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Psychological processes in adapting to dementia: illness representations among the IDEAL cohort

Clare, Linda, Gamble, Laura D., Martyr, Anthony, Quinn, Catherine, Litherland, Rachael, Morris, Robin G., Jones, Ian R. and Matthews, Fiona E 2021. Psychological processes in adapting to dementia: illness representations among the IDEAL cohort. Psychology and Aging 10.1037/pag0000650

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Abstract

How people understand and adapt to living with dementia may influence well-being. Leventhal’s Common Sense Model (CSM) of Self-Regulation provides a theoretical basis for exploring this process. We used cross-sectional and longitudinal data from 1,109 people with mild-to-moderate dementia in the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort. We elicited dementia representations (DRs) using the Representations and Adjustment to Dementia Index (RADIX), a validated measure based on the CSM, identified groups sharing distinct DR profiles, and explored predictors of group membership and associations with well-being, and whether problem-focused coping played a mediating role in these associations. We identified four DR classes: people who see the condition as a disease and adopt a diagnostic label; people who see the condition as a disease but refer to symptoms rather than a diagnostic label; those who see the condition as part of aging; and those who are unsure how to make sense of the condition. A fifth group did not acknowledge any difficulties. “Disease” representations were associated with better cognition and younger age, while “aging” and “no problem” representations were associated with better mood and well-being. The association with well-being remained stable over 24 months. There was limited partial support for a mediating role of problem-focused coping. Variations in DRs may reflect individual differences in the psychological processes involved in adjusting to dementia. DRs provide a framework for personalizing and tailoring both communications about dementia and interventions aimed at supporting people in coping with dementia. There is a need to debate what constitutes a positive DR and how its development might be encouraged.

Item Type: Article
Date Type: Published Online
Status: In Press
Schools: Social Sciences (Includes Criminology and Education)
Wales Institute of Social & Economic Research, Data & Methods (WISERD)
Publisher: American Psychological Association
ISSN: 0882-7974
Date of First Compliant Deposit: 4 October 2021
Date of Acceptance: 15 September 2021
Last Modified: 13 Dec 2021 11:20
URI: http://orca.cardiff.ac.uk/id/eprint/144638

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