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Background and Objectives: This article reviews an instrument used in cross-national research with dementia family caregivers-the Revised Scale for Caregiving Self-Efficacy (RSCSE). Although the RSCSE has been translated into multiple languages, few studies have examined scale performance across samples. We examine congruence of psychometric, reliability, and validity data to inform research and practice., Methods: We conducted citation searches using Scopus, Google Scholar, Web of Science, and PsycINFO. Identified dementia caregiving studies cited the original RSCSE article and described results of English and/or non-English translations of the scale., Results: Peer-reviewed published studies (N = 58) of dementia family caregivers included data for Arabic, Chinese, English, French, Italian, and Spanish translations of the RSCSE; the majority (72%) reported use of non-English translations. Studies utilizing confirmatory factor analytic approaches reported findings consistent with the original development study. Internal consistency, convergent/discriminant validity, and criterion validity indices were congruent across diverse cross-national caregiving samples assessed with different translations. Data supported the RSCSE's sensitivity to change following specific psychosocial caregiving interventions., Discussion: The reliability and validity of different translations of the RSCSE support continued use with cross-national samples of dementia family caregivers. Limitations of the scale point to the need for further self-efficacy measurement development within caregiving domains. Consistent with Bandura's discussion of social cognitive theory in cultural contexts, personal agency for caregiving challenges remains generalizable to cross-national populations. This review discusses the implications for cross-cultural research and practice., (© The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: Rumination has been described as a dysfunctional coping strategy related to emotional distress. Recently, it has been highlighted from the Acceptance and Commitment Therapy therapeutic approach, the negative role that cognitive fusion (the extent to which we are psychologically tangled with and dominated by the form or content of our thoughts) has on the explanation of distress. The aim of this study is to simultaneously analyze the role of rumination and cognitive fusion in the caregiving stress process., Material and Methods: The sample of 176 dementia caregivers was divided in four groups, taking into account their levels of rumination and cognitive fusion: HRHF=high rumination+high cognitive fusion; HRLF=high rumination+low cognitive fusion; LRHF= low rumination+high cognitive fusion; and LRLC=low rumination and low cognitive fusion. Caregiver stress factors, frequency of pleasant events, experiential avoidance, coherence and satisfaction with personal values, depression, anxiety and satisfaction with life, were measured., Results: The HRHF group showed higher levels of depression, anxiety, experiential avoidance and lower levels of satisfaction with life, frequency of pleasant events, coherence and satisfaction with personal values, than the other three groups., Conclusions: Considering simultaneously rumination and cognitive fusion may contribute to a better understanding of caregiver coping and distress., (Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.)

Objective: The differential efficacy of acceptance and commitment therapy (ACT) and cognitive-behavioral therapy (CBT) for dementia family caregivers' is analyzed through a randomized controlled trial., Method: Participants were 135 caregivers with high depressive symptomatology who were randomly allocated to the intervention conditions or a control group (CG). Pre-, postintervention, and follow-up measurements assessed depressive symptomatology, anxiety, leisure, dysfunctional thoughts, and experiential avoidance., Results: Depression: Significant effects of interventions compared with CG were found for CBT (p < .001, d = 0.98, number needed to treat [NNT] = 3.61) and ACT (p < .001, d = 1.17, NNT = 3.53) at postintervention, but were maintained only at follow-up for CBT (p = .02, d = 0.74, NNT = 9.71). Clinically significant change was observed in 26.7% participants in CBT, 24.2% in ACT, and 0% in CG. At follow-up, 10.53% in CBT and 4% in ACT were recovered (0% CG). Anxiety: At postintervention, ACT participants showed lower anxiety than CBT participants (p < .05, d = 0.50) and CG participants (p < .01, d = 0.79, NNT = 3.86), with no effects at follow-up. At postintervention, 23.33% in CBT, 36.36% in ACT, and 6.45% in CG showed clinically significant change. At follow-up, 26.32% in CBT, 36% in ACT, and 13.64% in CG were recovered. Significant changes at postintervention were found in leisure and dysfunctional thoughts in both ACT and CBT, with changes in experiential avoidance only for ACT., Conclusion: Similar results were obtained for ACT and CBT. ACT seems to be a viable and effective treatment for dementia caregivers., ((c) 2015 APA, all rights reserved).)

