Clinical trial NCT05237466: Motivational Interviewing to Enhance Behavioral Change in Older Adults with Hoarding Disorder
Official title: Motivational Interviewing to Enhance Behavioral Change in Older Adults with Hoarding Disorder
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Hoarding Disorder
Lead sponsor: Mississippi State University
Sponsor class: OTHER
Collaborators: name: National Institute of Mental Health (NIMH)
First posted: 2022-02-14
Enrollment: 60
Sex: ALL
Minimum age (years): 60
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This study will compare two behavioral interventions for hoarding disorder in older adults.

Detailed description: 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.

Eligibility criteria: Inclusion Criteria:

* Aged 60+
* Live within a 60-minute driving radius of Starkville, MS
* Have a primary psychiatric diagnosis of hoarding disorder

Exclusion Criteria:

* Major cognitive impairment
* Active psychosis, drug use, or acute suicidal ideation
* Concurrent psychotherapy focused on hoarding
* Changed psychotropic medications within the past three months

Primary outcomes:
measure: Change in frequency of sorting/discarding behavior
timeFrame: Four months
measure: Change in duration of sorting/discarding behavior
timeFrame: Four months
measure: Change in score on the University of Rhode Island Change Assessment Questionnaire McConnaughy et al., 1983)
timeFrame: Four months
measure: Change in score on the Apathy Evaluation Scale (AES-S; Marin, 1991)
timeFrame: Four months
Secondary outcomes:
measure: Rating on the Treatment Acceptability/ Adherence Scale (TAAS; Milsevic et al., 2015)
timeFrame: Immediately after session one
Other outcomes:
measure: Change in score on the Saving Inventory-Revised (SI-R; Frost et al., 2004)
timeFrame: Four months
measure: Change in score on the Clutter Image Rating (CIR; Frost et al., 2008)
timeFrame: Four months
measure: Change in scores on the Behavioral Approach Task for sorting/discarding(BAT; Dozier & Ayers, 2017; Dozier et al., 2020)
timeFrame: Four months
Locations:
city: Starkville
country: United States
facility: Mississippi State University
state: Mississippi
Study officials:
References: