Depression in family members caring for a relative with Alzheimer's disease.

The reformulated learned helplessness model of depression was tested in a study of families caring for relatives with Alzheimer's disease who did not participate in family support groups or have access to respite care. Family members who identified themselves as major caregivers, ie, those providing daily assistance to the patient, received a clinical psychiatric interview, the Beck Self-Report Depression Scale, and a modified Hammen and deMayo Attributional Style Questionnaire. The results showed that 55% of major caregivers, primarily spouses, living with an older relative with dementia experienced clinical depression. Depressed caregivers were more likely to perceive a lack of control over their situation than those who were not depressed. Contrary to the reformulated learned helplessness hypothesis, they did not perceive their situation to be the result of internal, stable, and global attributions. The results suggest the need to study depression in ecologically stressful natural settings and to develop effective clinical intervention strategies.