Disruptions in motivation and/or cognition are common symptoms of many psychiatric disorders. By studying these from different perspectives, we hope to gain an understanding of how motivational and cognitive processes interact in both ‘normal’ and ‘abnormal’ states.
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Alcohol misuse (or alcohol-related problems) is a serious and hidden problem among seniors, but effective screening tools are not available for this population. Assessments are seldom sensitive to the physiological, social, emotional, and cognitive changes that accompany aging and may provoke strong defense mechanisms in seniors, such as denial and defensiveness. The development of a senior-specific screening tool may help health care professionals to better elicit alcohol-related information in a professional and compassionate manner in order to recognize alcohol-related problems in older persons. At the University of Toronto and the Centre for Addiction and Mental Health, under the supervision of Dr. Usoa Busto and Margaret Flower, Bonnie Lum developed and validated a brief screening tool to detect alcohol problems in seniors, the Senior Alcohol Misuse Indicator, or SAMI. The SAMI was developed as the first language-sensitive tool to be used by health care workers concerned about establishing and maintaining rapport with their senior clients. The tool was developed with the feedback of health care workers across Canada and was effective in identifying problem and at-risk drinkers from a sample of seniors. Bonnie Lum is continuing this line of work by further investigating the effectiveness of the SAMI. She is also conducting cross-validation studies of the SAMI with two other brief alcohol screening tools, the CAGE and SMAST-G, and testing the feasibility of these tools with geriatric psychiatry outreach teams. The use of psychiatry outreach populations will provide insight into the unique working environment of these health care providers; in particular, the primary focus of their work is to establish and maintain rapport with clients in order to remain welcome in their client’s home. This research will demonstrate which screening tool provides the most sensitive assessment of alcohol-related problems in seniors, is the easiest to incorporate into an already existing assessment, and may be welcomed by these health care workers.