Psychosocial Intervention Psychosocial Intervention
Psychosocial Intervention 26 (2017) 165-70 - Vol. 26 No.3 DOI: 10.1016/j.psi.2017.06.002
A cognitive-behavioural intervention improves cognition in caregivers of people with autism spectrum disorder: A pilot study
La intervención cognitivo-conductual mejora la cognición de los cuidadores de personas con trastorno del espectro autista: estudio piloto
Angel Romero-Martíneza,, , Nicolás Ruiz-Robledilloa, Patricia Sariñana-Gonzáleza, Sara de Andrés-Garcíab, Sara Vitoria-Estrucha, Luis Moya-Albiola
a Department of Psychobiology, University of Valencia, Spain
b Neuropsychological Rehabilitation Unit of Valencia, NEURAL, Spain
Received 25 April 2017, Accepted 04 June 2017
Abstract

As postulated by the stress process model, chronically stressed individuals, such as caregivers of people with chronic psychological disorders, have poorer cognitive performance and higher age-related cognitive decline than individuals not exposed to chronic stress. When analysing this topic in caregivers, the majority of research has been conducted in populations in which the care recipient has dementia and/or Alzheimer's disease, while relatively few studies have analysed cognition in caregivers of offspring with autism spectrum disorder (ASD). The main objective of this pilot study was to analyse the effect of a cognitive-behavioural intervention on cognition in caregivers of people with ASD. Specifically, we sought to gather evidence on whether there were clinically significant improvements in speed/attention, memory, and visuospatial, language and executive functions after the intervention. The participants were 17 parents (mean age of 52 years, 59% females) of ASD-diagnosed people who had cared for their offspring for approximately 14 years. The study had a pre-post design. After the cognitive-behavioural intervention, ASD caregivers had better selective attention, short- and long-term memory for words, stories and images, naming, cognitive flexibility and planning skills (p=.01 for all). Nevertheless, no changes were observed in general cognitive status, working memory for digits, verbal fluency, processing speed or inhibitory control (p>.05 for all). These findings underline the relevance of proper support and respite services to help caregivers cope with and reduce stress. A comprehensive neuropsychological assessment together with adjuvant domain-specific procedures and programmes to improve cognitive abilities are required to improve caregivers’ well-being and health.

Keywords
  • Autism spectrum disorder
  • Caregivers
  • Chronic stress
  • Cognition
  • Cognitive-behavioural intervention
Resumen

Según los postulados del modelo del proceso del estrés, los individuos con situación de estrés crónico, tales como los cuidadores de personas con trastornos psicológicos crónicos, tienen un desempeño cognitivo más pobre y un deterioro cognitivo relacionado con la edad más acentuado que los individuos no expuestos al estrés crónico. Al analizar esta cuestión en los cuidadores, la mayoría de los estudios se han realizado en poblaciones en las que los receptores de los cuidados padecen demencia y/o Alzheimer, y pocos estudios han analizado la cognición en los cuidadores de los hijos con trastorno del espectro autista (ASD). El objetivo principal de este estudio piloto fue analizar el efecto de una intervención cognitivo-conductual en los cuidadores de personas con ASD. De manera específica, tratamos de reunir evidencia sobre las posibles mejoras con significación clínica en cuestiones tales como velocidad/atención, memoria y funciones visuoespaciales, del lenguaje y ejecutivas tras la intervención. Los participantes fueron 17 padres (edad media de 52 años, 59% de mujeres) de personas diagnosticadas de ASD que habían cuidado de sus hijos durante aproximadamente 14 años. El estudio tenía un diseño pre-post. Tras la intervención cognitivo-conductual, los cuidadores de las personas con ASD tenían mejor atención selectiva, memoria a corto y largo plazo en relación con las palabras, cuentos e imágenes, es decir, flexibilidad cognitiva y técnicas de planificación (p=0.01 en total). Sin embargo, no se observaron cambios con relación al estado cognitivo general, memoria operativa para cifras, fluidez verbal, velocidad de procesamiento o control inhibitorio (p>0.05 en total). Estos hallazgos subrayan la relevancia de un respaldo adecuado y de unos servicios de relevo que ayuden a los cuidadores a enfrentarse al estrés, y reducir el mismo. Se precisan amplias valoraciones neuropsicológicas y procedimientos y programas adyuvantes, específicos en la materia, para mejorar las capacidades cognitivas, así como el bienestar y la salud, de los cuidadores.

Keywords
  • Trastorno del espectro autista
  • Cuidadores
  • Estrés crónico
  • Cognición
  • Intervención cognitivo-conductual
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Psychosocial Intervention 26 (2017) 165-70 - Vol. 26 No.3 DOI: 10.1016/j.psi.2017.06.002