The moderating role of perceived social support on early maladaptive schemas and well-being for primary caregivers of dementia patients

Objective: This study aims to investigate the moderating role of perceived social support on early maladaptive schemas and well-being for primary caregivers of dementia patients. Method: Ninety-nine adult children as the primary caregivers of dementia patients participated in the study. They completed the measures of Young Schema Questionnaires-Short Form 3 (YSQ-SF3), Caregiver Well-Being Scale, and Multidimensional Scale of Perceived Social Support (MSPSS). Results: According to the results of the regression analyses, total perceived social support and perceived social support from significant others moderated the association of early maladaptive schemas and caregiver well-being-basic needs, unlike the perceived social support from family and perceived social support from friends. For the early maladaptive schemas and caregiver well-being-activities of living association, however, the moderator roles of total perceived social support and perceived social support from different sources were not confirmed. Conclusion: Since caregiving has negative effects on caregivers, it is important to identify the protective factors. The findings emphasize the buffering role of perceived social support from significant others, especially in terms of meeting basic needs, in the caregiving process

___

1. Turkish Statistical Institute. Elderly statistics, 2019. https:// data.tuik.gov.tr/Bulten/Index?p=Istatistiklerle-Yaslilar-2019- 33712#:~:text=Ya%C5%9Fl%C4%B1%20n%C3%BCfus%20 olarak%20kabul%20edilen,9%2C1'e%20y%C3%BCkseldi. Accessed April 15, 2020.

2. World Health Organization (WHO). Global health and aging. https://www.who.int/ageing/publications/global_health.pdf. Accessed February 20, 2020.

3. World Health Organization (WHO). The epidemiology and ımpact of dementia. https://www.who.int/mental_health/ neurology/dementia/dementia_thematicbrief epidemiology.pdf. Accessed February 12, 2020.

4. Arslantas D, Ozbabalik D, Metintas S, Ozkan S, Kalyoncu C, Ozdemir G, et al. Prevalence of dementia and associated risk factors in Middle Anatolia, Turkey. J Clin Neurosci 2009; 16:1455-1459.

5. Gurvit H, Emre M, Tinaz S, Bilgic B, Hanagasi H, Sahin H, et al. The prevalence of dementia in an urban Turkish population. Am J Alzheimers Dis Other Demen 2008; 23:67-76.

6. Keskinoglu P, Yaka E, Ucku R, Yener G, Kurt P. Prevalence and risk factors of dementia among community dwelling elderly people in İzmir, Turkey. Turk Geriatri Derg 2013; 16:135-141.

7. Alzheimer’s Association. What İs dementia?. https://www.alz. org/alzheimers-dementia/what-is-dementia. Accessed February 15, 2020.

8. Plassman BL, Langa KM, Fisher GG, Heeringa SG, Weir DR, Ofstedal MB, et al. Prevalence of dementia in the United States: the aging, demographics, and memory study. Neuroepidemiology 2007; 29:125-132.

9. Alzheimer’s Association. 2018 Alzheimer’s disease facts and figures. https://www.alz.org/media/Documents/facts-andfigures-2018-r.pdf. Accessed February 13, 2020.

10. Heru AM, Ryan CE. Family functioning in the caregivers of patients with dementia: one–year follow–up. Bull Menninger Clin 2006; 70:222-231.

11. Heru AM, Ryan CE, Iqbal A. Family functioning in the caregivers of patients with dementia. Int J Geriatr Psychiatry 2004; 19:533- 537.

12. Wimo A, Prince M. Alzheimer’s disease international: World Alzheimer Report 2010. The global economic ımpact of dementia. http://www.alz.co.uk/research/files/ WorldAlzheimerReport2010.pdf. Accessed March 5, 2020.

13. Perren S, Schmid R, Herrmann S, Wettstein A. The impact of attachment on dementia-related problem behavior and spousal caregivers' well-being. Attach Human Dev 2007; 9:163-178.

14. Pinquart M, Sorensen S. Differences between caregivers and non–caregivers in psychological health and physical health: A meta–analysis. Psychol Aging 2003; 18:250-267.

15. Lawton MP, Moss M, Kleban MH, Glicksman A, Rovine M. A two–factor model of caregiving appraisal and psychological well–being. J Gerontol 1991; 46:P181-P189.

16. Berg–Weger M, Rubio DM, Tebb SS. The caregiver well–being scale revisited. Health Soc Work 2000; 25:255-263.

17. Schulz R, Mendelsohn AB, Haley WE, Mahoney D, Allen RS, Zhang S, et al. End-of-life care and the effects of bereavement on family caregivers of persons with dementia. N Eng J Med 2003; 349:1936-1942.

