This is a competing renewal of a mid-career mentor award that was originally titled """"""""Treating Depression in Low-Income Elderly with CIND/aMCI"""""""" and is now titled Strategic and Plasticity Interventions for Late Life Depression in Community Settings. The title change reflects the additional training I wish to pursue in the next five years of my career. In the original award, I studied neuropsychology and behavioral neurology associated with mild cognitive impairment. This experience allowed me to develop interventions that would address cognitive moderators of psychotherapy outcomes, and to mentor the next generation of psychotherapy researchers who are also interested in the intersection of cognitive impairments and the treatment of mood disorders in late life. That award resulted in 20 papers and 5 grant applications (4 were subsequently funded), the development of a mentoring program for junior faculty in my home department and personal mentorship of 9 junior faculty at UCSF, 3 faculty outside the UC system and 7 post doctoral fellows. In this proposal, I wish to study cognitive neuroscience of late life depression (LLD) and to learn more about plasticity interventions and their potential role in the treatment of LLD. My intent is not to change who I am as a researcher, but learn enough about these two vast fields so that I can (1) integrate what I learn from biological theory with the knowledge I already possess about psychological and sociological explanations of LLD, (2) work collaboratively with cognitive neuroscientists and plasticity interventionists to develop targeted behavioral interventions for LLD, and (3) add my expertise in the development of portable and geriatric friendly behavioral interventions to the field of plasticity intervention research. I believe this training will allow for better and mutual cross fertilization between the fields of psychotherapy and cognitive neuroscience, which will serve to improve mental health research directions. Because few scientists in our field have attempted to engage in this type of cross fertilization, I plan to also develop a training curriculum for post-doctoral fellows focused on the intersection of behavioral interventions research and cognitive neuroscience, to develop a generation of psychotherapy researchers who can work collaboratively with biologically oriented researchers in the treatment of late life mood disorders.
I am applying for an additional five years to my career award from NIMH so that I can learn more about what happens in the brain when older people are depressed, and if problems in how the brain works affect depression treatment. In 2010, NIMH asked researchers like me to start thinking about how our treatments work, so that we can create better treatments;this recommendation is challenging for many psychotherapy researchers like me who have limited knowledge of neurobiological research. I plan to overcome this barrier by improving my understanding of this science, creating better psychotherapies based on what I learn, and then training new researchers in how to do this type of work.
|Alexopoulos, George S; Raue, Patrick J; McCulloch, Charles et al. (2016) Clinical Case Management versus Case Management with Problem-Solving Therapy in Low-Income, Disabled Elders with Major Depression: A Randomized Clinical Trial. Am J Geriatr Psychiatry 24:50-9|
|Anguera, Joaquin A; Jordan, Joshua T; Castaneda, Diego et al. (2016) Conducting a fully mobile and randomised clinical trial for depression: access, engagement and expense. BMJ Innov 2:14-21|
|Alexopoulos, George S; Raue, Patrick J; Gunning, Faith et al. (2016) ""Engage"" Therapy: Behavioral Activation and Improvement of Late-Life Major Depression. Am J Geriatr Psychiatry 24:320-6|
|Gustavson, Kristen A; Alexopoulos, George S; Niu, Grace C et al. (2016) Problem-Solving Therapy Reduces Suicidal Ideation In Depressed Older Adults with Executive Dysfunction. Am J Geriatr Psychiatry 24:11-7|
|Alexopoulos, George S; Raue, Patrick J; Kiosses, Dimitris N et al. (2015) Comparing engage with PST in late-life major depression: a preliminary report. Am J Geriatr Psychiatry 23:506-13|
|Gansler, David A; Suvak, Michael; Arean, Patricia et al. (2015) Role of Executive Dysfunction and Dysexecutive Behavior in Late-Life Depression and Disability. Am J Geriatr Psychiatry 23:1038-45|
|AreÃ¡n, Patricia A; Raue, Patrick J; McCulloch, Charles et al. (2015) Effects of Problem-Solving Therapy and Clinical Case Management on Disability in Low-Income Older Adults. Am J Geriatr Psychiatry 23:1307-14|
|Beaudreau, Sherry A; Rideaux, Tiffany; O'Hara, Ruth et al. (2015) Does cognition predict treatment response and remission in psychotherapy for late-life depression? Am J Geriatr Psychiatry 23:215-9|
|Alexopoulos, G S; Arean, P (2014) A model for streamlining psychotherapy in the RDoC era: the example of 'Engage'. Mol Psychiatry 19:14-9|
|Bauer, Amy M; Thielke, Stephen M; Katon, Wayne et al. (2014) Aligning health information technologies with effective service delivery models to improve chronic disease care. Prev Med 66:167-72|
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