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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