Dr. GallagherThompson specializes in treatment of late-life depression and anxiety disorders and in working with persons with dementia and their family caregivers. She uses a cognitive/behavioral (CBT) approach and offers both individual and group therapy. She is a board-certified specialist in Geropsychology (psychology of older adults) and is a licensed clinical psychologist who has been in practice for 25 years.

She received her degree in clinical psychology/adult development and aging from the University of Southern California and did her clinical training at UCLA. She has been an NIH funded researcher for the past 25 years and is most noted for her empirical studies on the efficacy of psychoeducational interventions to reduce stress and improve the psychological status of family caregivers of older adults with Alzheimer’s disease or other forms of dementia. She has culturally modified, translated, and tailored programs for Chinese-speaking, Spanish-speaking, and Farci-speaking caregivers. In addition she works with an international advisory group to create an on-line web-based program to provide education and skill training globally. She is also a Fellow of the Academy of Cognitive Therapy and a recognized Trainer/ Consultant/ Supervisor in CBT. In collaboration with others she is completing 2nd edition of the book: Cognitive/ Behavior Therapy with Older Adults, to be published in 2017.

At present she is Emerita Professor of Research in the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine, and former Director of the Outreach, Recruitment and Education Core of the Stanford Alzheimer's Disease Research Center which focuses on recruiting Latino and American Indian persons with dementia and their family caregivers. She has authored about 200 papers in major journals in the field and has co-edited the critically well-received second edition of "Ethnicity and the Dementias" (with Gwen Yeo, senior editor). She serves in several volunteer positions with the Alzheimer’s Association Northern CA/ Northern NV chapter. She is very interested and enthusiastic to find ways to deliver effective mental health care through technology so that services will be available to more persons in need.

Clinical Focus

  • Geropsychology
  • Psychoeducational programs for family caregivers
  • Health/ Behavioral Psychology
  • Impact of Diversity on Mental Health
  • Designing and Implementing Technology for mental health concerns
  • Cognitive/Behavioral Therapy for Late Life Depression
  • Psychology

Academic Appointments

  • Professor Emeritus-Hourly, Psychiatry and Behavioral Sciences

Administrative Appointments

  • Senior Fellow, Stanford Center for Innovation in Global Health (2015 - Present)
  • Director, Outreach, Recruitment and Education Core, Stanford Alzheimer's Disease Research Center (2015 - 2020)
  • Member, Departmental Community Engagement Advisory Committee, Dept. of Psychiatry & Behavioral Sciences (2013 - Present)
  • Member, Education Leadership & Integration Committee, Dept. of Psychiatry & Behavioral Sciences (2013 - Present)
  • Representative, Faculty Senate of the School of Medicine and Dept. of Psychiatry & Behavioral Sciences (2013 - 2015)
  • Director, Principal Investigator, Stanford Geriatric Education Center (2010 - 2015)
  • Affiliated Faculty, Global Health Initiative, Stanford University School of Medicine (2009 - Present)
  • Director, Stanford Geriatric Education Center (2008 - 2015)
  • CONA: Committee on Aging. Shapes APA policy as it relates to geriatric mental health, American Psychological Association (2008 - 2010)
  • Affiliated Faculty, Clayman Institute for Gender Research (2004 - Present)
  • Affiliated Faculty, Stanford Center on Longevity (2004 - Present)
  • Director, Education & Information Transfer Core, Alzheimer's Clinical Research Center of Stanford Univ/VA Palo Alto (2002 - 2007)
  • Director, Older Adult & Family Center, VA Palo Alto Health Care Center/Stanford Univ. (2000 - 2007)
  • Core Faculty in Psychology, Stanford Geriatric Education Center (1987 - 2006)

Honors & Awards

  • M Powell Lawton Award for Lifetime Distinguished Contributions to Applied Geropsychology, American Psychological Association, Division 20: Adult Development and Aging (2018)
  • T J McCallum Inaugural Gerodiversity Award, American Psychological Association, Division 12, Section II: Geropsychology (2018)
  • Honorary Professorship (3 year term), School of Psychology, University of Queensland, Australia (2017)
  • Honorary Professorship (5 year term), Norwich Medical School, University of East Anglia, Norwich, England (2017)
  • Diplomate in Geropsychology, American Board of Professional Psychology (2014)
  • Honorary Doctorate, The Hong Kong Institute of Education (2014)
  • M. Powell Lawton award for distinguished life-time contributions to the field of Psychology, The Annual Meeting of the American Psychological Association, San Francisco (2007)
  • Volunteer Appreciation, Self-Help for the Elderly, a service program for Chinese families (2003)
  • Volunteer Appreciation, Alzheimer's Association, Greater San Francisco Bay Area chapter (2000, 2002, 2004, 2017)
  • Outstanding Mentorship Award, American Psychological Assn, Div. 20 (Adult Development & Aging) (2000)
  • Founding Fellow, Academy of Cognitive Therapy (1999)
  • Diplomate in Clinical Psychology, American Board of Professional Psychology (1997)
  • Outstanding Teacher Award, Stanford Univ. School of Education (1992)
  • Distinguished Alumni Award, UCLA Neuro-psychiatric Institute (1985)

Boards, Advisory Committees, Professional Organizations

  • Associate Editor, Clinical Gerontologist (2018 - Present)
  • Co-Editor-in-Chief, Clinical Gerontologist: The journal of aging and mental health (2006 - Present)
  • Founding Fellow, Academy of Cognitive Therapy (1999 - 1999)
  • Editorial Board, Journal of Aging and Ethnicity (1994 - 1996)
  • Editorial Board, Journal of Clinical Geropsychology (1993 - 1995)
  • Editorial Board, Psychology and Aging (1988 - 1989)
  • Editorial Board, The Gerontologist (1987 - 1989)
  • Editorial Board, Journal of Gerontology (1984 - 1985)

Professional Education

  • PhD Training:University of Southern California Keck School of Medicine (1979) CA
  • Board certification, American Board of Professional Psychology, Clinical Psychology (1997)
  • Board Certification, American Board of Professional Psychology, Geropsychology (2014)
  • Ph.D., University of Southern California, Clinical Psychology (1979)
  • Certificate of completion, UCLA Neuropsychiatric Institute, pre-doctoral internship (1978)

Community and International Work

  • ACES: Active Caregiving Empowerment Skills, Stanford Neuroscience Center


    stress reduction training for dementia family caregivers

    Partnering Organization(s)

    Stanford Neuroscience Center Support Services Program

    Populations Served

    caregivers of persons with various forms of dementia


    Bay Area

    Ongoing Project


    Opportunities for Student Involvement


  • PRISM: Partnership in Implementation Science for Geriatric Mental Health, Thailand and Shanghai


    Program development, implementation, and evaluation in Thailand and Shanghai, China

    Partnering Organization(s)

    University College London & government entities in Thailand and Shanghai

    Populations Served

    Carers of persons with dementia in Thailand and Shanghai



    Ongoing Project


    Opportunities for Student Involvement


  • Caregiving in China: Group Workshops and Self-Care Mobile Apps to Improve Coping Skills and mental Health among Dementia Carers in China, mainland China


    Program development for dementia carers in Zhejiang province of China

    Partnering Organization(s)

    University College, London; Hong Kong Polytechnic Univ; others

    Populations Served

    Family carers of persons with dementia in China



    Ongoing Project


    Opportunities for Student Involvement


  • MIRELA: How a Latino Family Copes with Cognitive Loss, Bay Area current focus


    Uses "soap opera" segments in Spanish

    Partnering Organization(s)

    Photozig Inc & Alzheimer's Assn.

    Populations Served

    Spanish speaking persons who identify as Hispanic/ Latino



    Ongoing Project


    Opportunities for Student Involvement


  • iSupport for Dementia Family Caregivers


    Diversity & Dementia

    Partnering Organization(s)

    World Health Organization

    Populations Served

    Globally: family members of persons with significant cognitive confusion



    Ongoing Project


    Opportunities for Student Involvement


  • Interventions for Grandparents Caring for Problematic Grandchildren

    Partnering Organization(s)

    University of North Texas, Denton



    Ongoing Project


    Opportunities for Student Involvement


  • Caregiving Interventions for Latino Family Caregivers of Older Cognitively Impaired Persons

    Partnering Organization(s)

    Southern Caregiver Resource Center



    Ongoing Project


    Opportunities for Student Involvement


  • Caregiving for Persons with Dementia

    Partnering Organization(s)

    Australian Government in Queensland



    Ongoing Project


    Opportunities for Student Involvement


  • Cognitive Behavioral Therapy for Late Life Depression Among Stroke Patients

    Partnering Organization(s)

    University of Edinburgh, Scotland, UK

    Ongoing Project


    Opportunities for Student Involvement


  • Coping with Caregiving: A Group Program for Spanish Dementia Family Caregivers

    Partnering Organization(s)

    Departamento de Psicologia, Universidad Autonoma de Madrid, Spain

    Ongoing Project


    Opportunities for Student Involvement


  • In Home Intervention versus Telephone Support to Reduce Stress of Dementia Caregivers

    Partnering Organization(s)

    Hong Kong Polytechnic University



    Ongoing Project


    Opportunities for Student Involvement


  • Cognitive Behavioral Therapy for Late Life Depression, Shanghai, China

    Partnering Organization(s)

    Shanghai Medical College, Fudan University



    Ongoing Project


    Opportunities for Student Involvement


  • Caring for the Caregiver in Japan & China, Tokyo, Beijing


    Skill training for Japanese & Chinese family caregivers

    Partnering Organization(s)

    International Alzheimer's Assn.

    Populations Served

    Japanese & Chinese family members caring at home for frail elderly relatives



    Ongoing Project


    Opportunities for Student Involvement


  • Skill Training for Family Caregivers


    "Train the Trainers" to deliver psychoeducational skill building programs to family caregivers

    Partnering Organization(s)

    Caregiver Resource Centers of CA & San Francisco Bay Area chapter of the Alzheimer's Association

    Populations Served

    Staff and families caring for physically and/or cognitively impaired elder relatives



    Ongoing Project


    Opportunities for Student Involvement


Current Research and Scholarly Interests

Currently I am researching how non-traditional methods to deliver information and to provide services to distressed persons and families can be used effectively, AND, how these non-traditional methods vary by culture and other dimensions of diversity.

Specifically, I have 4 new projects that involve novel approaches:

1) PRISM: this project is an innovative collaboration among academic institutions (Harvard, Stanford, Univ. of South Carolina), government entities in Thailand and Shanghai, China, and health care providers in those countries. The goal is to develop culturally appropriate intervention programs for carers of persons with neurocognitive disorders in those countries. This 5 year project began Jan. 2018. It is expected that both in-person workshops and technology-driven approaches will be developed and researched.

2) In collaboration with researchers from University College, London, we are working in several provinces in mainland China to develop technology-delivered mental health interventions to carers of persons with neurocognitive disorders in those areas. We work with government groups to ensure safety and fidelity. This project will officially begin July 2018.

3) MIRELA is a recently completed project that developed and tested a webnovela, entirely in Spanish, that follows the trajectory of an elder Latina as she declines over time from Alzheimer's disease. It depicts (in novel soap opera format) what the challenges are and how this multi-generational family responds to them - compared to a comparison condition. The RCT clearly showed that MIRELA was superior to the control condition in reducing depression and improving coping skills in caregivers.

4) I am working with the World Health Organization to test an on-line web based open source platform to teach about dementia and family coping skills to caregivers. The pilot study is in progress in Bangalore, India and is expected to be completed later in 2018. An international team of content experts developed the web based material which is set up in modules for ease of access and learning. So far we have experienced enrollment challenges as the program is entirely web-based, including informed consent, completion of questionnaires, etc. The latter appear to pose problems for carers to overcome before they can access the program. This will be addressed in future iterations of this program.

Finally, I have substantially revised my "Coping with Caregiving" evidence-based program for dementia family caregivers to include an emphasis on positive psychology by incorporation gratitude, forgiveness, and hope in the intervention program. The new program is called ACES: Active Caregiving: Empowerment Skills This new workshop is offered free of charge through Aging Adult Services and the Neuroscience Supportive Care Program at Stanford University School of Medicine. .


  • iSupport web-based program for dementia family caregivers around the world, World Health Organization & Stanford Univ. School of Medicine faculty

    iSupport is a collaborative effort between Stanford faculty, the World Health Organization, and a panel of international dementia care experts who are working together to create an open-source platform of information, support, and skill training exercises to assist dementia caregivers around the world. Content development will be completed by end of 2015. In 2016 the platform will be developed and pilot tested in a randomized trial to be conducted in Bangalore, India, after cultural "tailoring" of content and language. If successful the program and platform will be made available free of charge to any country that is interested. They are free then to do their own cultural & linguistic "tailoring" as appropriate for their country.




    • Kala Mehta, D Sc, Collaborator , Univ. CA at San Francisco
  • MIRELA: A webnovela for Hispanic/ Latino dementia family caregivers, Photozig, Inc, Mountain View; Stanford Univ. School of Medicine faculty; Alzheimer's Assn - multiple chapters throughout California and Nevada and several community-based organizations that serve Latino elders and their families

    This is an 18-episode "soap opera" formatted webnovela, entirely in Spanish and filmed by skilled actors, that is being used to educate Latino families about cognitive decline. It shows how a real-life multi-generational Latino family learns that grandma has significant memory loss; it shows how they cope initially, and with changes over time, in her condition. It is both entertaining and informative. We are currently recruiting (through June 2016) for participants. It is entirely web-based so geographical proximity is not an issue. If there is no computer/ internet availability but a family is eligible, a DVD can be provided and all pre and post tests mailed. This project is funded by the National Institute on Aging. Student participation welcome!




    • Larry Thompson, PhD, Professor Emeritus, Stanford University School of Medicine
  • CLASP, Stanford Alzheimer's Disease Research Center

    Longitudinal study of how caregivers of older persons with dementia of some type adapt over time. Conducted collaboratively with the Stanford Alzheimer's Disease Research Center


    San Francisco Bay Area


    • Ann Choryan Bilbrey, School of Medicine
  • Our Family Journey, Stanford University

    4-part workshop series designed to teach adaptive coping skills to family caregivers of persons with dementia. Offered throughout the community in various locations. Spanish language version will soon be available.


    greater San Francisco Bay area


    • Nusha Askari, Ph.D., Senior Administrator, Alzheimer's Disease Research Center , Stanford University School of Medicine
    • Ann Choryan Bilbrey, School of Medicine

2018-19 Courses

All Publications

  • iSupport, an online training and support program for caregivers of people with dementia: study protocol for a randomized controlled trial in India TRIALS Mehta, K. M., Gallagher-Thompson, D., Varghese, M., Loganathan, S., Baruah, U., Seeher, K., Zandi, D., Dua, T., Pot, A. 2018; 19: 271


    Dementia has a huge physical, psychological, social and economic impact upon caregivers, families and societies at large. There has been a growing impetus to utilize Internet interventions given the potential scalability, and presumed cost-effectiveness and accessibility. In this paper, we describe the design of a randomized controlled trial (RCT) aiming to study the impact of online self-help programs on caregivers of people with dementia in India. The experimental group will receive an interactive training and support program and the comparison group will receive an education-only e-book. It will be among the first online support intervention RCTs for a mental health condition in a lower-middle income country.Two hundred and eight participants are expected to be recruited via several strategies (email, Internet and social media, telephone and face-to-face) starting in the Bangalore region of India. The inclusion criteria for participation in the trial are: (1) being 18 years or older, (2) being a self-reported caregiver of a person with dementia, (3) self-report that a family member has a diagnosis of dementia (AD8 ≥ 2), and experience caregiver distress (≥ 4 on a 1-item burden scale ranging from 1 to 10 or ≥ 4 or < 20 on the Center for Epidemiologic Study-Depression (CES-D) scale (10-item) or ≥ 4 or < 15 on the Generalized Anxiety Disorder Scale (7-item). The intervention group will be offered iSupport, an online self-help training and support program, enabling a personalized education plan with a maximum of 23 lessons. These modules present a range of topics from "what is dementia?" to "dealing with challenging behaviors like aggression." The comparison group will receive an education-only e-book containing similar content. The outcomes of this trial are: caregiver burden as measured by the 22-item Zarit Burden Scale, depressive symptoms, anxiety symptoms (primary outcomes), quality of life, person-centered attitude, self-efficacy and mastery (secondary outcomes).Based on the findings of this trial, we will examine the potential use and scale up of iSupport for caregiver distress in India. This style of online self-help programs could be expanded to other regions or countries or to other suitable caregiver groups.Clinical Trials Registry-India (CTRI), ID: CTRI/2017/02/007876 .

    View details for DOI 10.1186/s13063-018-2604-9

    View details for Web of Science ID 000431914800001

    View details for PubMedID 29739423

    View details for PubMedCentralID PMC5941472

  • The Impact of Latino Values and Cultural Beliefs on Brain Donation: Results of a Pilot Study to Develop Culturally Appropriate Materials and Methods to Increase Rates of Brain Donation in this Under-Studied Patient Group CLINICAL GERONTOLOGIST Bilbrey, A., Humber, M. B., Plowey, E. D., Garcia, I., Chennapragada, L., Desai, K., Rosen, A., Askari, N., Gallagher-Thompson, D. 2018; 41 (3): 237–48


    Increasing the number of Latino persons with dementia who consent to brain donation (BD) upon death is an important public health goal that has not yet been realized. This study identified the need for culturally sensitive materials to answer questions and support the decision-making process for the family.Information about existing rates of BD was obtained from the Alzheimer's Disease Centers. Several methods of data collection (query NACC database, contacting Centers, focus groups, online survey, assessing current protocol and materials) were used to give the needed background to create culturally appropriate BD materials.A decision was made that a brochure for undecided enrollees would be beneficial to discuss BD with family members. For those needing further details, a step-by-step handout would provide additional information.Through team collaboration and engagement of others in the community who work with Latinos with dementia, we believe this process allowed us to successfully create culturally appropriate informational materials that address a sensitive topic for Hispanic/Latino families.Brain tissue is needed to further knowledge about underlying biological mechanism of neurodegenerative diseases, however it is a sensitive topic. Materials assist with family discussion and facilitate the family's follow-through with BD.

    View details for DOI 10.1080/07317115.2017.1373178

    View details for Web of Science ID 000430043400007

    View details for PubMedID 29227743

    View details for PubMedCentralID PMC5962259

  • Dementia Awareness Campaign in the Latino Community: A Novel Community Engagement Pilot Training Program with Promotoras CLINICAL GERONTOLOGIST Askari, N., Bilbrey, A., Ruiz, I., Humber, M., Gallagher-Thompson, D. 2018; 41 (3): 200–208


    To create a curriculum about Alzheimer's disease and dementia, and to train Promotoras affiliated with a local community education and health advocacy organization, in order to raise awareness and knowledge of what dementia is, and how it can be recognized, in persons of Hispanic/Latino descent.Community based participatory research (CPBR) model was used to create materials, implement training, and engage/empower Promotoras to educate the local community.Pre-post findings indicated a positive learning experience for the Promotoras and willingness to share new dementia information with their community. One year post-evaluative survey with a subset showed outreach to an average of 15-25 community members, indicating positive reception of this new information.CPBR model is a successful education and outreach tool with Latino communities. Our Dementia Awareness Campaign was a success with the first 20 Promotoras trained; at present we plan to train additional groups in nearby communities with significant Hispanic/Latino populations.In order to get Latinos to seek early detection, we need to first educate them about dementia, win trust, and encourage treatment-seeking. Early intervention, diagnosis, and prevention will benefit from educational campaigns using the CBPR model.

    View details for DOI 10.1080/07317115.2017.1398799

    View details for Web of Science ID 000430043400003

    View details for PubMedID 29240536

    View details for PubMedCentralID PMC5935246

  • Perspectives and Insights from Vietnamese American Mental Health Professionals on How to Culturally Tailor a Vietnamese Dementia Caregiving Program CLINICAL GERONTOLOGIST Park, V., Nguyen, K., Tran, Y., Yeo, G., Tiet, Q., Suen, J., Gallagher-Thompson, D. 2018; 41 (3): 184–99


    Little is known about dementia and caregiving among the rapidly growing Vietnamese American population. This qualitative study elicited insights on culturally tailoring an intervention to address mental health needs in Vietnamese American dementia caregivers from Vietnamese American mental health professionals.Eight Vietnamese American mental health professionals were interviewed to explore: experiences working with and needs of the community; Vietnamese attitudes toward treatment; and acculturation in Vietnamese caregiving. Participants provided recommendations on tailoring a program for Vietnamese dementia caregivers. Content analysis of their responses was conducted.Themes included: a) caregivers' unique needs and experiences; b) different waves of immigration and acculturation levels affect views on mental health, treatment, and caregiving; c); traditions and beliefs on caregiving; d) mental health, help-seeking and health services; e) how to culturally tailor a program for Vietnamese dementia caregivers; and f) cultural acceptance of the program.An intervention to reduce stress and depression among Vietnamese American dementia caregivers should recognize the special risks of the experiences of war and immigration of the caregivers as well as the pressure of the expectations of the Vietnamese culture on family care. For the program to be acceptable and effective, it needs to consider all aspects of caregivers' health, and incorporate Vietnamese cultural values/beliefs.A successful Vietnamese dementia caregiver intervention should include traditional Vietnamese values/beliefs, holistic experiences, spirituality, and background/immigration experiences. Evidence-based programs may be used with this population if they are culturally tailored.