18. Langa KM, Chernew ME, Kabeto MU, Regula Herzog A, Beth Ofstedal M, Willis RJ, et al. National estimates of the quantity and cost of informal caregiving for the elderly with dementia. J Gen Intern Med 2001; 16:770-778.

19. Altuntas O, Koc C. Investigation of activity performance of primer caregivers of individuals with dementia. Journal of Occupational Therapy and Rehabilitation 2015; 3:35-44. [Turkish]

20. Gallant MP, Connell CM. Predictors of decreased self–care among spouse caregivers of older adults with dementing illnesses. J Aging Health 1997; 9:373-395.

21. Simpson C, Carter P. Dementia behavioral and psychiatric symptoms: Effect on caregiver’s sleep. J Clin Nurs 2013; 22:3042- 3052.

22. Wang J, Xiao LD, He G, De Bellis A. Family caregiver challenges in dementia care in a country with undeveloped dementia services. J Adv Nurs 2014; 70:1369-1380.

23. Andren S, Elmstahl S. Relationships between income, subjective health and caregiver burden in caregivers of people with dementia in group living care: a cross–sectional community– based study. Int J Nurs Stud 2007; 44:435-446.

24. Bertrand RM, Fredman L, Saczynski J. Are all caregivers created equal? Stress in caregivers to adults with and without dementia. J Aging Health 2006; 18:534-551.

25. Le´vesque L, Ducharme F, Lachance L. Is there a difference between family caregiving of institutionalized elders with or without dementia? West J Nurs Res 1999; 21:472-497.

26. Pinquart M, Sorensen S. Associations of stressors and uplifts of caregiving with caregiver burden and depressive mood: A meta– analysis. J Gerontol Psychol Sci 2003; 58B:P112-P128.

27. Vedhara K, Cox NK, Wilcock GK, Perks P, Hunt M, Anderson S, et al. Chronic stress in elderly carers of dementia patients and antibody response to influenza vaccination. Lancet 1999; 353:627-631.

28. Vitaliano PP, Zhang J, Scanlan JM. Is caregiving hazardous to one’s physical health? A metaanalysis. Psychol Bull 2003; 129:946-972.

29. Mausbach BT, Chattillion E, Roepke SK, Ziegler MG, Milic M, von Känel R, et al. A longitudinal analysis of the relations among stress, depressive symptoms, leisure satisfaction, and endothelial function in caregivers. Health Psychol 2012; 31:433-440.

30. Mausbach BT, Roepke SK, Ziegler MG, Milic M, von Känel R, Dimsdale JE, et al. Association between chronic caregiving stress and impaired endothelial function in the elderly. J Am Coll Cardiol 2010; 55:2599-2606.

31. Roepke SK, Mausbach BT, Patterson TL, Von Känel R, AncoliIsrael S, Harmell AL, et al. Effects of alzheimer caregiving on allostatic load. J Health Psychol 2011; 16:58-69.

32. Mills PJ, Adler KA, Dimsdale JE, Perez CJ, Ziegler MG, AncoliIsrael S, et al. Vulnerable caregivers of Alzheimer disease patients have a deficit in β2-adrenergic receptor sensitivity and density. Am J Geriatr Psychiatry 2004; 12:281-286.

33. Mahoney R, Regan C, Katona C, Livingston G. Anxiety and depression in family caregivers of people with Alzheimer’s disease — the LASER–AD study. Am J Geriatr Psychiatry 2005; 13:795-801.

34. Fauth EB, Gibbons A. Which behavioral and psychological symptoms of dementia are the most problematic? Variability by prevalence, intensity, distress ratings, and associations with caregiver depressive symptoms. Int J Geriatr Psychiatry 2014; 29:263-271.

35. Cassidy J, Shaver PR. Handbook of Attachment: Theory, Research, and Clinical Applications. NY: Guilford Press, 2009.

36. Segal Z. Appraisal of the self–schema: Construct in cognitive models of depression. Psychol Bull 1988; 103:147-162.

37. Shaver PR, Fraley RC. Attachment, Loss, and Grief: Bowlby’s Views and Current Contraversies. In J Cassidy, PR Shaver (editors). Handbook of Attachment: Theory, Research, and Clinical Applications. New York: Guilford Press, 2009, 48-77.

