Risk and Protective Factors in Late-Life Suicide

描述（由申请人提供）：这是一份修订后的申请，要求获得指导患者导向研究职业发展奖（K23）。这位候选人是匹兹堡大学的精神病学家，他建议发展技能和知识，以发展和评估一种以理论和证据为基础的干预措施，以预防老年人的自杀企图。在所有年龄组中，老年人完成自杀的风险最高，自杀企图和自杀意念是完成自杀的可靠预测因素。根据我们的初步研究，有必要针对与自杀相关的临床特征，制定更有针对性的自杀干预措施。该奖项的资助将为她提供必要的时间和资源，使她能够发展成为一名独立的调查员，能够对高自杀风险的老年人进行心理社会干预研究。

DESCRIPTION (provided by applicant): This revised application requesting a Mentored Patient-Oriented Research Career Development Award (K23). The candidate is a psychiatrist at the University of Pittsburgh who proposes to develop skills and knowledge to develop and evaluate a theory- and evidence-based intervention to prevent suicide attempts in the elderly. Elderly are at the highest risk for completing suicide among all age groups, and suicide attempt and suicidal ideation are robust predictors of completed suicide. Based on our preliminary studies there is a need to develop a more focused suicide intervention that will target clinical characteristics that are associated with suicidality. Funding of this award would provide time and resources necessary for her to develop into an independent investigator capable of conducting psychosocial intervention studies in high suicide risk elderly. To perform such research the candidate will develop skills in the following areas: clinical intervention research methodology with a special focus on the assessment of suicidal behavior and related risk factors; ethical issues related to studies of suicide; formal training in psychosocial treatment development and treatment trials methodology with a special emphasis on the suicidal depressed elderly; and biostatistics, with emphasis on longitudinal data analysis. Proposed research consists of a longitudinal follow up project of 100 consecutive depressed elderly inpatients who are at high suicide risk (60 with current suicide attempt and 40 with current suicidal ideation) and 40 age/gender and education matched depressed elderly inpatients who are at low suicide risk (no history of suicidal ideation or attempt). The project will characterize risk and protective factors for suicidal relapse with special emphasis on executive control function and its relationship to personality characteristics and problem solving deficits. This will lead to a pilot intervention study with the aim of developing a modified interpersonal psychotherapy, Suicide Prevention-Interpersonal Psychotherapy (SP-IPT) for high-suicide risk patients. SP-IPT seeks to optimize the relationship with a significant other and uses support from significant other to motivate patients to increase compliance with treatment and substance abstinence. It also increases the sense of autonomy by improving problem solving and supports and enhances thinking and behaviors that decrease hopelessness and increases self-esteem. The research studies will take place and be supported by the Intervention Research Center for Late-Life Mood Disorders.