Psychiatry and Psychology Commons^™

A Novel Approach To Identifying A Neuroimaging Biomarker For Patients With Serious Mental Illness, Alok Madan, J Christopher Fowler, Michelle A Patriquin, Ramiro Salas, Philip R Baldwin, Kenia M Velasquez, Humsini Viswanath, David L Molfese, Carla Sharp, Jon G Allen, Susan Hardesty, John M Oldham, B Christopher Frueh

Staff and Researcher Publications

Serious mental illness (SMI) is disabling, and current interventions are ineffective for many. This exploratory study sought to demonstrate the feasibility of applying topological data analysis (TDA) to resting-state functional connectivity data obtained from a heterogeneous sample of 235 adult inpatients to identify a biomarker of treatment response. TDA identified two groups based on connectivity between the prefrontal cortex and striatal regions: patients admitted with greater functional connectivity between these regions evidenced less improvement from admission to discharge than patients with lesser connectivity between them. TDA identified a potential biomarker of an attenuated treatment response among inpatients with SMI. Insofar …

Alcohol Use And Strenuous Physical Activity In College Students: A Longitudinal Test Of 2 Explanatory Models Of Health Behavior, Heather A. Davis, Elizabeth N. Riley, Gregory T. Smith, Richard S. Milich, Jessica L. Burris

Psychology Faculty Publications

Objective: To help clarify the effect of gender on the bidirectional relationship between alcohol use and strenuous physical activity in college students. Participants: Five hundred twenty-four (52% female) college students recruited in August 2008 and 2009 and followed up in April 2009 and April 2011, respectively. Methods: Participants reported their alcohol use and strenuous physical activity on 2 occasions (baseline and follow-up) spaced approximately 1 or 2 years apart. Results: For females, alcohol use quantity at baseline was associated with increased strenuous physical activity at 1- and 2-year follow-ups, and alcohol use frequency at baseline was …

Development Of A Measure Of Model Fidelity For Mental Health Crisis Resolution Teams, Brynmor Lloyd-Evans, Gary R. Bond, Torleif Ruud, Ada Ivanecka

Dartmouth Scholarship

Crisis Resolution Teams (CRTs) provide short-term intensive home treatment to people experiencing mental health crisis. Trial evidence suggests CRTs can be effective at reducing hospital admissions and increasing satisfaction with acute care. When scaled up to national level however, CRT implementation and outcomes have been variable. We aimed to develop and test a fidelity scale to assess adherence to a model of best practice for CRTs, based on best available evidence.

Circumcision Status Is Not Associated With Condom Use And Prevalence Of Sexually Transmitted Infections Among Young Black Msm, Richard A. Crosby, Cynthia A. Graham, Leandro Mena, William L. Yarber, Stephanie A. Sanders, Robin R. Milhausen, Angelica Geter

Health, Behavior & Society Faculty Publications

This study investigated whether intact young Black MSM differed from their circumcised counterparts regarding condom use behaviors and perceptions and HIV/Chlamydia/gonorrhea. Young Black MSM completed a self-interview, including a pictorial item assessing circumcision status and measures of condom use. Twenty-seven percent of 388 participants reported not being circumcised. With one exception, no associations tested approached significance. The mean frequency of unprotected insertive anal sex for circumcised men was about twice as high compared to those intact (P = .04). Intact young Black MSM did not differ from circumcised men relative to prevalence of STIs (including HIV) or condom use behaviors …

Ambivalence: Prerequisite For Success In Motivational Interviewing With Adolescents?, Sarah W. Feldstein Ewing, Timothy R. Apodaca, Jacques Gaume

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND AND AIMS: The exploration and resolution of ambivalence play an essential role in motivational interviewing (MI) theory. However, most adolescent MI studies have not examined ambivalence as a contributor to behaviour change. This paper reviewed research findings on the role of ambivalence in the adolescent change process.

METHODS AND RESULTS: We undertook a narrative review of the published empirical and theoretical literature on ambivalence and mechanisms of change in MI for adolescents and found that current MI evaluations appear not to have access to reliable and valid measures of ambivalence in adolescence or neuroimaging methods to evaluate the mechanisms …

Can Academic Medicine Lead The Way In The Refugee Crisis?, Amir A Afkhami

Psychiatry and Behavioral Sciences Faculty Publications

The world is currently in the midst of the largest refugee crisis since World War II, with the highest interval of mass displacement in recorded history according to the United Nations. The United States has pledged to maintain its position as one of the world's top resettlement countries in response to this crisis. These new immigrants will arrive with exceptional chronic and acute medical needs, including higher rates of behavioral health disorders. The author describes the health care challenges experienced by refugees seeking asylum in the United States and outlines the ways in which our health care system is currently …

The Influence Of Televised Food Commercials On Children's Food Choices: Evidence From Ventromedial Prefrontal Cortex Activations., Amanda S. Bruce, Stephen W. Pruitt, Oh-Ryeong Ha, J Bradley C Cherry, Timothy R. Smith, Jared M. Bruce, Seung-Lark Lim

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To investigate how food commercials influence children's food choices.

