The investigators hypothesized that during the 9-week course of Engage \& Connect treatment there will be an increase in brain functions of the Positive Valence System which in turn will lead to reduction in suicidality.
Social disconnection peaks in middle and late life and leads to an increased risk of suicide, persistent depression, and poor response to psychosocial interventions. There is a critical need to develop a mechanistic understanding of the link between social disconnection and suicidality, identify biological targets, and address targets with scalable interventions. The investigators developed a novel psychotherapy, Engage \& Connect, aimed to improve functions of the Positive Valence System (PVS) that are impaired in suicidality through increased engagement in rewarding social activities. This study will use state-of-the-art precision imaging methods and clinical measures to evaluate brain- and behavioral changes in the PVS during psychotherapy. Participants will: * Be randomly assigned to 9-weekly sessions of either Engage \& Connect therapy or Symptom Review and Psychoeducation * Complete 4 research assessments * Complete 3 MRI scans
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
128
9-weeks of weekly psychotherapy sessions focused on social reward exposure
9-weeks of weekly psychotherapy sessions focused on symptom review and psychoeducation about depression and aging
Weill Cornell Medicine
New York, New York, United States
RECRUITINGChange in resting state functional connectivity of the Positive Valence System
Change in resting state fMRI connectivity of functional networks representing structures previously associated with the Positive Valence System (Dorsal anterior cingulate cortex \[dACC\], the Subgenual Anterior Cingulate Cortex \[sgACC\], and the basal forebrain/nucleus accumbens \[NAcc\]). The investigators will also test between-network connectivity between the positive valence system and the default mode-, salience-, and fronto-parietal networks. Functional connectivity within- and between-network will be measured with a correlational score of 0 to 1, with 0 being the lowest and 1 being the highest.
Time frame: Baseline, midtreatment (week 6) and post treatment (week 9)
Change in STAR task reaction time following social feedback
"The Social Task for Assessment of Reward" is a computerized task that measures response to social rewards. Reaction time will be measures in milliseconds.
Time frame: Baseline, midtreatment (week 6), and post treatment (week 9)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.