    View details for DOI 10.1080/07317115.2018.1432734

    View details for Web of Science ID 000430043400002

    View details for PubMedID 29419364

  • The Importance of Attention to Cultural Factors in the Approach to Dementia Care Services for Older Persons CLINICAL GERONTOLOGIST Pachana, N. A., Gallagher-Thompson, D. 2018; 41 (3): 181–83
  • Geriatric psychiatry: Cognitive behavioral therapy with older adults. In B. J. Sadock & V. A. Sadock (Eds.) Comprehensive textbook of psychiatry Thompson, L.W., McGee, J.S., & Gallagher-Thompson, D.
  • Entries on CBT and Aging, and CBT and Caregiving, for A. Freeman (Ed.) International encyclopedia of cognitive behavior therapy Gallagher-Thompson, D., Coon, D.W.
  • Randomized Controlled Trial of Inner Resources Meditation for Family Dementia Caregivers. Journal of clinical psychology Waelde, L. C., Meyer, H., Thompson, J. M., Thompson, L., Gallagher-Thompson, D. 2017


    This randomized controlled trial examined the comparative effectiveness of 2 interventions for improving diurnal cortisol slope and life satisfaction and reducing stress symptoms among older female dementia family caregivers.Thirty-one family dementia caregivers were randomized to 8 weeks of Inner Resources for Stress mindfulness meditation and mantra training (IR) or psychoeducation and telephone support (PTS).Intention-to-treat analyses revealed statistically significant pre-post improvements in diurnal cortisol slope and overall life satisfaction, but not depression or self-efficacy, in the IR relative to the PTS group. Adherence to between-session meditation practice was significantly associated with decreases in depression and self-reported improvements in ability to cope with stress. In addition, IR participants rated the overall benefits of the program more highly than the PTS group.These results indicate that mindfulness meditation and mantra has promise as a feasible and effective caregiver intervention for quality of life and physiological responding to stress.

    View details for DOI 10.1002/jclp.22470

    View details for PubMedID 28263398

  • The impact of executive function on response to cognitive behavioral therapy in late-life depression INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Goodkind, M. S., Gallagher-Thompson, D., Thompson, L. W., Kesler, S. R., Anker, L., Flournoy, J., Berman, M. P., Holland, J. M., O'Hara, R. M. 2016; 31 (4): 334-339

    View details for DOI 10.1002/gps.4325

    View details for Web of Science ID 000372192200002

  • Treatment Preferences of Older Adults with Substance Use Problems CLINICAL GERONTOLOGIST Holland, J. M., Rozalski, V., Beckman, L., Rakhkovskaya, L. M., Klingspon, K. L., Donohue, B., Williams, C., Thompson, L. W., Gallagher-Thompson, D. 2016; 39 (1): 15-24
  • California Older Persons Pleasant Events Scale: a Tool to Help Older Adults Increase Positive Experiences CLINICAL GERONTOLOGIST Rider, K. L., Thompson, L. W., Gallagher-Thompson, D. 2016; 39 (1): 64-83
  • Using an Emic Lens to Understand How Latino Families Cope With Dementia Behavioral Problems AMERICAN JOURNAL OF ALZHEIMERS DISEASE AND OTHER DEMENTIAS Turner, R. M., Hinton, L., Gallagher-Thompson, D., Tzuang, M., Tran, C., Valle, R. 2015; 30 (5): 454-462


    Focus group data collected for a larger project to develop a fotonovela for Latino caregivers was used to conduct a meaning-centered thematic analysis in order to elicit Latino family caregiver perspectives on how behavior problems occurring in the context of dementia are perceived and managed. A sample of 42 Spanish-speaking Latino caregivers were recruited from organizations affiliated with the Alzheimer's Association near San Diego, California. Caregivers were queried on challenging behaviors, coping strategies, as well as other daily challenges. Focus group sessions were conducted in Spanish, translated and transcribed into English, and analyzed using qualitative, grounded anthropological methods. In addition to a range of behavior problems, five indigenous approaches to managing challenging behaviors were identified: acceptance, love, patience, adaptability, and establishing routines of care. Additionally, participants identified persistent challenges which deter effective coping. These include: issues with providers, problems with family members, limited knowledge of resources, emotional distress, and financial strain. To our knowledge, this is one of the few qualitative studies to report indigenous coping strategies for dementia behavioral problems. These findings have the potential to inform culturally-tailored intervention.

    View details for DOI 10.1177/1533317514566115

    View details for Web of Science ID 000358412700004

  • Effectiveness of a Fotonovela for Reducing Depression and Stress in Latino Dementia Family Caregivers ALZHEIMER DISEASE & ASSOCIATED DISORDERS Gallagher-Thompson, D., Tzuang, M., Hinton, L., Alvarez, P., Rengifo, J., Valverde, I., Chen, N., Emrani, T., Thompson, L. W. 2015; 29 (2): 146-153


    The clinical need to address stress and depression in Latino dementia caregivers (CGs) combined with low health literacy and less accurate knowledge of dementia motivated the development of a pictorial tool [called a fotonovela (FN)] to teach (a) coping skills for caregiver (CG) stress; (b) self-assessment of depression; and (c) encourage improved utilization of available resources. To test the effectiveness of the FN, 110 of 147 Latino CGs, who were randomly assigned to the Fotonovela Condition (FNC) or the Usual Information Condition (UIC), were included in the final analyses. Self-report measures were given at baseline and post intervention. Results showed that FNC CGs demonstrated significantly greater reductions in level of depressive symptoms than UIC CGs. A significant decrease in level of stress due to memory and behavioral problems exhibited by their loved ones was similar in both groups. The FNC CGs reported that the FN was more helpful and that they referred to it more often than the UIC CGs did with regard to the informational materials they were provided about dementia. In conclusion, a culturally tailored FN can be an effective tool for Latino CGs given their high unmet needs for assistance and various barriers in accessing resources.

    View details for Web of Science ID 000354889200007

    View details for PubMedID 25590939

  • Does cognitive-behavioural therapy promote meaning making? A preliminary test in the context of geriatric depression. Psychology and psychotherapy Holland, J. M., Chong, G., Currier, J. M., O'Hara, R., Gallagher-Thompson, D. 2015; 88 (1): 120-124


    This study examined the extent to which cognitive-behavioural therapy (CBT) for geriatric depression promoted meaning made of stress.Fifty-one participants received CBT and were assessed at pre- and post-treatment.The primary outcome was the Integration of Stressful Life Experiences Scale (ISLES) and demographic factors were examined as moderators of changes over time.Those with more education showed improvement in their ability to regain positive values, worldviews, and purpose in life after a stressor.It appears that CBT promotes some forms of meaning made of stress for those with higher education.Cognitive-behavioural therapy as it is routinely practiced may help highly educated older adults regain their Footing in the World (e.g., maintain positive values, worldviews, and purpose in life) in the aftermath of a stressful life event. Cognitive-behavioural therapy appears to offer fewer gains for less educated older adults (in terms of Footing in the World) as well as for other aspects of meaning-making, such as the ability to 'make sense' of a significant stressor. Although more empirical work is necessary, meaning-oriented interventions (e.g., 're-authoring' a fragmented self-narrative; Neimeyer, 2009, p. 97) hold promise as useful adjuncts to routine therapy that could augment outcomes.

    View details for DOI 10.1111/papt.12030

    View details for PubMedID 24839175

  • fMRI Activation During Executive Function Predicts Response to Cognitive Behavioral Therapy in Older, Depressed Adults AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY Thompson, D. G., Kesler, S. R., Sudheimer, K., Mehta, K. M., Thompson, L. W., Marquett, R. M., Holland, J. M., Reiser, R., Rasgon, N., Schatzberg, A., O'Hara, R. M. 2015; 23 (1): 13-22


    To test our hypothesis that pre-treatment executive function and brain regional activation during executive function would discriminate between responders and non-responders to cognitive behavioral therapy (CBT) in elderly depressed outpatients.Clinical cohort study.University-affiliated hospital.Sixty outpatients (age 59 years and older) completed 12 weeks of CBT between July 2010 and December 2011. Forty-four completed fMRI procedures.The main outcome consisted of a conversion from a clinical diagnosis (Mini-International Neuropsychiatric Interview) of depression to no clinical diagnosis of depression or a significant improvement in diagnostic criteria. Brain activation measured by functional magnetic resonance imaging during the Wisconsin Card Sorting task (WCST) was the primary predictor variable.67% of patients had a positive response to CBT. Decreased activation in the left inferior frontal triangle and right superior frontal gyrus as well as increased activity in the right middle frontal gyrus and left superior frontal gyrus predicted a positive response to CBT. Demographic and neurocognitive measures of WCST performance were not significant predictors of a positive CBT outcome, whereas the measure of WCST-induced activity in the prefrontal cortex was a significant predictor.These data are among the first to suggest that measures of prefrontal brain activation during executive functioning predict response to CBT in older adults. Further exploration of the specific underlying processes that these prefrontal cortical regions are engaging that contributes to better CBT outcomes is warranted in larger, randomized studies.

    View details for DOI 10.1016/j.jagp.2014.02.001

    View details for Web of Science ID 000346204400003

    View details for PubMedID 24656506

  • Behavioral activation for dementia caregivers: scheduling pleasant events and enhancing communications CLINICAL INTERVENTIONS IN AGING Au, A., Gallagher-Thompson, D., Wong, M., Leung, J., Chan, W., Chan, C. C., Lu, H., Lai, M. K., Chan, K. 2015; 10: 611-619


    Dementia caregiving is often associated with increase in depressive symptoms and strained relationships. This study tested whether telephone-delivered psychoeducation combined with an enhanced behavioral activation (BA) module had a better effect on the well-being of Alzheimer's caregivers than psychoeducation alone. The focus is on enhancing the competent use of coping skills via BA. The program is delivered by telephone to increase accessibility and sustainability for caregivers. Senior citizens are trained as paraprofessionals to deliver the BA module to increase the potential for sustainability of the program.The study compared two telephone interventions using a 4-month longitudinal randomized controlled trial. For the first 4 weeks, all participants received the same psychoeducation program via telephone. Then for the following 4 months, eight biweekly telephone follow-up calls were carried out. For these eight follow-up calls, participants were randomized into either one of the two following groups with different conditions. For the psychoeducation with BA (PsyED-BA) group, participants received eight biweekly sessions of BA practice focused on pleasant event scheduling and improving communications. For the psychoeducation only (PsyED only) group, participants received eight biweekly sessions of general discussion of psychoeducation and related information. A total of 62 family caregivers of persons living with dementia were recruited and 59 (29 in the PsyED-BA group and 30 in the PsyED only group) completed the whole study.As compared to the group with psychoeducation and discussion, the group with enhanced BA had decreased levels of depressive symptoms. The study had a low attrition rate.Results suggested that competence-based training could be effectively administered through the telephone with the help of senior citizens trained and engaged as paraprofessionals. Results contribute to the present literature by offering some framework for developing effective, accessible, sustainable, and less costly interventions.

    View details for DOI 10.2147/CIA.S72348

    View details for Web of Science ID 000351759100001

    View details for PubMedID 25848237

    View details for PubMedCentralID PMC4381894

  • Using an emic lens to understand how Latino families cope with dementia behavioral problems: A focus group study Alzheimer's Disease & Other Dementias Hinton , L. ., Gallagher-Thompson , D., Tzuang , M., Valle , R. 2015
  • Psychosocial predictors of salivary cortisol among older adults with depression INTERNATIONAL PSYCHOGERIATRICS Holland, J. M., Rengifo, J., Currier, J. M., O'Hara, R., Sudheimer, K., Gallagher-Thompson, D. 2014; 26 (9): 1531-1539
  • A Pilot of an Intervention Delivered to Chinese- and Spanish-Speaking Carers of People With Dementia in Australia AMERICAN JOURNAL OF ALZHEIMERS DISEASE AND OTHER DEMENTIAS Leone, D., Carragher, N., Santalucia, Y., Draper, B., Thompson, L. W., Shanley, C., Mollina, A., Chen, L., Kyriazopoulos, H., Thompson, D. G. 2014; 29 (1): 32-37


    There are limited language- and culture-specific support programs for carers of people with dementia living in Australia. A group intervention for use with Chinese and Spanish speakers in the United States was adapted to the Australian context, and a pilot study was undertaken with these 2 communities. The intervention is based on a cognitive behavioral therapy approach and was delivered by bilingual health professionals. The adapted material comprised 7 sessions, spanning 2 hours in duration. All 22 participants completed the Depression Anxiety and Stress Scale-Short form (DASS-21) pre- and postintervention. A significant decrease in depression, anxiety, and stress was observed among Spanish speakers; a significant decrease in depression and anxiety was present among the Chinese speakers. The implications are considered in the context of Australia's changing aged care service system.

    View details for Web of Science ID 000331463000005

    View details for PubMedID 24085251

  • The unique impact of late-life bereavement and prolonged grief on diurnal cortisol. journals of gerontology. Series B, Psychological sciences and social sciences Holland, J. M., Rozalski, V., Thompson, K. L., Tiongson, R. J., Schatzberg, A. F., O'Hara, R., Gallagher-Thompson, D. 2014; 69 (1): 4-11


    This study expands on previous research by examining the effects of prolonged grief disorder (PGD) symptoms and bereavement on diurnal cortisol patterns above and beyond depressive symptomatology.Drawing on information from 56 depressed older adults, 3 groups were compared: (1) a depressed nonbereaved group, (2) a depressed bereaved without elevated PGD symptoms group, and (3) a depressed bereaved with elevated PGD symptoms group. Multilevel modeling was used to examine differences in diurnal cortisol profiles between these 3 groups, controlling for demographic factors and depressive symptoms.Results revealed that those who were bereaved had more dysregulated cortisol patterns, but PGD symptomatology seemed to have little effect. Subsidiary analysis with just the bereaved participants suggests that those who were recently widowed may have had greater cortisol dysregulation compared with other bereaved individuals in the sample.These findings suggest that the circumstance of being bereaved may be associated with more dysregulated cortisol, regardless of PGD symptomatology. This pattern of results might reflect greater disturbance in daily routines among bereaved individuals and acute stress in the case of those experiencing the recent loss of a spouse, which leads to disruption in circadian rhythms and the diurnal cycle of cortisol.

    View details for DOI 10.1093/geronb/gbt051

    View details for PubMedID 23740094

    View details for PubMedCentralID PMC3894130

  • Latino Older Adults and Mental Health: A Review and Commentary CLINICAL GERONTOLOGIST Alvarez, P., Rengifo, J., Emrani, T., Gallagher-Thompson, D. 2014; 37 (1): 33-48
  • Psychosocial predictors of salivary cortisol among older adults with depression International Psychogeriatrics Holland, J. M., Rengifo, J., Currier, J. M., O'Hara, R., Sudheimer, K., Gallagher-Thompson, D. 2014; 26 (9): 1531-1539

    View details for DOI 10.1017/S104160214000489

  • Pretreatment cortisol levels predict posttreatment outcomes among older adults with depression in cognitive behavioral therapy. Psychiatry research Holland, J. M., Schatzberg, A. F., O'Hara, R., Marquett, R. M., Gallagher-Thompson, D. 2013; 210 (2): 444-450


    Previous studies suggest that individuals with elevated levels of cortisol (the "stress hormone") could be particularly resistant to treatment for depression. However, most of these studies have been conducted in the context of antidepressant medications, and no study has examined pretreatment cortisol levels as a predictor of treatment outcomes among older adults with depression in cognitive-behavioral therapy (CBT), despite the relevance of this population for such a research question. The current study includes 54 older adults with depression who provided salivary cortisol samples at baseline and completed measures of depression at pretreatment and posttreatment, following a 12-week course of CBT. Structural equation modeling results suggest that those with higher daily outputs of cortisol and flatter diurnal slopes were less likely to benefit from CBT-a finding which if replicated could have important implications for clinical practice and future research.

    View details for DOI 10.1016/j.psychres.2013.07.033

    View details for PubMedID 23953171

    View details for PubMedCentralID PMC3818434

  • Psychosocial predictors of treatment response to cognitive-behavior therapy for late-life depression: an exploratory study AGING & MENTAL HEALTH Marquett, R. M., Thompson, L. W., Reiser, R. P., Holland, J. M., O'Hara, R. M., Kesler, S. R., Stepanenko, A., Bilbrey, A., Rengifo, J., Majoros, A., Thompson, D. G. 2013; 17 (7): 830-838


    Objective: The primary objective of this study was to examine a variety of potential predictors of response to Cognitive Behavioral Therapy (CBT) in depressed older adults. Method: Sixty older adults with a clinical diagnosis of major or minor depression or dysthymic disorder received 12 individual sessions of CBT over a three- to four-month-period. The BDI-II was administered pre- and post-intervention to assess change in the level of depression. A cutoff score of 13 or less at post was used to determine positive treatment response. A variety of measures (obtained at baseline) were evaluated using hierarchical regression techniques to predict improvement following treatment. Results: Individuals who showed greater improvement were: (a) more open to new experiences; (b) less negatively affected by past stressors; (c) less inclined to have an external locus of control but more likely to cite others as responsible for negative stress in their lives; and (d) were more likely to seek emotional support when symptomatic. Lower education level and reported use of active coping strategies at baseline were associated with less improvement. Other variables (e.g., age, overall physical health, and cognitive status) were not associated with treatment response. Use of logistic regression to predict responders vs. nonresponders yielded a similar pattern. Conclusion: These findings agree with prior research confirming the effectiveness of a brief CBT intervention for older depressed persons and suggest further exploration of several psychosocial factors that may contribute to a stronger response to CBT.

    View details for DOI 10.1080/13607863.2013.791661

    View details for Web of Science ID 000323476600008

    View details for PubMedID 23631698

  • Exploring the effectiveness of an Internet-based program for reducing caregiver distress using the iCare Stress Management e-Training Program AGING & MENTAL HEALTH Kajiyama, B., Thompson, L. W., Eto-Iwase, T., Yamashita, M., Di Mario, J., Tzuang, Y. M., Gallagher-Thompson, D. 2013; 17 (5): 544-554


    Determine if the online iCare Stress Management e-Training Program reduces stress, bother, depression, and poor life quality for dementia family caregivers (CGs).CGs (N = 150) were randomly assigned to the iCare Condition (ICC) or to the Education/Information-Only Condition (EOC) for a 3-month period. Change in self-report measures of stress (PSS) (primary outcome), caregiver bother(RMBPC), depression (CES-D), and quality of life (PQOL) (secondary outcomes) was determined, along with usage of new information in one's own caregiving.A mixed ANOVA revealed that change in perceived stress was significant for the ICC but not the EOC (p = .017). Changes in the other measures were not significant. More caregivers in the ICC used the materials in their own caregiving situation than those in the EOC. Roughly one-third of the caregivers enrolled in the study dropped prior to completion.Results are promising, but the high dropout is a concern. Future efforts to improve dropout rate and increase participant engagement are warranted. To our knowledge, this is the first attempt to present an evidence-based intervention for CGs via the Internet.

