The role of experiential avoidance and cognitive fusion in the development of anxiety symptoms among family carers of people with dementia

Van Hout, Elien ORCID: https://orcid.org/0000-0002-2956-7575, Contreras, Milena, Mioshi, Eneida and Kishita, Naoko ORCID: https://orcid.org/0000-0001-8453-2714 (2024) The role of experiential avoidance and cognitive fusion in the development of anxiety symptoms among family carers of people with dementia. Journal of Behavioral and Cognitive Therapy, 34 (1). ISSN 2666-3473

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Abstract

Despite high prevalence of anxiety, current interventions for family carers of people with dementia are considered to be not as effective for anxiety as they are for depression. Understanding the mechanism by which a common stressor (i.e. carer subjective burden) and underlying psychological processes influence anxiety among this population is critical to inform these interventions. Roles of two psychological processes were explored: experiential avoidance in caregiving (attempt to control distressing thoughts/feelings related to caregiving) and cognitive fusion (tendency for one’s behaviour to be overly regulated by thoughts). With a sample of seventy-seven family carers, this study examined the indirect effect of carer subjective burden (ZBI-12) on anxiety (GAD-7) through experiential avoidance in caregiving (EACQ) and cognitive fusion (CFQ) using path analysis approach. The whole sample model showed a good fit to the data and accounted for 54 % of the variance in anxiety. The indirect effect of carer subjective burden on anxiety through its effect on cognitive fusion (β = 0.17), and its combined effect on experiential avoidance in caregiving and cognitive fusion (β = 0.01) were significant. Given the higher explanatory value of cognitive fusion alone, facilitating cognitive defusion through psychological interventions may be critical for preventing clinically significant levels of anxiety, particularly among those carers experiencing high levels of carer subjective burden. Results also demonstrated that carers with higher experiential avoidance in caregiving may be prone to cognitive fusion, which in turn could lead to greater anxiety. Therefore, early interventions targeting experiential avoidance may be beneficial for preventing increased cognitive fusion and anxiety.

Item Type:	Article
Additional Information:	Funding information: This work was supported by 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. EVH’s studentship was supported by Faculty of Medicine and Health Sciences, University of East Anglia. EM is supported by the National Institute for Health and Care Research Applied Research Collaboration East of England (ARC EoE).
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health Faculty of Medicine and Health Sciences > Research Groups > Dementia & Complexity in Later Life Faculty of Arts and Humanities > Research Groups > Centre for Japanese Studies Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging
Depositing User:	LivePure Connector
Date Deposited:	06 Dec 2023 02:20
Last Modified:	31 Dec 2024 00:59
URI:	https://ueaeprints.uea.ac.uk/id/eprint/93878
DOI:	10.1016/j.jbct.2023.12.001

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