Background: Research on the behavioral correlates of anxiety in older adults is sparse. The aim of this study was to explore the association of anxiety with behavioral patterns defined by health, activity, emotional and social variables., Methods: A convenience sample of 395 older adults completed measures of health, activity, emotions, social variables and experiential avoidance. Cross-sectional data were analysed using cluster analysis., Results: Five clusters were identified: active healthy, healthy, active vulnerable, lonely inactive and frail lonely. Participants in the active healthy and healthy clusters showed the highest scores on health variables (vitality and physical function), and adaptive scores on the rest of variables. They also reported the lowest scores on anxiety and included the lowest number of cases with clinically significant anxiety levels. Active vulnerable showed high scores on social support, leisure activities and capitalization on them but low scores in vitality and physical functioning. Participants in the lonely inactive cluster reported the highest mean score in experiential avoidance and high scores on boredom and loneliness, and low scores on social support, leisure activities capitalizing on pleasant activities and health variables. Frail lonely represent a particularly vulnerable profile of participants, similar to that of lonely inactive, but with significantly lower scores on health variables and higher scores on boredom and hours watching TV., Conclusions: Anxiety in older adults is not only linked to poor health, but also to dysfunctional social behavior, loneliness, boredom and experiential avoidance. Maladaptive profiles of older adults with regard to these variables have been identified.

Background: Behavioral and psychological symptoms of Dementia (BPSD) are a cause of significant stress in caregivers. The revised memory and behavior problems checklist (RMBPC) (Teri et al., 1992) is an instrument used for the assessment of BPSD. The psychometric properties of the RMBPC-Spanish version were analyzed., Method: 361 family caregivers of people with dementia were interviewed individually. The RMBPC is a 24-item questionnaire that assesses both the frequency of the BPSD and the reaction they cause in the caregiver. It has three factors: memory problems, disruptive behaviors, and depressive behaviors. Caregivers' depressive symptomatology, anxiety and burden, and the functional capacity of the person with dementia were also measured., Results: The results of a confirmatory factor analysis (CFA) show that the original three-factor model with 24 items, with error covariances, had a marginally acceptable adjustment for the frequency and reaction scales. The deletion of items with low factor loadings results in a better adjustment of the data to the model, for both the frequency and reaction scales. We found adequate internal consistency for all subscales, and significant associations between the subscales, burden, anxiety, and depression., Conclusions: The results suggest that the Spanish version of the RMBPC shows adequate adjustment for the three-factor model with 24-items, but that removing some of the items improves the adjustment. The results support the use of this instrument for the assessment of BPSD in Spanish people with dementia.

Objectives: The moderator role of guilt on the effect of leisure activities on dementia caregivers' depressive symptoms was analyzed, considering differences by kinship and guilt as a multidimensional construct., Method: Participants were 351 caregivers (58.97% daughters, 10.54% sons, 19.66% wives, and 10.83% husbands). Measures included frequency of leisure activities, depressive symptoms, and guilt (total scale and 5 factors)., Results: A moderator role of guilt was found only for daughters. Specifically, significant interactions between guilt and frequency of leisure activities were found for the total scale and for the Factors 1 (guilt about doing wrong by the care recipient), 2 (guilt about failing to meet the challenges of caregiving), and 3 (guilt about self-care). For those daughters who reported lower levels of leisure activities, showing higher levels of guilt was associated with higher scores in depressive symptoms, whereas those with lower levels of guilt showed lower depressive symptoms scores., Discussion: Feelings of guilt may have different consequences on caregivers' distress depending on caregivers' gender and kinship. Daughters with higher levels of guilt who do not engage in leisure activities may be especially vulnerable to suffering psychological distress., (© The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

We conducted 2 studies on reinforcer preference in patients with dementia. Results of preference assessments yielded differential selections by 14 participants. Unlike prior studies with individuals with intellectual disabilities, all participants showed a noticeable preference for leisure items over edible items. Results of a subsequent analysis with 3 participants showed reinforcement effects when highly preferred items were delivered as consequences.