    View details for DOI 10.1080/13607863.2013.775641

    View details for Web of Science ID 000320913300004

    View details for PubMedID 23461355

  • Difficulties Accepting the Loss of a Spouse: A Precursor for Intensified Grieving Among Widowed Older Adults DEATH STUDIES Holland, J. M., Futterman, A., Thompson, L. W., Moran, C., Gallagher-Thompson, D. 2013; 37 (2): 126-144
  • Latino older adults and mental health: A review and commentary Clinical Gerontologist Alvarez, P., Rengifo, J., Emrani, T., Gallagher-Thompson, D. 2013; 37 (1)
  • A pilot of an intervention delivered to Chinese- and Spanish-speaking carers of people with dementia in Australia Journal of Alzheimer’s Disease & Other Dementias Leone, D., Carragher, N., Santaluciz, Y., Draper, B., Thompson, L. W., Shanley, C., Mollina, A., Chen, L., Kyriazopoulos, H., Gallagher Thompson, D. 2013

    View details for DOI 10.1177/1533317513505130

  • Common, specific and treatment fit variables in psychotherapy outcome Journal of Psychotherapy Integration Beutler, L. E., Forrester, B., Gallagher-Thompson, D., Thompson, L. W., Tomlins, J. B. 2012; 22 (3): 255-281

    View details for DOI 10.1037/a0029695

  • International Perspectives on Nonpharmacological Best Practices for Dementia Family Caregivers: A Review CLINICAL GERONTOLOGIST Gallagher-Thompson, D., Tzuang, Y. M., Au, A., Brodaty, H., Charlesworth, G., Gupta, R., Lee, S. E., Losada, A., Shyu, Y. 2012; 35 (4): 316-355
  • Cortisol Outcomes among Caucasian and Latina/Hispanic Women Caring for a Family Member with Dementia: A Preliminary Examination of Psychosocial Predictors and Effects of a Psychoeducational Intervention STRESS AND HEALTH Holland, J. M., Thompson, L. W., Cucciare, M. A., Tsuda, A., Okamura, H., Spiegel, D., Rasgon, N. L., Gallagher-Thompson, D. 2011; 27 (4): 334-346

    View details for DOI 10.1002/smi.1375

    View details for Web of Science ID 000295876000007

  • Understanding Caregiver Health Behaviors: Depressive Symptoms Mediate Caregiver Self-Efficacy and Health Behavior Patterns AMERICAN JOURNAL OF ALZHEIMERS DISEASE AND OTHER DEMENTIAS Rabinowitz, Y. G., Saenz, E. C., Thompson, L. W., Gallagher-Thompson, D. 2011; 26 (4): 310-316


    Previous research on female caregivers of elderly relatives with dementia has demonstrated that caregiving self-efficacy (SE) is associated with reduced cumulative health risk. The overarching aim of the current study was to expand on that research by exploring whether depressive symptoms mediate the relationship between 3 domains of caregiving SE and cumulative health risk associated with health behavior patterns. Data from 256 female family caregivers of patients with dementia are presented. Path analysis revealed a significant mediated effect for depressive symptoms as both SE for obtaining respite and SE for controlling upsetting Thoughts had a significant, indirect effect on cumulative health risk. There were no direct effects between caregiver SE and cumulative health risk. The current study sheds light on the complex pathway between caregiver SE and health and speaks to the importance of skills-based interventions designed to enhance efficacy beliefs and minimize depression in dementia caregivers.

    View details for DOI 10.1177/1533317511410557

    View details for Web of Science ID 000292570400006

    View details for PubMedID 21636582

  • Successful Interventions for Family Caregivers Principles and Practice of Geriatric Psychiatry Zeiss, L. M., Kwon, Y., Marquett, R., Gallagher-Thompson, D. John Wiley & Sons Limited. 2011; 3
  • Is Religious Coping Associated with Cumulative Health Risk? An Examination of Religious Coping Styles and Health Behavior Patterns in Alzheimer's Dementia Caregivers JOURNAL OF RELIGION & HEALTH Rabinowitz, Y. G., Hartlaub, M. G., Saenz, E. C., Thompson, L. W., Gallagher-Thompson, D. 2010; 49 (4): 498-512


    The current study explored the relationship between religious coping and cumulative health risk associated with health behavior patterns in a sample of 256 Latina and Caucasian female caregivers of elderly relatives with dementia. Primary analyses examined the relationship between religious coping (both positive and negative) and an overall index of cumulative health risk. Secondary analyses were conducted on the individual health behaviors subsumed in the broader index. Findings revealed that negative religious coping was significantly associated with increased cumulative health risk. Positive religious coping was predictive of decreased cumulative health risk among Latina caregivers but not among Caucasians. Negative religious coping was significantly associated with both an increased likelihood for weight gain and increased dietary restriction. Positive religious coping was associated with decreased likelihood for weight gain in Latinas. Implications for both caregivers and clinicians are discussed.

    View details for DOI 10.1007/s10943-009-9300-8

    View details for Web of Science ID 000284654500007

    View details for PubMedID 19904608

  • The impact of education on care practices: an exploratory study of the influence of "action plans" on the behavior of health professionals INTERNATIONAL PSYCHOGERIATRICS Rodriguez, E., Marquett, R., Hinton, L., McBride, M., Gallagher-Thompson, D. 2010; 22 (6): 897-908


    There has been limited focus on evaluation of continuing education (CEU) and continuing medical education (CME) in the fields of gerontology and geriatrics. The increasing elderly population combined with the limited clinical workforce highlights the need for more effective methods of continuing education. Traditionally, outcomes of CEU and CME programs relied on self-report measures of satisfaction with the scope and quality of the training, but more recent efforts in this area have focused on outcomes indicating level of improved skills and attitudinal changes of medical and allied health professionals towards working with elderly patients in need of assistance.This study focused on the use of "Action Plans" as a tool to stimulate changes in clinical programs following training, along with attempting to determine typical barriers to change and how to deal with them. More than 600 action plans were obtained from participants attending various continuing education classes providing training on care of patients with dementia (PWD) and their families. Both qualitative and quantitative methods, including logistic regression models were used to analyze the data.Three months following training 366 participants reported whether they were successful in implementing their action plans and identified factors that either facilitated or hindered their goal to make changes outlined in their action plans. Despite the low response rate of program participants, the "action plan" (with follow up to determine degree of completion) appeared to stimulate effective behavioral changes in clinicians working with dementia patients and their family members. Seventy three percent of the respondents reported at least some level of success in implementing specific changes. Specific details about barriers to change and how to overcome them are discussed.Our results support that developing and writing action plans can be a useful tool to self- monitor behavioral change among trainees over time.

    View details for DOI 10.1017/S1041610210001031

    View details for Web of Science ID 000282078000006

    View details for PubMedID 20594385

  • Factorial Validity of the Texas Revised Inventory of Grief-Present Scale Among Bereaved Older Adults PSYCHOLOGICAL ASSESSMENT Futterman, A., Holland, J. M., Brown, P. J., Thompson, L. W., Gallagher-Thompson, D. 2010; 22 (3): 675-687


    The Texas Revised Inventory of Grief-Present scale (TRIG-Present) is one of the most widely used grief measures; however, researchers have only empirically examined the validity and underlying factor structure of TRIG-Present scores in a few studies. Hence, in the present investigation, we sought to examine the factorial validity of the TRIG-Present (those scores that index current grief) among 2 samples of bereaved older adults--a community-dwelling sample of 162 individuals who experienced a diverse set of losses in terms of relationship to the deceased and time since loss, and a recently widowed sample of 212 individuals who were assessed at 2-months and 12-months postloss. Across both samples, we found support for a 3-factor model, composed of clusters of items representing Emotional Response, Thoughts, and Nonacceptance regarding a loss. Additionally, this 3-factor model exhibited significant invariance from 2-months to 12-months postloss in the recently widowed sample. Analyses examining the convergent validity of these 3 factors also suggest that this conceptualization of the TRIG-Present could have practical advantages and potentially influence the way in which clinicians and/or researchers assess grief and evaluate bereavement interventions.

    View details for DOI 10.1037/a0019914

    View details for Web of Science ID 000281588600020

    View details for PubMedID 20822280

  • Recruitment and retention of ethnic minority elders into clinical research. Alzheimer disease & associated disorders Rabinowitz, Y. G., Gallagher-Thompson, D. 2010; 24: S35-41


    Despite an increasing awareness of the problem, clinical research continues to include lesser numbers of ethnic minority participants disproportionate to their population percentages. To rectify this problem, this article attempts to identify key barriers to minority recruitment and retention as well as specific strategies and methods successful in the past. We propose specific recommendations to address these barriers, and formulate a 3-prong approach to increasing minority recruitment and retention, with emphasis on elderly participants. The article discusses such concerns as building trust in the target community, using appropriate methods of outreach, and providing culturally sensitive written materials at appropriate health literacy levels. Through an awareness of and attention to cultural differences and sensitivities, researchers can and must address the chronic underrepresentation of ethnic minorities in clinical research.

    View details for PubMedID 22720320

  • The Coping with Caregiving Group Program for Chinese caregivers of patients with Alzheimer's disease in Hong Kong PATIENT EDUCATION AND COUNSELING Au, A., Li, S., Lee, K., Leung, P., Pan, P., Thompson, L., Gallagher-Thompson, D. 2010; 78 (2): 256-260


    This pilot study evaluated the effectiveness of Coping with Caregiving (CWC) psychoeducational program for Chinese family caregivers of patients with Alzheimer's disease in Hong Kong.Twenty-seven female primary caregivers were randomized to join the treatment group or wait-list control group. The caregivers in the treatment group participated in 13 weekly training sessions which taught specific cognitive-behavioral strategies to handle caregiving stress.As compared to the wait-list control group, caregivers completing the CWC program demonstrated a significant increase in their self-efficacy for controlling their upsetting thoughts and handling disruptive behaviors of the care recipients. They also reported a significant increase in the use of both problem-focused and emotion-focused coping strategies.These findings suggested that cognitive-behavioral programs can be effective in improving the resourcefulness of Chinese caregivers of persons with dementia in Hong Kong.Future CWC programs will have to enhance participants' ability to differentiate among various coping skills and to use situation-appropriate strategies.

    View details for DOI 10.1016/j.pec.2009.06.005

    View details for Web of Science ID 000275010300020

    View details for PubMedID 19619974

  • Effectiveness of a psychoeducational skill training DVD program to reduce stress in Chinese American dementia caregivers: Results of a preliminary study AGING & MENTAL HEALTH Gallagher-Thompson, D., Wang, P., Liu, W., Cheung, V., Peng, R., China, D., Thompson, L. W. 2010; 14 (3): 263-273


    Prior research (Gallagher-Thompson, D., Gray, H., Tang, P., Pu, C.-Y., Tse, C., Hsu, S., et al. (2007). Impact of in-home intervention versus telephone support in reducing depression and stress of Chinese caregivers: Results of a pilot study. American Journal of Geriatric Psychiatry, 15, 425-434.) found that an in-home behavioral management program, derived conceptually from cognitive behavioral theories (CBT), was effective in reducing caregiver related stress and depressive symptoms in Chinese American dementia caregivers (CGs). Results were promising, but a more cost-effective intervention is needed to serve this growing population. Past work also found that a psychoeducational videotaped training program based on CBT was effective in reducing stress due to caregiving in Caucasian and African American dementia family CGs (Steffen, 2000, Anger management for dementia caregivers: A preliminary study using video and telephone interventions. Behavior Therapy, 31, 281-299.). To date no research has been conducted using a technological medium to deliver a similar kind of intervention to Chinese American caregivers. The present study evaluated the effectiveness of a similar but culturally "tailored" program in which 70 CGs were randomly assigned to a 12-week CBT skill training program delivered on a DVD, or to a general educational DVD program on dementia. Both were available in Mandarin Chinese or English as preferred. Pre post change analyses indicated that CGs did not differ on change in level of negative depressive symptoms, but positive affect was higher, and patient behaviors were appraised as less stressful and bothersome, for CGs in the CBT skill training program. They were also more satisfied with the program overall and reported that they believed they were able to give care more effectively. Results encourage further development of theoretically based interventions, delivered using modern technology, for this ever increasing group of CGs.

    View details for DOI 10.1080/13607860903420989

    View details for Web of Science ID 000277438700004

    View details for PubMedID 20425645

  • Families dealing with dementia: Insights from Mainland China, Hong Kong, and Taiwan Aging Asia: The economic and social implications of rapid demographic change in China, Japan, and South Korea Gallagher-Thompson, D., Tzuang, M., Au, A., Wang, D., Tsien, T. B., Wang, P., Huang, Y. Stanford University Press: Walter H. Shorenstein Asia-Pacific Research Center. 2010: 157–176
  • Effectively Using Cognitive Behavioral Therapy with the Oldest-Old: Case Examples and Issues for Consideration Casebook of clinical geropsychology: International perspectives on practice Gallagher-Thompson, D., Thompson, L. W. Oxford University Press. 2010
  • Using the Revised Acculturation Rating Scale for Mexican Americans (ARSMA-II) with Older Adults. Hispanic health care international : the official journal of the National Association of Hispanic Nurses Jimenez, D. E., Gray, H. L., Cucciare, M., Kumbhani, S., Gallagher-Thompson, D. 2010; 8 (1): 14–22


    Projections for the year 2030 show that Latinos are expected to make the largest population increase. Cultural values create expectation levels about what will happen to the elderly. Acculturation is a concept that has been studied extensively, yet the relationship between age and acculturation has not been a focus of study. The present study has proposed an alternate way of scoring the ARSMA-II based on receiver operating characteristics. Specifically, this approach looks at participants' responses to two individual items to determine the level of acculturation of the older adults. It is a quicker method and one that could save healthcare providers a great deal of time as well as help them better understand their clients' level of acculturation; thus, being able to provide the appropriate educational materials.

    View details for DOI 10.1891/1540-4153.8.1.14

    View details for PubMedID 21998557

    View details for PubMedCentralID PMC3190130

  • Exploring the relationship between physical health, depressive symptoms, and depression diagnoses in Hispanic dementia caregivers AGING & MENTAL HEALTH Cucciare, M. A., Gray, H., Azar, A., Jimenez, D., Gallagher-Thompson, D. 2010; 14 (3): 274-282


    The present study examined the relationship between self-reported physical health, depressive symptoms, and the occurrence of depression diagnosis in Hispanic female dementia caregivers.Participants were 89 Hispanic female dementia caregivers.This study used a cross-sectional design. Baseline depression and physical health data were collected from participants enrolled in the 'Reducing Stress in Hispanic Anglo Dementia Caregivers' study sponsored by the National Institute on Aging.Physical health was assessed using the Medical Outcome Study Short Form-36 (SF-36), a one-item self-report health rating, body mass index, and the presence or history of self-reported physical illness. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression Scale (CES-D). The occurrence of depression diagnosis was assessed using the Clinical Interview for DSM-IV Axis I Disorders (SCID).Multiple linear and logistic regression analysis was used to examine the extent to which indices of physical health and depressive symptoms accounted for variance in participants' depressive symptoms and depressive diagnoses.Self-reported indices of health (e.g., SF-36) accounted for a significant portion of variance in both CES-D scores and SCID diagnoses. Caregivers who reported worsened health tended to report increased symptoms of depression on the CES-D and increased likelihood of an SCID diagnosis of a depressive disorder.Self-reported health indices are helpful in identifying Hispanic dementia caregivers at risk for clinical levels of depression.

    View details for DOI 10.1080/13607860903483128

    View details for Web of Science ID 000277438700005

    View details for PubMedID 20425646

  • Ethnic Differences in Beliefs Regarding Alzheimer Disease Among Dementia Family Caregivers AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY Gray, H. L., Jimenez, D. E., Cucciare, M. A., Tong, H., Gallagher-Thompson, D. 2009; 17 (11): 925-933


    The purpose of this study was to examine ethnic differences in female dementia family caregivers' knowledge, attitudes, and beliefs about Alzheimer disease (AD).Baseline data were collected from 215 female caregivers before their participation in various psychoeducational intervention programs. Caregivers were questioned about the epidemiology, etiology, and treatment of AD. Logistic regressions and one-way analysis of variance were conducted to assess ethnic differences.Hispanic and Chinese caregivers were more likely to believe that AD is a normal part of aging and that AD can be diagnosed by a blood test than the white group. These beliefs about AD may delay help-seeking activities for these patients and their family caregivers.Increased public education about AD is needed in these communities. Results are discussed in terms of barriers to accessing information about AD and ways to improve public informational outreach activities, so that the intended audiences are reached more effectively.

    View details for DOI 10.1097/JGP.0b013e3181ad4f3c

    View details for Web of Science ID 000271657200003

    View details for PubMedID 20104051

  • Self-efficacy as a Moderator of the Relationship Between Care Recipient Memory and Behavioral Problems and Caregiver Depression in Female Dementia Caregivers ALZHEIMER DISEASE & ASSOCIATED DISORDERS Rabinowitz, Y. G., Mausbach, B. T., Gallagher-Thompson, D. 2009; 23 (4): 389-394


    The purpose of the current study was to explore the moderating effect of 3 domains of caregiver self-efficacy on the relationship between exogenous caregiving stressors (care recipient memory and behavioral problems) and depression.Moderator analyses were used to analyze data for 256 caregivers of elder relatives with dementia recruited at the Palo-Alto site of the National REACH (Resources for Enhancing Alzheimer's Caregiver Health) Project. Significant interactions between the stressor and self-efficacy indicated a potential moderating effect. Post hoc analyses were then conducted to determine the nature of the interaction(s).Self-efficacy for managing disruptive behaviors and self-efficacy for controlling upsetting thoughts had a direct effect on depression. Self-efficacy for responding to disruptive behaviors moderated the relationship between care recipient memory and behavioral problems and symptoms of depression.Self-efficacy may be an important clinical tool for identifying the caregivers who are most vulnerable to depression. Self-efficacy for responding to disruptive behaviors may be especially helpful in identifying caregivers at the greatest risk for depression when care recipient memory and behavior problems are high.

    View details for Web of Science ID 000272403700015

    View details for PubMedID 19935146

  • Development of the Risk Appraisal Measure: A Brief Screen to Identify Risk Areas and Guide Interventions for Dementia Caregivers JOURNAL OF THE AMERICAN GERIATRICS SOCIETY Czaja, S. J., Gitlin, L. N., Schulz, R., Zhang, S., Burgio, L. D., Stevens, A. B., Nichols, L. O., Gallagher-Thompson, D. 2009; 57 (6): 1064-1072


    To develop and validate a brief screening measure for use in research, healthcare, and community settings to systematically assess well-being and identify needed areas of support for caregivers of patients with dementia.This study used data from Resources for Enhancing Alzheimer's Caregiver Health (REACH II), a multisite randomized clinical trial of a behavioral intervention designed to improve the quality of life of caregivers in multiple domains.REACH II.Two hundred twelve Hispanic, 211 black, and 219 white family caregivers providing in-home care to patients with dementia.Based on conceptual and psychometric analyses, a 16-item measure was developed that assesses six domains linked to caregiver risk and amenable to intervention: depression, burden, self-care and health behaviors, social support, safety, and patient problem behaviors. The reliability and validity of the instrument was evaluated with 642 dementia caregiver dyads from the REACH II program.The measure was found to have acceptable internal consistency for a multidimensional scale and similar measurement properties for each of the racial and ethnic groups. Concurrent validity was also demonstrated for the measure.The REACH Risk Appraisal Measure developed in this study shows promise as an assessment tool that can be used in research, clinical, and community settings to guide, prioritize, and target needed areas of support for caregivers of patients with dementia.

    View details for DOI 10.1111/j.1532-5415.2009.02260.x

    View details for Web of Science ID 000266490500017

    View details for PubMedID 19453305

  • Testing a Theoretical Model of the Stress Process in Alzheimer's Caregivers With Race as a Moderator GERONTOLOGIST Hilgeman, M. M., Durkin, D. W., Sun, F., DeCoster, J., Allen, R. S., Gallagher-Thompson, D., Burgio, L. D. 2009; 49 (2): 248-261


    The primary aim of this study was to test the stress process model (SPM; Pearlin, Mullan, Semple, & Skaff, 1990) in a racially diverse sample of Alzheimer's caregivers (CGs) using structural equation modeling (SEM) and regression techniques. A secondary aim was to examine race or ethnicity as a moderator of the relation between latent constructs (e.g., subjective stressors and role strain) in the SPM.Participants included White or Caucasian (n = 212), Black or African American (n = 201), and Hispanic or Latino (n = 196) Alzheimer's CGs from the Resources for Enhancing Alzheimer's Caregiver Health (REACH) II clinical trial.SEM revealed that the Pearlin model obtains a satisfactory fit across race or ethnicity in the REACH II data, despite significant racial differences in each of the latent constructs. Race or ethnicity moderated the impact of resources on intrapsychic strain, such that CGs reported similar intrapsychic strain across race at lower levels of resources, but White or Caucasian CGs reported more intrapsychic strain than Black or African American or Hispanic or Latino CGs when resources are higher.Strengths and weaknesses for each race or ethnicity vary considerably, suggesting that interventions must target different aspects of the stress process to provide optimal benefit for individuals of different cultural or ethnic backgrounds.

    View details for DOI 10.1093/geront/gnp015

    View details for Web of Science ID 000265400300010

    View details for PubMedID 19363019

  • Outcomes From the Resources for Enhancing Alzheimer's Caregiver Health (REACH) Program for Bereaved Caregivers PSYCHOLOGY AND AGING Holland, J. M., Currier, J. M., Gallagher-Thompson, D. 2009; 24 (1): 190-202


    Although preventive efforts for bereaved individuals have not been shown to be particularly effective in past studies, it has been suggested that intervention effects might be underestimated due to methodological issues such as short follow-up assessments. Thus, the present study aimed to assess the efficacy (as whole intervention packages and as component parts) of the Resources for Enhancing Alzheimer's Caregiver Health (REACH) interventions in preventing complicated grief, normal grief, and depressive symptoms at a longer term follow-up assessment among bereaved caregivers (N = 224). On average, active interventions showed a statistically significant effect on normal grief symptoms (d = 0.28), exhibited a trend toward improvement on complicated grief symptoms (d = 0.25), and demonstrated little impact on depressive symptoms (d = 0.09). Interestingly, the examination of intervention components revealed differential effects, whereby cognitive and behavioral strategies were most effective at reducing levels of complicated grief, information and emotional support were most effective for addressing normal grief, and environmental modifications were most effective for ameliorating depressive symptoms. These findings suggest that different preloss interventions might be warranted depending on a caregiver's unique clinical presentation and combination of risk factors.

