Motivational Interviewing to Enhance Behavioral Change in Older Adults with Hoarding Disorder

动机访谈可促进患有囤积症的老年人的行为改变

基本信息

批准号：
10436587
负责人：
Mary Elizabeth Dozier
金额：
$ 42.74万
依托单位：
MISSISSIPPI STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-02-01 至 2025-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10436587
关键词：
Adult Affect Attention Concentration Behavior Behavior Therapy Behavioral Catchment Area Clinical Trials Clutterings Cognition Cognitive Cognitive Therapy Compulsive Hoarding Development Diet Disease Disease Management Dose Elderly Environment Evidence based treatment Fire - disasters Fright Future Goals Health Health behavior Home Individual Insecta Intervention Investigation Knowledge Medical Mental Health Services Mental disorders Methods Mississippi Motivation Municipalities Outcome Participant Patient Self-Report Patients Pattern Physical activity Population Prevalence Psychopathology Public Health Randomized Controlled Trials Readiness Recruitment Activity Research Risk Sampling Severities Sorting - Cell Movement Techniques Testing Treatment Efficacy Universities Work base behavior measurement design efficacious treatment executive function experience hands on research implementation facilitation improved motivational enhancement therapy novel psychiatric symptom psychologic recruit response rural residence treatment response trial comparing undergraduate research experience undergraduate student

项目摘要

Project Summary 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, we need to identify other mechanisms. 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. Rural-dwelling older adults with hoarding disorder represent a particularly difficult to treat population, as they are less likely to experience external motivating factors to seek treatment (e.g., complaints from neighbors/municipal officials). This project would represent the first step in a broader course of research to investigate efficacious treatment targets for late life hoarding. The long-term goal of this research is to determine if conceptualizing the psychopathology of hoarding as a deficit in a health behavior can inform our development and implementation of evidence-based treatment for geriatric hoarding across contexts.

项目概要囤积症是一种心理疾病，会对老年人产生一系列独特的后果成年人，包括火灾和火灾死亡风险增加、昆虫侵扰和医疗问题。由于执行功能、注意力、和浓度。囤积心理病理学源于适应不良的认知（例如，渴望保留其他人会丢弃的物品）和适应不良的行为模式（例如，避免分类/丢弃项目）。现有的囤积治疗方法都以减少恐惧作为改变的机制通过专注于认知重组的认知行为疗法或专注于认知重建的行为疗法暴露疗法。老年人对囤积的认知重建反应平淡，而且，尽管暴露疗法可以提高治疗反应，但这两种方法都需要漫长的六个月剂量。我们的初步工作表明，减少恐惧可能不是一个普遍相关的目标老年人的机制，为了满足老年人的具体需求，我们需要确定其他机制。动机访谈是一种通常已被采用的技术囤积治疗已被证明可以增加行为改变的动力老年人的一系列健康状况，包括身体活动、饮食和疾病管理。因为分类/丢弃本质上是一种健康行为，囤积患者缺乏这样做的动力参与，动机性访谈可能会通过引发更高水平的囤积行为来降低囤积的严重程度分类/丢弃。拟议的项目将使用机械临床试验方法来确定是否将动机性访谈与分类实践相结合的为期四个月的干预可以吸引与四个月的分类剂量相比，提出的目标、行为改变的动机在农村老年人样本中单独练习。农村老年人囤积物品障碍代表了特别难以治疗的人群，因为他们不太可能经历外部影响寻求治疗的激励因素（例如邻居/市政官员的投诉）。本项目将代表着调查有效治疗目标的更广泛研究过程的第一步用于晚年囤积。这项研究的长期目标是确定是否将将囤积作为一种健康行为缺陷的精神病理学可以为我们的发展和对不同背景下的老年人囤积症实施循证治疗。