ENHANCING INFORMED CONSENT IN LATE-LIFE PSYCHOSIS

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DESCRIPTION (provided by applicant): The goal of this five-year training award is to further Dr. Laura Dunn's development as a geriatric psychiatry researcher, with a focus on psychiatric research ethics, specifically the empirical study of improving informed consent for research in older persons with schizophrenia or related disorders. The career development plan will build on Dr. Dunn's clinical background in psychiatry and geriatric psychiatry, and on her research background in psychiatric research ethics. In June 2001, Dr. Dunn completed her psychiatric residency at University of California, San Diego. She is currently a clinical fellow in Geriatric Psychiatry at UCSD. She has authored or co-authored a total of 14 articles that are published or in press, and she has presented six abstracts at national meetings. The overriding goal of the career development plan is to enable Dr. Dunn to become an independent investigator in geriatric psychiatry and psychiatric research ethics. The specific training targets are as follows: 1) attainment of a solid knowledge base in biomedical ethics, emphasizing ethical issues in geriatric psychiatry research and intervention studies; 2) coursework and consultation in experimental design, scale development, and quantitative and qualitative data analytic methods; 3) understanding of procedural, philosophical, and ethical issues arising in the design, implementation, analysis, and reporting of intervention trials (both psychopharmacologic and psychosocial); 4) empirical study of methods to enhance research participants' decisional abilities relevant for informed consent; 5) development, based on results and questions raised by the proposed study, of further interventions designed to enhance informed consent and decision-making processes for both research and treatment; and 6) dissemination of research findings to investigators in psychiatry and other biomedical fields. The plan includes structured coursework and consultation with experts in the fields of bioethics, geriatric psychiatry, schizophrenia research, psychiatric research ethics, and intervention studies. Dr. Dunn's firsthand research training will involve the implementation of a randomized trial of the effects of an enhanced consent procedure on decision-making capacity for research in middle-aged and older (>/= 50 years old) patients with schizophrenia or schizoaffective disorder. The relationship of decisional abilities to psychopathology and cognitive functioning will be examined, and qualitative information about participants' attitudes toward and experience with research will be explored.