    View details for DOI 10.1037/a0014303

    View details for Web of Science ID 000264315800019

    View details for PubMedID 19290751

  • The role of resources and appraisals in predicting burden among Latina and non-Hispanic white female caregivers: A test of an expanded socio-cultural model of stress and coping AGING & MENTAL HEALTH Montoro-Rodriguez, J., Gallagher-Thompson, D. 2009; 13 (5): 648-658


    The goal of this study is to propose and evaluate an expanded socio-cultural model of stress and coping that examines the role of culturally situated factors, such as coping abilities and the caregiver's self-efficacy beliefs, as mediators of outcomes among Latina and non-Hispanic white female caregivers.Using baseline data from 89 Latina and 96 non-Hispanic white female caregivers enrolled in an intervention study in the San Francisco area, exogenous and mediating factors were regressed on levels of burden among self-identified caregivers of older adults with Alzheimer's disease or another form of dementia.Results from structural equation modeling provided empirical evidence for a model in which the effects of ethnicity and other background variables are mediated through coping resources and appraisals of self-efficacy for managing care.This study adds to the existing literature that underscores the importance of evaluating the role of culturally mediated values for their impact on mental health outcomes. This influence is not only due to structural factors that reflect the disadvantaged minority status of ethnically diverse caregivers (e.g. socioeconomic status), but also to their coping resources and their appraisal of being able to meet caregiving demands, as shaped by their perceptions about caregiving. Future research is encouraged to explore the role of other culturally mediated factors that may affect mental health outcomes among caregivers of relatives with dementia.

    View details for DOI 10.1080/13607860802534658

    View details for Web of Science ID 000271511800002

    View details for PubMedID 19882403

  • Social support and well-being in dementia family caregivers: The mediating role of self-efficacy AGING & MENTAL HEALTH Au, A., Lai, M., Lau, K., Pan, P., Lam, L., Thompson, L., Gallagher-Thompson, D. 2009; 13 (5): 761-768


    The study investigated self-efficacy as a possible mediator of the relationship between the social support and depressive symptoms of primarily informal caregivers, mainly family members, of patients with dementia in Hong Kong.One hundred and thirty-four caregivers were interviewed. Path analyses were conducted using a self-efficacy scale that consists of three subscales assessing three domains of caregiving self-efficacy. Self-efficacy for obtaining respite, responding to disruptive patient behaviours, and controlling upsetting thoughts about caregiving were measured.Results showed that self-efficacy acted as a partial mediator between social support and depressive symptoms of these caregivers.Findings suggest that self-efficacy may function as a mechanism through which social support influences depressive symptoms, and the importance of this self-efficacy mechanism can be domain-specific.

    View details for DOI 10.1080/13607860902918223

    View details for Web of Science ID 000271511800014

    View details for PubMedID 19882415

  • The relationship between religiosity and health behaviors in female caregivers of older adults with dementia AGING & MENTAL HEALTH Rabinowitz, Y. G., Mausbach, B. T., Atkinson, P. J., Gallagher-Thompson, D. 2009; 13 (6): 788-798


    The current study explored the relationship between three dimensions of religiosity: (a) organizational religiosity (e.g. attendance at religious events), (b) non-organizational religiosity (e.g. prayer), and (c) subjective religiosity (e.g. importance of religion) and caregiver health behavior patterns in a sample of Latina and Caucasian female caregivers of older adult relatives with dementia. It was hypothesized that religiosity would have a significant association with reduced cumulative health risk as determined by an index of health behaviors. It was also hypothesized that, when examining the individual health behaviors subsumed in the overarching index, religiosity would be positively associated with adaptive health behaviors like exercise and negatively associated with health risk behaviors like smoking. Amongst Caucasians, increased subjective religiosity was related to increased cumulative health risk. Conversely, in Latinas, non-organizational religiosity was positively correlated with improved dietary practices (reduced dietary restriction). Increased levels of subjective religiosity were significantly associated with decreased maintenance of a routine exercise regimen across ethnic groups. Recommendations for clinicians and religious leaders, and avenues of future research are discussed.

    View details for DOI 10.1080/13607860903046446

    View details for Web of Science ID 000271511900002

    View details for PubMedID 19888699

  • Effectiveness of Cognitive/Behavioral Small Group Intervention for Reduction of Depression and Stress in Non-Hispanic White and Hispanic/Latino Women Dementia Family Caregivers: Outcomes and Mediators of Change. Journal of rational-emotive and cognitive-behavior therapy : RET Gallagher-Thompson, D., Gray, H. L., Dupart, T., Jimenez, D., Thompson, L. W. 2008; 26 (4): 286-303


    This study enrolled 184 middle-aged and older women (95 Non-Hispanic White and 89 Hispanic/Latino) who provided in-home hands-on care to an elderly relative with Alzheimer's disease or another form of dementia. Within ethnic group they were randomly assigned to either a CBT-based small group intervention program called "Coping with Caregiving" (CWC) that taught a variety of cognitive and behavioral skills to reduce stress and depression, or to a minimal telephone based control condition (TSC). Intervention lasted about 4 months; one post-treatment assessment was completed 6 months after baseline by interviewers blind to the intervention condition. Interviews and interventions were conducted in English or Spanish by trained staff. Results indicated that those in the CWC (regardless of ethnicity) showed greater improvement from pre to post intervention than those in the TSC on measures of depressive symptoms, overall life stress, and caregiving-specific stress. In order to investigate if these changes may have been related to one proposed mechanism of change in CBT (skill utilization), a new measure was constructed. Change in frequency of use and perceived helpfulness of adaptive coping skills were assessed in all caregivers. Results indicated that caregivers in CWC reported greater frequency of use, and greater perceived helpfulness, of these skills at post intervention compared to caregivers in the TSC. Improvement measured by dependent measures was correlated with an increase in these indices for those in the CWC. Tests for mediation suggest that effective skill utilization may mediate the effect of treatment on outcome. Implications of these findings are discussed and recommendations provided for future research.

    View details for PubMedID 25067886

  • The relationship between objectively measured sleep disturbance and dementia family caregiver distress and burden JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY Beaudreau, S. A., Spira, A. P., Gray, H. L., Depp, C. A., Long, J., Rothkopf, M., Gallagher-Thompson, D. 2008; 21 (3): 159-165


    The aim of this study was to determine whether distress and burden were associated with objective measures of sleep disturbance in dementia caregivers. Using wrist actigraphy, sleep was measured in 60 female, Caucasian dementia family caregivers (mean age, 64.8 years). Caregivers completed questionnaires about demographics, health, depression, duration of caregiving and care recipient nighttime behavior. Care recipients completed a mental status exam. We investigated whether these measures were associated with actigraphic sleep parameters. Greater depressive symptoms among caregivers were associated with poorer sleep efficiency. Older caregiver age and poorer self-rated health were associated with longer time in bed. Sleep disturbance, which is common among dementia caregivers, might be an important index of caregiver distress (ie, depression) but might not be associated with burden (based on the care recipient's general cognitive impairment or nighttime awakenings.).

    View details for DOI 10.1177/0891988708316857

    View details for Web of Science ID 000259164100001

    View details for PubMedID 18503035

  • The benefits of using psychotherapy skills following treatment for depression: An examination of "afterwork" and a test of the skills hypothesis in older adults COGNITIVE AND BEHAVIORAL PRACTICE Powers, D. V., Thompson, L. W., Gallagher-Thompson, D. 2008; 15 (2): 194-202
  • The relationship self-efficacy and between cumulative health risk associated with health behavior patterns in female caregivers of elderly relatives with Alzheimer's dementia JOURNAL OF AGING AND HEALTH Rabinowitz, Y. G., Mausbach, B. T., Thompson, L. W., Gallagher-Thompson, D. 2007; 19 (6): 946-964


    To promote caregiver well-being and to help caregivers persevere in their invaluable roles, personal resources that predict increased self-care and reduced health risk behaviors need to be identified.This study examined relationships between self-efficacy beliefs in three distinct domains of caregiving and cumulative health risk associated with health behavior patterns.Higher levels of self-efficacy for Obtaining Respite and self-efficacy for Controlling Upsetting Thoughts were found to be related to reduced health risk.These findings suggest that caregivers who believe that they can remove themselves from the stresses of caregiving and who can manage the distorted cognitions often associated with caregiving may experience tangible benefits in health behaviors and, ultimately, improved physical health.

    View details for DOI 10.1177/0898264307308559

    View details for Web of Science ID 000251065300005

    View details for PubMedID 18165290

  • Exciting advances in family caregiver research AGING & MENTAL HEALTH Gallagher-Thompson, D. 2007; 11 (6): 613-615

    View details for DOI 10.1080/13607860701786698

    View details for Web of Science ID 000252476800001

    View details for PubMedID 18074248

  • Adapting homework for an older adult client with cognitive impairment 35th Annual Congress of the European-Association-of-Behavioural-and-Cognitive-Therapies Coon, D. W., Thompson, L. W., Gallagher-Thompson, D. ELSEVIER SCIENCE INC. 2007: 252–60
  • Impact of in-home behavioral management versus telephone support to reduce depressive symptoms and perceived stress in Chinese caregivers: Results of a pilot study AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY Gallagher-Thompson, D., Gray, H. L., Tang, P. C., Pu, C. Y., Leung, L. Y., Wang, P., Tse, C., Hsu, S., Kwo, E., Tong, H., Long, J., Thompson, L. W. 2007; 15 (5): 425-434


    Recent work has shown that Chinese Americans caring for a family member with dementia experience considerable psychological distress. However, few studies evaluate treatments for them. This study evaluated the efficacy of in-home intervention, based on cognitive behavior therapy principles, to relieve stress and depression in female Chinese American caregivers (CGs).Fifty-five CGs who met inclusion criteria were randomly assigned to a telephone support condition (TSC) or to an in-home behavioral management program (IHBMP) for 4 months. In the TSC, biweekly calls were made and relevant material was mailed. In the IHBMP, specific psychological skills were taught to deal with caregiving stress. CGs were assessed before and after treatment. Outcome measures evaluated overall perceived stress, caregiving-specific stress, and depressive symptoms.CGs in IHBMP were less bothered by caregiving-specific stressors and had lower depression levels than CGs in TSC. There was no difference in overall stress. CGs with low baseline level of self-efficacy for obtaining respite benefited from IHBMP, but showed little improvement in the TSC. CGs with higher self-efficacy benefited from both treatments.This intervention is promising and warrants replication in future studies. Additional research is needed to evaluate longer-term effects and to identify individual differences associated with improvement.

    View details for Web of Science ID 000246299600008

    View details for PubMedID 17463192

  • Reflections about the attention to family caregivers of people with dementia and proposal of an interdisciplinary psychoeducational intervention BEHAVIORAL PSYCHOLOGY-PSICOLOGIA CONDUCTUAL Losada, A., Marquez-Gonzalez, M., Penacoba, C., Gallagher-Thompson, D., Knight, B. G. 2007; 15 (1): 57-76
  • Evidence-based psychological treatments for distress in family caregivers of older adults PSYCHOLOGY AND AGING Gallagher-Thompson, D., Coon, D. W. 2007; 22 (1): 37-51


    This review identifies evidence-based psychological treatments (EBTs) for reducing distress, and improving well-being, of family members caring for an older relative with significant cognitive and/or physical impairment. Three categories of psychologically derived treatments met EBT criteria: psychoeducational programs (N = 14 studies), psychotherapy (N = 3 studies), and multicomponent interventions (N = 2 studies). Specifically, support within the psychoeducational category was found for skill-training programs focused on behavior management, depression management, and anger management and for the progressively lowered threshold model. Within the psychotherapy category, cognitive-behavioral therapy enjoys strong empirical support. Within the multicomponent category, programs using a combination of at least 2 distinct theoretical approaches (e.g., individual counseling and support group attendance) were also found to be effective. Suggestions for future research include the development of more well-integrated multicomponent approaches, greater inclusion of ethnically diverse family caregivers in research protocols, and greater incorporation of new technologies for treatment delivery.

    View details for DOI 10.1037/0882-7974.22.1.37

    View details for Web of Science ID 000245060300006

    View details for PubMedID 17385981

  • Health and Health Behaviors Among Female Caregivers of Elderly Relatives with Dementia: The Role of Ethnicity and Kinship Status CLINICAL GERONTOLOGIST Rabinowitz, Y. G., Gallagher-Thompson, D. 2007; 31 (2): 1-15
  • Enhancing the quality of life of dementia caregivers from different ethnic or racial groups - A randomized, controlled trial ANNALS OF INTERNAL MEDICINE Belle, S. H., Burgio, L., Burns, R., Coon, D., Czaja, S. J., Gallagher-Thompson, D., Gitlin, L. N., Klinger, J., Koepke, K. M., Lee, C. C., Martindale-Adam, J., Nichols, L., Schulz, R., Stahl, S., Stevens, A., Winter, L., Zhang, S. 2006; 145 (10): 727-738


    Caring for a family member with dementia is extremely stressful, contributes to psychiatric and physical illness among caregivers, and increases the risk for caregiver death. Finding better ways to support family caregivers is a major public health challenge.To test the effects of a structured multicomponent intervention on quality of life and clinical depression in caregivers and on rates of institutional placement of care recipients in 3 diverse racial or ethnic groups.Randomized, controlled trial.In-home caregivers in 5 U.S. cities.212 Hispanic or Latino, 219 white or Caucasian, and 211 black or African-American caregivers and their care recipients with Alzheimer disease or related disorders.Caregivers within each racial or ethnic group were randomly assigned to an intervention or to a control group. The intervention addressed caregiver depression, burden, self-care, and social support and care recipient problem behaviors through 12 in-home and telephone sessions over 6 months. Caregivers in the control group received 2 brief "check-in" telephone calls during the 6-month intervention.The primary outcome was a quality-of-life indicator comprising measures of 6-month caregiver depression, burden, self-care, and social support and care recipient problem behaviors. Secondary outcomes were caregiver clinical depression and institutional placement of the care recipient at 6 months.Hispanic or Latino and white or Caucasian caregivers in the intervention group experienced significantly greater improvement in quality of life than those in the control group (P < 0.001 and P = 0.037, respectively). Black or African-American spouse caregivers also improved significantly more (P = 0.003). Prevalence of clinical depression was lower among caregivers in the intervention group (12.6% vs. 22.7%; P = 0.001). There were no statistically significant differences in institutionalization at 6 months.The study used only a single 6-month follow-up assessment, combined heterogeneous cultures and ethnicities into a single group, and excluded some ethnic groups.A structured multicomponent intervention adapted to individual risk profiles can increase the quality of life of ethnically diverse dementia caregivers. identifier: NCT00177489.

    View details for Web of Science ID 000242387100002

    View details for PubMedID 17116917

  • Recruiting Chinese Americans for dementia caregiver intervention research: Suggestions for success AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY Gallagher-Thompson, D., Rabinowitz, Y., Tang, P. C., Tse, C., Kwo, E., Hsu, S., Wang, P., Leung, L., Tong, H., Thompson, L. W. 2006; 14 (8): 676-683


    The purpose of this study was to compare the relative effectiveness of three recruitment modalities for enrolling Chinese-American and white family caregivers into research studies to evaluate intervention strategies.A total of 116 Chinese Americans and 134 whites were screened for eligibility to participate in one of two clinical intervention trials. Participants were recruited using: 1) media sources; 2) nonprofessional referral sources; or 3) professional referrals. Each participant was asked an open-ended question about how they became aware of the programs offered.A smaller proportion of Chinese Americans (39%) than whites (50%) who responded to recruiting strategies actually enrolled as subjects. There was a significant interaction between ethnicity and recruitment strategy. Chinese-American caregivers who were recruited by nonprofessional sources were less likely to enroll in the intervention studies than those who were recruited through media sources or professional referrals. Whites, on the other hand, were more likely to be recruited through nonprofessional sources than the other two.A consumer-oriented approach, which included direct face-to-face contact with key community leaders, generated the highest number of Chinese-American participants. Culture-specific factors such as trust-building with social service agencies, demonstrating genuine commitment to the well-being of the target community, and linguistic and ethnic matching between research staff and potential participants appear helpful to successful research recruitment in this rapidly increasing segment of dementia caregivers.

    View details for Web of Science ID 000239205500006

    View details for PubMedID 16861372

  • The moderating effect of self-efficacy on intervention response in women family caregivers of older adults with dementia AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY Rabinowitz, Y. G., Mausbach, B. T., Coon, D. W., Depp, C., Thompson, L. W., Gallagher-Thompson, D. 2006; 14 (8): 642-649


    This study performed moderator analyses to determine if self-efficacy predicted differential outcome in a randomized trial comparing a cognitive behavior psychoeducational intervention and an enhanced support group (ESG). The four key outcomes were depression, anxiety, social support, and coping. Low baseline self-efficacy scores were hypothesized to be more predictive of positive response in the psychoeducational intervention than in the support group. Change from pre- to posttreatment (baseline to three months) for 213 female caregivers of older adult relatives with dementia (122 Anglos and 91 Latinos) are presented. Caregivers were randomly assigned to either the coping with caregiving class (CWC), a skill-building, small group intervention designed to reduce caregiving stress, or to an enhanced support group (ESG), which used guided discussion and empathic listening to develop within-group reciprocal support. The findings showed that low baseline self-efficacy scores better predicted positive response to treatment in the CWC intervention than in the ESG intervention. This study supports the use of self-efficacy as a screening tool for appropriate caregiver intervention assignment.

    View details for Web of Science ID 000239205500002

    View details for PubMedID 16861368

  • Impact of current grief on memory for past grief in spousal bereavement MEMORY Field, N. P., Thompson, L. W., Gallagher-Thompson, D. 2006; 14 (3): 297-306


    This study examined the impact of changes in level of current grief over time on changes in memory for past grief. Following from previous work on the impact of current affective state on memory for past affectively salient events, bereaved individuals who underwent a greater reduction in grief over time were expected to show a similar pattern of changes in memory for past grief. A sample of conjugally bereaved participants completed measures of current grief and memory for past grief at the time of the loss of their spouse at each of the 2, 6, 13, and 30 month post-loss time periods. As predicted, those who reported greater reduction in grief over the course of the study were more likely to remember their past grief as progressively less severe relative to those who underwent less reduction in grief over time. A nonrecursive causal model analysis verified that changes in memory for past grief were explained by changes in current grief. These results were discussed in terms of contemporary reconstructive memory accounts of the effect of affective state on memory.

    View details for DOI 10.1080/09658210500243747

    View details for Web of Science ID 000237386700004

    View details for PubMedID 16574586

  • Ethnicity, stress, and cortisol function in Hispanic and non-Hispanic white women: A preliminary study of family dementia caregivers and noncaregivers AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY Gallagher-Thompson, D., Shurgot, G. R., Rider, K., Gray, H. L., McKibbin, C. L., Kraemer, H. C., Sephton, S. E., Thompson, L. W. 2006; 14 (4): 334-342


    This study examined differences in psychologic and physiological responses to caregiving stress in Hispanic and non-Hispanic white women dementia caregivers and noncaregivers. Dependent variables were perceived stress, depression, and salivary cortisol.Eighty-three women caregivers (20 Hispanic and 24 non-Hispanic white) and noncaregivers (19 Hispanic and 20 non-Hispanic white) completed the Perceived Stress Scale (PSS), Center for Epidemiological Studies-Depression Scale (CES-D), and collected three saliva samples daily for 3 consecutive days. A subsample of 17 Hispanic and 28 non-Hispanic white participants matched on age and education was used for the main analyses.Caregivers had higher levels of 8 am, 5 pm, and 9 pm log cortisol as well as higher perceived stress than noncaregivers. Non-Hispanic whites had higher depression scores than noncaregivers, but there was no significant difference for Hispanics. Hispanics, regardless of caregiving status had flatter daytime cortisol slopes than the non-Hispanic whites. Multivariate regression analyses showed that both ethnicity and depressive symptoms independently predicted daytime cortisol slope.Results support the relationship between chronic stress and hypothalamic-pituitary-adrenal axis dysregulation among women dementia caregivers and highlight the need to examine further the role of ethnicity and depressive symptoms in their physiological responses.