38. Young JE, Klosko JS, Weishaar ME. Schema Therapy: A Practitioner’s Guide. New York: The Guilford Press, 2003.

39. Welburn K, Coristine M, Dagg P, Pontefract A, Jordan S. The schema questionnaire–short form: factor analysis and relationship between schemas and symptoms. Cognit Ther Res 2002; 26:519-530.

40. Calvete E, Orue I, Hankin BL. Transactional relationships among cognitive vulnerabilities, stressors, and depressive symptoms in adolescence. J Abnorm Child Psychol 2013; 41:399-410.

41. Kim JE, Lee SW, Lee SJ. Relationship between early maladaptive schemas and symptom dimensions in patients with obsessive– compulsive disorder. Psychiatry Res 2014; 215:134-140.

42. Muris P. Maladaptive schemas in non–clinical adolescents: relations to perceived parental rearing parental rearing behaviours, big five personality factors and psychopathological symptoms. Clin Psychol Psychother 2006; 13:405-413.

43. Oliveira C, Nobre PJ. Cognitive structures in women with sexual dysfunction: the role of early maladaptive schemas. J Sex Med 2013; 10:1755-1763.

44. Bortolon C, Capdevielle D, Boulenger JP, Gely–Nargeot MC, Raffard S. Early maladaptive schemas predict positive symptomatology in schizophrenia: A cross–sectional study. Psychiatry Res 2013; 209:361-366.

45. Saariaho THJ, Saariaho ASI, Karila IA, Joukamaa MI. Early maladaptive schemas in Finnish adult chronic male and female pain patients. Scand J Pain 2010; 1:196-202.

46. Roper L, Dickson JM, Tinwell C, Booth PG, McGuire J. Maladaptive cognitive schemas in alcohol dependence: Changes associated with a brief residential abstinence program. Cognit Ther Res 2010; 34: 207–215.

47. Brotchie J, Meyer C, Copello A, Kidney R, Waller G. Cognitive representations in alcohol and opiate abuse: The role of core beliefs. Br J Clin Psychol 2004; 43:337-342.

48. Shorey RC, Stuart GL, Anderson S. Early maladaptive schemas among young adult male substance abusers: A comparison with a non– clinical group. J Subst Abuse Treat 2013; 44:522-527.

49. Lawrance KA, Allen JS, Chanen AM. A study of maladaptive schemas and borderline personality disorder in young people. Cognit Ther Res 2011; 35:30-39.

50. McLean HR, Bailey HN, Lumley MN. The secure base script: Associated with early maladaptive schemas related to attachment. Psychol Psychother 2014; 87:425-446.

51. Simard V, Moss E, Pascuzzo K. Early maladaptive schemas and child and adult attachment: A 15‐year longitudinal study. Psychol Psychother 2011; 84:349-366.

52. Roelofs J, Onckels L, Muris P. Attachment quality and psychopathological symptoms in clinically referred adolescents: The mediating role of early maladaptive schema. J Child Fam Stud 2013; 22:377-385.

53. Roelofs J, Lee C, Ruijten T, Lobbestael J. The mediating role of early maladaptive schemas in the relation between quality of attachment relationships and symptoms of depression in adolescents. Behav Cogn Psychother 2011; 39:471-479.

54. Magai C, Cohen CI. Attachment style and emotion regulation in dementia patients and their relation to caregiver burden. J Gerontol B Psychol Sci Soc Sci 1998; 53B:P147-P154.

55. Carnelley KB, Pietromonaco PR, Jaffe K. Attachment, caregiving, and relationship functioning in couples: Effects of self and partner. Pers Relatsh 1996; 3:257-278.

56. Carpenter BD. Attachment bonds between adult daughters and their older mothers: Associations with contemporary caregiving. J Gerontol B Psychol Sci Soc Sci 2001; 56:P257-P266.

57. Crispi EL, Schiaffino K, Berman WH. The contribution of attachment to burden in adult children of institutionalized parents with dementia. Gerontologist 1997; 37:52-60.

58. Daire AP. The influence of parental bonding on emotional distress in caregiving sons for a parent with dementia. Gerontologist 2002; 42:766-771.

59. Cobb S. Social support as a moderator of life stress. Psychosom Med 1976; 38:300-314.

60. Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychol Bull 1985; 98:310-357.

61. Mackinnon SP. Perceived social support and academic achievement: Cross–lagged panel and bivariate growth curve analyses. J Youth Adolesc 2012; 41:474-485.

