Examinando por Autor "Barrera-Caballero, Samara"

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Cognitive fusion and distress in family caregivers: the role of satisfaction with personal values
(Taylor and Francis - Revista Agind and Mental Health, 2022-09-27) Barrera-Caballero, Samara; Rosa Romero-Moreno, Rosa; Vara-García, Carlos; Márquez-González, María; Olazarán, Javier; Losada-Baltar, Andrés
Objectives: cognitive fusion (the tendency towards behavior that is overly regulated and influenced by cognition) and dissatisfaction with personal values are central processes of psychological inflexibility and are related to distress. Being cognitively fused may interfere with achieving satisfaction from personal values. This study analyzed the role of satisfaction with the value of caregiving and other personal values (e.g. personal growth) in the relationship between cognitive fusion and caregivers’ distress.Method: a total of 287 dementia family caregivers participated in this quantitative study carried out in Madrid, Spain, from January 2016 to February 2020. We measured sociodemographic and stressor variables, cognitive fusion, caregivers’ satisfaction with values and depressive and anxiety symptoms. The indirect effect of cognitive fusion on distress through caregivers’ satisfaction with caregiving value and with other personal values was tested. Four hierarchical regression models were analyzed: the role of satisfaction with the caregiving value in the association between cognitive fusion and depressive (Model 1a) and anxiety (Model 1b) symptoms; and the role of satisfaction with other personal values in the association between cognitive fusion and depressive (Model 2a) and anxiety (Model 2b) symptoms.Results: the results showed an indirect effect of cognitive fusion on both depressive and anxiety symptoms only through satisfaction with other personal values. Those reporting higher cognitive fusion reported lower satisfaction with other personal values, and this association was related to higher scores in depressive and anxiety symptoms (Models 2a and 2b).Conclusion: cognitive fusion could be a variable that interferes in obtaining satisfaction from personal values, something that increases caregivers’ distress.
Cognitive fusion and treatment response to depression in caregivers of relatives with dementia
(Elsevier, 2022-11-03) Barrera-Caballero, Samara; Romero-Moreno, Rosa; Vara-García, Carlos; Olmos, Ricardo; Márquez-González, María; Losada-Baltar, Andrés
Caring for a relative with dementia is associated with negative psychological consequences for the caregivers, such as depression. Cognitive fusion is considered a key process of psychological inflexibility, associated with psychological distress. The aim of this study is to analyze whether baseline levels of cognitive fusion predict different treatment response of depressive symptoms, comparing individual Acceptance and Commitment Therapy (ACT), Cognitive and Behavioral Therapy (CBT) interventions and a control group. A total of 130 family caregivers participated in the study: ACT intervention (N = 49), CBT intervention (N = 41) and control group (N = 40). Moderation analyses were conducted. The results show a significant effect of the interaction between baseline levels of cognitive fusion and the treatment condition (p < .05) on depressive symptoms. Specifically, caregivers in the CBT condition presented higher change in depressive symptoms than those in the control group when their baseline levels of cognitive fusion were low, medium and high. Participants in the ACT condition showed a greater change in depressive symptoms than participants in the control group when their baseline levels of cognitive fusion were medium and high. Finally, the findings suggest that caregivers in the ACT condition showed a greater change in depressive symptoms than those in the CBT condition when their baseline levels of cognitive fusion were high. These results seem to support the use of cognitive fusion as a screening tool for intervention assignment in clinical practice with dementia caregivers.
Equity in care and support provision for people affected by dementia: experiences of people from UK South Asian and White British backgrounds
(Cambridge University Press - Revista International Psychogeriatrics, 2023-02-23) James, Tiffeny; Mukadam, Naaheed; Sommerlad, Andrew; Barrera-Caballero, Samara; Livingston, Gill
Objectives: To explore the care and support received and wanted by United Kingdom (UK) South Asian and White British people affected by dementia and whether access to it is equitable. Design: Semi-structured interviews using a topic guide. Setting: Eight memory clinics across four UK National Health Service Trusts; three in London and one in Leicester. Participants: We purposefully recruited a maximum variation sample of people living with dementia from South Asian or White British backgrounds, their family carers, and memory clinic clinicians. We interviewed 62 participants including 13 people living with dementia, 24 family carers, and 25 clinicians. Measurements: We audio-recorded interviews, transcribed them, and analyzed them using reflexive thematic analysis. Results: People from either background were willing to accept needed care and wanted competence and communication from carers. South Asian people frequently discussed needing care from someone with a shared language, but language differences could also be an issue for White British people. Some clinicians thought South Asian people had a stronger preference to provide care within the family. We found that preferences for who provides care varied across families regardless of ethnicity. Those with more financial resources and English language have more options for care that meets their needs. Conclusions: People of the same background make differing choices about care. Equitable access to care is impacted by people’s personal resources, and people from South Asian backgrounds may experience the double disadvantage of having fewer options for care that meets their needs and fewer resources to seek care elsewhere.
