Pilot testing a dyadic intervention for couples coping with stroke

Principal Investigator: Alexandra Terrill
Keywords: Stroke , Couples , Depression , Well-being , Behavioral intervention , Positive psychology , Resilience , Caregiver , Rehabilitation Department: OCCUPATIONAL THERAPY
IRB Number: 00094857 Co Investigator:  
Specialty: Occupational Therapy, Adult Behavioral Health, Physical Medicine and Rehabilitation, Psychology, Clinical, Neurology
Sub Specialties: Stroke , Stroke
Recruitment Status: Not yet recruiting

Contact Information

Alexandra Terrill
alex.terrill@hsc.utah.edu
801-581-5951

Brief Summary

We have developed a dyadic (couples-based) positive psychology intervention (PPI) protocol to simultaneously target stroke survivors (>6months since stroke) and their partner caregiver. Preliminary data from a small sample suggest that the PPI protocol is feasible in this population (IRB_00080565). We will now test this intervention and explore potential pathways for its efficacy of through the following aims:

Aim 1. To determine preliminary efficacy of the PPI in 24 couples with depressive symptoms in a randomized waitlist control pilot trial on mood and well-being. H1a: The PPI will improve well-being and mood as assessed by established outcome measures in survivors and caregivers from pre- to post-intervention. H1b: Improvements in well-being and mood will be greater in the PPI vs. control group.

Aim 2. To determine if the PPI improves quality of interactions in couples during stressful discussion and collaborative problem-solving tasks. H2: The PPI will enhance the emotional tone of the couple’s interactions from pre- to post-intervention as measured by observational interaction coding.

Exploratory Aim 3. To determine whether increases in mood in one partner leads to improvement in mood in the other partner over time as assessed by weekly self-report. H3: Increases in mood in one partner will be positively associated with increase mood in the other partner and vice-versa; i.e. be synergistic across couples.

Inclusion Criteria

Inclusion criteria are:

1) Couples consisting of one partner who had an ischemic or hemorrhagic stroke > 6 months ago and a cohabiting partner (living together > 1 year) who self-identifies as the caregiver and is willing to enroll in the study.

2) Either one or both partner(s) report depressive symptoms as assessed by the PROMIS-Depression measure (no formal diagnosis is required).

3) Both partners must be community-dwelling adults age 18 years and older.

4) Both partners must be able to understand printed English instructions

Exclusion Criteria

Exclusion criteria are:

1) Either partner does not consent to participate.

2) The caregiving partner has had a stroke or other major neurological condition.

3) Either partner is unable to understand printed English instructions.

4) Either partner has significant cognitive impairment (as assessed by the Telephone Interview for Cognitive Status, TICS).

Note: As this is a pilot study, we are restricting participation to only those who are able to understand printed English instructions and have mild/no cognitive impairment. We anticipate expanding inclusion criteria for future trials.