62. Haber MG, Cohen JL, Lucas T, Baltes BB. The relationship between self-reported received and perceived social support: A meta-analytic review. Am J Community Psychol 2007; 39:133-144.

63. Chiou CJ, Chang HY, Chen IP, Wang HH. Social support and caregiving circumstances as predictors of caregiver burden in Taiwan. Arch Gerontol Geriatr 2009; 48:419-424.

64. Thoits PA. Stress, coping and social support processes: Where are we? What next? J Health Soc Behav 1995; Spec No:53-79.

65. Bozo O, Anahar S, Ates G, Etel E. Effects of illness representation, perceived quality of information provided by the health– care professional, and perceived social support on depressive symptoms of the caregivers of children with leukemia. J Clin Psychol Med Settings 2010; 17:23-30.

66. Ozpolat AGY, Ayaz T, Konag O, Ozkan A. Attachment style and perceived social support as predictors of biopsychosocial adjustment to cancer. Turk J Med Sci 2014; 44:24-30.

67. Chappell N, Reid R. Burden and well–being among caregivers: Examining the distinction. Gerontologist 2002; 42:772-780.

68. Bergman–Evans BF. Alzheimer’s and related disorders: loneliness, depression, and social support of spousal caregivers. J Gerontol Nurs 1994; 20:6-9.

69. Brummett BH, Babyak MA, Siegler IC, Vitaliano PP, Ballard EL, Gwyther LP, et al. Associations among perceptions of social support, negative affect, and quality of sleep in caregivers and noncaregivers. Health Psychol 2006; 25:220-225.

70. Young JE. Schema therapy in applications in borderline and narcissistic personality disorders. Schema Therapy Symposium II, 2006.

71. Soygut G, Karaosmanoglu A, Cakir Z. Assessment of early maladaptive schemas: A psychometric study of the Turkish young schema questionnaire–short form–3. Turk J Psychiatry 2009; 20:75-84. [Turkish]

72. Demirtepe D, Bozo O. Caregiver well-being scale: A study of validity and reliability. Turkish Psychological Articles 2009; 12:28-37. [Turkish]

73. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess 1988; 52:30-41.

74. Eker D, Arkar H. Perceived social support: psychometric properties of the MSPSS in normal and pathological groups in a developing country. Soc Psychiatry Psychiatr Epidemiol 1995; 30:121-126.

75. Eker D, Arkar H, Yaldiz H. Factorial structure, validity, and reliability of revised form of the multidimensional scale of perceived social support. Turk J Psychiatry 2001; 12:17-25. [Turkish]

76. Aiken LS, West SG. Multiple Regression: Testing and Interpreting Interactions. Los Angeles, Sage Publications, 1991.

77. Cohen J, Cohen P, West SG, Aiken LS. Applied multiple Regression / Correlation Analysis for the Behavioral Sciences. New York: Routledge, 2002.

78. Baron RM, Kenny DA. The moderator – mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J Pers Soc Psychol 1986; 51:1173-1182.

79. Goode KT, Haley WE, Roth DL, Ford GR. Predicting longitudinal changes in caregiver physical and mental health: A stress process model. Health Psychol 1998; 17:190-198.

80. Nightingale CL, Curbow BA, Wingard JR, Pereira DB, Carnaby GD. Burden, quality of life, and social support in caregivers of patients undergoing radiotherapy for head and neck cancer: A pilot study. Chronic Illn 2016; 12:236-245.

81. Bowlby JA. Secure Base: Clinical Applications of Attachment Theory. London: Tavistock/Routledge, 1988.

82. Hsiao YJ. Pathways to mental health-related quality of life for parents of children with autism spectrum disorder: roles of parental stress, children’s performance, medical support, and neighbor support. Res Autism Spectr Disord 2016; 23:122-130.

83. Peeters JM, van Beek AP, Meerveld JH, Spreeuwenberg PM, Francke AL. Informal caregivers of persons with dementia, their use of and needs for specific professional support: a survey of the National Dementia Programme. BMC Nurs 2010; 9:9.

84. Nordtug B, Krokstad S, Sletvold O, Holen A. Differences in social support of caregivers living with partners suffering from COPD or dementia. Int J Older People Nurs 2011; 8:93-103.

85. Savva GM, Zaccai J, Matthews FE, Davidson JE, McKeith I, Brayne C. Prevalence, correlates and course of behavioural and psychological symptoms of dementia in the population. Br J Psychiatry 2009; 194:212-219.

86. Demirtepe–Saygili D, Bozo Ö. Perceived social support as a moderator of the relationship between caregiver well–being indicators and psychological symptoms. J Health Psychol 2011; 16:1091-1100.

