Major depressive disorder was significantly related to lifetime panic disorder. Panic disorder was also related to a lower health-related quality of life and dual medical conditions. The authors conclude that the correlation between panic disorder and major depressive disorder raised further questions about the nature of panic disorder in the elderly. This study supports the idea that panic disorder has a strong impact on quality of life in old age.
Levels, types, and predictors of family caregiver strain during hospice home care for an older adult
- Authors:
- TOWNSEND Aloen L., et al
- Journal article citation:
- Journal of Social Work in End-of-Life and Palliative Care, 6(1-2), January 2010, pp.51-72.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
This study investigated levels of physical, psychological, social, economic, and spiritual strain reported by family caregivers to older adults receiving hospice home care together with risk and protective factors that predict strain. The project and resulting instrument (Western Reserve Family Assessment Instrument) resulted from a multidisciplinary collaboration between academic researchers at Case Western Reserve University and hospice providers at Hospice of the Western Reserve. Structured interviews were conducted with 162 family caregivers providing care to patients aged 65 years or more newly admitted to hospice home care. Caregivers spanned a broad age range, with an average age in the early 60s, and they were predominantly female and Caucasian. Hierarchical multiple regressions revealed that caregivers’ age and race, hospice patients’ major illness (particularly cancer), caregivers’ appraisal of their situation, and resources were significant risk or protective factors for caregiver strain, although the predictors varied by type of strain and amount of strain. The discussion focuses on the importance of identifying family caregivers at risk of higher strain during hospice home care and implications for family caregiver interventions.