Psychosocial Intervention for Age- Related Macular Degeneration: A Pilot Project

This study evaluated an emotion-focused and a problem-focused intervention designed for patients with age-related macular degeneration. It found a limited decrease in depression in the emotion-focused group and an increase in active problem orientation and in adaptation to vision loss in the problemfocused group. This study was supported by a grant from the Wilhelm Woort Foundation for Aging Research awarded to the first three authors. The authors thank the ophthalmologists of the Department of Ophthalmology at the University of Heidelberg and Dr. J. Jonas of the Department of Ophthalmology at the University of Mannheim for supporting the comparison group sampling and Mrs. L. Jan Cargile for improving the language style of the article. The emotional consequences of agerelated vision loss, including reduced levels of well-being and positive affect and greater levels of depression and negative affect, have been reported in the literature (see, for example, Burmedi, Becker, Heyl, Wahl, & Himmelsbach, 2002; Horowitz & Reinhardt, 2000). Longitudinal research has shown that behavioral and emotional adjustment in older adults who are visually impaired (that is, are blind or have low vision) worsens over time (Heyl & Wahl, 2001; Wahl, Schilling, Oswald, & Heyl, 1999). The provision of psychosocial services to older adults to counteract the negative emotional consequences of visual impairment, including age-related macular degeneration (AMD), has been identified as an unmet need in the field of ophthalmological treatment, rehabilitation, and education (Birk et al., 2004; Crews, 2000; Harshbarger, 1980; Horowitz & Reinhardt, 2000). Researchers have found that AMD is associated with significantly lowered functional ability, increased depression, and loss of psychological control (Brody et al., 2001; Rovner, Casten, & Tasman, 2002; Wahl, Becker, Burmedi, & Schilling, 2004). AMD has become the target of controlled research on psychosocial interventions in the past 10 years. Brody et al.’s (1999) randomized clinical trial of the efficacy of a self-management intervention for elderly patients with AMD, consisting of six weekly two-hour group sessions with 7–10 participants in each group, revealed that the participants experienced significantly reduced psychological distress and greater self-efficacy after the intervention. Brody et al. (2002) repeated and extended their earlier findings by showing that their intervention program resulted in significantly better mood and