title: The contribution of caregiver psychosocial factors to distress associated with behavioural and psychological symptoms in dementia.
abstract: The objective of the study is to examine caregiver factors as predictors of BPSD-related distress and their potential mechanisms.
  
  
  
  Informal caregivers of people with dementia (n = 157) recruited from 28 community mental health teams in six NHS Trusts across England completed questionnaires regarding psychosocial factors (relationship quality, competence, guilt, health-related quality of life in the caregiver and person with dementia, reactivity to behavioural and psychological symptoms in dementia [BPSD] and burden) and frequency of BPSD. Analyses of BPSD-related distress include hierarchical multiple regression, mediation, moderation and path analysis.
  
  
  
  Caregiver psychosocial factors explained 56% of the variance in BPSD-related distress. After controlling for these factors, frequency of BPSD was not a significant predictor of BPSD-related distress. Caregiver reactivity to BPSD, burden, competence and relationship quality directly influenced BPSD-related distress. Guilt influenced distress indirectly via competence, burden and reactivity to BPSD. The final model accounted for 41% of the variance in BPSD-related distress and achieved a good fit to the data (χ2= 23.920, df = 19, p = 0.199).
  
  
  
  Caregiver psychosocial factors including sense of competence, guilt, burden and reactivity to BPSD contribute to BPSD-related distress. Tailored interventions for managing behaviour problems in family settings could focus on these factors associated with BPSD-related distress to minimise distress in families. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Division of Psychiatry, University College London, London, UK.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Feast
authors.affiliation: Institute of Mental Health, University of Nottingham, Nottingham, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Orrell
authors.affiliation: Swansea University Medical School, Swansea University, Swansea, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Russell
authors.affiliation: Research Department of Clinical, Educational, and Health Psychology, University College London, London, UK.
authors.forename: Georgina
authors.initials: G
authors.lastname: Charlesworth
authors.affiliation: Faculty of Health and Social Care, University of Hull, Hull, UK.
authors.forename: Esme
authors.initials: E
authors.lastname: Moniz-Cook
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001526:Behavioral Symptoms / Q000523:psychology*; D017028:Caregivers / Q000523:psychology* / Q000592:standards*; D002983:Clinical Competence; D003704:Dementia / Q000523:psychology*; D004739:England; D005260:Female; D006167:Guilt; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D016526:Workload
keywords: behavioural symptoms; caregivers; dementia; path analysis; psychological stress; psychosocial factors; regression analysis