I wish to pursue an academic career as a clinical psychologist studying treatment and preventative interventions for depression in the elderly and old-age depression with Axis II comorbidity. As an Assistant Professor at DUMC, I am currently conducting a pilot study examining treatment of depression among older adults. It is time now to expand the scope of this research. To do so, I will need further training and experience in [1] gerontology and geriatric psychiatry, (2) clinical trial study design and operation, (3) clinical trial methodology, longitudinal data analysis, and related statistical techniques, (4) psychopharmacological and psychotherapeutic treatments for geriatric depression, (5) personality disorder assessment and treatment issues for older adults. Methods: Training Experiences. I will receive close supervision and tutoring by local experts in each of these areas, as well as advice and input by renowned educators and investigators from outside institutions. In order to develop abilities as an educator and mentor of others, I will myself be involved in the teaching of psychology students, interns, residents, and fellows. Finally, I will be taking classes in geriatric psychiatry, gerontology, longitudinal data analysis, regression techniques, and clinical trial methodology that will help enhance my understanding of geriatric issues and refine my skills in study design and data analysis. Research Project. Treatment of Elderly Depression with Axis II Comorbidity. The major aims of the project are to (1) to determine whether a combination of a cognitive-behavioral treatment (Dialectical Behavior Therapy; DBT-D) and antidepressant medication will augment treatment response among elderly depressed individuals with Axis II comorbidity who have had no response or only a partial response to antidepressant medication alone, (2) to determine rates of depressive episode recurrence during Maintenance Phase DBT-D plus antidepressant medication, (3) to determine rates of depressive episode recurrence during Maintenance Phase medication plus clinical management, (4) to determine characteristics of depressed elderly patients with Axis II comorbidity who respond/fail to respond to treatment (5) to determine characteristics of patients who have a recurrence of a depressive episode or maintain recovery. The project is divided into three major parts: a comprehensive baseline assessment, a treatment intervention component, and post-treatment assessment.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23MH001614-05
Application #
6774705
Study Section
Special Emphasis Panel (ZMH1-ITV-D (01))
Program Officer
Wynne, Debra K
Project Start
2000-08-01
Project End
2005-07-31
Budget Start
2004-08-01
Budget End
2005-07-31
Support Year
5
Fiscal Year
2004
Total Cost
$152,728
Indirect Cost
Name
Duke University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
044387793
City
Durham
State
NC
Country
United States
Zip Code
27705
Smoski, Moria J; Lynch, Thomas R; Rosenthal, M Zachary et al. (2008) Decision-making and risk aversion among depressive adults. J Behav Ther Exp Psychiatry 39:567-76
Cukrowicz, Kelly C; Franzese, Alexis T; Thorp, Steven R et al. (2008) Personality traits and perceived social support among depressed older adults. Aging Ment Health 12:662-9
Lynch, Thomas R; Cheavens, Jennifer S (2008) Dialectical behavior therapy for comorbid personality disorders. J Clin Psychol 64:154-67
Cukrowicz, K C; Ekblad, A G; Cheavens, J S et al. (2008) Coping and thought suppression as predictors of suicidal ideation in depressed older adults with personality disorders. Aging Ment Health 12:149-57
Lynch, Thomas R; Chapman, Alexander L; Rosenthal, M Zachary et al. (2006) Mechanisms of change in dialectical behavior therapy: theoretical and empirical observations. J Clin Psychol 62:459-80
Vujanovic, Anka A; Zvolensky, Michael J; Gibson, Laura E et al. (2006) Affect intensity: association with anxious and fearful responding to bodily sensations. J Anxiety Disord 20:192-206
Morse, J Q; Lynch, T R (2004) A preliminary investigation of self-reported personality disorders in late life: prevalence, predictors of depressive severity, and clinical correlates. Aging Ment Health 8:307-15
Keefe, Francis J; McKee, Daphne; Lynch, Thomas (2002) Point of view. Spine (Phila Pa 1976) 27:1237