Cognitive fusion and treatment response to depression in caregivers of relatives with dementia

Abstract

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.