Reducing Depression in Dementia Caregivers

Overview

The purpose of this study was to develop and examine the initial impact of a distance-based intervention for female family dementia caregivers. As stated in the original proposal, the primary hypothesis of the study was that family caregivers who participated in the Video Intervention would show greater reduction in psychological distress (i.e., on measures of depression and emotional distress following problematic patient behaviors) compared to those in the Basic Education condition, and that this effect would be maintained over time (3 and 6 months post-tx).

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Single (Outcomes Assessor)
  • Study Primary Completion Date: August 2004

Detailed Description

Family caregivers of individuals with dementia commonly report depressive symptoms, along with other forms of emotional distress. This study compared the effectiveness of two home-based interventions to reduce levels of depressed, anxious, and other negative moods in women living with a family member with dementia. Eligible caregivers were randomly assigned to participate in either a video/workbook/telephone coaching intervention, or to a basic education condition consisting of a workbook and supportive telephone calls. Participants were evaluated for psychosocial distress after treatment, and at 3- and 6-months following the end of intervention.

Interventions

  • Behavioral: Basic Education
    • Participants receive 37-page Basic Care Guide (Education Institute, 2001) and bi-weekly telephone calls by a trained staff member.
  • Behavioral: Behavioral Skills Training: Experimental
    • Multicomponent behavioral intervention using 10-session video series (Steffen, et al., 2001) workbook (Steffen, et al., 2001), and weekly telephone coaching sessions.

Arms, Groups and Cohorts

  • Experimental: Behavioral Skills Training
    • Multicomponent behavioral intervention using 10-session video series (Steffen, et al., 2001) workbook (Steffen, et al., 2001), and weekly telephone coaching sessions.
  • Active Comparator: Basic Education
    • Participants receive 37-page Basic Care Guide (Education Institute, 2001) and bi-weekly telephone calls by a trained staff member.

Clinical Trial Outcome Measures

Primary Measures

  • Beck Depression Inventory II (Beck, Steer & Brown, 1996)
    • Time Frame: Pre-intervention intake assessment, conducted 7-14 days prior to start of intervention
    • 21-item self-report instrument to assess severity of symptoms of depression. There is a four-point scale for each item ranging from 0 to 3. The total continuous score can range from 0 to 63 points, with higher scores reflective of greater severity.
  • Primary Outcome: Beck Depression Inventory II (Beck, Steer & Brown, 1996)
    • Time Frame: Post-intervention, assessed 4-14 days after final intervention session.
    • 21-item self-report instrument to assess severity of symptoms of depression. There is a four-point scale for each item ranging from 0 to 3. The total continuous score can range from 0 to 63 points, with higher scores reflective of greater severity.

Secondary Measures

  • Negative Affect Schedule (Watson, Clark & Tellegen, 1988)
    • Time Frame: Pre-intervention intake assessment, conducted 7-14 days prior to start of intervention
    • 10 item self-report assessment of negative affects. Participants rate items on a scale from 1 to 5, based on the strength of emotion where 1 = “very slightly or not at all,” and 5 = “extremely”. The total continuous score may range from 10 to 50, with higher values indicative of stronger negative emotion.
  • Secondary Outcome: Negative Affect Scale (Watson, Clark & Tellegen, 1988)
    • Time Frame: Post-intervention, assessed 4-14 days after final intervention session.
    • 10 item self-report assessment of negative affects. Participants rate items on a scale from 1 to 5, based on the strength of emotion where 1 = “very slightly or not at all,” and 5 = “extremely”. The total continuous score may range from 10 to 50, with higher values indicative of stronger negative emotion.

Participating in This Clinical Trial

Inclusion Criteria

  • Caregiver and dementia pt live in the same home – Resident of following states: Il,IN, IO, KS, MI, MN, MO, NB,WI Exclusion Criteria:

  • Insulin dependent diabetes – Thyroid disease

Gender Eligibility: Female

Minimum Age: 50 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • University of Missouri, St. Louis
  • Collaborator
    • National Institute of Mental Health (NIMH)
  • Provider of Information About this Clinical Study
    • Ann M. Steffen, Ph.D./Associate Professor of Psychology, University of Missouri-St. Louis
  • Overall Official(s)
    • Ann M. Steffen, PhD, Principal Investigator, University of Missouri, St. Louis

References

Steffen AM. Anger management for dementia caregivers: A preliminary study using video and telephone interventions. Behavior Therapy 31:281-299, 2000.

Steffen AM, McKibbin C, Zeiss AM, Gallagher-Thompson D, Bandura A. The revised scale for caregiving self-efficacy: reliability and validity studies. J Gerontol B Psychol Sci Soc Sci. 2002 Jan;57(1):P74-86. doi: 10.1093/geronb/57.1.p74.

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