87. Au A, Shardlow SM, Teng YUE, Tsien T, Chan C. Coping strategies and social support-seeking behaviour among Chinese caring for older people with dementia. Ageing Soc 2013; 33:1422-1441.

88. Barrera M, D’agostino NM, Gibson J, Gilbert T, Weksberg R, Malkin D. Predictors and mediators of psychological adjustment in mothers of children newly diagnosed with cancer. Psychooncology 2004; 13:630-641.

89. Coope B, Ballard C, Saad K, Patel A, Bentham P, Bannister C, et al. The prevalence of depression in the carers of dementia sufferers. Int J Geriatr Psychiatry 1995; 10:237-242.

90. De Vugt ME, Stevens F, Aalten P, Lousberg R, Jaspers N, Winkens I, et al. Behavioural disturbances in dementia patients and quality of the marital relationship. Int J Geriatr Psychiatry 2003; 18:149-154.

91. Kazak AE, Barakat LP, Meeske K, Christakis D, Meadows AT, Casey R, et al. Posttraumatic stress, family functioning, and social support in survivors of childhood leukemia and their mothers and fathers. J Consult Clin Psychol 1997; 65:120-129.

92. Rosa E, Lussignoli G, Sabbatini F, Chiappa A, Di Cesare S, Lamanna L, et al. Needs of caregivers of the patients with dementia. Arch Gerontol Geriatr 2010; 51:54-58.

93. Burton AM, Haley WE, Small BJ. Bereavement after caregiving or unexpected death: effects on elderly spouses. Aging Ment Health 2006; 10:319-326.

94. Giese-Davis J, Hermanson K, Koopman C, Weibel D, Spiegel D. Quality of couples' relationship and adjustment to metastatic breast cancer. J Fam Psychol 2000; 14:251-266.

95. Jackson PB. Specifying the buffering hypothesis: Support, strain, and depression. Soc Psychol Q 1992; 55:363-378.

96. Manne S, Ostroff J, Winkel G, Goldstein L, Fox K, Grana G. Posttraumatic growth after breast cancer: patient, partner, and couple perspectives. Psychosom Med 2004; 66:442-454.
Düşünen Adam - Psikiyatri ve Nörolojik Bilimler Dergisi-Cover
  • ISSN: 1018-8681
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1984
  • Yayıncı: Kare Yayıncılık
Sayıdaki Diğer Makaleler

Evaluation of the procedures of people applying to the psychiatry outpatient clinics to remove their past diagnosis

Sare AYDIN, Esma AKPINAR ASLAN, Sedat BATMAZ, Zekiye ÇELİKBAŞ

Autistic traits, emotional recognition and empathy in adolescents with gender dysphoria

Kübra Bercem KAHRAMAN, Zilan TOPCU, Duygu YAVUZ, Erten DİRENC, Ayşe Burcu ERDOĞDU

The moderating role of perceived social support on early maladaptive schemas and well-being for primary caregivers of dementia patients

Elçin YORULMAZ, Özlem BOZO

The mediating role of cognitive flexibility in therelationship between metacognition andpsychological health: A study in a non-clinical sample

Hande KAYNAK, Oyku AYDIN

Pimavanserin in psychiatry- novel facts vs fiction

Sheikh SHOIB, Alaa BAIOU, Sana JAVAD, Dom nica Nathaly CEVALLOS-ROBALİNO, Fahimeh SAEED

24-hour mobile phone helpline service for women discharged from mother-baby psychiatry unit (MBU): Is it enough?

Sheikh SHOIB, Seshadri Sekhar CHATTERJEE, Soumitra DAS, Irfan ULLAH, Renato de FİLİPPİS

YouTube as a source of information: How good is the quality and reliability of videos related to obsessive compulsive disorder?

Hasan KAYA, Aybeniz CİVAN KAHVE, Alper BÜLBÜL

The relation between resilience and problematic Internet use among youth

Mehmet DİNC, Feyza TOPCU

The effect of childhood trauma on alcohol and non alcohol substance use in a Turkish sample ofuniversity students: The mediating role ofdissociative experiences

Murat YALÇIN, Batuhan HOKTEM, Hakan KARAS

Prenatal attachment in the COVID-19 pandemic: A cluster analysis

Zeynep Seda ALBAYRAK, Sefa COŞGUN, Eralp BULUTLAR, Tuğçe ÖNCÜ, Gizem Berfin ULUUTKU