STUDY DESIGN: Twenty-three children ages 8-14 years provided taste and health ratings for 60 food items. Subsequently, these children were scanned with the use of functional magnetic resonance imaging while making food choices (ie, "eat" or "not eat") after watching food and nonfood television commercials.

RESULTS: Our results show that watching food commercials changes the way children consider the importance of taste when making food choices. Children did not use health values for their food choices, indicating children's decisions were largely driven by hedonic, immediate rewards (ie, "tastiness"); however, children …

Adverse Childhood Experiences, Support, And The Perception Of Ability To Work In Adults With Disability, Sophia Miryam Schüssler-Fiorenza Rose, Jessica G. Eslinger, Lindsey Zimmerman, Jamie Scaccia, Betty S. Lai, Catrin Lewis, Eva Alisic

Psychiatry Faculty Publications

Objective To examine the impact of adverse childhood experiences (ACEs) and support on self-reported work inability of adults reporting disability.

Participants Adults (ages 18-64) who participated in the Behavioral Risk Factor Surveillance System in 2009 or 2010 and who reported having a disability (n = 13,009).

Design and Main Outcome Measures The study used a retrospective cohort design with work inability as the main outcome. ACE categories included abuse (sexual, physical, emotional) and family dysfunction (domestic violence, incarceration, mental illness, substance abuse, divorce). Support included functional (perceived emotional/social support) and structural (living with another adult) support. Logistic regression was …

National Trends In Off-Label Use Of Atypical Antipsychotics In Children And Adolescents In The United States, Minji Sohn, Daniela C. Moga, Karen Blumenschein, Jeffery C. Talbert

Pharmacy Practice and Science Faculty Publications

The objectives of the study were as follows: to examine the national trend of pediatric atypical antipsychotic (AAP) use in the United States; to identify primary mental disorders associated with AAPs; to estimate the strength of independent associations between patient/provider characteristics and AAP use. Data are from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. First, average AAP prescription rates among 4 and 18-year-old patients between 1993 and 2010 were estimated. Second, data from 2007 to 2010 were combined and analyzed to identify primary mental disorders related to AAP prescription. Third, a multivariate logistic …

Music Therapy In Patients With Dementia And Behavioral Disturbance On An Inpatient Psychiatry Unit: Results From A Pilot Randomized Controlled Study., Joanna Thornley, Hussein Hirjee, Akshya Vasudev

Psychiatry Publications

The prevalence of dementia continues to grow worldwide due to an aging population and is projected to affect 65.7 million people by 2030 (World Health Organization, 2012). Behavioral and psychological symptoms of dementia (BPSD), including agitation, anxiety, aggression, depression, and psychosis, can occur in as much as 80% of the affected population, frequently necessitating psychiatric admission. Traditionally BPSD have been treated using pharmacological approaches. However, such medications could have serious adverse effects and additionally have limited efficacy in reducing such symptoms (Ballard et al., 2009).

The Behavioral Addiction Indoor Tanning Screener (Baits): An Evaluation Of A Brief Measure Of Behavioral Addictive Symptoms, Jerod L. Stapleton, Joel J. Hillhouse, Rob Turrisi, Katie Baker, Sharon L. Manne, Elliot J. Coups

ETSU Faculty Works

No abstract provided.

Juvenile Justice—Translational Research On Interventions For Adolescents In The Legal System (Jj-Trials): A Cluster Randomized Trial Targeting System-Wide Improvement In Substance Use Services, Danica K. Knight, Steven Belenko, Tisha Wiley, Angela A. Robertson, Nancy Arrigona, Michael Dennis, John P. Bartkowski, Larkin S. Mcreynolds, Jennifer E. Becan, Hannah K. Knudsen, Gail A. Wasserman, Eve Rose, Ralph Diclemente, Carl G. Leukefeld, Jj-Trials Cooperative

