Date of Submission

2007

Degree Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

Department Chair

Robert A. DiTomasso, Ph.D., ABPP

First Advisor

Stephanie Felgoise, Ph.D., ABPP, Chairperson

Second Advisor

Barbara Golden, Psy.D., ABPP

Third Advisor

Zachary Simmons, M.D.

Abstract

Amyotrophic lateral sclerosis (ALS) is a progressive, neurodegenerative disease resulting from generalized degeneration of motor cells in the brain and spinal cord (The Amyotrophic Lateral Sclerosis Association [ALSA], 2004). Also known as Lou Gehrig’s disease, ALS has no conclusive etiology, no known cure, and death generally occurs within three to five years following the diagnosis (Rabkin, Wagner, & Del Bene, 2000). Given the devastating and predictable course of ALS, it is understandable that this disease can have a profound, adverse impact on the quality of life (QOL) of the patient and the caregiver. However, not all caregivers, particularly spouses who assume the primary care for patients with ALS, perceive the experience of caregiving as a profound burden (Miller & Lawton, 1997). In fact, some ALS caregivers appear to be psychologically resilient to the stress associated with caregiving, and even endorse satisfaction with their QOL. Yet the protective factors, or resiliency variables, that contribute to ALS caregivers’ positive QOL are largely unexplored in empirical research. This is a cross-sectional study, and data generated by ALS caregivers using the following measures were collected: Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS), State Hope Scale (SHS), Life Orientation Test – Revised (LOT-R), Social Problem Solving Inventory – Revised: Short (SPSI-R: S), and the World Health Organization Quality of Life – Brief Form (WHOQOL-BREF). The following hypotheses were tested: (1) Hope, optimism, social problem solving abilities, relationship satisfaction, and religiosity/spirituality will be significant predictors of the quality of life for caregivers of patients with ALS. (2) Positive problem orientation and rational problem solving skills will be positively correlated with the relationship satisfaction of spousal caregivers of patients with ALS. (3) ALS caregivers’ religiosity/spirituality will be positively correlated with caregivers’ state hope and dispositional optimism (i.e., positive life orientation). Analyses of the data collected from the sample participants (n = 58) are at least preliminarily consistent with prior research suggesting that there are some significant inter-construct relationships between the independent variables. This study supports the notion that clinicians can identify at-risk caregivers early in the caregiving experience, in order to engage these caregivers in appropriate interventions designed to enhance their quality of life and the quality of life of patients living with ALS. Limitations of the study and clinical implications of the development of the ALS Caregiver Resiliency Training, an intervention model, are discussed.

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