Longitudinal effects of ambivalent and guilt feelings on dementia family caregivers' depressive symptoms
(Wiley, 2024-03-14) Losada-Baltar, Andrés; Mausbach, Brent T.; Romero-Moreno, Rosa; Jiménez-Gonzalo, Lucía; Huertas-Domingo, Cristina; Fernandes-Pires, José A.; Barrera-Caballero, Samara; Gallego-Alberto, Laura; Martín-María, Natalia; Olazarán, Javier; Márquez-González, María
Background The world prevalence of people with dementia is increasing. Most of the care received by people with dementia is provided by family caregivers, and this prolonged activity has a significant impact on caregivers' levels of depression. Stressors and frequency of leisure are known predictors of caregivers' depressive levels. The longitudinal impact of caregivers' ambivalent and guilt feelings is unknown. Methods Participants were 177 family caregivers of relatives with dementia who were assessed three times during a 2-year period. In addition to demographic variables, psychological symptoms of the dementias, and frequency of leisure activities, caregivers' ambivalent feelings, guilt, and depressive symptoms were measured. The longitudinal association of changes in these variables with changes in caregivers' depressive symptoms over time was assessed using mixed linear models. Results Changes over time in the assessed variables predicted 48.05% of variance of changes over time in depressive symptoms. Even when variables strongly associated with increased depressive symptoms were controlled (lower caregivers' age and educational level, higher reaction to BPSD, and lower leisure activities), increases in ambivalence and guilt contributed to an increase of 9.22% of the variance of changes depressive symptoms over a 2-year period. The effects of ambivalent feelings on depression are indirect, mediated by guilt feelings. Cessation of caregiving do not seem to alter these findings. Conclusions Caregivers' ambivalent and guilt feelings are significant predictors of caregivers' mental health. Caregivers may significantly benefit from early detection of ambivalent and guilt feelings and preventive strategies targeting triggers associated with ambivalent and guilt symptoms
Longitudinal effects of cognitive fusion in depressive and anxious symptoms of family caregivers of people with dementia
(Elsevier, 2024-07) Barrera-Caballero, Samara; Romero-Moreno, Rosa; Márquez-González, María; Jiménez-Gonzalo, Lucía; Huertas-Domingo, Cristina; Olazarán, Javier; Losada-Baltar, Andrés
Family dementia caregiving has been commonly associated with psychological distress for caregivers. Cognitive fusion, that is, the tendency to become too entangled in thoughts, beliefs, or judgments (in the absence of objectivity) that may often lead to rigid thinking and impact psychological distress, is a transdiagnostic and central process of psychological inflexibility. Cross-sectional studies have shown that family caregivers of people with dementia who could present high levels of stress may be vulnerable to experiencing psychological symptoms such as depression and anxiety (even comorbidity) if they present this rigid way of thinking without seeing the objectivity of their thoughts, which could be related to aspects of the family member's dementia or helplessness in being a caregiver, for example. Specifically, studies in the caregiving field, as well as in other populations, suggest that cognitive fusion could play a mediating role in the relationship between stress and psychological symptoms. However, the predictive role of caregivers' cognitive fusion on psychological distress has not been analyzed in longitudinal studies. The objective of this study was to analyze the longitudinal effect of cognitive fusion in depressive and anxious symptoms after controlling for other relevant variables in a sample of Spanish family caregivers. Face to face assessments were conducted with a total of 176 Spanish family dementia caregivers. The study involved three assessments in a two-year period (baseline, 12 and 24 months). Linear mixed model analysis was used to analyze the associations between time-varying values of frequency and reaction to care-recipient behavioral problems, cognitive fusion, and caregivers' depressive and anxiety symptoms. Increases in cognitive fusion significantly predicted depressive and anxious symptoms (p < 0.01). In addition, reaction to care-recipients’ behavioral problems and being a female caregiver predicted increases in anxiety symptoms over time (p < 0.05). These results suggested that cognitive fusion may constitute a core dysfunctional mechanism involved in depressive and anxious symptoms. Psychological strategies aimed at reducing cognitive fusion and stress levels may be especially helpful for reducing caregivers' distress.
