Bente Nordtug

Personality features, caring burden and mental health of cohabitants of partners with chronic obstructive pulmonary disease or dementia

Objectives: The interplay between personality, mental health and type of disease in explaining caring burden was studied in home-dwelling cohabitants of partners with chronic obstructive pulmonary disease (COPD) or dementia. Methods: A cross-sectional study including 206 participants with 80% response rate. Neuroticism was assessed by Eysenck Personality Questionnaire (EPQ) and externality by Locus of Control of Behaviour. The Relative Stress Scale evaluated caring burden. Mental health was determined by the General Health Quality (GHQ-28) questionnaire. Results: Neuroticism and type of illness played a major role in explaining caring burden and mental health. In the COPD and dementia groups, 30.5% and 58.4%, respectively, were above the cut-off point for psychiatric caseness on the GHQ. Both groups had low scores for depression and high scores for social dysfunction, anxiety, insomnia and somatisation. Compared to the dementia group, the COPD group had lower scores and fairly stable levels on all subscales of the GHQ. Females had higher scores on somatic symptoms, anxiety and insomnia; they also reported higher scores on neuroticism and externality. Conclusion: Differences in personality and illness explained both caring burden and mental health among caregivers. To mitigate the caring burden and mental health problems among home-dwelling caregivers, public health services need to take into account the personality and gender of the caregiver, and also the disease of the ill partner.

Similarities and Differences in Caring Burden of Home Dwellers With Partners Suffering From Chronic Obstructive Pulmonary Disease or Dementia

The aim of this study was to explore caring burden of cohabitants (N = 206) having partners with chronic obstructive pulmonary disease (COPD) or dementia in relation to aspects of social support. Caring burden was measured by the Relative Stress Scale and was found to be lower and to change less with severity in the COPD group. In multiple regression analyses, characteristics of the ill partners such as aggressive behaviors, degree of self-reliance, hours they could adequately be alone, in addition to public services, social support or withdrawal from family and friends, and gender of the caregiver were overriding the type of illness. Different factors added to the caring burden of females and males. In the total sample, those factors explained 62.9% of the caring burden, while for females 58% was explained, and 77% for males.

Can the Psycho-Emotional State be Optimized by Regular Use of Positive Imagery?, Psychological and Electroencephalographic Study of Self-Guided Training

The guided imagery training is considered as an effective method and therefore widely used in modern cognitive psychotherapy, while less is known about the effectiveness of self-guided. The present study investigated the effects of regular use of self-guided positive imagery, applying both subjective (assessment of the psycho-emotional state) and objective (electroencephalographic, EEG) approaches to research. Thirty healthy subjects participated in the cognitive imagery-training program for 12 weeks. The schedule began with group training with an instructor for 2 days, where the participants learned various techniques of positive imagery, after which they continued their individual training at home. Psychological and EEG evaluations were applied at the baseline and at the end of the training period. The impact of training on the psycho-emotional states of the participants was evaluated through: Center for epidemiologic studies- Depression (CES-D) 20 item scale, Satisfaction with life scale (SWLS) and General Self-Efficacy scale (GSE). EEGs (19-channels) were recorded at rest with eyes closed. EEG analysis was performed using Low resolution electromagnetic tomography (LORETA) software that allows the comparison of current source density (CSD) and functional connectivity (lagged phase and coherence) in the default mode network before and after a workout. Initial assessment with CES-D indicated that 22 participants had subthreshold depression. After the training participants had less prominent depressive symptoms (CES-D, p = 0.002), were more satisfied with their lives (SWLS, p = 0.036), and also evaluated themselves as more effective (GSE, p = 0.0002). LORETA source analysis revealed an increase in the CSD in the right mPFC (Brodmann area 10) for beta-2 band after training (p = 0.038). LORETA connectivity analysis demonstrated an increase in lagged coherence between temporal gyruses of both hemispheres in the delta band, as well as between the Posterior cingulate cortex and right BA21 in the theta band after a workout. Since mPFC is involved in emotional regulation, functional changes in this region can be seen in line with the results of psychological tests and their objective validation. A possible activation of GAMK-ergic system is discussed. Self-guided positive imagery (after instructions) can be helpful for emotional selfregulation in healthy subjects and has the potential to be useful in subthreshold depression.

Self-guided Positive Imagery Training: Effects beyond the Emotions–A Loreta Study

Previously we demonstrated that a 12-week lasting self-guided positive imagery training had a positive effect on the psycho-emotional state of healthy subjects and was associated with an increase in functional connectivity in the brain. Here we repeated the previous project, but expanded the study, testing the hypothesis that training can also affect cognitive functions. Twenty subjects (half of them with subthreshold depression according CES-D) participated in the program of positive imagery training for 12 weeks. The schedule began with group training for 2 days, followed by training at home. Evaluations of cognitive functions and electroencephalographic (EEG) activity were conducted during three examinations as follows: E0-baseline (1 month before the training); E1-pre-training and E2-post-training. CNS Vital Signs battery was used to test the following cognitive domains: verbal and visual memory, executive functions, cognitive flexibility, social acuity, non-verbal reasoning. EEGs (19-channel) were recorded at rest with closed eyes and analyzed with Low-resolution electromagnetic tomography software. One-way repeated measures ANOVA, followed by pairwise comparison showed a significant increase after training (E2 vs. E1; E2 vs. E0) in the number of correct hits for positive emotions received during perception of emotions test (POET); after the sample was split according to the initial presence of depressive symptoms, the effect was present only in the subgroup with subthreshold depressive symptomatology. Post-training (E2 vs. E1; E2 vs. E0) the number of correct answers on non-verbal reasoning test increased; this effect was observed only in the subgroup that does have any depressive symptoms. Comparison of EEG post-training vs. pre-training demonstrated a significant reduction in current source density (CSD) after the training in the left hemisphere (insular cortex, frontal and temporal lobes in delta, theta and alpha1 bands). The observed changes were presented only in the subgroup with initial subthreshold depressive symptomatology. A negative correlation was found between POET and CSD in the left insular cortex for theta band. No significant differences were observed when data from EEG and cognitive tests obtained during pre-training were compared with baseline values. Potential use of training for the rehabilitation of various disturbances with cognitive and emotional deficits is discussed.

Former Work Life and People With Dementia

Twelve persons with dementia were interviewed about their former work lives. Their motivation for choosing their past work was influenced by values of their contemporary culture. Those who had come to terms with their illness had positive feelings about their past contributions in their former paid work. However, they often felt that unpaid work was taken for granted and not fully recognized by family or society. Some wrestled with accepting their illness; they were grieving their losses, regardless of former success. Caregivers may use parts of work narratives to elevate the self-esteem and quality of life of persons with dementia.