MUTUAL SUPPORT OF CAREGIVERS: TEST OF A PREVENTIVE MODEL

建议的研究是一项对照的纵向试验，包括两种预防性试验 成人家庭照料者的相互支持干预：一种认知 适应干预与传统的教育支持自助 干预。认知适应干预的评价 对泰勒(1983)的调整模型进行了实证检验 威胁生活的事件，它坚持认为适应集中在 三种认知任务的解决：(A)在任务中寻找意义 事件，(B)试图控制它，和(C)努力 通过自我提升来增强自尊，尤其是 通过向下的社会比较和向上的社会联系。互 假设支持提供了一个独特的机会来测试 模型是因为：a)组成员资格的一个常见标准涉及 经历一次常见的威胁生命事件(通常是威胁 自尊)，以及b)在此基础上组织的团体已经包含 促进解决所确定的认知任务的活动。 6-16岁儿童的母亲，也是初中生 主要是家中年迈父母或姻亲的照顾者 拟议研究中的目标群体。双重主要照顾者在 有相当大的精神障碍和行为障碍风险， 尤其是抑郁症、焦虑症和与健康相关的问题。 这项研究中的第二组是照顾者的孩子，他们在 行为问题的风险，因为父母的风险增加了。这个 拟议的研究将是第一个系统地检查健康状况的研究 父母养育对孙辈的影响。 这项研究有三个具体目标：(1)预防精神障碍和 成年女儿行为障碍与心理健康的关系 和儿媳照顾者；(2)防止问题行为和 促进照顾者子女的适应能力；及 测试一种对威胁生活事件的认知适应模型 将相互支持的预防性影响概念化。总共240个 照顾者将被招募并随机分配到三个人中的一个 条件：(1)认知适应互助小组，(2)a 常规互助小组，以及(3)无干预对照 一群人。每一次干预将包括12次会议--每周进行一次 六周，然后每月六个月--由训练有素的照顾者照看。 精神、健康和心理社会功能的评估 照顾者和他们的孩子将在前测、后测、 并进行6个月的随访。

The proposed study is a controlled, longitudinal trial of two preventive mutual support interventions for adult family caregivers: a cognitive adaptation intervention and a conventional educational-support self-help intervention. Evaluation of the cognitive adaptation intervention provides an empirical test of Taylor's (1983) model of adjustment to threatening life events which maintains that adaptation centers around the resolution of three cognitive tasks: (a) a search for meaning in the event, (b) attempts at gaining mastery over it, and (c) efforts to bolster self-esteem through self-enhancing perceptions, particularly through downward social comparisons and upward social contacts. Mutual support is hypothesized to provide a unique opportunity to test such a model because: a) a frequent criteria for group membership involves the experience of a common threatening life event (which usually threatens self-esteem), and b) groups organized on this basis already contain activities which promote resolution of the cognitive tasks identified. Mothers of children between the ages of 6-16 who are also the primary caregiver of an elderly parent or in-law in the home are the major target group in the proposed study. Dual primary caregivers are at considerable risk for mental disorders and behavioral dysfunction, particularly depression, anxiety disorders, and health-related problems. A second group in this study are the children of caregivers who are at risk for behavior problems because of the increased parental risk. The proposed study would be the first to examine systematically the health impact of parent-care on the grandchildren. The study has three specific aims: (1) to prevent mental disorders and behavioral dysfunctions and promote mental health among adult daughter and daughter-in-law caregivers; (2) to prevent problem behaviors and promote adaptive capabilities in the children of caregivers; and (3) to test a model of cognitive adaptation to threatening life events used to conceptualize the preventive impact of mutual support. A total of 240 caregivers will be recruited and randomly assigned to one of three conditions: (1) a cognitive adaptation mutual support group, (2) a conventional mutual support group, and (3) a no-intervention control group. Each intervention will consist of 12 sessions --delivered weekly for six weeks and then monthly for six months--with a trained caregiver. Assessments of psychiatric, health, and psychosocial functioning for caregivers and their children will be conducted at pretest, posttest, and six months follow-up.