Target Engagement During Social Reward Psychotherapy for Mid- and Late-Life Suicidality: A Precision Imaging Trial

针对中年和晚年自杀的社会奖励心理治疗期间的目标参与：精确成像试验

基本信息

批准号：
10727335
负责人：
Nili Solomonov
金额：
$ 71.94万
依托单位：
WEILL MEDICAL COLL OF CORNELL UNIV
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-07-21 至 2028-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10727335
关键词：
Address Adult Age Aging Anterior Behavioral Behavioral Mechanisms Biological Brain Brain Mapping Clinical Data Depressed mood Development Dorsal Elderly Feedback Feeling suicidal Functional Magnetic Resonance Imaging Future Image Impairment Individual Insula of Reil Intervention Learning Link Magnetic Resonance Imaging Major Depressive Disorder Maps Measures Medial Mediating Mediation Mental Depression Methodology Nucleus Accumbens Participant Pilot Projects Play Positive Valence Prediction of Response to Therapy Prefrontal Cortex Protocols documentation Psychotherapy Randomized Reaction Time Recording of previous events Reporting Rest Rewards Risk Factors Role Social Interaction Social isolation Social support Structure Structure of superior frontal gyrus Suicide Suicide attempt Symptoms System Testing Ventral Striatum Woman active control age effect aged brain based brain circuitry cingulate cortex design efficacious intervention functional improvement geriatric depression imaging approach imaging modality improved individual patient innovation men middle age neuroimaging novel predicting response psychoeducation psychoeducational psychosocial remote delivery response reward processing serial imaging sex social suicidal suicidal risk suicide rate treatment effect treatment response

项目摘要

PROJECT SUMMARY / ABSTRACT Suicide rates are high in late adulthood, peaking in midlife among women and late life among men. Social disconnection also peaks in late life and increases risks of suicide, persistent suicidality, and poor response to psychosocial interventions. Our proposal responds to RFA-MH-22-135, outlining the critical need to identify the mechanisms mediating the relationship between social disconnection and late-life suicidality and develop efficacious interventions to target these mechanisms. The proposed study leverages methodological and conceptual innovations, developed by our team, to investigate target engagement of the Positive Valence System (PVS) during a novel social reward psychotherapy for mid- and late-life suicidality. We designed Engage & Connect, a remotely delivered psychotherapy that targets social disconnection by increasing engagement in rewarding social activities. Engage & Connect aims to alter disturbances of the PVS that may underlie late-life suicidality. In this study, 128 adults aged 50-80 with major depressive disorder and suicidal ideation will be randomized to 9 weeks of Engage & Connect or Symptom Review and Psychoeducation (SRP) active control condition. We will measure PVS functions on brain and behavioral levels, through resting state functional connectivity of the PVS and behavioral changes in social reward responsivity using our novel validated STAR task (Social Task for Assessment of Reward). We will employ a cutting-edge “precision imaging” approach to estimate the functional brain map of each individual and track the longitudinal effects of treatment on PVS circuitry. Our rigorous methodological approach will allow us to test, at the individual level, the brain-based and behavioral mechanisms underlying response to psychotherapy that targets social disconnection. Identification of individual patients’ biological and behavioral profiles, linked with treatment response, can guide future psychotherapy personalization and increase its efficacy and reach to vulnerable older adults at risk of suicide.

项目摘要 /摘要自杀率在成年后期很高，女性中年和男性后期的中年达到顶峰。社会的断开连接也达到后期的高峰，增加了自杀，持续自杀的风险，对社会心理干预措施。我们对RFA-MH-22-135的提议回应，概述了确定的关键需求介导社会脱节与后期自杀与发展之间关系的机制易于针对这些机制的简单干预措施。拟议的研究利用我们团队开发的方法论和概念创新在新的社会奖励心理治疗期间调查正价系统（PVS）的目标参与适用于中期和晚期自杀。我们设计了参与与连接，这是一种远程提供的心理治疗通过增加参与奖励社会活动来定位社会脱节。参与与连接的目标改变可能是后期自杀的PV的干扰。在这项研究中，有128名50-80岁的成年人重度抑郁症和自杀想法将随机分为9周的参与和连接或症状审查和心理教育（SRP）主动控制条件。我们将测量大脑上的PVS功能行为层面，通过静止的状态功能连通性和社会行为变化使用我们的新颖验证的星星任务（评估奖励的社会任务）的奖励响应能力。我们将员工一种尖端的“精度成像”方法来估计每个人的功能性脑图和跟踪治疗对PVS电路的纵向影响。我们严格的方法论方法将使我们在个人层面测试对心理疗法的基于大脑和行为机制这是针对社会断开连接的。鉴定单个患者的生物学和行为特征，相连通过治疗反应，可以指导未来的心理治疗个性化，并提高其有效性并触及到脆弱的老年人有自杀风险。