Risk and Protective Factors in Late-Life Suicide

描述（由申请人提供）：此修订后的申请要求获得指导性的以患者为导向的研究职业发展奖（K23）。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，以开发和评估基于理论和证据的干预措施，以防止老年人自杀企图。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自杀完成的可靠预测因素。根据我们的初步研究，有必要制定一个更集中的自杀干预措施，将目标与自杀相关的临床特征。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，能够在高自杀风险的老年人中进行心理社会干预研究。 为了进行这样的研究，候选人将在以下领域发展技能：临床干预研究方法，特别关注自杀行为和相关风险因素的评估;与自杀研究相关的伦理问题;心理社会治疗开发和治疗试验方法的正式培训，特别强调自杀抑郁症老年人;和生物统计学，重点是纵向数据分析。 建议的研究包括一个纵向跟踪项目的100个连续的抑郁症老年住院患者谁是在高自杀风险（60个与当前的自杀企图和40个与当前的自杀意念）和40个年龄/性别和教育匹配的抑郁症老年住院患者谁是在低自杀风险（没有自杀意念或企图的历史）。该项目将描述自杀复发的风险和保护因素，特别强调执行控制功能及其与人格特征和解决问题缺陷的关系。这将导致一个先导性的干预研究，目的是发展一种改良的人际心理治疗，自杀预防-人际心理治疗（SP-IPT）的高自杀风险的病人。SP-IPT寻求优化与重要他人的关系，并利用重要他人的支持来激励患者增加对治疗和物质戒断的依从性。它还通过改善解决问题的能力来增加自主感，并支持和增强减少绝望和增加自尊的思维和行为。这些研究将由晚年情绪障碍干预研究中心进行并提供支持。

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.