    View details for Web of Science ID 000236540800006

    View details for PubMedID 16582042

  • The geriatric caregiver Principles and practice of geriatric psychiatry Thompson, L.W., Spira, A. P., Depp, C. A., McGee, J. S., & Gallagher-Thompson, D. 2006: 37-48
  • Women?s issues at the end of life Handbook of girls? and women?s psychological health Gallagher-Thompson, D., Dillinger, J., Gray, H., L., Cardenas, V., Singer, L., & Hsu, S. 2006
  • Treatment of depression in low-income older adults PSYCHOLOGY AND AGING Arean, P. A., Gum, A., McCulloch, C. E., Bostrom, A., Gallagher-Thompson, D., Thompson, L. 2005; 20 (4): 601-609


    The purpose of this study was to compare cognitive-behavioral group therapy (CBGT), clinical case management (CCM), and their combination (CBGT + CCM) to treat depression in low-income older adults (60+). Sixty-seven participants with major depressive disorder or dysthymia were randomly assigned and entered into 1 of the 3 treatment conditions for 6 months. They were followed for 18 months after treatment initiation on depression and functional outcomes. CCM and CBGT + CCM led to greater improvements in depressive symptoms than CBGT, but CBGT led to greater improvements in physical functioning. All 3 conditions resulted in similar reduction of needs. Findings suggest that disadvantaged older adults with depression benefit from increased access to social services either alone or combined with psychotherapy.

    View details for DOI 10.1037/0882-7974.20.4.601

    View details for Web of Science ID 000234623100007

    View details for PubMedID 16420135

  • Caregiver self-efficacy, ethnicity, and kinship differences in dementia caregivers AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY Depp, C., Sorocco, K., Kasl-Godley, J., Thompson, L., Rabinowitz, Y., Gallagher-Thompson, D. 2005; 13 (9): 787-794


    The authors sought to determine the effect of kinship status (daughters versus wives) and ethnicity (Hispanic/Latino versus Caucasian) on self-efficacy to perform tasks relevant to caregiving in a sample of family caregivers for people with memory problems.Baseline data were collected from 238 female caregivers who participated in an intervention program. Ethnic and kin relationship groups were compared on measures of caregiver self-efficacy, acculturation within the Hispanic/Latino sample, and the relationship of self-efficacy to key outcome variables.Hispanics/Latinos reported higher self-efficacy on two of three self-efficacy subscales (Responding to Disruptive Behaviors and Controlling Negative Thoughts About Caregiving). Daughters reported higher self-efficacy on all three self-efficacy scales. Among Hispanics/Latinos, acculturation did not relate strongly to self-efficacy. Caucasian and spousal caregivers appeared to make more generalized appraisals about caregiving.Higher self-efficacy among Hispanic/Latino caregivers may relate to cultural values about caregiving and/or ethnic differences in appraisal. Wives may be more at risk for low self-efficacy, which may relate to greater role frustration and distress. This study highlights the heterogeneity among caregivers in their experience of caregiving.

    View details for Web of Science ID 000231755800007

    View details for PubMedID 16166408

  • Psychotherapy across the lifecycle: Old age. In G. Gabbard, J. Beck & J. Holmes (Eds.) Concise Oxford textbook of psychotherapy Cook, J., Katz, I., & Gallagher-Thompson, D. 2005
  • Cognitive-Behavioral Group Interventions Oxford textbook of psychotherapy Coon, D.W., Robinson Shurgot, G., Gillispie, Z., Cardenas, V., Gallagher-Thompson, D. ( 2005
  • Social marketing as a framework for recruitment: Illustrations from the REACH study JOURNAL OF AGING AND HEALTH Nichols, L., Martindale-Adams, J., Burns, R., Coon, D., Ory, M., Mahoney, D., Tarlow, B., Burgio, L., Gallagher-Thompson, D., Guy, D., Arguelles, T., Winter, L. 2004; 16 (5): 157S-176S


    Recruitment is often the most challenging aspect of research with older persons. Social marketing--applying marketing techniques to influence the behavior of target audiences to improve their welfare--can help researchers identify factors that influence recruitment.Illustrations of social marketing principles are provided from the Resources for Enhancing Alzheimer's Caregiver Health project, a national Alzheimer's caregivers study that targeted ethnic and racial minorities.Social marketing principles--the six Ps of participants, product, price, place, promotion, and partners--provide a theoretical framework for organizing and planning recruitment activities, including developing varying strategies to define the target audience (participants), develop the intervention (product), manage time and trouble (price), target the audience, improve accessibility (place), promote the study, and develop and work with partners.Strategies to enhance recruitment are often undertaken without a comprehensive plan. A social marketing plan provides a framework to map out the steps in recruitment that will be needed and to plan for allocations of time, staff, and resources.

    View details for DOI 10.1177/0898264304269727

    View details for Web of Science ID 000224424800010

    View details for PubMedID 15448292

    View details for PubMedCentralID PMC2579268

  • Effective recruitment strategies for Latino and Caucasian dementia family caregivers in intervention research AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY Gallagher-Thompson, D., Singer, L. S., Depp, C., Mausbach, B. T., Cardenas, V., Coon, D. W. 2004; 12 (5): 484-490


    Latino family caregivers of older people with memory problems are a rapidly growing group. However, their participation in intervention research is disproportionately low. The authors compared the participant retention rates of three different recruitment strategies in a sample of Latino and Caucasian family caregivers.A total of 310 caregivers (195 Latino and 105 Caucasian) were screened for participation in one of two clinical intervention trials. Potential participants were recruited from one of three sources: 1) non-professional (e.g., health fairs); 2) professional (e.g., community agencies); and 3) advertisements. Reasons for non-participation were also obtained.Caucasians were significantly more likely to be successfully retained across all recruitment strategies (52% versus 31%, respectively). However, logistic regression revealed a recruitment strategy-by-ethnicity interaction: Latinos were highly similar in retention rates to Caucasians when recruited through professional referrals, and far less likely to participate with other strategies. Descriptive analyses also revealed ethnic differences for non-participation.Partnership of Latino family caregivers with community agencies may result in the highest recruitment rates among this group. Latino cultural values likely play a role in the success of these partnerships in participant recruitment.

    View details for Web of Science ID 000223685700006

    View details for PubMedID 15353386

  • Ethnicity and time to institutionalization of dementia patients: A comparison of Latina and Caucasian female family caregivers JOURNAL OF THE AMERICAN GERIATRICS SOCIETY Mausbach, B. T., Coon, D. W., Depp, C., Rabinowitz, Y. G., Wilson-Arias, E., Kraemer, H. C., Thompson, L. W., Lane, G., Gallagher-Thompson, D. 2004; 52 (7): 1077-1084


    To compare rates of institutionalization of dementia patients cared for by Latina and Caucasian female caregivers and to explore which caregiver and care-recipient characteristics predicted institutionalization.Longitudinal.San Francisco Bay area, California.Two hundred sixty-four female caregivers of dementia patients (154 Caucasian women, 110 Latinas) who participated in an intervention project designed to reduce caregiver stress and may represent a sample that is more stressed and motivated than a general sample of caregivers.Number of days between baseline interview and institutionalization was recorded over an 18-month period. Kaplan-Meier survival analysis with the log rank statistic was used to test for ethnic differences in time to institutionalization. Cox regression analyses were conducted to determine whether care-recipient or caregiver characteristics (e.g., care-recipient age and memory and behavior problems; caregiver depression, years of education, income, and views of the caregiving role) significantly interacted with ethnicity to explain time to institutionalization.Latinas delayed institutionalization significantly longer than their Caucasian counterparts; care-recipient characteristics or caregiver demographics did not explain these results, although Latinas who identified greater benefits or more-positive aspects of the caregiving process at baseline were less likely to institutionalize their loved one than those who reported fewer benefits of caregiving. Less-acculturated Latinas were significantly more likely to identify positive aspects of caregiving than more-acculturated Latinas.Latina dementia caregivers delay institutionalization significantly longer than female Caucasian caregivers. In addition, Latino cultural values and positive views of the caregiving role are important factors that may significantly influence their decision to institutionalize loved ones with dementia.

    View details for Web of Science ID 000222070900005

    View details for PubMedID 15209644

  • Positive aspects of caregiving - Contributions of the REACH project to the development of new measures for Alzheimer's caregiving RESEARCH ON AGING Tarlow, B. J., Wisniewski, S. R., Belle, S. H., Rubert, M., Ory, M. G., Gallagher-Thompson, D. 2004; 26 (4): 429-453
  • Well-being, appraisal, and coping in Latina and Caucasian female dementia caregivers: findings from the REACH study AGING & MENTAL HEALTH Coon, D. W., Rubert, M., Solano, N., Mausbach, B., Kraemer, H., Arguelles, T., Haley, W. E., Thompson, L. W., Gallagher-Thompson, D. 2004; 8 (4): 330-345


    While there has been considerable interest in studying ethnically diverse family caregivers, few studies have investigated the influence of dementia caregiving on Latino families. The current study includes participants from two sites of the REACH (Resources for Enhancing Alzheimer's Caregiver Health) project to compare well-being, appraisal, and religiosity by ethnicity, with specific attention to levels of acculturation. Latina (n = 191) and Caucasian female (n = 229) dementia family caregivers from two regions of the United States (Miami, Florida and Northern California) were compared at baseline on demographics, care recipient characteristics, mental and physical health, and psychosocial resources, including appraisal style and religiosity. Latina caregivers reported lower appraisals of stress, greater perceived benefits of caregiving, and greater use of religious coping than Caucasian caregivers. The relationship of these variables to level of acculturation for the Latina caregivers was also explored. Implications of these results for psychosocial interventions with Latino and Caucasian family caregivers are discussed.

    View details for DOI 10.1080/13607860410001709683

    View details for Web of Science ID 000222784200005

    View details for PubMedID 15370049

  • A pilot study of a yoga and meditation intervention for dementia caregiver stress 109th Annual Convention of the American-Psychological-Association Waelde, L. C., Thompson, L., Gallagher-Thompson, D. JOHN WILEY & SONS INC. 2004: 677–87


    Twelve older female dementia patient family caregivers (eight Latinas and four Caucasians) participated in a six-session manualized yoga-meditation program (called Inner Resources) designed to help caregivers cope with stress. Pre/post comparisons revealed statistically significant reductions in depression and anxiety and improvements in perceived self-efficacy. Average minutes of weekly yoga-meditation practice were significantly associated with improvements in depression. The majority of caregivers found the intervention useful and reported subjective improvements in physical and emotional functioning. These findings suggest that Inner Resources may be a feasible and effective intervention for family caregivers and may improve affect, coping, physical well-being, and stress management.

    View details for DOI 10.1002/jclp.10259

    View details for Web of Science ID 000221622900009

    View details for PubMedID 15141399

  • Caregiver stress and physical health: The case for stress management therapy The Clinical Psychologist Long, C., Krisztal, E., Rabinowitz, R., Gillispie, Z., Oportot, M., Tse, C., Singer, L., & Gallagher-Thompson, D. 2004; 8 (1): 22-28
  • Positive Aspects of Caregiving: Contributions of the REACH Project to the development of new measures for Alzheimer?s caregiving Research of Aging Tarlow, B.J., Wisniewski, S.R., Belle, S.H., Rubert, M., Ory, M.G., & Gallagher-Thompson, D. 2004; 26 (4): 429-453
  • Japanese American caregivers of individuals with dementia: An examination of Japanese cultural values and dementia caregiving Clinical Gerontologist Kinoshita, L.M., Gallagher-Thompson, D. 2004; 27 (1/2): 87-102
  • Bereavement and adjustment disorders. In D. Blazer, D. Steffens & E. Busse (Eds.) Textbook of Geriatric Psychiatry, 3rd ed Thompson, L.W., Kaye, J.L., Tang, P.C.Y., & Gallagher-Thompson, D. 2004
  • Psychometric analysis of the revised memory and behavior problems checklist: Factor structure of occurrence and reaction ratings PSYCHOLOGY AND AGING Roth, D. L., Burgio, L. D., Gitlin, L. N., Gallagher-Thompson, D., Coon, D. W., Belle, S. H., Stevens, A. B., Burns, R. 2003; 18 (4): 906-915


    A modified version of the Revised Memory and Behavior Problems Checklist (RMBPC; L. Teri et al., 1992) was administered across 6 different sites to 1,229 family caregivers of community-dwelling adults with dementia. The total sample was divided randomly into 2 subsamples. Principal components analyses on occurrence responses and reaction ratings from the first subsample resulted in a 3-factor solution that closely resembled the originally proposed dimensions (memory-related problems, disruptive behaviors, and depression). Confirmatory factor analyses on data from the second subsample indicated adequate fit for the 3-factor model. Correlations with other caregiver and care-recipient measures supported the convergent and discriminant validity of the RMBPC measures. In addition, female caregivers and White caregivers reported more problems, on average, than male caregivers and African American caregivers, respectively.

    View details for DOI 10.1037/0882-7974.18.4.906

    View details for Web of Science ID 000187350900024

    View details for PubMedID 14692875

  • Anger and depression management: Psychoeducational skill training interventions for women caregivers of a relative with dementia GERONTOLOGIST Coon, D. W., Thompson, L., Steffen, A., Sorocco, K., Gallagher-Thompson, D. 2003; 43 (5): 678-689


    This study examines the short-term impact of two theoretically based psychoeducational small group interventions with distressed caregivers, and it also examines the role of specific moderator and mediator variables on caregiver outcomes.Female participants (N = 169) aged 50 and older who were caring for a community-dwelling relative with a dementing illness were randomly assigned to one of three treatment interventions: anger management, depression management, or a wait-list control group. These interventions took place over a 3- to 4-month period. The primary outcomes examined were anger or hostile mood, depressed mood, frequency of use of positive and negative coping strategies, and perceived caregiving self-efficacy.Significant main effects in the expected direction were found for changes in most of these measures. Participants in both anger management and depression management groups had significant reductions in their levels of anger or hostility and depression from Time 1 to Time 2 in comparison to participants in the wait-list control group. Use of positive cognitive coping strategies increased in the anger management group only. Self-efficacy significantly increased for participants in both intervention groups, and it was also demonstrated to function as a mediator of intervention effects. Pretreatment levels of depressive symptoms and anger expression style (Anger Expression-Out) moderated the relative effects of the two interventions on mood and coping.These data are consistent with a growing body of evidence supporting the effectiveness of skills training, in small groups, to improve both the affective states and the type of coping strategies used by caregivers. In addition, this study underscores the need to evaluate key pretreatment variables in order to determine which form of treatment may be more compatible with caregiver characteristics and thus more likely to be beneficial to individuals.

    View details for Web of Science ID 000186088100008

    View details for PubMedID 14570964

  • Effect of multicomponent interventions on caregiver burden and depression: The REACH multisite initiative at 6-month follow-up PSYCHOLOGY AND AGING Gitlin, L. N., Belle, S. H., Burgio, L. D., Czaja, S. J., Mahoney, D., Gallagher-Thompson, D., Burns, R., Hauck, W. W., Zhang, S., Schulz, R., Ory, M. G. 2003; 18 (3): 361-374


    Meta-analysis was used to examine pooled parameter estimates of 9 active compared with 6 control conditions of the Resources for Enhancing Alzheimer's Caregiver Health (REACH) project at 6 months on caregiver burden and depressive symptoms. Associations of caregiver characteristics and outcomes were examined. For burden, active interventions were superior to control conditions (p = .022). Also, active interventions were superior to control conditions for women versus men and for caregivers with lower education versus those with higher education. For depressive symptoms, a statistically significant association of group assignment was found for Miami's family therapy and computer technology intervention (p = .034). Also, active interventions were superior to control conditions for Hispanics, nonspouses, and caregivers with lower education. Results suggest interventions should be multicomponent and tailored.

    View details for DOI 10.1037//0882-7974.18.3.361

    View details for Web of Science ID 000185419700002

    View details for PubMedID 14518800

    View details for PubMedCentralID PMC2583061

  • Resources for Enhancing Alzheimer's Caregiver Health (REACH): Overview, site-specific outcomes, and future directions GERONTOLOGIST Schulz, R., Burgio, L., Burns, R., Eisdorfer, C., Gallagher-Thompson, D., Gitlin, L. N., Mahoney, D. F. 2003; 43 (4): 514-520

    View details for Web of Science ID 000184967700008

    View details for PubMedID 12937330

    View details for PubMedCentralID PMC2579756

  • Recommendations about the knowledge and skills required of psychologists working with older adults PROFESSIONAL PSYCHOLOGY-RESEARCH AND PRACTICE Molinari, V., Karel, M., Jones, S., Zeiss, A., Cooley, S. G., Wray, L., Brown, E., Gallagher-Thompson, D. 2003; 34 (4): 435-443
  • Change in indices of distress among Latino and Anglo female caregivers of elderly relatives with dementia: Site-specific results from the REACH national collaborative study GERONTOLOGIST Gallagher-Thompson, D., Coon, D. W., Solano, N., Ambler, C., Rabinowitz, Y., Thompson, L. W. 2003; 43 (4): 580-591


    Few empirical studies have compared the efficacy between psychoeducational (skill-building) approaches for reducing caregivers' psychological distress and interventions modeled after typical community-based support groups. We compare the impact of two distinct interventions on Anglo and Latino caregivers of elderly relatives with dementia.The change from preassessment to postassessment (baseline to 3 months) for 213 female caregivers (122 Anglo and 91 Latino) is presented. They were seen weekly for 10 weeks in either the Coping With Caregiving psychoeducational program (instruction and practice in small groups to learn specific cognitive and behavioral skills) or in the Enhanced Support Group condition (guided discussion and empathic listening to develop reciprocal support within the group). Both programs were tailored to be sensitive to the cultural concerns of Anglo and Latino caregivers, and they were delivered in either English or Spanish by trained interventionists.Overall, participants in the Coping With Caregiving condition reported a significant reduction in depressive symptoms, increased use of adaptive coping strategies, and a trend toward decreased use of negative coping strategies when compared with those in the Enhanced Support Group condition. Results were similar for both ethnic groups: there were no main effects for ethnicity, and no significant ethnicity by treatment interaction effects.This study provides empirical support that female caregivers benefit more from a skill-building approach to managing their distress than from support group membership alone. We find it very encouraging that the Latino caregivers responded well on key outcome variables, suggesting that Latinos will participate in clinical research and will benefit from their involvement when services are provided to meet their specific needs.

    View details for Web of Science ID 000184967700014

    View details for PubMedID 12937336

  • Are all cognitive therapies alike? A comparison of cognitive and noncognitive therapy process and implications for the application of empirically supported treatments JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Malik, M. L., BEUTLER, L. E., Alimohamed, S., Gallagher-Thompson, D., Thompson, L. 2003; 71 (1): 150-158


    The definition of an empirically supported treatment (EST) arguably embodies 2 untested assumptions: (a) that different manualized renditions of the same therapy are functionally equivalent and (b) that therapies can be reliably applied independently of therapist, setting, and format. These assumptions were tested as applied to cognitive therapy (CT), using process data from a large multisite study (N = 235) that included 3 cognitive and 6 alternative therapies. Although the non-CTs were more variable than the CTs on 2 of 4 dimensions studied (directiveness and emotional arousal), there was considerable variation among the 3 CTs, even when implemented in the current context of rigorous training, manualization, and adherence checks. Results are discussed as related to the assumptions underlying EST criteria.

    View details for DOI 10.1037//0022-006X.71.1.150

    View details for Web of Science ID 000180591700017

    View details for PubMedID 12602435

  • Recruitment and retention of Latino dementia family Caregivers in intervention research: Issues to face, lessons to learn GERONTOLOGIST Gallagher-Thompson, D., Solano, N., Coon, D., Arean, P. 2003; 43 (1): 45-51


    This article reviews and critiques several issues of importance to those whose goal is to make intervention research with Latino caregivers more "user-friendly." Issues range from current demographic trends showing the ever-increasing number of Latino caregivers to discussion of cultural values that influence their help-seeking behavior.This article presents a review of current published information on this topic. The gerontological literature was searched for the past decade for relevant material; in addition, the authors' own experience in this area is described.Although limited information was found that derived from actual empirical studies, a number of articles describe potential barriers to research involvement and provide suggestions for making participation more attractive and culturally appropriate for Latinos.Clinical researchers need to increase their sensitivity to such issues as cultural values and language preference and develop effective collaborations with the Latino community so that intervention research programs can be designed and implemented successfully with Latinos caring for cognitively impaired elderly family members at home.

