Cross-cultural analysis of the role of ambivalent feelings for understanding caregivers’ depressive symptoms

Abstract

Objectives

Behavioral and psychological symptoms of dementia (BPSD) are considered to cause ambivalent feelings in caregivers that may contribute to understanding their depressive symptoms. Transnational research is needed in order to increase our knowledge about the cross-cultural equivalence of theoretical models to understand caregivers’ mental health. The aim of this study was to cross-culturally analyze the association between BPSD, ambivalent feelings and depressive symptoms in two samples of family caregivers of people with dementia from Spain and the UK.

Methods

Participants in this study were 432 caregivers who completed measures of BPSD, ambivalent feelings and depressive symptoms. The association between the assessed variables was tested through path-analysis, with differences between countries tested through multigroup analysis.

Results

The results suggest that the influence of BPSD on caregivers’ depressive symptoms is indirect, through ambivalent feelings. The observed associations were equivalent between countries and explained a significant percentage of the variance of depressive symptoms.

Conclusion

The findings of this study provide, for the first time, evidence of equivalent cross-cultural paths analyzing the role of ambivalent feelings for understanding caregivers’ depressive symptoms. The practical implications of these results are discussed.

Keywords:

• Alzheimer
• ambivalence
• caregiving
• dementia
• distress

Acknowledgements

We want to thank all the caregivers who took part in the study, and the following Spanish centres for collaborating in the project: Aulas Kalevi, Asociacion de Familiares de Enfermos de Alzheimer Madrid Suroeste (AFAMSO), Dirección General de Mayores del Ayuntamiento de Madrid, Neurology Service of the Hospital General Universitario Gregorio Marañon and Centro de Especialidades Hermanos Sangro.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Spanish Ministry of Science and Innovation (grants PID2019-106714RB-C21 and PID2019-106714RB-C22); Lucía Jiménez-Gonzalo, Cristina Huertas-Domingo, and José Fernandes-Pires were supported by pre-doctoral grants from the URJC; and the National Institute for Health and Care Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0418-20001). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.