Trial to Test Effectiveness of Depression Intervention for Mistreated Older Adults

Weill Cornell Medicine (WCM)

Status

Completed

Conditions

Depression in Old Age

Elder Abuse

Depression

Anxiety

Treatments

Behavioral: PROTECT with Technology Augmentation

Study type

Interventional

Funder types

Other

NIH

Identifiers

NCT04258579

19-09020854

P50MH113838-03 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The investigators developed EM/PROTECT, a behavioral intervention for depressed EM (elderly mistreatment) victims, to work in synergy with EM mistreatment resolution services that provide safety planning, support services, and links to legal services. PROTECT is built on a model which postulates that chronic stress promotes dysfunction of the cognitive control (CCN) and reward networks, impairing the victims' ability to flexibly respond to the environment and limits their reward activities. PROTECT therapists work with victims to develop action plans to reduce stress, and to increase rewarding experiences. EM/PROTECT has been designed in an iterative process with community EM providers of the New York City (NYC) Department for the Aging (DFTA) to use agencies' routine PHQ-9 depression screening and referral for service. In the current study, the investigators will compare the effectiveness of EM/PROTECT with EM enriched with staff training in linking EM victims to community mental health services (EM/MH). The investigators intend to enroll 50 subjects that will participate in the study for approximately 12 weeks.

Enrollment

40 patients

Sex

All

Ages

55 to 100 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

55 years of age or older
Capacity to consent (per Elder Mistreatment staff)
Significant depression (per Elder Mistreatment staff) as indicated by a score of 10 or above on the Patient Health Questionnaire-9 (PHQ-9), a widely used screening tool routinely administered in Elder Mistreatment (EM) agency settings (the PHQ-9 has a sensitivity of 88% and a specificity of 88% for major depression)
Need for EM services

Exclusion criteria

Active suicidal ideation (Montgomery Asberg Depression Rating Scale item 10>4)
Inability to speak English or Spanish
Axis 1 Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) diagnoses other than unipolar depression or generalized anxiety disorder (by Structured Clinical Interview for DSM-5)
Severe or life-threatening medical illness
EM emergency and or referral out of EM agency (per EM staff)