    View details for Web of Science ID 000180943600006

    View details for PubMedID 12604745

  • Innovative interventions to reduce dementia caregiver distress: A clinical guide Coon, D.W., Gallagher-Thompson, D., & Thompson, L.W. (Eds.) 2003
  • Treatment options for improving Wellbeing in Dementia Family caregivers: The case for psychoeducational interventions The Clinical Psychologist Depp, C., Krisztal, E., Cardenas, V., Oportot, M., Mausbach, B., Ambler, C., Leung, L., & Gallagher-Thompson, D. 2003; 7 (1): 21-31
  • Interventions for a multicultural society Innovative interventions to reduce dementia caregiver distress. A clinical guide Gallagher-Thompson, D., Hargrave, R., Hinton, L., Arean, P., Iwamasa, G., & Zeiss, L.M. 2003
  • Guidelines for conducting geropsychotherapy research AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY Arean, P. A., Cook, B. L., Gallagher-Thompson, D., Hegel, M. T., Schulberg, H. C., Schulz, R. 2003; 11 (1): 9-16


    Geropsychotherapy researchers have established specific methods that improve the reliability and generalizability of the data from this research. To date, there has been little formal dissemination of these methods. The authors present guidelines for the optimal conduct of psychotherapy research in older adults, which include selection of age-appropriate psychotherapies and control conditions, use of consumer-based methods for recruitment, evaluation of age-related treatment processes and outcomes, and adjusting the research design to accommodate age-specific life events and provide examples of how each guideline was used in their psychotherapy studies. Psychotherapy research with older adults has benefited from methodological advances that improve our ability to ascertain the impact of psychotherapy on late-life disorders. However, the field is still in need of better outcome and process measures, methods for measuring the therapeutic content of non-psychotherapy encounters, and methods for determining the impact of choice of treatment on outcome.

    View details for Web of Science ID 000180366400003

    View details for PubMedID 12527535

  • Tailoring psychological interventions for ethnically diverse dementia caregivers CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE Gallagher-Thompson, D., Haley, W., Guy, D., Rupert, M., Arguelles, T., Zeiss, L. M., Long, C., Tennstedt, S., Ory, M. 2003; 10 (4): 423-438
  • A comparison of the Dodo, EST, and ATI factors among co-morbid stimulant dependent, depressed patients Clinical Psychology and Psychotherapy Beutler, L.E., Moleiro C., Malik, M., Harwood, T.M., Romanelli, R., Gallagher-Thompson, D., & Thompson, L.W. 2003; 10: 69-85
  • Cognitive-behaviour therapy with older people Laidlaw, K., Thompson, L.W., Dick-Siskin, L., & Gallagher-Thompson, D. 2003
  • Pleasurable activities and mood: Differences between Latina and Caucasian dementia family caregivers Journal of Mental Health and Aging Thompson, L.W., Solano, N., Kinoshita, L., Coon, D.W., Mausbach, B., & Gallagher-Thompson, D. 2003; 8 (3): 211-224
  • Religious coping among Caucasian and Latina dementia caregivers Journal of Mental Health And Aging Mausbach, B.T., Coon, D.W., Cardenas, V., & Thompson, L.W. 2003; 9: 97-110
  • Tailoring psychological interventions for ethnically diverse caregivers Clinical Psychology: Science and Practice Gallagher-Thompson, D., Haley, W., Guy, D., Rupert, M., Arguelles, T., Zeiss, L., Long, C., Tennstedt, S., & Ory, M. 2003; 10: 423-438
  • Dementia caregiver intervention research: In search of clinical significance GERONTOLOGIST Schulz, R., O'Brien, A., Czaja, S., Ory, M., Norris, R., Martire, L. M., Belle, S. H., Burgio, L., Gitlin, L., Coon, D., Burns, R., Gallagher-Thompson, D., Stevens, A. 2002; 42 (5): 589-602


    We reviewed intervention studies that reported dementia caregiver outcomes published since 1996, including psychosocial interventions for caregivers and environmental and pharmacological interventions for care recipients. Our goal was to focus on issues of clinical significance in caregiver intervention research in order to move the field toward a greater emphasis on achieving reliable and clinically meaningful outcomes.MEDLINE, PsycINFO, and Cumulative Index to Nursing & Allied Health databases from 1996 through 2001 were searched to identify articles and book chapters mapping to two medical subject headings: caregivers and either dementia or Alzheimer's disease. Articles were evaluated on two dimensions, outcomes in four domains thought to be important to the individual or society and the magnitude of reported effects for these outcomes in order to determine if they were large enough to be clinically meaningful.Although many studies have reported small to moderate statistically significant effects on a broad range of outcomes, only a small proportion of these studies achieved clinically meaningful outcomes. Nevertheless, caregiving intervention studies have increasingly shown promise of affecting important public health outcomes in areas such as service utilization, including delayed institutionalization; psychiatric symptomatology, including the successful treatment of major and minor depression; and providing services that are highly valued by caregivers.Assessment of clinical significance in addition to statistical significance is needed in this research area. Specific recommendations on design, measurement, and conceptual issues are made to enhance the clinical significance of future research.

    View details for Web of Science ID 000178363300002

    View details for PubMedID 12351794

  • Psychologists in practice with older adults: Current patterns, source's of training, and need for continuing education PROFESSIONAL PSYCHOLOGY-RESEARCH AND PRACTICE Qualls, S. H., Segal, D. L., Norman, S., Niederehe, G., Gallagher-Thompson, D. 2002; 33 (5): 435-442
  • Family issues in end-of-life decision making and end-of-life care AMERICAN BEHAVIORAL SCIENTIST Haley, W. E., Allen, R. S., Reynolds, S., Chen, H. B., Burton, A., Gallagher-Thompson, D. 2002; 46 (2): 284-298
  • Coping and depression in Alzheimer's caregivers: Longitudinal evidence of stability JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES Powers, D. V., Gallagher-Thompson, D., Kraemer, H. C. 2002; 57 (3): P205-P211


    The present study examined the longitudinal relationship between depressive symptoms and coping strategies in older adult primary caregivers of noninstitutionalized Alzheimer's patients. Coping and depression were measured in 51 healthy, nondepressed caregivers (37 women, 14 men) at 4 times of testing approximately 6 months apart. The caregivers' coping strategies and depressive symptoms were found to be largely stable over all times of testing-with a recently developed method for evaluating construct stability-despite significant decline in the patients' cognitive functioning over the same interval. Avoidance coping was also found to be positively associated with depressive symptoms. Results suggest that a strong stable component is present in caregiver coping style and that caregiver intervention researchers may want to examine the extent to which commonly used outcome measures are assessing stable caregiver traits rather than state-dependent distress.

    View details for Web of Science ID 000175480300002

    View details for PubMedID 11983731

  • Encouraging homework completion among older adults in therapy JOURNAL OF CLINICAL PSYCHOLOGY Coon, D. W., Gallagher-Thompson, D. 2002; 58 (5): 549-563


    A growing body of research suggests that homework assignments facilitate positive outcomes in psychotherapy. We describe a cognitive behavioral outpatient therapy that stresses the important role homework plays in psychotherapy outcomes and that is found to be successful for treating emotional distress in both older adults and family caregivers. Just as a number of barriers can make it difficult for older clients to commit to regular therapy appointments, a variety of factors can also influence their completion of homework. We also address key issues frequently encountered when fostering homework compliance among older adults and utilize case vignettes to illustrate successful approaches to address these barriers. We present basic tenets for effective homework completion regardless of age group as well as several methods to address homework challenges that we find to be particularly pertinent for therapists treating today's older adults.

    View details for DOI 10.1002/jclp.10032

    View details for Web of Science ID 000175167500007

    View details for PubMedID 11967880

  • Psychologists in practice with older adults: Current patterns, sources of training, and need for continuing education Professional Psychology: Research and Practice Qualls, S.H., Segal, D.L., Norman, S., Niederehe, G., & Gallagher-Thompson, D. 2002; 33: 435-442
  • Men providing care: What do they need and how can we do it? Clinical Gerontologist Lauderdale, S.A., Gallagher-Thompson, D. 2002; 26 (1/2): 53-70
  • Depression in later life: Epidemiology, assessment, impact, and treatment Handbook of depression, 3rd ed. Powers, D.V., Thompson, L., Futterman, A., & Gallagher-Thompson, D. 2002: 560-580
  • Ethnic minority older adults in clinical and research programs: Issues and recommendations The Behavior Therapist Lau, A.W., Gallagher-Thompson, D. 2002; 25 (1): 10-11 and 16
  • Family issues in end-of-life decision making and end-of-life care American Behavioral Scientist Haley, W.E., Allen, R.S., Reynolds, S., Chen, H., Burton, A., & Gallagher-Thompson, D. 2002; 46 (2): 284-298
  • A multi-module psychoeducational approach to reduce distress in dementia caregivers Research and Practice in Alzheimer?s Disease Gallagher-Thompson, D., Tang, P.C.Y. 2002; 5: 149-155
  • The revised scale for caregiving self-efficacy: Reliability and validity studies JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES Steffen, A. M., McKibbin, C., Zeiss, A. M., Gallagher-Thompson, D., Bandura, A. 2002; 57 (1): P74-P86


    Two samples of family caregivers (Study 1: N = 169; Study 2: N = 145) of cognitively impaired older adults were used to revise, extend, and evaluate a measure of perceived self-efficacy for caregiving tasks. The Revised Scale for Caregiving Self-Efficacy measures 3 domains of caregiving self-efficacy: Obtaining Respite, Responding to Disruptive Patient Behaviors, and Controlling Upsetting Thoughts. The 3 subscales show strong internal consistency and adequate test-retest reliability. Construct validity is supported by relationships between these 3 facets of perceived caregiving efficacy and depression, anxiety, anger, perceived social support, and criticism expressed in speech samples. The Revised Scale for Caregiving Self-Efficacy has potential uses for both research and clinical purposes.

    View details for Web of Science ID 000173164100009

    View details for PubMedID 11773226

  • Research with older adults. In J. Thomas & M. Hersen (Eds.) Understanding research in clinical and counseling psychology: A textbook OHara, R., Higgins, A., DAndrea, J., Kennedy, Q., & Gallagher-Thompson, D. 2002: 441-467
  • Screening for depression in immigrant Chinese ? American elders: Results of a pilot study Journal of Gerontological Social Work Chen Stokes, S., Thompson, L.W., Murphy, S., & Gallagher-Thompson, D. 2002; 36 (1/2): 27-44
  • Apolipoprotein E epsilon 4 allele affects the relationship between stress and depression in caregivers of patients with Alzheimer's disease JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY Gallagher-Thompson, D., O'Hara, R., Simmons, A., Kraemer, H. C., Murphy, G. M. 2001; 14 (3): 115-119


    We examined the effect of the apolipoprotein E (apo E) epsilon4 allele on the relationship between self-reported stress and mood in caregivers of patients with Alzheimer's disease. Eighty-six female subjects between the ages of 28 and 82 years who were community-dwelling AD patient caregivers participated in the study. A cross-sectional analysis of stress and mood was performed using the Revised Memory and Behavior Problem Checklist and the Geriatric Depression Scale. All subjects were evaluated for normal cognitive function (Mini-Mental Status Examination) and apo E genotype. The results indicated that increased levels of stress were associated with increased levels of depressive symptoms in nondemented caregivers with the epsilon4 allele. This relationship was not observed in caregivers without the epsilon4 allele. These results suggest that carriers of the epsilon4 allele may respond differently to psychological stress than do individuals without the epsilon4 allele.

    View details for Web of Science ID 000170894200002

    View details for PubMedID 11563433

  • Judging outcomes in psychosocial interventions for dementia caregivers: The problem of treatment implementation GERONTOLOGIST Burgio, L., Corcoran, M., Lichstein, K. L., Nichols, L., Czaja, S., Gallagher-Thompson, D., BOURGEOIS, M., Stevens, A., Ory, M., Schulz, R. 2001; 41 (4): 481-489


    In published dementia caregiver intervention research, there is widespread failure to measure the level at which treatment was implemented as intended, thereby introducing threats to internal and external validity. The purpose of this article is to discuss the importance of inducing and assessing treatment implementation (TI) strategies in caregiving trials and to propose Lichstein's TI model as a potential guide.The efforts of a large cooperative research study of caregiving interventions, Resources for Enhancing Alzheimer's Caregiver Health (REACH), illustrates induction and assessment of the three components of TI: delivery, receipt, and enactment.The approaches taken in REACH vary with the intervention protocols and include using treatment manuals, training and certification of interventionists, and continuous monitoring of actual implementation.Investigation and description of treatment process variables allows researchers to understand which aspects of the intervention are responsible for therapeutic change, potentially resulting in development of more efficacious and efficient interventions.

    View details for Web of Science ID 000170248300006

    View details for PubMedID 11490046

  • Comparison of desipramine and cognitive/behavioral therapy in the treatment of elderly outpatients with mild-to-moderate depression AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY Thompson, L. W., Coon, D. W., Gallagher-Thompson, D., Sommer, B. R., Koin, D. 2001; 9 (3): 225-240


    The authors evaluated the efficacy of desipramine-alone, vs. cognitive/behavioral therapy-alone (CBT) vs. a combination of the two, for the treatment of depression in older adult outpatients. Patients (N=102) meeting criteria for major depressive disorder were randomly assigned to one of these three treatments for 16 to 20 therapy sessions. All treatments resulted in substantial improvement. In general, the CBT-Alone and Combined groups had similar levels of improvement. In most analyses, the Combined group showed greater improvement than the Desipramine-Alone group, whereas the CBT-Alone group showed only marginally better improvement. The combined therapies were most effective in patients who were more severely depressed, particularly when desipramine was at or above recommended stable dosage levels. The results indicate that psychotherapy can be an effective treatment for older adult outpatients with moderate levels of depression.

    View details for Web of Science ID 000170372300005

    View details for PubMedID 11481130

  • A comparison of marital interaction patterns between couples in which the husband does or does not have Alzheimer's disease JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES Gallagher-Thompson, D., Dal Canto, P. G., Jacob, T., Thompson, L. W. 2001; 56 (3): S140-S150


    Objectives. Our main purpose was to examine similarities and differences in patterns of interpersonal interaction between Alzheimer's disease (AD) caregiving and noncaregiving couples (n = 54). Methods. Twenty-seven wives caring for moderately impaired husbands with probable AD and 27 noncaregiving wives from comparable sociodemographic backgrounds were videotaped in their homes during both mealtime and a future event planning task. In addition, they completed self-report questionnaires to assess depression, stress, relationship mutuality, and perceived hope. Results. Compared with their counterparts, caregiving wives reported higher levels of depression and stress, but similar shared values and closeness. For the three factors developed from the Marital Interaction Coding System (MICS, version IV; Supportive Facilitative, and Rapport Building), a complex pattern of results was found in which disease status, type of task, and gender interacted significantly. Noncaregiving couples were more interactive overall and expressed more support to each other. Caregiving wives were found to be most facilitative during the planning task, whereas AD husbands were highest on interactions that built rapport (e.g., smiling) during that same task. Caregiving wives actually increased their facilitative behavior from the mealtime to planning task, probably reflecting the increased demand characteristics of the latter.This study is one of a small body of literature to describe the negative impact of AD on spousal communication as observed and coded in two videotaped interaction situations in the home. Suggestions are made for future research, including the inclusion of longitudinal designs and non-Caucasian couples.

    View details for Web of Science ID 000168341400010

    View details for PubMedID 11316839

  • Intervenciones cognitivo-conductuales para la depression en personas mayors. La eficacia de la terapie cognitivo-conductual para el tratamiento de la depression en personas mayores (translation: Cognitive-behavioral interventions for depression in older persons: The efficacy of cognitive/behavioral therapy for treatment of late life depression). Rev. Esp Geriatr Gerontol (Spanish Review of Geriatrics & Gerontology, published in Madrid) Solano, N., Gallagher-Thompson, D. 2001; 36 (4): 189-194
  • Chapter: Interventi psicoterapici con anziani a rischio suicidario. In P. Scocco, D. De Leo & L. Pavan (Eds.) (Psychotherapeutic intervention in the elderly with suicidal behaviors: Cognitive behavioral perspectives and approaches. Invited chapter for a book on cognitive/behavioral therapy in the Italian language). Coon, D.W., Gallagher-Thompson, D. 2001
  • A psychoeducational intervention to reduce distress in Hispanic family caregivers: Results of a pilot study Clinical Gerontologist Gallagher-Thompson, D., Arean, P., Rivera, P., & Thompson, L.W. 2001; 23 (1/2): 17-32
  • Training psychologists for service delivery in long-term care settings CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE Gallagher-Thompson, D., Cassidy, E. L., LOVETT, S. 2000; 7 (3): 329-336
  • alpha 2 macroglobulin and the risk of Alzheimer's disease NEUROLOGY Dodel, R. C., Du, Y., Bales, K. R., Gao, F., Eastwood, B., Glazier, B., Zimmer, R., Cordell, B., Hake, A., Evans, R., Gallagher-Thompson, D., Thompson, L. W., Tinklenberg, J. R., Pfefferbaum, A., SULLIVAN, E. V., Yesavage, J., Altstiel, L., Gasser, T., Farlow, M. R., Murphy, G. M., Paul, S. M. 2000; 54 (2): 438-442


    alpha2 Macroglobulin is a panproteinase inhibitor that is found immunohistochemically in neuritic plaques, a requisite neuropathologic feature of AD. Recently, a pentanucleotide deletion near the 5' end of the "bait region" of the alpha2 macroglobulin (A2M) gene was reported to be associated with AD in a large cohort of sibpairs, in which the mutation conferred a similar odds ratio with AD as the APOE-epsilon4 allele for carriers of at least one copy of the A2M gene (Mantel-Haenszel odds ratio, 3.56).We studied three independent association samples of AD patients (n = 309) with an age range of 50 to 94 years and representative controls (n = 281) to characterize the allele frequency of the pentanucleotide deletion in this cohort. We detected the mutation near the 5' splice site of exon 18 using standard PCR and restriction fragment length polymorphism methods. The results were adjusted for age, gender, education, and APOE polymorphism.We found that the A2M gene polymorphism conferred an increased risk for AD, with an estimated Mantel-Haenszel ratio of 1.5 (95% CI 1.1 to 2.2; p = 0.025). There was no age- or gender-dependent increase in A2M gene allele frequencies in AD patients compared with controls. The combined sample showed the expected association between AD and APOE-epsilon 4. In one of our three samples there was an interaction between the A2M and APOE-epsilon4 genes, but the other two samples showed no interaction between the two risk factors.Our data support an association between the A2M gene and AD. This association is less pronounced, however, in our cohort than in the previously reported sample of sibpairs.

    View details for Web of Science ID 000085043800030

    View details for PubMedID 10668709

  • There?s still a person in there: The complete to treating and coping with Alzheimer?s Castleman, M., Gallagher-Thompson, D., & Naythons, M. 2000
  • Impact of an Alzheimer?s disease education program: Focus on Hispanic families Gerontology and Geriatrics Education Gallagher-Thompson, D., Haynie, D., Takagi, K.A., Valverde, I., & Thompson, L.W. 2000; 20 (3): 25-40
  • Psychotherapy with older adults. In C.R. Snyder & R. Ingram (Eds.) Handbook of psychological change: Psychotherapy processes and practices for the 21st century Gallagher-Thompson, D., cKibbin, C., Koonce-Volwiler, D., Menéndez, A., Stewart, D., & Thompson, L.W. 2000: 614-637
  • Older adults. In J.R. White & A.S. Freeman (Eds.) Cognitive-behavioral group therapy for specific problems and populations Thompson, L.W., Powers, D.V., Coon, D.W., Takagi, K., McKibbin, C., & Gallagher-Thompson, D. 2000: 235-261
  • Impact of psychoeducational interventions on distressed family caregivers Journal of Clinical Geropsychology Gallagher-Thompson, D., Lovett, S., Rose, J., McKibbin C., Coon, D., Futterman, A., & Thompson, L.W. 2000; 6: 91-110
  • Understanding the intervention process: A theoretical/conceptual framework for intervention approaches to caregiving. In R. Schulz (Ed.) Handbook on dementia caregiving Schulz, R., Gallagher-Thompson, D., Haley, W., & Czaja, S. 2000: 33-60
  • Psychological, social, and economic implications of bereavement among older women. In L. Sherr and J. S. St. Lawrence (Eds.) Women, Health, and the Mind McKibbin, C.L., Koonce-Volwiler, D., Cronkite, R.C., & Gallagher-Thompson, D. 2000: 151-171
  • Development and implementation of intervention strategies for culturally diverse caregiving populations. In Schulz, R. (Ed.) Handbook on dementia caregiving Gallagher-Thompson, D., Arean, P., Coon, D., Menéndez, A., Takagi, K., Haley, W., Arguelles, T., Rupert, M., Loewenstein, D., & Szapocznik, J. 2000: 151-185
  • Training psychologists for service delivery in long-term care settings Clinical Psychology: Science & Practice Gallagher-Thompson, D., Cassidy, E.L., & Lovett, S. 2000; 7: 329-336
  • Lifestyle and health behaviors among female family dementia caregivers: a comparison of wives and daughters AGING & MENTAL HEALTH McKibbin, C. L., Walsh, W., Rinki, M., Koin, D., Gallagher-Thompson, D. 1999; 3 (2): 165-172
  • Physical and psychosocial correlates of hormone replacement therapy with chronically stressed postmenopausal women JOURNAL OF AGING AND HEALTH Steffen, A. M., Thompson, L. W., Gallagher-Thompson, D., Koin, D. 1999; 11 (1): 3-26


    This study investigated the relationship between hormone replacement therapy (HRT) use and physical and psychosocial functioning in a sample of chronically stressed older women.Participants (N = 94) were postmenopausal women caring for a parent or spouse with dementia. Caregivers were evaluated using both psychological and physical health indices.Caregivers receiving HRT reported lower levels of hostility and were less likely to report unpleasant interactions with members of their support network; these findings were unrelated to demographic variables, caregiving-related indices, or health behaviors. HRT recipients had lower 10-year risk scores for cardiovascular disease, but there were no group differences in stroke risk. The largest effects on hostility, depression, heart and stroke risk were observed in caregivers receiving a combination of estradiol and progesterone.HRT for postmenopausal women may promote positive outcomes for some, but not for all, affective states and cardiovascular variables vulnerable to chronic life stressors.

    View details for Web of Science ID 000078453600001

    View details for PubMedID 10848139

  • Personality disorders and treatment outcome. In E. Rosowksy, R.C., Abrams & R.A. Zweig (Eds.) Personality disorders in older adults Gradman, T.J., Thompson, L.W. & Gallagher-Thompson, D. 1999: 69-94
  • Lifestyle and health behaviors among female family dementia caregivers: A comparison of wives and daughters Aging and Mental Health McKibbin, C.L., Walsh, W., Rinki, M., Koin, D., & Gallagher-Thompson, D. 1999; 3 (2): 165-172
  • Cognitive-behavioral therapy for the treatment of late-life distress. In M. Duffy (Ed.) Handbook of counseling and psychotherapy with older adults Coon, D.W., Rider, K., Gallagher-Thompson, D., & Thompson, L.W. 1999: 487-510
  • Self-efficacy as mediator of caregiving coping: Development and testing of an assessment model Journal of Clinical Geropsychology Zeiss, A.,, Gallagher-Thompson, D., Lovett, S., Rose, J., & McKibbin, C. 1999; 5 (3): 221-230
  • The psychological impact of genetic testing for Alzheimer disease 49th Annual Meeting of the American-Society-of-Human-Genetics Coon, D. W., Davies, H., McKibben, C., Gallagher-Thompson, D. MARY ANN LIEBERT INC. 1999: 121–31


    Information regarding one's genetic risk for a particular disease might effectively inform medical, financial, and reproductive decisions and perhaps promote established risk reduction behaviors. However, genetic testing may also lead to significant levels of anxiety, depression, or other forms of distress, especially when psychological coping strategies and social reserves are not adequate to manage positive or inconclusive results. This paper focuses on the psychological impact of predisposition genetic for Alzheimer disease (AD). We present stress and coping models that capture the essence of this impact and discuss the potential role of counseling and follow-up interventions. The discussion draws primarily from the experiences of professionals working with other diseases, and seeks to expand that experience into the AD arena. In addition, we emphasize two issues we believe need additional attention in the psychological literature regarding genetic testing and counseling: (i) the psychosocial vulnerability of individuals being tested and, (ii) the sociocultural context of the AD patient and their family members.

    View details for Web of Science ID 000087218200016

    View details for PubMedID 10464586

  • Postdoctoral training in professional geropsychology: A survey of recent fellowship graduates Professional Psychology: Research and Practice Karel, M.J., Molinari, V., Gallagher-Thompson, D., & Hillman, S. 1999; 30: 617-622
  • Hopelessness and suicidal ideation in older adults GERONTOLOGIST Uncapher, H., Gallagher-Thompson, D., OSGOOD, N. J., Bongar, B. 1998; 38 (1): 62-70


    This study examined the role that hopelessness plays in geriatric suicidal ideation. Sixty institutionalized elderly males were recruited. Multiple regression analyses revealed that while hopelessness was strongly related to suicidal ideation, the relationship between hopelessness and suicidal ideation was dependent on level of depression. Participants who reported moderate or higher levels of depressive symptoms were more likely to have suicidal ideation with increasing hopelessness, whereas hopelessness had little effect on level of ideation at mild or lower depressive symptom levels. Unlike previous studies in younger adults, hopelessness did not predict suicidal ideation better than depressive symptoms, although the relationship between depression and suicidal ideation was stronger within higher levels of hopelessness. These findings highlight the importance of considering depression and hopelessness simultaneously when assessing and treating geriatric suicidal ideation.

    View details for Web of Science ID 000071944000008

    View details for PubMedID 9499654

  • Standards for psychological services in long-term care facilities GERONTOLOGIST Lichtenberg, P. A., Smith, M., Frazer, D., Molinari, V., Rosowsky, E., Crose, R., Stillwell, N., Kramer, N., Hartman-Stein, P., Qualls, S., Salamon, M., Duffy, M., Parr, J., Gallagher-Thompson, D. 1998; 38 (1): 122-127


    Psychologists in Long-Term Care (PLTC), a national network established in 1983, has developed, with input from colleagues and consumers, standards for psychological practice in long-term care facilities. These standards address provider characteristics, methods of referral, assessment practices, treatment, and ethical issues. This article describes the document's development and offers suggestions for its use.

    View details for Web of Science ID 000071944000014

    View details for PubMedID 9499660

  • Effect of geriatric clinical rotations on health professional trainee?s attitudes about older adults Journal of Gerontology and Geriatrics Education Damron-Rodriguez, J.A., Kramer, B.J., & Gallagher-Thompson, D. 1998; 19 (2): 67-79
  • Suicidal thoughts in male nursing home residents Annals of Long Term Care Uncapher, H., Levy, M., Skoloda, T., Osgood, N., Gallagher-Thompson, D., & Bongar, B. 1998; 6: 301-308
  • Depressed caregivers: Comparative outcomes of two interventions Clinical Gerontologist Steffen, A.M., Futterman, A., & Gallagher-Thompson, D. 1998; 19 (4): 3-15
  • Alliance, technique, and their interactions in predicting outcome of behavioral, cognitive, and brief dynamic therapy. Psychotherapy Research Gaston, L., Thompson, L., Gallagher, D., Cournoyer, L.G., & Gagnon, R. 1998; 8: 190-209
  • Family caregiving: Stress, coping, and intervention. In M. Hersen & V. B. Van Hasselt (Eds.) Handbook of clinical geropsychology Gallagher-Thompson, D., Coon, D.W., Rivera, P., Powers, D., & Zeiss, A.M. 1998: 469-494
  • A feasibility study of videotaping to assess the relationship between distress in Alzheimer's disease caregivers and their interaction style AGING & MENTAL HEALTH GALLAGHERTHOMPSON, D., DalCanto, P. G., Darnley, S., Basilio, L. A., Whelan, L., Jacob, T. 1997; 1 (4): 346-355
  • Primary stressors and depressive symptoms in caregivers of dementia patients AGING & MENTAL HEALTH GALLAGHERTHOMPSON, D., Powers, D. V. 1997; 1 (3): 248-255
  • Patterns of coping preferences for male and female caregivers of frail older adults PSYCHOLOGY AND AGING DEVRIES, H. M., Hamilton, D. W., LOVETT, S., GALLAGHERTHOMPSON, D. 1997; 12 (2): 263-267


    The similarities and differences in male and female caregivers' preferred strategies for coping and the perceived helpfulness of these strategies in managing caregiving stressors were examined in this study. Respondents were 170 caregivers (139 women and 31 men) who were primary caregivers for an elderly adult relative who was either cognitively impaired or physically frail. Results provide preliminary evidence that gender is related to frequency of use but not to the perceived helpfulness of specific coping strategies.

    View details for Web of Science ID A1997XD03100007

    View details for PubMedID 9189986

  • Hispanic caregivers of older adults with dementia: Cultural issues in outreach and intervention GROUP GALLAGHERTHOMPSON, D., Leary, M. C., Ossinalde, C., Romero, J. J., Wald, M. J., FernandezGamarra, E. 1997; 21 (2): 211-232
  • No association between the alpha 1-antichymotrypsin A allele and Alzheimer's disease NEUROLOGY Murphy, G. M., SULLIVAN, E. V., GALLAGHERTHOMPSON, D., Thompson, L. W., vanDuijn, C. M., Forno, L. S., Ellis, W. G., Jagust, W. J., Yesavage, J., Tinklenberg, J. R. 1997; 48 (5): 1313-1316


    The alpha 1-antichymotrypsin (ACT) A allele was recently associated with Alzheimer's disease (AD), and the ACT AA genotype was reported to be more frequent in AD subjects with the apolipoprotein E (APOE) epsilon4 allele. We examined ACT and APOE genotypes in a sample of 160 subjects with probable AD and in 102 elderly control subjects. ACT A allele frequencies were similar in AD subjects (0.503) and elderly controls (0.519). In addition, we found no evidence that in AD the AA genotype is more frequent in subjects with the APOE epsilon4 allele than in those without it. Our results do not support an association between the ACT A allele and AD.

    View details for Web of Science ID A1997WZ77800030

    View details for PubMedID 9153464

  • Distress levels and coping in female caregivers and non-caregivers with major depressive disorder. Journal of Clinical Geropsychology Steffen, A.M., Gallagher-Thompson, D., & Thompson, L.W. 1997; 3: 101-110
  • Suicide in later life BEHAVIOR THERAPY GALLAGHERTHOMPSON, D., OSGOOD, N. J. 1997; 28 (1): 23-41
  • The relationship of dimensions of acculturation to self-reported depression in older Mexican American women Journal of Clinical Geropsychology Gallagher- Thompson, D., Tazeau, Y.N., Basilio, L., Hansen, H., Polich, T., Menéndez, A., & Villa, M.L. 1997; 3 (2): 123-137
  • ispanic caregivers of older adults with dementia: Cultural issues in outreach and intervention Group: Journal of the Eastern Group Psychotherapy Society Gallagher-Thompson, D., Leary, M.C., Ossinalde, C., Romero, J.J., Wald, M.J., & Fernandez-Gamarra, E. 1997; 21 (2): 211-232
  • Preliminary study investigating psychological distress among female Hispanic caregivers Journal of Clinical Geropsychology Polich, T.M., Gallagher-Thompson, D. 1997; 3 (1): 1-15
  • Primary stressors and depressive symptoms in caregivers of dementia patients. Aging and Mental Health Gallagher-Thompson, D., Powers, D.V. 1997; 1 (3): 248-255
  • A feasibility study of videotaping to assess the relationship between distress in Alzheimer?s disease caregivers and their interaction style Aging and Mental Health Gallagher-Thompson, D., DalCanto, P.G., Darnley, S., Basilio, L.A., Whelan, L., & Jacob, T. 1997; 1 (4): 346-355
  • Psychotherapeutic interventions with older adults in outpatient and extended care settings. In R.L. Rubinstein, & M.P. Lawton (Eds.) Depression in long term and residential care Thompson, L.W., Gallagher-Thompson, D. 1997: 169-184
  • Suicide in later life Behavior Therapy Gallagher-Thompson, D., Osgood, N.J. 1997; 28: 23-41
  • Issues and recommendations for the recruitment and retention of older ethnic minority adults into clinical research JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Arean, P. A., GALLAGHERTHOMPSON, D. 1996; 64 (5): 875-880


    A burgeoning literature indicates that treatment of mental disorders offsets mortality, morbidity, and poor quality of life in senior citizens. Unfortunately, ethnic minority senior citizens, who are in most need of mental health services, have not been well represented in psychosocial research. This lack of attention is due, in large part, to difficulties that may arise in recruitment and retention of older ethnic minority adults in research studies. The purpose of this article is to discuss successful methods for recruiting older ethnic minority adults into psychosocial research and to offer specific suggestions for keeping this population involved in longitudinal studies. Also included is a discussion of past research and present data from treatment studies that used the methods discussed in this article.

    View details for Web of Science ID A1996VM70000007

    View details for PubMedID 8916614


    View details for Web of Science ID A1996WC50100013

    View details for PubMedID 8809012

  • Strategies for increasing participation of ethnic minorities in Alzheimer's Disease Diagnostic Centers: A multifaceted approach in California GERONTOLOGIST Hart, V. R., GALLAGHERTHOMPSON, D., Davies, H. D., DiMinno, M., LESSIN, P. J. 1996; 36 (2): 259-262


    A unified, state-wide effort to increase outreach activities targeted to ethnic minority families with a demented relative is described. A variety of strategies are reported, along with data supporting the effectiveness of these outreach efforts. At present, it appears that the three major ethnic minority groups in the State of California (i.e., Hispanic, African American, and Asian) are utilizing the network of state diagnostic centers at a rate proportional to their representation in the population.

    View details for Web of Science ID A1996UL78000019

    View details for PubMedID 8920098

  • Assessment, treatment, and management of depression. In J. Sheikh (Ed.) Management of psychiatric problems in the elderly Gallagher-Thompson, D., Coon, D. 1996: 1-44
  • Dimensions of post traumatic stress disorders among older veterans seeking outpatient medical care: A pilot study Journal of Clinical Geropsychology Hankin C.S, Abueg, F.R., Gallagher-Thompson, D., & Laws, A. 1996; 2 (4): 239-246
  • Variations in dementia characteristics by ethnic category. In G. Yeo & D. Gallagher-Thompson (Eds.) Ethnicity and the dementias Yeo, G., Gallagher-Thompson, D., & Lieberman, M. 1996: 21-30
  • Ethnicity and the dementias Yeo, G., Gallagher-Thompson, D. (Eds.) 1996
  • Cognitive-behavioral therapy. In R.T. Woods (Ed.) Handbook of the clinical psychology of aging Dick, L.P., Gallagher-Thompson, D., & Thompson, L.W. 1996: 509-544
  • Internal resourcefulness, task demands, coping, and dysphoric affect among caregivers of the frail elderly INTERNATIONAL JOURNAL OF AGING & HUMAN DEVELOPMENT Fingerman, K. L., GALLAGHERTHOMPSON, D., LOVETT, S., Rose, J. 1996; 42 (3): 229-248


    Internal resourcefulness is defined as the repertoire of skills and behaviors individuals employ to deal with negative affective states. The relationships among caregivers' internal resourcefulness, demands of the caregiving situation, and caregivers' self-reported coping behaviors were examined relative to changes in dysphoric affect over time. Primary caregivers of the frail elderly (N = 143) completed the following measures, at two time periods, approximately four months apart: Rosenbaum's Self Control Schedule, assessing internal resourcefulness; Poulshock and Deimling's list of tasks carried out for the frail elder; Zarit et al.'s Memory and Behavior Problem Check List assessing caregiver burden; Moos et al.'s Indices of Coping; and Beck et al.'s Depression Inventory as a means of assessing dysphoric affect. Although caregivers' reactions to the care recipients' annoying behaviors predicted negative affect at time 1 and avoidant coping behavior predicted negative affect at times 1 and 2, internal resourcefulness was the only significant predictor of changes in dysphoric affect over time. Decreased dysphoric affect among caregivers was linked to possession of a larger initial set of internal resources to deal with negative internal experiences.

    View details for Web of Science ID A1996UT02200005

    View details for PubMedID 8805085

  • Applying cognitive- behavior therapy to the psychological problems of later life. In S.H. Zarit & B.G. Knight (Eds.) A Guide to Psychotherapy and aging: Effective clinical interventions in a life stage context Gallagher-Thompson, D., Thompson, L.W. 1996: 61-82
  • Practical issues related to maintenance of mental health and positive well-being in family caregivers. In: L.L. Carstensen, B.A. Edelstein, & L. Dornbrand (Eds.) The practical handbook of clinical gerontology Thompson, L.W., Gallagher-Thompson, D. 1996: 129-150
  • Bereavement and adjustment disorders. In E.W. Busse and D.G. Blazer (Eds.) Textbook of geriatric psychiatry, 2nd edition Gallagher-Thompson, D., Thompson, L.W. 1996: 313-328
  • Late-life depression. In M. Hersen & V.B. Van Hasselt (Eds.) Psychological treatment of older adults: An introductory text Dick, L., Gallagher-Thompson, D. 1996: 181-208
  • Service delivery issues and recommendations for working with Mexican American family caregivers. In G. Yeo, & D. Gallagher-Thompson (Eds.) Ethnicity and the dementias Gallagher-Thompson, D., Talamantes, M., Ramirez, R., & Valverde, I. 1996: 137-152
  • Psychotherapy with older adults in theory and practice. In B. Bongar and L.E. Beutler (Eds.) Comprehensive textbook of psychotherapy: Theory, and Practice Gallagher-Thompson, D., Thompson, L. 1995: 359-379
  • Linear and nonlinear changes in mood between psychotherapy sessions: Implications for treatment outcome and relapse risk PSYCHOTHERAPY RESEARCH Thompson, M. G., Thompson, L., GALLAGHERTHOMPSON, D. 1995; 5 (4): 327-336
  • Cognitive therapy with the core beliefs of a distressed, lonely caregiver Journal of Cognitive Psychotherapy: An International Quarterly Dick, L., Gallagher-Thompson, D. 1995; 9 (4): 215-227
  • Depression in later life. In E.E. Beckham & R. Leber (Eds.) ndbook of depression: Treatment, assessment and research. 2nd ed. Futterman, A., Thompson, L., Gallagher-Thompson, D., & Ferris, R. 1995: 494-525
  • Treatment of clinical depression in caregivers of spouses with dementia Journal of Cognitive Psychotherapy: An International Quarterly Kaplan, C.P., Gallagher-Thompson, D. 1995; 9 (1): 35-44
  • Issues in geropsychological training at the internship level. In B.G. Knight, L. Teri, J. Santos & P. Wohlford (Eds.) Mental health services for older adults: Implications for training and practice in geropsychology Gallagher-Thompson, D., Thompson, L.W. 1995: 129-142
  • Linear and nonlinear changes in mood between psychotherapy sessions: Implications for treatment and outcome and relapse risk Psychotherapy Research Thompson, M., Gallagher-Thompson, D., & Thompson, L.W. 1995; 5 (4): 327-336


    We describe a novel intervention program in which wives or daughters who are caregivers are taught several specific skills to enable them to manage their frustrations more effectively. These skills include learning to relax in very stressful situations and learning to be appropriately assertive with their frail elder and with other family members. Class content and structure are presented, along with preliminary data on class efficacy that is based on an N of 48 caregivers who have currently completed this particular class series. We close by noting that this psychoeducational intervention has been very well received by colleagues in other agencies serving family caregivers. In fact, this class series is now being offered to a broad range of caregivers in the San Francisco Bay area.

    View details for Web of Science ID A1994PB46900018

    View details for PubMedID 7959115



    Clinically depressed family caregivers (N = 66) of frail, elderly relatives were randomly assigned to 20 sessions of either cognitive-behavioral (CB) or brief psychodynamic (PD) individual psychotherapy. At posttreatment, 71% of the caregivers were no longer clinically depressed according to research diagnostic criteria (RDC), with no differences found between the 2 outpatient treatments. The results suggested therapy specificity; there was an interaction between treatment modality and length of caregiving on symptom-oriented measures. Clients who had been caregivers for a shorter period showed improvement in the PD condition, whereas those who had been caregivers for at least 44 months improved with CB therapy. These findings suggest that patient-specific variables should be considered when choosing treatment for clinically depressed family caregivers.

    View details for Web of Science ID A1994NR92300013

    View details for PubMedID 8063980

  • A comparison of outreach strategies for Hispanic caregivers of Alzheimer's victims Clinical Gerontologist Gallagher-Thompson, D., Moorehead, R.S., Polich, T.M., Arguello, D., Johnson, C., Rodriquez, V., & Meyer, M. 1994; 15 (1): 57-63
  • Older Adults. In F.M. Dattilio & A. Freeman (Eds.) Cognitive-behavior strategies in crisis intervention DeVries, H.M., Gallagher-Thompson, D. 1994: 200-218
  • Clinical intervention strategies for distressed family caregivers: Rationale and development of psychoeducational approaches. In E. Light, G. Niederehe, & B. Lebowitz (Eds.) Stress effects on family caregivers of Alzheimer's patients Gallagher-Thompson, D. 1994: 260-277
  • Cognitive/behavior therapy with depressed older adults. In L.S. Schneider, C.F. Reynolds, B.D. Lebowitz, & A.J. Friedhoff (Eds.) Diagnosis and treatment of depression in late life Teri, L., Curtis, J., Gallagher-Thompson, D., & Thompson, L.W. 1994: 279-291
  • Direct services and interventions for caregivers: A review of extant programs and a look to the future. In M.H. Cantor (Ed.) Family caregiving: Agenda for the future Gallagher-Thompson, D. 1994: 102-122
  • Assessment of depression. In M.P. Lawton and J. Teresi (Eds.) Annual review of gerontology and geriatrics Pachana, N.A., Gallagher-Thompson, D., & Thompson, L.W. 1994: 234-256


    This study assessed the relationships between six different types of social support and five measures of caregiving burden. Two questions were addressed: Are all types of social support equally associated with burden, and do the same types of support correlate with different types of burden? Family caregivers (N = 217) to frail elders composed the sample. Multiple regression analyses demonstrated that all types of social support for caregivers of frail elders are not equal. Engaging in social interaction for fun and recreation appears to be the most important in diminishing the burden of caregiving. These findings are instructive both theoretically and clinically. The theoretical import of greater social participation under a condition of chronic stress is discussed. Further, interventions that focus on caregivers regularly experiencing pleasant activity with friends and other family would seem to go a long way toward managing the burden of caregiving.