Behavioral Science Faculty Publications

Background: The purpose of this paper is to describe the Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) study, a cooperative implementation science initiative involving the National Institute on Drug Abuse, six research centers, a coordinating center, and Juvenile Justice Partners representing seven US states. While the pooling of resources across centers enables a robust implementation study design involving 36 juvenile justice agencies and their behavioral health partner agencies, co-producing a study protocol that has potential to advance implementation science, meets the needs of all constituencies (funding agency, researchers, partners, study sites), and can be implemented …

Similarities And Differences In Sexual Risk Behaviors Between Young Black Msm Who Do And Do Not Have Sex With Females, Richard A. Crosby, Leandro Mena, Angelica Geter, Demarc Hickson

Health, Behavior & Society Faculty Publications

The objective of this study is to determine whether young Black MSM who also have sex with females report similar levels of sexual risk behaviors as those not having sex with females. YBMSM (N = 400) were recruited from an STI clinic, located in the Southern U.S. Men completed an audio-computer assisted self-interview and donated specimens for STI/HIV testing. Forty-three percent recently engaged in penile-vaginal sex. They were less likely to report having concurrent partners (P = .01), unprotected fellatio (P = .04), multiple partners as a bottom (P < .02), any unprotected anal sex as a bottom (P < .013), and any anal sex (P = .007). They were equally likely …

Managing Agitation Associated With Schizophrenia And Bipolar Disorder In The Emergency Setting, Scott Zeller, Leslie Citrome

NYMC Faculty Publications

INTRODUCTION: Patient agitation represents a significant challenge in the emergency department (ED), a setting in which medical staff are working under pressure dealing with a diverse range of medical emergencies. The potential for escalation into aggressive behavior, putting patients, staff, and others at risk, makes it imperative to address agitated behavior rapidly and efficiently. Time constraints and limited access to specialist psychiatric support have in the past led to the strategy of "restrain and sedate," which was believed to represent the optimal approach; however, it is increasingly recognized that more patient-centered approaches result in improved outcomes. The objective of this …

Colorectal Cancer Prevention: Perspectives Of Key Players From Social Networks In A Low-Income Rural Us Region, Nancy E. Schoenberg, Kathryn Eddens, Adam Jonas, Claire Snell-Rood, Christina R. Studts, Benjamin Broder-Oldach, Mira L. Katz

Behavioral Science Faculty Publications

Social networks influence health behavior and health status. Within social networks, “key players” often influence those around them, particularly in traditionally underserved areas like the Appalachian region in the USA. From a total sample of 787 Appalachian residents, we identified and interviewed 10 key players in complex networks, asking them what comprises a key player, their role in their network and community, and ideas to overcome and increase colorectal cancer (CRC) screening. Key players emphasized their communication skills, resourcefulness, and special occupational and educational status in the community. Barriers to CRC screening included negative perceptions of the colonoscopy screening procedure, …

Which Individual Therapist Behaviors Elicit Client Change Talk And Sustain Talk In Motivational Interviewing?, Timothy R. Apodaca, Kristina M. Jackson, Brian Borsari, Molly Magill, Richard Longabaugh, Nadine R. Mastroleo, Nancy P. Barnett

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To identify individual therapist behaviors which elicit client change talk or sustain talk in motivational interviewing sessions.

METHOD: Motivational interviewing sessions from a single-session alcohol intervention delivered to college students were audio-taped, transcribed, and coded using the Motivational Interviewing Skill Code (MISC), a therapy process coding system. Participants included 92 college students and eight therapists who provided their treatment. The MISC was used to code 17 therapist behaviors related to the use of motivational interviewing, and client language reflecting movement toward behavior change (change talk), away from behavior change (sustain talk), or unrelated to the target behavior (follow/neutral).

RESULTS: …

Understanding And Meeting Information Needs For Patients With Posttraumatic Stress Disorder, Bradley V. Watts, Maha H. Zayed, Hilary Llewellyn-Thomas, Paula P. Schnurr

Dartmouth Scholarship

Background:

Posttraumatic Stress Disorder (PTSD) is a commonly occurring mental illness. There are multiple treatments for PTSD that have similar effectiveness, but these treatments differ substantially in other ways. It is desirable to have well-informed patients involved in treatment choices. A patient decision aid (PtDA) is one method to achieve this goal. This manuscript describes the rationale and development of a patient decision aid (PtDA) designed for patients with PTSD.

