Caregiver Mental Health other than Burden/Stress/Strain Assessments

Aside from burden, stress and strain, caregiving can elicit a number of other mental health responses.  For example, caregiving has been found to have negative outcomes such as depression (Beck et al., 1961; Radloff, 1977), anxiety (Cicirelli, 1998; Rosenberg, 1962), and decreased quality of life (Bass et al., 1999; Gerritsen & van der Ende, 1994), affect (Folkman & Moskowitz, 2000), well-being (Berg-Wenger et al., 2000; Schofield et al., 1997 ) and self-esteem (Skaff & Pearlin, 1992).  In has also been found to elicit feelings of guilt (Holley & Mast, 2009).   A number of instruments have been developed to assess mental health in general, while other instruments are more focused and measure one particular concept (details provided in parentheses after scale name).

Beck’s Depression Inventory (depression)

  • Measure of depression based on a time frame of ‘past week’.  Tool not designed specifically for caregivers.
  • 21 items (4-point scale)
  • Beck, A. T., Ward, C. H., Medelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571.

Brief Symptom Inventory – 18 (general)

  • Shortened version of the Brief Symptom Inventory that measures symptoms of depression, anxiety, and hostility.  Tool not designed specifically for caregivers.
  • 18 items (5-point scale)
  • Derogatis, L. R., & Savitz, K. L. (1999). The SCL-90-R, Brief Symptom Inventory, and Mathcing Clinical Rating Scales. In M. E. Maruish (Ed.), The use of psychological testing for treatment planning and outcomes assessment. Mahwah, N.J.: Lawrence Erlbaum Associates, Inc.

Beck’s Depression Inventory (depression)

  • Measure of depression based on a time frame of ‘past week’.  Tool not designed specifically for caregivers.
  • 21 items (4-point scale)
  • Beck, A. T., Ward, C. H., Medelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571.

Caregiver Well-Being Scale (well-being)

  • Measures frequency of 4 domains of well-being: low affect, cognitive depression, anxiety, and anger.
  • 7 items for low affect, 6 items for cognitive depression, 4 items for anxiety, 4 items for anger (4-point scales)
  • Zarit, S., & Whitlatch, C. J. (1992). Institutional placement: Phases of the transition. The Gerontologist, 32, 665-672.

Caregiver Well Being Scale (well-being)

  • Measures the extent to which caregiver needs are met in relation to love, physical needs, and self-esteem.  Based on Maslow’s (1968) hierarchy of needs.  Also measures non-basic needs in relation to time for self, home, and family.
  • 23 items for basic needs (7-point scale)
  • 22 items for activities of living (7-point scale)
  • Tebb, S. (1995). An aid to empowerment: A caregiver well-being scale. Health & Social Work, 20(2), 87.

Filial Anxiety Scale (anxiety)

  • Measures 2 types of anxiety: anxiety over one’s ability to take on a caregiving role, and anxiety over the aging parent’s welfare.  Tool designed for adult child caregivers.
  • 13 items (5-point scale)
  • Cicirelli, V. G. (1988). A measure of filial anxiety regarding anticipated care of elderly parents. The Gerontologist, 28, 478-482.

Geriatric Depression Scale (depression)

  • Measures depression in older adults in terms of loss, cognitive complaints, somatic complaints, and self-image.  Tool not designed specifically for caregivers.
  • 30 items (2-point scale)
  • Brink, T. L. (1982). Screening tests for geriatric depression. Clinical Gerontologist, 1, 37-43.

Guilt (guilt)

  • Measures feelings of guilt and regret related to the caregiver’s relationship with the care recipient.
  • 5 items (4-point scale)
  • Mullan, J. T. (1992). The bereaved caregiver: A prospective study of changes in well-being. The Gerontologist, 32, 673-683.

Guilt Scale (guilt)

  • Measures guilt felt by caregivers in relation to their caregiving role.
  • 9 items (4-point scale)
  • Wells, Y. D., & Jorm, A. F. (1987). Evaluation of a special nursing home unit for dementia sufferers: A randomized controlled comparison with community care. New Zealand Journal of Psychiatry, 21, 524-531.

Health-related Quality of Life (quality of life)

  • Measures 8 dimensions of health: hsyical functioning, role limitations due to physical health problems, bodily pain, general health, vitality, social functioning, role limitations due to emotional problems, and mental health.
  • 36 items (2-point, 3-point, 5-point, 6-point scales)
  • Ware Jr., J. E., Snow, K. K., Kosinski, M., & Gandek, B. (1993). The SF-36 Health Survey manual and interpretation guide. Boston: The Health Institute, New England Medical Center.

Loss of Self (loss of self)

  • Measures sense of loss of self.
  • 2 items (4-point scale)
  • Skaff, M. M., & Pearlin, L. I. (1992). Caregiving: Role engulfment and the loss of self. The Gerontologist, 32, 656-664.