Medical conditions and depressive symptoms: a study of kinship profiles in dementia caregivers
(Wiley, 2022-10-05) Martín-María, Natalia; Vara-García, Carlos; Romero-Moreno, Rosa; Jiménez-Gonzalo, Lucía; Barrera-Caballero, Samara; Fernandes-Pires, Jose; Olazarán, Javier; Losada-Baltar, Andrés
Objective To analyze the association between diverse medical conditions and depressive symptoms in different profiles of dementia caregivers based on sex and kinship (wives, husbands, daughters, and sons). Methods Individual interviews were conducted with 338 dementia family caregivers. Depressive symptoms were measured with the Spanish version of the Center for Epidemiologic Studies-Depression Scale. Medical conditions encompassed the following physical diseases: high cholesterol, osteoarthritis, hypertension, diabetes, cancer, and cardiovascular, brain, kidney, liver, and stomach diseases.Logistic regression analyses were carried out to identify determinants associated to thepresenceof depressive symptoms. Results High cholesterol was the most frequent disease among caregivers.Significant differences among groups were found in depressive symptoms: between wives (50.60%) and husbands (28.40%),(p = 0.033), and between daughters (57.00%) and husbands (p = 0.001). Half of the sonsreported thepresenceof depressive symptoms. In daughters, depressive symptomatology was significantly more likely whether they presented a worse reaction to disruptive behaviors, a poor assessment of global deterioration of care recipient, and less perceived health status. Furthermore, daughters were 1.94 times more likely to experience depressive symptoms if they presented medical conditions (p = 0.017). Conclusions Daughter caregivers that have depressive and physical diseases may be an especially vulnerable subgroup of caregivers that may not be the ideal population to provide care. Access to high-quality, evidence-based therapies focused on improving caregivers' physical health could have a positiveeffecton thepresenceof depressive symptoms, particularly in the case of daughter caregivers.
Psychometric properties of the Insomnia Severity Index in a sample of family dementia caregivers
(Elsevier - Sleep Medicine, 2021-04-02) Jimenez-Gonzalo, Lucía; Romero-Moreno, Rosa; Pedroso-Chaparro, María; Gallego-Alberto, Laura; Barrera-Caballero, Samara; Olazarán, Javier; Losada-Baltar, Andrés
Study objectives: Family caregivers of people with dementia frequently report sleep problems that are linked to depressive and anxious symptoms. However, data are needed regarding the psychometric properties of specific measures of sleep problems in caregiving populations. The aim of this study is to analyse the psychometric properties of the Insomnia Severity Index (ISI; Morin, 1993) in a Spanish dementia caregiver sample. Methods: 271 participants took part in face-to face interviews where, along with sociodemographic variables, caregivers' sleep problems, depressive and anxious symptoms were measured. The psychometric properties of the ISI were analysed through Confirmatory Factor Analysis (CFA) and analysis of the internal consistency and convergent and criterion validity. Results: The Spanish version of the Insomnia Severity Index showed adequate indices of internal consistency (Cronbach's alpha ¼ 0.78) in our sample of family caregivers of people with dementia. A onefactor structure provided a better fit to the data than two- and three-factor structures. The ISI was significantly associated with lower sleep quality, less average sleep time per day and lower selfperception of vitality, as well as with higher depressive and anxious symptoms. Differences in ISI scores were found between people with and without depressive and anxious symptoms. Statistically significant gender-based differences in sleep problems were also found, with female caregivers showing higher sleep problems. Conclusions: The ISI is a reliable and valid instrument to assess the subjective severity of sleep problems in the family dementia caregiver population and may be a useful instrument in intervention and research settings. Additional evidence was also provided of the importance of considering sleep problems in the studied population.