Methods:

We conducted an informational needs assessment of veterans (n = 19) to obtain their baseline information needs prior to the development of the PtDA. We also conducted a …

Transdiagnostic Psychiatric Symptoms And Event-Related Potentials Following Rewarding And Aversive Outcomes, Jeffrey S. Bedwell, Geoffrey Potts, Diane C. Gooding, Benjamin J. Trachik, Chi C. Chan, Christopher C. Spencer

Psychology Faculty Publications

There is a need for a better understanding of transdiagnostic psychiatric symptoms that relate to neurophysiological abnormalities following rewarding and aversive feedback in order to inform development of novel targeted treatments. To address this need, we examined a transdiagnostic sample of 44 adults (mean age: 35.52; 57% female), which consisted of individuals with broadly-defined schizophrenia-spectrum disorders (n = 16), bipolar disorders (n = 10), other mood and anxiety disorders (n = 5), and no history of a psychiatric disorder (n = 13). Participants completed a Pavlovian monetary reward prediction task during 32-channel electroencephalogram recording. We assessed the event-related potentials (ERPs) …

Depressive Symptoms In Children With Chronic Kidney Disease., Amy J. Kogon, Matthew B. Matheson, Joseph T. Flynn, Arlene C. Gerson, Bradley A. Warady, Susan L. Furth, Stephen R. Hooper, Chronic Kidney Disease In Children (Ckid) Study Group

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To assess depression in children with chronic kidney disease and to determine associations with patient characteristics, intellectual and educational levels, and health-related quality of life (HRQoL).

STUDY DESIGN: Subjects aged 6-17 years from the Chronic Kidney Disease in Children cohort study completed the Children's Depression Inventory (CDI), Wechsler Abbreviated Scales of Intelligence, Wechsler Individual Achievement Test-II-Abbreviated, and the Pediatric Inventory of Quality of Life Core Scales 4.0. Regression analyses determined associations of CDI score and depression status with subject characteristics, intellectual and educational levels, and HRQoL. A joint linear mixed model and Weibull model were used to determine the …

The Happy Older Latinos Are Active (Hola) Health Promotion And Prevention Study: Study Protocol For A Pilot Randomized Controlled Trial, Daniel E. Jimenez, Charles F. Reynolds, Margarita Alegría, Philip Harvey, Stephen Bartels

Dartmouth Scholarship

Results of previous studies attest to the greater illness burden of common mental disorders (anxiety and depression) in older Latinos and the need for developing preventive interventions that are effective, acceptable, and scalable. Happy Older Latinos are Active (HOLA) is a newly developed intervention that uses a community health worker (CHW) to lead a health promotion program in order to prevent common mental disorders among at-risk older Latinos. This pilot study tests the feasibility and acceptability of delivering HOLA to older, at-risk Latinos.

Methods/Design: HOLA is a multi-component, health promotion intervention funded by the National Institute of Mental Health (NIMH). …

The Visual Priming Of Motion-Defined 3d Objects, Xiong Jiang, Yang Jiang, Raja Parasuraman

Behavioral Science Faculty Publications

The perception of a stimulus can be influenced by previous perceptual experience, a phenomenon known as perceptual priming. However, there has been limited investigation on perceptual priming of shape perception of three-dimensional object structures defined by moving dots. Here we examined the perceptual priming of a 3D object shape defined purely by motion-in-depth cues (i.e., Shape-From-Motion, SFM) using a classic prime-target paradigm. The results from the first two experiments revealed a significant increase in accuracy when a "cloudy" SFM stimulus (whose object structure was difficult to recognize due to the presence of strong noise) was preceded by an unambiguous SFM …

Trends In Psychotropic Dispensing Among Older Adults With Dementia Living In Long-Term Care Facilities: 2004-2013., Akshya Vasudev, Salimah Z Shariff, Kuan Liu, Amer M Burhan, Nathan Herrmann, Sean Leonard, Muhammad Mamdani

Psychiatry Publications

OBJECTIVE: Guidelines worldwide have cautioned against the use of antipsychotics as first-line agents to treat neuropsychiatric symptoms of dementia. We aimed to investigate the changes over time in the dispensing of antipsychotics and other psychotropics among older adults with dementia living in long-term care facilities.

METHODS: We used drug claims data from Ontario, Canada, to calculate quarterly rates of prescription dispensing of six psychotropic drug classes among all elderly (≥65 years of age) long-term care residents with dementia from January 1, 2004, to March 31, 2013. Psychotropic drugs were classified into the following categories: atypical and conventional antipsychotics, non-sedative and …

A Piece Of My Mind. A Piece Of My Mind--Actually., Herbert M. Adler

Department of Psychiatry and Human Behavior Faculty Papers

No abstract provided.

