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A randomized clinical trial of Behavioral Activation (BA) therapy for improving psychological and physical health in dementia caregivers: results of the Pleasant Events Program (PEP)


Moore, Raeanne C., Chattillion, Elizabeth A., Ceglowski, Jennifer, Ho, Jennifer, von Känel, Roland, Mills, Paul J., Ziegler, Michael G., Patterson, Thomas L., Grant, Igor, Mausbach, Brent T.


Behaviour Research And Therapy, Volume: 51, No.: 10, Pages.: 623-632

Year of Publication



Dementia caregiving is associated with elevations in depressive symptoms and increased risk for cardiovascular diseases (CVD). This study evaluated the efficacy of the Pleasant Events Program (PEP), a 6-week Behavioral Activation intervention designed to reduce CVD risk and depressive symptoms in caregivers. One hundred dementia family caregivers were randomized to either the 6-week PEP intervention (N = 49) or a time-equivalent Information-Support (IS) control condition (N = 51). Assessments were completed pre- and post-intervention and at 1-year follow-up. Biological assessments included CVD risk markers Interleukin-6 (IL-6) and D-dimer. Psychosocial outcomes included depressive symptoms, positive affect, and negative affect. Participants receiving the PEP intervention had significantly greater reductions in IL-6 (p = .040), depressive symptoms (p = .039), and negative affect (p = .021) from pre- to post-treatment. For IL-6, clinically significant improvement was observed in 20.0% of PEP participants and 6.5% of IS participants. For depressive symptoms, clinically significant improvement was found for 32.7% of PEP vs 11.8% of IS participants. Group differences in change from baseline to 1-year follow-up were non-significant for all outcomes. The PEP program decreased depression and improved a measure of physiological health in older dementia caregivers. Future research should examine the efficacy of PEP for improving other CVD biomarkers and seek to sustain the intervention’s effects.; Copyright © 2013 Elsevier Ltd. All rights reserved.

Bibtex Citation

@article{Moore_2013, doi = {10.1016/j.brat.2013.07.005}, url = {}, year = 2013, month = {oct}, publisher = {Elsevier {BV}}, volume = {51}, number = {10}, pages = {623--632}, author = {Raeanne C. Moore and Elizabeth A. Chattillion and Jennifer Ceglowski and Jennifer Ho and Roland von Känel and Paul J. Mills and Michael G. Ziegler and Thomas L. Patterson and Igor Grant and Brent T. Mausbach}, title = {A randomized clinical trial of Behavioral Activation ({BA}) therapy for improving psychological and physical health in dementia caregivers: Results of the Pleasant Events Program ({PEP})}, journal = {Behaviour Research and Therapy} }


affect, aged, alzheimer’s disease, behavior therapy, biological markers, blood, cardiovascular disease, cardiovascular diseases, caregivers, complications, dementia, depression, female, fibrin fibrinogen degradation products, humans, interleukin6, intervention, male, metabolism, methods, middle aged, nursing, prevention & control, psychology, social support, therapy, treatment

Countries of Study


Types of Dementia

Dementia (general / unspecified)

Types of Study

Randomised Controlled Trial

Type of Outcomes

Carers’ Mental Health, Carers’ Physical Health

Type of Interventions

Intervention for Carers

Carer Focussed Interventions

Information and Advice, Training programmes / workshops including behavioural training