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Benefit-Finding Intervention Delivered Individually to Alzheimer Family Caregivers: Longer-Term Outcomes of a Randomized Double-Blind Controlled Trial

Contact Information


Sheung-Tak Cheng, PhD,

Dementia caregiving, Depression, Cognitive reappraisal, Positive aspects of caregiving, Randomized controlled trial


Objectives: To examine the longer-term effects of benefit-finding on caregivers' depressive symptoms (primary outcome), and global burden, role overload, psychological well-being, and positive aspects of caregiving (secondary outcomes). Method: Ninety-six Hong Kong Chinese caregivers of relatives with Alzheimer's disease were randomly assigned to receive the benefit-finding intervention (BFT) or one of the two control conditions, namely, simplified psychoeducation (lectures only; SIM-PE) or standard psychoeducation (STD-PE). Caregivers received four biweekly one-to-one interventions of 3 hours each at their own homes. We focused on outcomes measured at 4- and 10-month follow-ups. The trajectories of intervention effects were modeled by BFT × time and BFT × time2 interaction terms. Results: Mixed-effects regression showed significant BFT × time2 interaction effects on depressive symptoms against both control conditions, suggesting diminishing BFT effects over time. Z tests showed that, compared with controls, BFT participants reported substantial reductions in depressive symptoms at 4-month follow-up (d = -0.85 and -0.75 vs. SIM-PE and STD-PE, respectively). For depressive symptoms measured at 10-month follow-up, BFT was indistinguishable from STD-PE, whereas a moderate effect was observed in comparison with SIM-PE (d = -0.52). Moreover, positive aspects of caregiving, but not other secondary outcomes, continued to show intervention effect up to 10-month follow-up. Discussion: Benefit-finding is an efficacious intervention for depressive symptoms in Alzheimer caregivers, with strong effects in the medium-term post-intervention and possible moderate effects in the longer-term post-intervention.


Sheung-Tak Cheng, Emily P M Mak, Timothy Kwok, Helene Fung, Linda C W Lam, Benefit-Finding Intervention Delivered Individually to Alzheimer Family Caregivers: Longer-Term Outcomes of a Randomized Double-Blind Controlled Trial, The Journals of Gerontology: Series B, Volume 75, Issue 9, November 2020, Pages 1884–1893,





Conent Area

Sheung-Tak Cheng

EWB-Related Construct

(1) goal pursuit
(2) life satisfaction
(3) positive affect
(5) sense of meaning

Study Design

Species or Study Population

(5) RCT

Sex (%Female)


Age (Mean, SD)

56.16, 10.56

Younger Controls?


Longitudinal Data?


Sample Size



Benefit-Finding Intervention

Ethnicity (%white)

0% (Hong Kong)

Inclusion Criteria

(a) being a primary caregiver aged 18 years or over
(b) providing ≥14 hr of care per week to a relative with Alzheimer’s disease in the mild-to-moderate stage (per Clinical Dementia Rating; Morris, 1993)
(c) a Mini-Mental State Examination (Cantonese version) score not, suggesting that cognitive impairment
(d) at least mild depressive symptoms operationalized as a score of ≥3 on the Hamilton Depression Rating Scale

Exclusion Criteria

Exclude the Care-recipient having parkinsonism or other forms of dementia (e.g., mixed dementia).

EWB Measures

(1) Psychological Well-being Scale Ryff’s (1989): Goal Pursuit, Life Satisfaction, Positive Affect, Sense of Meaning

Non-EWB Behavioral

(1) Depressive symptoms: Hamilton Depression Rating Scale
(2) Global Burden: Zairt Burden Interview
(3) role overload: Pearlin, Mullan, Semple, and Skaff’s (1990)
(4) behavioral and psychological symptoms of dementia: Neuropsychiatry Inventory (Cummings, 1997)
(5) Functional impairment: OARS Multidimensional Functional Assessment Questionnaire (Fillenbaum & Smyer, 1981)

Physiological Measures


Brain IMaging Modality

Brain IMaging Paradigm


Brain Region/Circuit


Biological Measures


Other Neural Measures

Data Availability?


Data Avalability Details

Data for the study can be obtained from the corresponding author.

Diagnostic Measures

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