Experiential Avoidance, Acceptance, and Depression in Dementia Family Caregivers
Abstract
Dementia caregivers commonly experience elevated levels of stress, and are at increased risk for psychological disorders. Recent research has implicated experiential avoidance and related processes in the development and maintenance of psychopathology, but no published studies have investigated the relation between experiential avoidance and caregiver depression. The present study examined this relationship in a sample of 28 female dementia family caregivers who completed a series of questionnaires, including measures of experiential avoidance and depression, as part of the pre-treatment protocol of a larger project. Results indicated a robust correlation between the Acceptance and Action Questionnaire and depression. Experiential avoidance was associated with depression even after accounting for caregivers' negative affect and care recipients' behavior problems. Implications of findings for the treatment of caregiver distress are discussed.
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Limited literature is available on the relationship between psychological flexibility and dementia caregiver burden and depressive and anxiety symptoms.
“However, limited literature is available on its relationship with dementia caregiver burden, and depressive and anxiety symptoms [78,79,80].”
From Relationship of Psychological Flexibility and Mindfulness to Caregiver Burden, and Depressive and Anxiety Symptoms in Caregivers of People with Dementia (2023) · cites this paper as [80]
Psychological inflexibility (as assessed by the AAQ) was the only significant independent predictor of carer depression when carer negative affect and neuropsychiatric symptoms of dementia were entered into the regression model simultaneously.
“A study conducted by Spira et al. (2007) demonstrated that psychological inflexibility (as assessed by the AAQ) was the only significant independent predictor of carer depression, when carer negative affect and neuropsychiatric symptoms of dementia were entered into the regression model simultaneously.”
From Exploring the impact of carer stressors and psychological inflexibility on depression and anxiety in family carers of people with dementia (2020) · cites this paper as Spira et al. (2007)
Avoidant coping strategies, including thought suppression, have been found to be associated with elevated symptoms of depression and anxiety in older adults and family caregivers of persons with dementia.
“while avoidant coping strategies, including thought suppression, have been found to be associated with elevated symptoms of depression and anxiety in older adults (Petkus, Gum, & Wetherell, 2012) and family caregivers of persons with dementia (García-Alberca et al., 2012;Spira et al., 2007).”
From Supported Web-Based Acceptance and Commitment Therapy for Older Family Caregivers (CareACT) Compared to Usual Care. (2022) · cites this paper as Spira et al., 2007
Ability to accept unchangeable circumstances and associated emotions may enhance mental health in family caregivers of people with dementia.
“Given the progressive and terminal nature of dementia, the ability to accept these unchangeable circumstances and the associated emotions may enhance mental health in family caregivers of people with dementia (Losada et al., Citation2014; Spira et al., Citation2007).”
From How do care-related beliefs contribute to depression and anxiety in family caregivers of people with dementia? Testing a cognitive vulnerability-stress model. (2025) · cites this paper as Spira et al., 2007
Emerging evidence indicates that psychological flexibility predicts both anxiety and depression in dementia carers.
“There is now emerging evidence that psychological flexibility predicts both anxiety 67 and depression 68 in carers of people with dementia.”
From Anxiety in Informal Dementia Carers: A Meta-Analysis of Prevalence (2020) · cites this paper as [68]
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“…while avoidant coping strategies, including thought suppression, have been found to be associated with elevated symptoms of depression and anxiety in older adults (Petkus, Gum, & Wetherell, 2012) and family caregivers of persons with dementia (García-Alberca et al., 2012; Spira et al., 2007).”
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“EA is also considered to have a significant association with depression and anxiety among dementia family caregivers (Kishita et al., 2020; Losada et al., 2014; Romero-Moreno et al., 2016; Spira et al., 2007).”
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“Given the progressive and terminal nature of dementia, the ability to accept these unchangeable circumstances and the associated emotions may enhance mental health in family caregivers of people with dementia (Losada et al., 2014; Spira et al., 2007).”
- Authors
- Spira, A. P., Beaudreau, S. A., Jimenez, D., Kierod, K., Cusing, M. M., Gray, H. L., & Gallagher-Thompson, D.
- Affiliations
- University of California, San Francisco (US)
- VA Palo Alto Health Care System (US)
- Venue
- Clinical Gerontologist
- Publisher
- The Haworth Press
- Published
- 2007-06-25
- Volume
- 30
- Issue
- 4
- Pages
- 55-64
- ISSN
- 0731-7115 (ISSN-L)
- 1545-2301
- OpenAlex
- W2043701812
- Cited by
- 64
- References
- 22
- Citations by year
- 2026: 1 · 2024: 5 · 2023: 3 · 2022: 3 · 2021: 9 · 2020: 6 · 2019: 3 · 2018: 2 · 2017: 3 · 2016: 7 · 2015: 7 · 2014: 4 · 2013: 4 · 2012: 1
- FWCI
- 1.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Gerontologist (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Keywords
- experiential avoidance, acceptance, depression, dementia, family caregivers, caregiver stress, Acceptance and Action Questionnaire, negative affect, caregiver distress
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