Motivational Interviewing to Enhance Behavioral Change in Older Adults With Hoarding Disorder
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 48
- 试验地点
- 1
- 主要终点
- Change in duration of sorting/discarding behavior
研究概览
简要总结
This study will compare two behavioral interventions for hoarding disorder in older adults.
详细描述
Hoarding disorder is a psychological condition with a unique constellation of consequences for older adults, including increased risk of fire and dying in a fire, insect infestation, and medical problems. Dangers related to cluttered living spaces are exacerbated by reduced executive functioning, attention, and concentration. Hoarding psychopathology results from maladaptive cognitions (e.g., desire to keep items others would discard) and maladaptive behavioral patterns (e.g., avoidance of sorting/discarding items).
Extant treatments for hoarding have targeted fear reduction as the mechanism of change, either through cognitive-behavioral therapy focusing on cognitive restructuring or behavior therapy focusing on exposure therapy. Older adults have a lackluster response to cognitive restructuring for hoarding, and, although exposure therapy increases treatment response, both approaches require a lengthy six-month dose. Our preliminary work suggests that fear reduction may not be a universally relevant target mechanism for older adults, and that to be responsive to the specific needs of older adults, other mechanisms need to be identified.
Motivational interviewing is a technique that is already typically incorporated into hoarding treatment and has been demonstrated to increase motivation for behavioral change across a range of health conditions for older adults, including physical activity, diet, and disease management. Because sorting/discarding is at its core a health behavior that hoarding patients lack the motivation to engage in, motivational interviewing is likely to decrease hoarding severity by eliciting increased levels of sorting/discarding.
The proposed project will use a mechanistic clinical trials approach to determine if a four-month intervention combining motivational interviewing with sorting practice can engage the proposed target, motivation for behavioral change, when compared to a four-month dose of sorting practice alone in a sample of rural-dwelling older adults with hoarding disorder.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 60 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Live within a 60-minute driving radius of Starkville, MS
- •Have a primary psychiatric diagnosis of hoarding disorder
排除标准
- •Major cognitive impairment
- •Active psychosis, drug use, or acute suicidal ideation
- •Concurrent psychotherapy focused on hoarding
- •Changed psychotropic medications within the past three months
研究组 & 干预措施
RECLAIM: Reducing Clutter and Increasing Meaning
Participants will receive a combination of motivational interviewing and sorting practice to reduce hoarding symptoms.
干预措施: RECLAIM: Reducing Clutter and Increasing Meaning (Behavioral)
Sorting Practice
Participants will receive sorting practice only to reduce hoarding symptoms.
干预措施: Sorting Practice (Behavioral)
结局指标
主要结局
Change in duration of sorting/discarding behavior
时间窗: Four months
As a behavioral indicator of motivation to engage in sorting/discarding behavior, participants will be asked to report at baseline and at their weekly treatment sessions the duration of sorting/discarding items in the previous week.
Change in score on the University of Rhode Island Change Assessment Questionnaire McConnaughy et al., 1983)
时间窗: Four months
The URICA is a 32-item Likert scale that assesses readiness for change and includes four subscales that individually assess stage of change (Precontemplation, Contemplation, Action, and Maintenance). Previous investigations have found adequate internal reliability for the URICA in treatment-seeking samples (Dozois et al., 2004), including in older hoarding samples specifically (Ayers et al., 2019).
Change in frequency of sorting/discarding behavior
时间窗: Four months
As a behavioral indicator of motivation to engage in sorting/discarding behavior, participants will be asked to report at baseline and at their weekly treatment sessions the frequency of sorting/discarding items in the previous week.
Change in score on the Apathy Evaluation Scale (AES-S; Marin, 1991)
时间窗: Four months
The AES is an 18-item measure of an individual's deficits in goal-directed thoughts and behavior. The AES was developed specifically to assess apathy in adults aged 55+ and is predictive of motivation for behavioral change (Resnick et al., 2012).
Frequency of Sorting/Discarding Behavior
时间窗: Four months
As a behavioral indicator of motivation to engage in sorting/discarding behavior, participants will be asked to report at their weekly treatment sessions the frequency of sorting/discarding items in the previous week. Data were analyzed as percentage of days sorted between sessions (assessed at sessions 2-16). Mixed effects models were used to analyze data such that participants with at least one timepoint were included in the analyses.
University of Rhode Island Change Assessment Questionnaire
时间窗: Four months
The University of Rhode Island Change Assessment Questionnaire (URICA) is a 32-item Likert scale that assesses readiness for change. Scores for readiness for change are calculated by subtracting pre contemplation items from the other summed items. Scores range from -2 to 14, with higher scores indicating greater readiness for change.
Apathy Evaluation Scale
时间窗: Four months
The Apathy Evaluation Scale is an 18-item measure of an individual's deficits in goal-directed thoughts and behavior. Scores range from 18-72, with higher scores reflecting more apathy.
次要结局
- Rating on the Treatment Acceptability/ Adherence Scale (TAAS; Milsevic et al., 2015)(Immediately after session one)
- Treatment Acceptability/ Adherence Scale(Immediately after session 1)
- Saving Inventory-Revised(Four months)
研究者
Mary Dozier
Assistant Professor
Mississippi State University