# Decision Processes of Late-Life Suicide:  Competitive Renewal

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2020 · $756,185

## Abstract

ABSTRACT
This is a competitive renewal of a longitudinal study of late-life suicide. Our ultimate aim is the greater
understanding of decision processes that underlie suicidal behavior in old age. Toward this goal, we have
accrued a high-risk cohort of depressed older adults (including 173 with past suicide attempts and 82 with serious
suicidal ideation) with prospectively ascertained high rates of suicidal behavior. AIM 1. To date, we have shown
robust associations between decision process alterations and cognitive control deficits on one hand, and the
history of suicidal behavior, on the other, consistent with the notion that these impairments undermine the search
for constructive alternatives to suicide. As a crucial next step, we will confirm these associations prospectively
through prediction of incident suicide attempts and death by suicide. We predict that decision indices will have
predictive power after accounting for recent suicidal ideation. To identify the most useful predictors of incident
suicidal behavior, we will also develop a parsimonious prediction model based on a broad range of potential risk
factors. AIM 2. Our studies to date have focused on decision-making in non-social contexts. However, many
precipitants and deterrents to suicide are rooted in social relationships. In a suicidal crisis, people often fail to
consider how devastating their suicide would be for those around them. Normative age-related events affecting
social status, such as disability or retirement, may trigger suicidal behavior in late life in a predisposition-
dependent manner. To probe the mechanisms underlying catastrophic decisions in response to loss of social
dominance, we propose a study of social decision-making involving a loss-of-status manipulation. In addition,
we propose to test whether blunted motivational effects of social relationships in high-suicide-risk individuals are
related to alterations in Pavlovian behavioral biases and neural responses evoked by social stimuli. To achieve
these aims, we propose to extend the follow-up of the current cohort and expand it with 80 newly recruited
attempters and 60 ideators. Our study of social decision-making will employ a case-control design (including
depressed individuals with no history of suicide attempt or ideation and non-psychiatric controls) to detect effects
beyond those by conferred by depression and suicide ideation, and to minimize confounders. We will use a
decision neuroscience framework, combining model-based imaging with multilevel clinical, behavioral, and
cognitive assessments. We have established procedures to conduct this research in a safe, ethical manner.
The investigative team contributes complementary expertise in suicidal behavior and neurocognitive processes
(Szanto), in Pavlovian and instrumental reward learning and model-based imaging (Dombrovski, Hallquist),
social decision-making (Crockett), analysis of neural and longitudinal data (Galfalvy), decision neuroscience and
...

## Key facts

- **NIH application ID:** 10006898
- **Project number:** 5R01MH085651-11
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Katalin Szanto
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $756,185
- **Award type:** 5
- **Project period:** 2010-09-15 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10006898

## Citation

> US National Institutes of Health, RePORTER application 10006898, Decision Processes of Late-Life Suicide:  Competitive Renewal (5R01MH085651-11). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10006898. Licensed CC0.

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