About the Project
As individuals age, there is an increased likelihood that they will develop multiple chronic physical conditions, such as diabetes, chronic obstructive pulmonary disease, and heart failure. As such chronic conditions are associated with depression, reduced quality of life, perceptions of being a burden, social isolation, and problems tolerating physical pain, elderly people with physical multi-morbidity are at increased risk of developing suicidal thoughts, feelings and behaviours. This is a serious concern especially as the population is getting older. However, some people with very debilitating conditions do not go on to experience suicidal thoughts and behaviours. It is important to understand this resilience.
Overarching objectives:
1) To establish what factors underpin and improve psychological resilience to suicidality in older people with multi-morbidity
2) To develop psychological interventions which both nurture and amplify resilience in this population.
Research questions:
1. What are the factors which underlie resilience to suicidal thoughts and behaviours in older people with physical multi-morbidity?
2. Can resilience to suicidal thoughts, plans and acts be developed and amplified in this population using psychological therapeutic techniques?
A service-user reference group will be formed at the outset of this PhD and will feed into the research process. All studies will recruit people aged over 65 years, with two or more chronic physical conditions who have experienced suicidal thoughts and/or behaviours recently. Three studies will follow a systematic review.
Study 1 will use qualitative methods and analyses (e.g., thematic analysis) to address the first research question. It is anticipated that the topic guide will explore triggers for suicidal thoughts and plans and factors which negated those thoughts and plans. Study 2 will build on the findings of study 1, and use experience sampling (a contemporary diary method) to investigate which psychological factors counter suicidality when physical systems range from mild to severe. Study 3 addresses the second research question and will develop a set of brief psychological techniques to boost psychological resilience in older people with physical multi-morbidity.
We anticipate being able to devise techniques, such as Broad Minded Affective Coping which seeks to use all senses in boosting positive affect via intensive recall of positive memories, and "if-then" planning to troubleshoot times of greatest physical and psychological challenges. These techniques will be evaluated using a multiple baseline case-series design with two groups of participants. The treatment group will receive our new bespoke intervention. The control group will practice relaxation techniques.
http://www.manchester.ac.uk/research/patricia.a.gooding/
http://www.manchester.ac.uk/research/maria.panagioti/
http://www.manchester.ac.uk/research/Chris.armitage/
http://www.manchester.ac.uk/research/sarah.peters/
Funding Notes
This project is to be funded under the MRC Doctoral Training Partnership. If you are interested in this project, please make direct contact with the Principal Supervisor to arrange to discuss the project further as soon as possible. You MUST also submit an online application form, full details on how to apply can be found on our website https://www.bmh.manchester.ac.uk/study/research/funded-programmes/mrc-dtp/.
Applications are invited from UK/EU nationals only. Applicants must have obtained, or be about to obtain, at least an upper second class honours degree (or equivalent) in a relevant subject.
References
1. Armitage, C. J., Abdul Rahim, W., Rowe, R., & O’Connor, R. C. (2016). An exploratory randomized trial of a simple, brief psychological intervention to reduce subsequent suicidal ideation and behaviour in patients hospitalized for self-harm. The British Journal of Psychiatry, 208(5), 470-476.
2. Gooding, P., Tarrier, N., Dunn, G., Shaw, J., Awenat, Y., Ulph, F., & Pratt, D. (2015). Effect of hopelessness on the links between psychiatric symptoms and suicidality in a vulnerable population at risk of suicide. Psychiatry Research, 230(2), 464-471.
3. Littlewood, D., Gooding, P., Kyle, S., Pratt, D., & Peters, S. (2016). Personal models of the relationship between sleep disturbances and suicidal thoughts and feelings in people with unipolar depression. British Medical Journal: Open, 6(8), e012113.
4. Panagioti, M., Bower, P., Kontopantelis, E., & et al. (2016). Association between chronic physical conditions and the effectiveness of collaborative care for depression: An individual participant data meta-analysis. JAMA Psychiatry. doi: 10.1001/jamapsychiatry.2016.1794
5. Panagioti, M., Stokes, J., Esmail, A., Coventry, P., Cheraghi-Sohi, S., Alam, R....Bower, P. (2015) Multimorbidity and patient safety incidents in primary care: A systematic review and meta-analysis. PloS one 10 (8), e0135947.
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