About

Our Research

Katalin Szántó founded the Longitudinal Research Program in Late-Life Suicide at the University of Pittsburgh to understand the interacting risk and protective factors related to biological and psychosocial factors of aging that lead to the elevated suicide rate in late-life. Known clinical and psychosocial suicide risk factors have low predictive value, and provide little insight into the high suicide rate in the elderly. Moreover only a small minority of those who contemplate suicide proceed to suicidal behavior, but traditional risk factors for suicide poorly distinguish between suicide ideators and suicide attempters and do not take into consideration the heterogeneity of suicidal behavior. In addition to a cross-sectional study of decision processes associated with late-life suicidal behavior, we conduct a longitudinal study of late-life suicide attempters, which provides a unique opportunity to evaluate the predictive value of these risk factors on prospectively assessed suicidal behavior. We use neurocognitive assessments, game theory experiments, and decision process measures to understand how cognitive abilities and decision making contribute to suicide risk.

While prior research from the Pittsburgh Longitudinal Research Program in Late-Life Suicide has identified distinct suicidal ideation trajectories and more stable longer-term suicide risk factors in late-life depression, there is a need to better understand dynamic proximal predictors to suicide risk in older adults. In collaboration with Dr. Sarah Stahl, the RISE (Rhythm after Loss and for Improving Suicide Risk in Elders) study will investigate proximal suicide risk factors (such as social isolation, sleep, and Rest-Activity Rhythm) in a group of adults ages 65 years and older who suffered the loss of their life-partner or spouse over the past year. We know from previous work that older adults (particularly men) are most at risk for death by suicide, and that after the death of a spouse, 20-35% older bereaved individuals experience depression, suicidal thoughts, and loneliness. Limited social connectedness is associated with suicidal ideation, non-fatal suicidal behavior, and suicide in later life. Bereavement causes sudden changes to older adults’ social connections — noted as a prominent protective factor to suicide. Some bereaved individuals never re-establish prior daily routines, have poor sleep, and circadian rhythm disruptions. Sleep disturbances are a well-established correlate of suicide ideation and behavior in older adults. Through a “behavioral probe”, a healthy life-style intervention, we will attempt to mitigate/restore the effects of disruption caused by spousal loss. We will recruit older adults who are at a higher risk for suicide due to a prior history of depression or suicidal behavior or current depressive symptoms. The study will use longitudinal observation and behavioral probe methods to determine whether directly targeting social disconnectedness decreases suicide risk among older bereaved spouses.

Why Suicide Research is Important

Worldwide, suicide rates are higher in older adults than in any other age group. Moreover, suicide attempts in late life are more lethal: 1 in 4 older adults who attempt suicide will die (compared to 1 in 200 youth). However, unsettlingly little is known about the complex causes of suicide in this at-risk population.

The media and even medical professionals often focus on precipitating factors: economic hardship, social adversity, or physical illnesses. However, as most people facing these circumstances will never attempt suicide, there must be a lock-and-key interaction, where the impact of stressors are moderated by individual vulnerability.

Moreover, the suicidal crisis is time-limited and people often question their own decision to die by suicide. One of our goals is to understand why some people with suicidal thoughts make a suicide attempt while others do not. Few people contemplate suicide (suicide ideators), and even fewer still will go on to have an attempt (suicide attempters). Traditional suicide risk factors poorly distinguish between these two groups. Understanding the transition between suicidal thoughts and suicidal behavior is critical to understanding and preventing suicide in late life.

Our research aims to understand risk and protective factors related to the changing biological, psychological, and social factors that lead to higher rates of suicide in late life. We investigate whether the salience of specific suicide risk factors changes across the adult life cycle. For example, we have uncovered that some suicide risk factors mark life-long vulnerabilities and help to understand pathways to suicidal behavior across the life span, while others are age-specific and increase risk only for certain age groups.

Currently, in our 12-year longitudinal study, we study the role of cognition, decision-making, clinical and neurocognitive characteristics in late life. Our research is made possible through our large group of participating older adults both with and without depression and suicidal thoughts or behaviors.

New Pilot Study

Our group recently received funding from the National Institute of Mental Health to study “short-term variability in affect and rest-activity rhythms in long-term chronic and highly variable suicidal ideation in depressed older adults.” Research has found that in geriatric populations, changes in sleep are closely related to mood changes including depression and, in some individuals, suicidal ideation. This research extends and builds on our previous findings that identified longitudinal ideation profiles that convey the differential risks of future suicidal behavior.

This supplement will be a 3-week pilot study measuring daily affect and rest-activity rhythms using digital monitoring and actigraphy in two high-suicide risk groups, chronic severe ideators, and highly variable ideators, as well as in a low-suicide risk group with no/minimal ideation. This study is led by experts in the areas of late-life depression, suicide, and sleep research to study the extent to which severity and variability in affect, inter-daily stability of the 24-hour rest-activity rhythm, and overall sleep health relate to suicide risk among depressed older adults.

Our Funding Sources












Location

Our lab is located on the 7th floor of the Bellefield Towers, at the center of Oakland, Pittsburgh
Our address is:
100 N Bellefield Ave.
Pittsburgh, PA 15213




Contact Us

Phone Number: (412) 301-3277
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