How Clinicians Feel About Working With Spouses Of The Chronically Ill, Douglas Ingram

NYMC Faculty Publications

Clinicians who provide psychotherapy to spouses or partners of the chronically ill were solicited through listserves of psychodynamic and other organizations. The current report excluded those therapists working with spouses of dementia patients. Interviews were conducted with clinicians who responded. The interviews highlight the challenges commonly encountered by psychotherapeutic work with this cohort of therapy patients. A comparison is drawn that shows both overlap and distinctions between the experiences of those therapists engaging with spouses of chronically ill patients without a dementing process and those working with spouses of chronically ill patients who do suffer from a dementing process.

Maternal Psychiatric Disease And Epigenetic Evidence Suggest A Common Biology For Poor Fetal Growth, Timothy H. Ciesielski, Carmen J. Marsit, Scott M. Williams

Dartmouth Scholarship

We sought to identify and characterize predictors of poor fetal growth among variables extracted from perinatal medical records to gain insight into potential etiologic mechanisms. In this process we reevaluated a previously observed association between poor fetal growth and maternal psychiatric disease. We evaluated 449 deliveries of >36 weeks gestation that occurred between 9/2008 and 9/2010 at the Women and Infants Hospital in Providence Rhode Island. This study group was oversampled for Small-for-Gestational-Age (SGA) infants and excluded Large-for-Gestational-Age (LGA) infants. We assessed the associations between recorded clinical variables and impaired fetal growth: SGA or Intrauterine Growth Restriction (IUGR) diagnosis. After …

Belief About Nicotine Selectively Modulates Value And Reward Prediction Error Signals In Smokers, Xiaosi Gu, Terry Lohrenz, Ramiro Salas, Philip R. Baldwin, Alireza Soltani

Dartmouth Scholarship

Little is known about how prior beliefs impact biophysically described processes in the presence of neuroactive drugs, which presents a profound challenge to the understanding of the mechanisms and treatments of addiction. We engineered smokers' prior beliefs about the presence of nicotine in a cigarette smoked before a functional magnetic resonance imaging session where subjects carried out a sequential choice task. Using a model-based approach, we show that smokers' beliefs about nicotine specifically modulated learning signals (value and reward prediction error) defined by a computational model of mesolimbic dopamine systems. Belief of "no nicotine in cigarette" (compared with "nicotine in …

Wordless Intervention For Epilepsy In Learning Disabilities (Wield): Study Protocol For A Randomized Controlled Feasibility Trial, Marie-Anne Durand, Bob Gates, Georgina Parkes, Asif Zia

Dartmouth Scholarship

Epilepsy is the most common neurological problem that affects people with learning disabilities. The high seizure frequency, resistance to treatments, associated skills deficit and co-morbidities make the management of epilepsy particularly challenging for people with learning disabilities. The Books Beyond Words booklet for epilepsy uses images to help people with learning disabilities manage their condition and improve quality of life. Our aim is to conduct a randomized controlled feasibility trial exploring key methodological, design and acceptability issues, in order to subsequently undertake a large-scale randomized controlled trial of the Books Beyond Words booklet for epilepsy.

Pharmacokinetic And Pharmacodynamic Interactions Between Antiepileptics And Antidepressants, Domenico Italiano, Edoardo Spina, Jose De Leon

Psychiatry Faculty Publications

INTRODUCTION: Antiepileptic-antidepressant combinations are frequently used by clinicians; their pharmacokinetic (PK) and pharmacodynamic (PD) drug interactions (DIs) have not been well studied but are frequently likely to be clinically relevant.

AREAS COVERED: This article provides a comprehensive review of PK DIs between antiepileptics and antidepressants. In the absence of PD DI studies, PD information on pharmacological mechanisms and studies on efficacy and safety of individual drugs are reviewed.

EXPERT OPINION: The clinical relevance of the inductive properties of carbamazepine, phenytoin, phenobarbital and primidone and the inhibitory properties of valproic acid and some antidepressants are well understood; correction factors are provided …

Psychiatry And Efforts To Build Community In Iraq., Amir A Afkhami

Psychiatry and Behavioral Sciences Faculty Publications

No abstract provided.

Intervention Impact On Depression Product Appraisal And Purchasing Behavior By Employers: A Randomized Trial, Kathryn M. Rost, Donna Marshall, Stanley Xu

Mental Health Law & Policy Faculty Publications

Background: Employers can purchase high quality depression products that provide the type, intensity and duration of depression care management shown to improve work outcomes sufficiently for many employers to achieve a return on investment. The purpose of this randomized controlled trial was to test an intervention to encourage employers to purchase a high quality depression product for their workforce.

Methods: Twenty nine organizations recruited senior health benefit professional members representing public or private employers who had not yet purchased a depression product for all 100+ workers in their company. The research team used randomization blocked by company size to …