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Effects of behavioral interventions on disruptive behavior and affect in demented nursing home residents

Contact Information


Cornelia K. Beck,

affect, Alzheimer’s disease, behavior therapy, dementia, nursing homes


Background: Disruptive behaviors are prevalent in nursing home residents with dementia and often have negative consequences for the resident, caregiver, and others in the environment. Behavioral interventions might ameliorate them and have a positive effect on residents' mood (affect). Objectives: This study tested two interventions-an activities of daily living and a psychosocial activity intervention-and a combination of the two to determine their efficacy in reducing disruptive behaviors and improving affect in nursing home residents with dementia. Methods: The study had three treatment groups (activities of daily living, psychosocial activity, and a combination) and two control groups (placebo and no intervention). Nursing assistants hired specifically for this study enacted the interventions under the direction of a master's prepared gerontological clinical nurse specialist. Nursing assistants employed at the nursing homes recorded the occurrence of disruptive behaviors. Raters analyzed videotapes filmed during the study to determine the interventions' influence on affect. Results: Findings indicated significantly more positive affect but not reduced disruptive behaviors in treatment groups compared to control groups.Conclusions: The treatments did not specifically address the factors that may have been triggering disruptive behaviors. Interventions much more precisely designed than those employed in this study require development to quell disruptive behaviors. Nontargeted interventions might increase positive affect. Treatments that produce even a brief improvement in affect indicate improved quality of mental health as mandated by federal law.


Beck, C. K., Vogelpohl, T. S., Rasin, J. H., Uriri, J. T., O'Sullivan, P., Walls, R., Phillips, R., & Baldwin, B. (2002). Effects of behavioral interventions on disruptive behavior and affect in demented nursing home residents. Nursing research, 51(4), 219–228.





Conent Area

Cornelia K Beck

EWB-Related Construct

(3) positive affect

Study Design

Species or Study Population

(5) RCT

Sex (%Female)


Age (Mean, SD)

83.64, 7.91

Younger Controls?


Longitudinal Data?


Sample Size



Activities Daily Living intervention ADL
Psychosocial activity intervention PSA
Combination intervention: ADL+PSA

Ethnicity (%white)


Inclusion Criteria

1) age greater than65;
2) a dementia diagnosis;
3) a Mini Mental Status Exam
(MMSE) score of
4) and a report of DB in the previous two weeks.

Exclusion Criteria

(1) a physical disability that severely
limited ADL;
(2) a psychiatric diagnosis;
(3) a progressive or recurring medical, metabolic, or neurological condition that might interfere with cognition or behavior

EWB Measures

(1) Observable Displays of Affect Scale. (ODAS)
(2) Apparent Affect Rating Scale. (AARS)

Non-EWB Behavioral

(1) Disruptive Behavior Scale (DBS)
(2) Mini Mental Status Exam (MMSE)
(3) Visual Analogue Scales (PVAS)

Physiological Measures


Brain IMaging Modality

Brain IMaging Paradigm


Brain Region/Circuit


Biological Measures


Other Neural Measures

Data Availability?


Data Avalability Details


Diagnostic Measures

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