Stress, cognitive fusion and comorbid depressive and anxiety symptomatology in dementia caregivers
(American Psychological Association, 2021-08-01) Barrera-Caballero, Samara; Romero-Moreno, Rosa; Del Sequeros Pedroso-Chaparro, María; Olmos, Ricardo; Vara-García, Carlos; Gallego-Alberto, Laura; Cabrera, Isabel; Márquez-González, María; Olazarán, Javier; Losada-Baltar, Andrés
Comorbid depression and anxiety is linked to worse outcomes such as increased impairment, distress, and morbidity, as well as worse treatment outcomes. Transdiagnostic variables such as cognitive fusion are considered potential factors for explaining comorbidity. The aim of this study was to analyze the differences between symptom profiles of caregivers (comorbid, depressive, anxiety, and subclinical) in terms of demographic and contextual factors, stress variables, and cognitive fusion. Individual interviews were conducted with 553 caregivers of a relative with dementia. Sociodemographic variables, stressors, cognitive fusion, and depressive and anxiety symptoms were assessed. Caregivers were grouped into four symptom profiles, comorbid (n = 303), depressed (n = 40) anxiety (n = 86), and subclinical (n = 124), based on their depressive and anxiety symptoms. The likelihood of presenting a comorbid profile relative to the subclinical profile was higher in female caregivers. In addition, higher frequency of disruptive behaviors of the care recipient was a risk factor for presenting a comorbid profile relative to the other three profiles, and higher scores in cognitive fusion were a risk factor of comorbidity relative to the other profiles (anxiety, depressive, and subclinical). The findings suggest that the likelihood of presenting comorbid symptomatology is higher for female caregivers and those reporting higher levels of cognitive fusion and higher frequency of disruptive behaviors
To pay attention or not: The associations between attentional bias towards negative emotional information and anxiety, guilt feelings, and experiential avoidance in dementia family caregivers
(Taylor and Francis - Revista Agind and Mental Health, 2021-06-13) Cabrera, Isabel; Márquez-González, María; Gallego-Alberto, Laura; del Sequeros Pedroso-Chaparro, María; Barrera-Caballero, Samara; Losada, Andrés
Caring for a relative with dementia has been linked to negative consequences for caregivers’ psychological health, such as anxiety or guilt. Cognitive theories of psychopathology propose that attentional bias towards negative stimuli contribute to the development and maintenance of emotional disorders and clinical symptomatology. However, attentional bias has scarcely been explored in dementia family caregivers. The aim of this study was to examine the relationship between attentional bias and anxiety symptomatology, guilt feelings, and experiential avoidance in a sample of dementia family caregivers. Participants were 226 dementia family caregivers. Attentional bias was measured using a novel priming adaptation of the dot-probe task. The sample was divided into high and low anxiety symptomatology, guilt feelings, and experiential avoidance groups. The results revealed two opposite patterns of emotional information processing in dementia family caregivers. While anxiety was found to be associated with an attentional preference for negative information, experiential avoidance was related to attentional avoidance of this information. Although guilt was also related to an attentional preference for negative information, this relationship was no longer significant when controlling for anxiety levels. These inflexible attentional patterns may have negative clinical consequences, given that in both cases relevant information necessary for adaptive coping with the stressful situation of caregiving may be unattended to or omitted.
Validation of the Guilt associated with Self-Perception as a Burden Scale (G-SPBS)
(Cambridge University Press., 2021) Pedroso-Chaparro, María del Sequeros; Cabrera, Isabel; Márquez-González, María; Olmos, Ricardo; Romero-Moreno, Rosa; Vara-García, Carlos; Gallego-Alberto, Laura; Barrera-Caballero, Samara; Losada-Baltar, Andrés
Background: One of the main health-related worries for older adults is becoming dependent. Even healthy older adults may worry about becoming dependent, generating guilt feelings due to the anticipation of future needs that others must solve. The guilt associated with self-perception as a burden has not been studied in older adults, and there is no instrument available to measure these feelings. Aims: To adapt the Self-Perceived Burden Scale (SPBS; Cousineau et al., 2003) for the assessment of feelings of guilt for perceiving oneself as a burden for the family in older adults without explicit functional or cognitive impairment. Method: Participants were 298 older adults living independently in the community. Participants completed the assessment protocol, which included measures of guilt associated with self-perception as a burden, depressive and anxious symptomatology, self-perceived burden, and sociodemographic information. Results: Results from exploratory, parallel and confirmatory factor analyses suggest that the scale, named Guilt associated with Self-Perception as a Burden Scale (G-SPBS), has a unidimensional structure, explaining 57.04% of the variance of guilt. Good reliability was found (Cronbach’s alpha = .94). The results revealed significant (p < .01) positive associations with depressive and anxious symptomatology. Discussion: These findings suggest that the G-SPBS shows good psychometric properties which endorse its use with healthy community older adults. Also, guilt associated with perceiving oneself as a burden seems to be a relevant variable that can contribute to improving our understanding of psychological distress in older adults.