    View details for Web of Science ID A1993LY22600015

    View details for PubMedID 8366273

  • The impact of spousal bereavement in older widows and widowers. In W. Stroebe, M. Stroebe, & R. Hansson (Eds.) Handbook of bereavement Gallagher-Thompson, D., Futterman, A., Farberow, N., Thompson, L.W., & Peterson, J. 1993: 227-239
  • Cardiovascular disease risk factors and attitudes towards prevention among Korean-American elders. Journal of cross-cultural gerontology Lee, J. A., Yeo, G., Gallagher-Thompson, D. 1993; 8 (1): 17-33


    The leading cause of death among the aging population is cardiovascular disease. Cardiovascular disease prevention and modification of disease risk factors are important and worthwhile directions for study because this population is rapidly increasing. Past studies have shown the significance of modifying cardiovascular disease risk factors in Anglo populations where major risk factors of hypertension, elevated cholesterol levels, diabetes, obesity, physical inactivity and smoking have been identified. However, the prevalence of these risk factors and the attitudes towards modifying them have not been studied in the Korean-American elderly population. This preliminary study used questionnaires given to fifty older recently immigrated Korean-American participants of a Korean senior center. Results show that this population has a lower frequency of cardiovascular disease and all risk factors, except for diabetes compared to an Anglo elderly population In addition, older Korean-American elders were generally unaware of risk factors for cardiovascular disease and uninterested in changing their habits to avoid cardiovascular disease. Increased availability of educational campaigns and health care in Korean are recommended.

    View details for DOI 10.1007/BF00973797

    View details for PubMedID 24389754

  • Cognitive/behavioral therapy and the angry caregiver Clinical Gerontologist DeVries, H.M., Gallagher-Thompson, D. 1993; 13 (4): 53-57
  • Cardiovascular disease risk factors and attitudes towards prevention among Korean-American elders Journal of Cross-Cultural Gerontology Lee, J.A., Yeo, G., & Gallagher-Thompson, D. 1993; 8: 17-33


    Comparisons are made of the impact of a suicide death on the surviving spouse (55 years and older) with that of a natural death on spouse survivors and a married nonbereaved control group over a bereavement period of 2 1/2 years after death. Regardless of mode of death, the loss of a loved one is a difficult psychological trauma, accompanied by depression, confusion, and pervasive feelings of emptiness. Few differences in the impact of the deaths in the early months of bereavement were reported, but changes appeared over the course of the 2 1/2-year measurement period. Compared with natural death survivors, the process of bereavement was found to be more difficult for the survivors of a suicide death, whose severe depressive feelings do not seem to lessen significantly and whose feelings of mental health do not seem to improve until after the first year. Women, in general, report greater feelings than men of anxiety, tension, and apprehension, especially within the first 6 months. By the end of the observation period, most of the differences between the two bereaved groups have disappeared, and both report functioning adequately despite continuing feelings of sadness and loss.

    View details for Web of Science ID A1992JX15700001

    View details for PubMedID 1430857



    To investigate the relations among the initial perceived stress of Alzheimer patients' caregivers, the rate of change of perceived stress, patients' sundowning behaviors, and patients' rate of cognitive decline.A longitudinal cohort study in which Alzheimer patients and their caregivers were assessed at 6-month intervals.Hospital out-patient clinic. Patients and caregivers lived at home.Subjects were 35 patients (50-79 years) with Alzheimer's disease and their primary caregivers (24 males and 11 females); all caregivers were spouses.At time of entry into the study, caregivers indicated which of seven behaviors indicative of sundowning were exhibited by the patient. Patients were evaluated successively using the Mini-Mental State Examination, whereas caregivers completed the Perceived Stress Scale, provided an index of social support utilization, and completed the Beck Depression Inventory.Caregivers' initial perceived stress and the rate of change of perceived stress, patients' sundowning behavior, and rate of cognitive decline.The pattern of correlations indicated that both rate of cognitive decline and initial sundowning behavior were significantly correlated with initial perceived caregiver stress. The average rate of increase of caregivers' perceived stress was positively correlated with the initial incidence of sundowning behaviors, even when controlling for the effects of caregiver depression and social support utilization.Sundowning behavior of Alzheimer patients is associated with an increased rate of change of caregivers' perceived stress. This association may be specific to sundowning behavior because there was no relation between the rate of change of perceived stress and morning agitation. The findings suggest that future caregiver intervention programs could profitably focus on sundowning behavior rather than general agitation.

    View details for Web of Science ID A1992JH34400009

    View details for PubMedID 1634724

  • Applying cognitive-behavioral psychotherapy to the chronically ill elderly: treatment issues and case illustration. International psychogeriatrics Rybarczyk, B., Gallagher-Thompson, D., Rodman, J., Zeiss, A., Gantz, F. E., Yesavage, J. 1992; 4 (1): 127-140


    A large percentage of older adults must endure at least one chronic medical illness. Clinically significant depression and anxiety are common among these patients. Specific psychotherapy approaches as well as adaptations required to address the unique issues of this population have not been delineated in the literature. We outline a cognitive-behavioral therapy approach and discuss five treatment issues we have found to be important for this population. These issues include: (1) resolving practical barriers to participation; (2) accepting depression as a separate and reversible problem; (3) limiting excess disability; (4) counteracting the loss of important social roles and autonomy; and (5) challenging the perception of being a "burden." A case study of a chronic obstructive pulmonary disease (COPD) patient with depression is presented and recommendations for future research are suggested.

    View details for PubMedID 1391668



    This article describes agreement among diagnoses made according to five definitions of endogenous depression in a sample of 99 depressed elders and discusses the relationship among these systems and selected demographic and clinical characteristics. Poor to fair agreement was generally demonstrated, except for Research Diagnostic Criteria (Spitzer, Endicott, & Robins, 1978) and Diagnostic and Statistical Manual of Mental Disorders, 3rd ed., rev. (American Psychiatric Association, 1987), which demonstrated excellent agreement. Mostly, demographic and clinical variables (e.g., severity of depression) were unrelated to endogeneity diagnoses. The conclusion was reached that these criteria are not all measuring the same construct in older adults and that the relationship between depression severity and endogeneity should be discussed in terms of specific definitions rather than general terms.

    View details for Web of Science ID A1992HM68200019

    View details for PubMedID 1592961



    This report examines the changing role of social supports in the bereavement of spouses of elderly suicide and natural deaths, focusing on differences and similarities in relation to gender, time, and mode of death. Measurements were obtained 4 times after death (within 2 months, at 6 months, at 12 months, and at 2 to 2 1/2 years) on 79% of the 108 survivors of elderly suicide, 89% of the 199 natural death survivors, and 79% of the nonbereaved controls. The results indicated that the suicide survivors received significantly less emotional support for their feelings of depression and grief than the natural death survivors, and that they did not confide in the persons in their network any more than the nonbereaved controls did. Women report receiving more support overall than men. A low spot in social supports occurred at the 6-month point after loss for both bereaved groups, but primarily in practical help received by natural death survivors. By the end of the second year, both practical and emotional supports had increased to at least the same level as immediately after death.

    View details for Web of Science ID A1992HX81400009

    View details for PubMedID 1579980

  • The older adult. In A. Freeman & F.M. Dattilio (Eds.) Comprehensive casebook of cognitive therapy Gallagher-Thompson, D., Thompson, L.W. 1992: 193-200
  • Inhibited grief. In A. Freeman and F. Dattilio (Eds.) Comprehensive casebook of cognitive-behavior therapy Gantz, F.E., Gallagher-Thompson, D., & Rodman, J.L. 1992: 201-207
  • A comparison of depression and coping among caregivers of physically and cognitively impaired elders. Journal of Verhaltenstherapie Walsh, W.A., Steffen, A., & Gallagher-Thompson, D. 1992; 3 (Band 2): 231-236


    Self-report measures of grief, depression, and general psychopathology were studied in widows and widowers over a 2.5-year period following death of their partner. A comparison sample of men and women was also followed for the same period. Differences in severity of depression and psychopathology previously reported at 2 months postloss (Gallagher, Breckenridge, Thompson, & Peterson, 1983) diminished to nonsignificant levels at 12 and 30 months. However, significant differences between bereaved and comparison subjects on measures of grief were still apparent 30 months after spousal loss. A main effect of gender for depression and psychopathology (but not for grief) was found at 2 and 12 months: Women reported more distress than men regardless of bereavement status. Results indicate that the experience of grief persists for at least 30 months in both older men and women who have lost their spouse.

    View details for Web of Science ID A1991GF57600011

    View details for PubMedID 1930760



    This paper presents two strategies for treating depression in Alzheimer's patients. Cognitive therapy, used with mildly demented adults, challenges the patient's negative cognitions in order to reduce distortions and enable the patient to generate more adaptive ways of viewing specific situations and events. Behavioral intervention, used with more moderately or severely demented adults, attempts to modify person-environment interactions by increasing the level of positive activities and decreasing negative ones (Lewinsohn et al., 1984). Both theories have been used successfully in clinical settings.

    View details for Web of Science ID A1991FQ07900018

    View details for PubMedID 1879719



    The relationship between social support and depression was studied in 165 women caring for frail family members. The Arizona Social Support Interview Schedule (Barrera, Sandler, & Ramsay, 1981), which includes 4 dimensions of availability and use of resources and satisfaction with and need for support, was used to examine 7 categories of supportive activity. Depression was assessed according to Research Diagnostic Criteria (Spitzer, Endicott, & Robins, 1978) with the Schedule of Affective Disorders and Schizophrenia (Endicott & Spitzer, 1978). There were no differences in overall satisfaction with received support in comparisons of depressed and nondepressed caregivers. However, depressed caregivers (n = 87) reported a higher incidence of negative interactions with others. Both groups appeared to have equal access to social support, with nondepressed caregivers (n = 78) reporting significantly greater use of those resources.

    View details for Web of Science ID A1991FQ04500008

    View details for PubMedID 1863392



    Three hundred ninety-three elderly adults aged 55 and older were divided into 1 of 9 subgroups in a 3 (bereavement group: survivors of spouses who died by natural death or by suicide and nonbereaved control Ss) x 3 (depression group: none, mild, and moderate-severe) design over 4 times of measurement--1 month, 6 months, 1 year, and 2.5 years after death of spouse. Significant Bereavement x Depression Group effects were obtained on Brief Symptom Inventory scores. The moderate-severe depression/suicide subgroup had the greatest psychiatric complications with bereavement. Results indicated that elderly persons with significant clinical depression at the time of a spouse's death were at significant risk for psychological complications during the bereavement process, and survivors of spouses who had committed suicide were even more at risk within the greatest depression group.

    View details for Web of Science ID A1991FA55300009

    View details for PubMedID 2029370

  • Meta-analysis of therapist effects in psychotherapy outcome studies Psychotherapy Research Crits-Christoph, P., Baronackie, K., Kurcias, J.S., Beck, A.T., Carroll, K., Perry, K., Luborsky, L, McLellan, A.T., Woody, G.E., Thompson, L., Gallagher, D., & Zitrin, C. 1991; 1 (2): 81-91
  • ). Short term treatment of endogenous depression using cognitive/behavioral therapy and pharmacotherapy Clinical Gerontologist Rodman, J., Gantz, F.E., Schneider, J., & Gallagher-Thompson, D. 1991; 10 (3): 81-84
  • ecommendations for handling termination from a cognitive/behavioral perspective. International Cognitive Therapy Newsletter Gallagher-Thompson, D. 1991; 5/6: 1-2
  • Psychotherapeutic interventions for stressed family caregivers. In W.A. Myers (Ed.) New Techniques in the Psychotherapy of older patients Gallagher-Thompson, D., Lovett, S., & Rose, J. 1991: 61-78
  • Problems of Aging, chapter in Text by Ronald Comer Abnormal Psychology Gallagher-Thompson, D., Thompson, L.W. 1991
  • An expansion of the A-B-C approach to cognitive/behavioral therapy Clinical Gerontologist Florsheim, M.J., Leavesley, G., Hanley-Petersen, P., & Gallagher-Thompson, D. 1991; 10 (4): 65-69
  • Alliance prediction of outcome beyond in-treatment symptomatic change as psychotherapy processes Psychotherapy Research Gaston, L., Marmar, C.R., Gallagher, D., & Thompson, L.W. 1991; 1 (2): 104-113
  • Cognitive/behavioral therapy for affective disorders in the elderly. In W.A. Myers (Ed.) New techniques in the psychotherapy of older patients Thompson, L.W., Gantz, F., Florsheim, M., DalMaestro, S., Rodman, J., Gallagher-Thompson, D., & Bryan, H. 1991: 3-18
  • Factor analysis and preliminary validation of the mini-mental state examination from a longitudinal perspective. International psychogeriatrics Tinklenberg, J., Brooks, J. O., Tanke, E. D., Khalid, K., POULSEN, S. L., Kraemer, H. C., Gallagher, D., Thornton, J. E., Yesavage, J. A. 1990; 2 (2): 123-134


    The Mini-Mental State Examination (MMSE) is a commonly used instrument for assessing mental impairment. Previous proposals for its underlying structure have focused on scores obtained from a single administration of the test. Because the MMSE is widely used in longitudinal studies, we examined the pattern of relations among the rates of chance of the items. Data were obtained from 63 subjects for 1.5 years or more. The relations among the rates of change of the MMSE items were described by a five-factor solution that accounted for 75% of the variance and comprised factors pertaining to orientation and concentration, obeying commands, learning and repetition, language, and recall. This was in contrast to the structure of the scores obtained from a single administration of the MMSE, which was best described by a two-factor solution. In order to provide a clinical validation, factor scores derived from the MMSE factors were used to predict scores on the Memory and Behavior Problems Checklist and the Brief Cognitive Rating Scale.

    View details for PubMedID 2101301



    Cross-sectional and longitudinal data are presented from a 2-year follow-up study of 91 older adults, initially diagnosed as in an episode of major depressive disorder (MDD), who were treated with brief cognitive, behavioral, or psychodynamic psychotherapy. Using research diagnostic criteria (RDC), 52%, 58%, and 70% of the sample did not meet criteria for any RDC depressive disorder at posttherapy, and 12- and 24-month follow-ups, respectively. There were no significant differences in response rate by therapy modality. Using Longitudinal Interval Follow-up Evaluation (LIFE; Shapiro & Keller, 1979; Keller et al., 1987) methodology, we noted that patients not depressed at posttreatment remained depression-free for longer time periods than those who were minor or MDD. These rates compare favorably with published reports on younger depressed patients.

    View details for Web of Science ID A1990DJ32800017

    View details for PubMedID 2365900



    Two hundred twelve bereaved elders rated marital adjustment using items drawn from the Locke and Wallace (1959) Marital Adjustment Test and completed the Beck Depression Inventory 2 months, 12 months, and 30 months after the loss of their spouses. Their responses were compared with those of 162 nonbereaved individuals of comparable age who were tested at the same times. More positive ratings of marital adjustment were made by bereaved subjects than by nonbereaved subjects. Among nonbereaved elders, more severe ratings of depression were associated with lower ratings of marital adjustment. In the bereaved sample, however, the opposite was found: More severe ratings of depression were associated with higher ratings of marital adjustment. This pattern of results changed only slightly over the 2.5-year course of bereavement and was not influenced by gender. These results are discussed in terms of cognitive processes (e.g., idealization) that influence retrospective assessments of marital adjustment during bereavement.

    View details for Web of Science ID A1990DH07000015

    View details for PubMedID 2378693

  • Depression and information valence influence depressive cognition Cognitive Therapy and Research Krantz, S.E., Gallagher-Thompson, D. 1990; 14 (1): 95-108
  • Cognitive/behavioral treatment of atypical bereavement: A case study Clinical Gerontologist Florsheim, M.J., Gallagher-Thompson, D. 1990; 10 (2): 73-76

    View details for Web of Science ID A1989AV89600012

    View details for PubMedID 2794323

  • PREVALENCE OF DEPRESSION IN FAMILY CAREGIVERS GERONTOLOGIST Gallagher, D., Rose, J., Rivera, P., LOVETT, S., Thompson, L. W. 1989; 29 (4): 449-456


    Family caregivers who sought help to increase their coping skills (N = 158) and caregivers who volunteered for a longitudinal study of Alzheimer's disease (N = 58) were screened for depression. Among help-seekers, 46% had depression according to Research Diagnostic Criteria (RDC), but among non-help-seekers, only 18% met this criterion. In general, women were more depressed than men, but no major differences in the extent of depression were found in those who cared for more impaired persons.

    View details for Web of Science ID A1989AK23600004

    View details for PubMedID 2521102

  • ALLIANCE AND OUTCOME IN LATE-LIFE DEPRESSION JOURNAL OF NERVOUS AND MENTAL DISEASE Marmar, C. R., Gaston, L., Gallagher, D., Thompson, L. W. 1989; 177 (8): 464-472


    Older adults who met criteria for major depressive disorder were randomly assigned to behavioral, cognitive, or brief dynamic therapy. Symptoms were equally reduced across the three treatment conditions. Early in treatment, alliance ratings were obtained from both therapists and patients and were related to outcome. We calculated one therapist alliance composite score and five patient alliance factor scores. In general, no agreement was found between therapists' and patients' judgments of alliance. Levels of alliance were found to be not significantly different across the three treatment conditions. For the sample as a whole, only the patient factor of Patient Commitment was found to be associated with depressive symptoms after treatment, with the strongest findings in the cognitive therapy condition. The Patient Commitment factor uniquely contributed to outcome over and above the contribution of initial symptomatology and symptomatic change at midpoint in therapy. Expected trends of association with outcome were observed for the therapist alliance composite score in brief dynamic therapy and for the patient factor of Patient Working Capacity in both cognitive and brief dynamic therapy. Findings are discussed in terms of their theoretical and clinical implications.

    View details for Web of Science ID A1989AK86300003

    View details for PubMedID 2760597

  • Bereavement and adjustment disorders. In. E.W. Busse, & D.G. Blazer (Eds.) Geriatric psychiatry Gallagher, D., Thompson, L.W. 1989: 459-473
  • Effects of bereavement on symptoms of psychopathology in older men and women. In D.G. Lund (Ed.) Older bereaved spouses: Research with practical applications Thompson, L.W., Gallagher, D.A., Cover, H., Gilewski, M., & Peterson, J. 1989
  • Use of select coping strategies during late-life spousal bereavement. In D. Lund (Ed) Older bereaved spouses: Research with practical applications Gallagher, D., Lovett, S., Hanley-Dunn, P., & Thompson, L.W. 1989
  • Interventions with caregivers of frail elderly persons. In M. Ory & K. Bond (Eds.) Aging and health care: Social science and policy perspectives Gallagher, D., Lovett, S., & Zeiss, A. 1989: 167-190
  • ). Impact of confirming patient expectations of change processes in behavioral, cognitive, and brief dynamic psychotherapy Psychotherapy Gaston, L., Marmar, C.R., Gallagher, D., & Thompson, L.W. 1989; 26: 296-302
  • Depression and other negative affects in family caregivers. In E. Light & B. Lebowitz (Eds.) Alzheimer's disease treatment and family stress: Directions for research Gallagher, D., Wrabetz. A., Lovett, S., DalMaestro, S., & Rose, J. 1989: 218-244
  • Training in clinical gero-psychology: Program descriptions and participant evaluation Gerontology and Geriatrics Education Gallagher, D.E., Cover, H.E., Zeiss, A.M., Breckenridge, J.S., Czirr, R., & Thompson, L.W. 1989; 10 (2): 1-17
  • Cognitive behavioral therapy with early stage Alzheimer?s patients: An exploratory view of the utility of this approach. In E. Light & B. Lebowitz (Eds.) Alzheimer?s disease treatment and family stress: Directions for research Thompson, L.W., Wagner, B., Zeiss, A., & Gallagher, D. 1989: 89-1569