Cognitive and Affective Neuroscience of Decision-Making in Late-Life Suicide

晚年自杀决策的认知和情感神经科学

• 批准号: 8301681
• 负责人: Alexandre Y. Dombrovski
• 金额: $ 16.99万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8301681
• 关键词: Acute; Affect; Age; Autopsy; Behavioral; Behavioral Model; Boxing; Brain; Clinical; Cognitive; Computer Simulation; Data; Decision Making; Dependence; Depressed mood; Disease susceptibility; Drug Formulations; Elderly; Exercise; Failure; Feedback; Feeling hopeless; Firearms; Functional Magnetic Resonance Imaging; Future; Gambling; Goals; Health; Health Services Research; Image; Impulsivity; Instruction; Intervention; Laboratories; Longevity; Magnetic Resonance; Magnetic Resonance Imaging; Mental Depression; Mentors; Modeling; Mood Disorders; Neurobiology; Neurosciences; Outcome; Pathology; Personal Communication; Persons; Population; Prefrontal Cortex; Prevention approach; Process; Psychiatrist; Public Health; Punishment; Questionnaires; Recording of previous events; Research; Research Personnel; Research Training; Resources; Reversal Learning; Rewards; Sampling; Signal Transduction; Substance abuse problem; Suicide; Suicide attempt; Testing; Time; Training; Universities; Work; accomplished suicide; affective neuroscience; age group; aging brain; base; career; cognitive neuroscience; coping; depressive symptoms; discount; discounting; experience; flexibility; geriatric depression; high reward; indexing; insight; neural model; neuroimaging; partial recovery; preference; relating to nervous system; response; reward processing; stressor; suicidal; suicidal behavior; suicidal risk; suicide attempter; suicide rate; trait; young adult

DESCRIPTION (provided by applicant): Brain mechanisms of vulnerability to suicide in old age remain unclear, and very few researchers study the neurobiology of late-life'suicide. In particular, the field of suicide research lacks an understanding of how psychoiogicai and cognitive markers of suicidal risk (hopelessness, executive dyscontrol) relate to brain markers identified in post-mortem and imaging studies. The applicant - a geriatric psychiatrist with a clinical background in late-life suicide and in the treatment of late-life depression - views suicide as an outcome of an altered decision process, a view supported by preliminary behavioral and imaging data. Thus, the applicant's career goals are to apply advances in the basic neuroscience of decision-making to investigate the brain mechanisms of late-life suicide and, in the future, to identify intervention targets. This approach aims to bridge existing cognitive research on suicidal diathesis with basic and clinical neuroscience. This will be achieved through training in functional magnetic resonance imaging (fMRI; including computational model-based fMRI), in neurobiology of decision-making, and in using neuroscience models to identify intervention targets. An fMRI study of decision-making in elderly depressed suicide attempters focused on disruptions in the processing of value signals in the ventromedial and ventrolateral prefrontal cortex will serve as a vehicle for proposed training. Proposed training and research will be supported by the Advanced Center for Interventions and Services Research for Late-Life Mood Disorders directed by CF. Reynolds (mentor), G.J. Siegle's fMRI lab (co-mentor), and L. Clark's imaging lab (Cambridge, UK). Taking advantage of the neuroimaging resources at the University of Pittsburgh, H.J. Aizenstein will help the applicant to overcome challenges in MR imaging of the aging brain and M.L. Phillips will aid in refining the neural model and developing a life-span perspective on decision-making in suicide. K. Szanto will help the applicant sharpen clinical characterization and manage suicidal risk. An ROl geared towards identifying intervention targets should result from this work. PUBLIC HEALTH RELEVANCE (See instructions): Worldwide and in the US, the elderly have the highest suicide rate of all age groups - a public burden likely to increase as US population ages and access to firearms is legally upheld. Current prevention approaches are not selective, targeting mainly depression. Insight into brain mechanisms will help identify elderly at risk for suicide and develop neuroscience-based interventions.

描述（由申请人提供）：老年自杀脆弱性的大脑机制尚不清楚，很少有研究人员研究晚期杀菌剂的神经生物学。特别是，自杀研究领域缺乏对自杀风险的心理和认知标记（Hoselessness，Executive Dyscontrol）如何与验尸和成像研究中确定的大脑标记有关的。申请人 - 一名具有临床背景自杀和治疗后期抑郁症的老年精神科医生 - 将自杀视为改变决策过程的结果，这是由初步行为和成像数据支持的观点。因此，申请人的职业目标是将决策基本神经科学的基本神经科学的进步运用，以调查后期自杀的大脑机制，并在将来确定干预目标。这种方法旨在通过基本和临床神经科学桥接现有的关于自杀核的认知研究。这将通过功能磁共振成像（fMRI；包括基于计算模型的fMRI），决策神经生物学以及使用神经科学模型来识别干预靶标的训练来实现这一点。对老年人抑郁症的自杀式预言的决策的功能磁共振成像研究，重点是处理腹侧和腹外侧前额叶皮层中价值信号的干扰，将作为拟议训练的工具。拟议的培训和研究将得到由CF指导的晚期情绪障碍的高级干预和服务研究中心的支持。雷诺（Mentor），G.J。 Siegle的FMRI实验室（Co-Inceror）和L. Clark的Imaging Lab（英国剑桥）。利用匹兹堡大学H.J. Aizenstein的神经影像资源将帮助申请人克服衰老大脑和M.L.的MR成像中的挑战。菲利普斯（Phillips）将有助于完善神经模型，并在自杀中发展生命跨度的观点。 K. Szanto将帮助申请人增强临床表征并管理自杀风险。旨在识别干预目标的ROL应由这项工作产生。公共卫生相关性（请参阅说明）：在全球范围内和美国，老年人的自杀率最高 - 随着美国人口年龄的年龄和获得枪支的机会，公共负担可能会增加。当前的预防方法不是选择性的，主要针对抑郁症。洞悉大脑机制将有助于确定有自杀风险的老年人并发展基于神经科学的干预措施。