application): This project is designed to evaluate the effectiveness of three intervention programs which are designed to improve the psychological functioning of women who are primary family caregivers of dementia victims. It will also examine the role of a specific set of individual-difference variables to determine how they interact with the various types of intervention in affecting outcome. Finally, the study will directly compare the response patterns of Anglo and Hispanic women caregivers on all the variables of interest. Thus, this study may provide theoretical and clinical understanding of the caregiving experience of minority families whose proportion are steadily increasing in this country. Caregivers selected for the study will be assigned to one of three intervention groups for a period of four months: 1) a psychoeducational class in learning how to improve life satisfaction, which relies heavily on the cognitive and behavioral principles developed by Peter Lewinsohn and Aaron Beck; 2) a class for learning how to cope with frustration and anger, derived from the stress and coping paradigm of Lazarus and Folkman, in addition to Novaco's work on anger management; and 3) participation in a typical support group, which is based on the stress- buffering view of social support advanced by Cobb and others. The classes and support groups will meet weekly for a period of eight weeks, followed by two monthly booster sessions. Following this, caregivers will be asked not to seek psychosocial treatment for three months, if possible. After that, they may seek additional services for psychological problems if they choose. During this study, data from several domains will be obtained (T1). Primary outcome measures will focus on psychological distress measures, such as depressive symptoms and state anger; indices of functioning, including coping responses and pleasurable activities; and various dimensions of caregiver burden and social support. Measures to explain the changes in outcome variables due to the interventions will also be obtained. Chief among these are self-efficacy, characteristic style of expressing anger, reactance, length of time as a caregiver, and, in the Hispanic group, the level of acculturation. At the conclusion of the intervention, outcome measures will be re-administered (T2). Caregivers will be re-assessed after a three-month no-treatment follow-up (T3), and again three-months later (T4).
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