McGill QOLLTI-F (quality of life)

  • Measures family caregiver quality of life.  Focuses specifically on caregivers providing care to someone with a life-threatening illness.
  • 19 items (scale from 1 to 10)
  • Cohen, S. R., Leis, A. M., Kohl, D., Charbonneau, C., Ritvo, P., & Ashbury, F. D. (2006). QOLLTI-F: Measuring family carer quality of life. Palliative Medicine, 20(8), 755-767.

Neuropsychiatric Inventory Caregiver Distress Scale (anxiety)

  • Measures subjective caregiver distress as impacted by personality changes, depression, psychosis and agitation that can be associated with persons with Alzheimer’s disease.  Caregivers are asked to rate the severity and frequency of each symptom, and the level of emotional or psychological distress.
  • 10 items (6-point scale)
  • Kaufer, D. I., Cummings, J. L., Christine, D., Bray, T., Castellon, S., Masterman, D., et al. (1997). Assessing the impact of neuropsychiatric symptoms in Alzheimer’s disease: The Neuropsychiatric Inventory Caregiver Distress Scale. Journal of the American Geriatrics Society, 46, 210-215.

Positive and Negative Affect Scales (affect/mood)

  • Measures psychological well-being according to the extent that people experience different feelings and emotions.  Tool not designed specifically for caregivers.
  • 20 items (5-point scale)
  • Bradburn, N. M. (1969). The structure of psychological well-being. Chicago: Aldine.

Quality of Life in Alzheimer’s Disease Scale (quality of life)

  • Measures caregiver and care recipient rating of care recipient quality of life in relation to physical health, energy, mood, memory, family self as a whole, ability to do things for fun, and life as a whole.
  • 13 items (4-point scale)
  • Logsdon, R., Gibbons, L., McCurry, S., & Teri, L. (1999). Quality of life in Alzheimer’s disease: Patient and caregiving reports. Journal of Mental Health and Ageing, 5(1).

Quality of Life Inventory (quality of life)

  • Measures positive mental health or overall life satisfaction with 16 areas.  Tool not designed specifically for caregivers.
  • 16 times (3-point scale)
  • Frisch, M. B. (1992). Use of the Quality of Life Inventory in problem assessment and treatment planning for cognitive therapy of depression. In A. Freeman & F. M. Dattilio (Eds.), Comprehensive casebook of cognitive therapy. New York, NY: Plenum Press.
  • Frisch, M. B., Cornell, J., Villanueva, M., & Retzlaff, P. J. (1992). Clinical validation of the Quality of Life Inventory: A measure of life satisfaction for use in treatment planning and outcome assessment. Psychological Assessment, 4, 92-101.

Schedule for the Evaluation of Individual Quality of Life – Direct Weighting (quality of life)

  • Open-ended measure where caregiver is asked to identify 5 areas most important in life and then rate each one using a visual analogue scale, and then assigns a relative weight to each.  Tool not designed specifically for caregivers.
  • 15 items (3 stages of questions)
  • Hickey, A. M., O’Boyle, C. A., McGee, H. M., & McDonald, N. J. (1997). The relationship between post-trauma problem reporting and carer quality of life after severe head injury. Psychology & Health, 12, 827-838.

Self-esteem Scale (self esteem)

  • Measures beliefs in one’s worth, competence, and capacity for success.  Tool not designed specifically for caregivers.
  • 10 items (5-point scale)
  • http://www.yorku.ca/rokada/psyctest/rosenbrg.pdf
  • Rosenberg, M. (1962). The association between self-esteem and anxiety. Journal of Psychiatric Research, 1, 135-152.

Self Rating Depression Scale (depression)

State-Trait Anxiety Inventory (anxiety)

  • Measures anxiety assessing both state (situational) and trait (dispositional) anxiety.  Tool not designed specifically for caregivers.
  • 40 items (4 point scale)
  • Spielberger, C. D., Gorusch, R. L., & Lushene, R. E. (1970). Manual for the State-Trait Anxiety Inventory. Palo Alto, California.

Symptom Inventory (general)

  • Measures symptoms of depression, anxiety, and hostility.  Tool not designed specifically for caregivers.
  • 53 items (5-point scale)
  • Derogatis, L. R., & Melisaratos, N. (1983). The Brief Symptom Inventory: An introductory report. Psychological Medicine, 13, 595-605.

Symptom Checklist SCL-90-R (general)

  • Measures psychological symptoms and distress across 9 symptoms: somatisation, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism.  Tool not designed specifically for caregivers.
  • 90 items (5-point scale)
  • Derogatis, L. R., Lipman, R. S., Rickels, K., Uhlenhuth, E. H., & Covi, L. (1974). The Hopkins Symptom Checklist (HSCL): Self-report symptom inventory. Behavioral Science, 19, 1-15.

Vulnerability Scale (affect/mood)

  • Measures 4 domains: dysphoria, alienation, annihilation, and denial.  Tool not designed specifically for caregivers.
  • 13 items
  • Weisman, A. D., & Worden, J. W. (1977). The existential plight in cancer: Significance of the first 100 days. International Journal of Psychiatry in Medicine, 7, 1-15.

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