Michael Travis - Academia.edu (original) (raw)
Papers by Michael Travis
Psychopharmacology, 2001
Head-twitch behavior (HTR) is the behavioral signature of psychedelic drugs upon stimulation of t... more Head-twitch behavior (HTR) is the behavioral signature of psychedelic drugs upon stimulation of the serotonin 5-HT 2A receptor (5-HT 2A R) in rodents. Following the previous report of a semi-automated detection of HTR based on the dynamics of mouse's head movement, here we present a system for the identification of individual HTR events in a fully automated fashion. The validity of this fully automated HTR detection system was tested with the psychedelic drug DOI in 5-HT 2A R-Ko mice, and via evaluation of potential sources of false-positive and false-negative HTR events. The increased throughput in data processing achieved via automation afforded the possibility of conducting otherwise time consuming HTR time-course studies. To further assess the versatility of our system, we also explored the pharmacological interactions between 5-HT 2A R and the metabotropic glutamate receptor 2 (mGluR2). Our data demonstrate the potentiation effect of the mGluR2/3 antagonist LY341495 on DOI-induced HTR, as well as the HTR-blocking effect of the mGluR2/3 agonist and antipsychotic drug in development LY404039. This fully automated system can contribute to speed up our understanding of 5-HT 2A R's pharmacology and its characteristic behavioral outputs in rodents. The study of rodent behavior has experienced in recent years a significant degree of automation, which is consonant with the demand of reproducibility in biomedical research 1. The outcomes of rodent behavior studies are sensitive to a number of biases emerging from laboratory idiosyncrasies and analyst's expectations that can affect the output of behavior assessment in traditional scoring by direct observation. As a consequence, elimination of the observer via automation offers both a greater degree of homogeneity in the execution of behavioral techniques and significant increases of data throughput by enabling the processing of larger datasets that would otherwise be unfeasible or extremely time consuming 1,2. Classic hallucinogens, also known as psychedelics, such as lysergic acid diethylamide (LSD), psilocybin (and its active dephosphorylated metabolite psilocin), mescaline and (±)-2,5-dimethoxy-4-iodoamphetamine (DOI), induce profound alterations in human perception, cognition, emotion and sense of self 3,4. In rodents, psychedelics produce a characteristic side-to-side movement of the head commonly known as head-twitch response (HTR). This characteristic behavior is not induced by other psychoactive drugs, such as cocaine, phencyclidine (PCP), scopolamine, or amphetamine, and is thus widely employed to study the behavioral pharmacology of psychedelics in rodent models 5-7. Previous findings based on both pharmacological blockade with relatively selective serotonin 5-HT 2A receptor (5-HT 2A R) antagonists, such as volinanserin (M100907) and ketanserin, and genetic deletion of certain G protein-coupled receptors (GPCRs) in knockout (KO) mice have provided convincing evidence that the HTR induced by psychedelics is at least in part mediated via serotonin 5-HT 2A R-dependent signaling 5,8-13. Regarding the subjective effects of psychedelics, analogous findings have been observed in healthy volunteers. Thus, administration of the 5-HT 2A R antagonist ketanserin prevented the psychedelic effects of psilocybin and LSD in humans 14-16. Our previous work focused on the fundamental paradox that all known hallucinogens, such as LSD, mescaline and
Psychopharmacology, 2001
Head-twitch behavior (HTR) is the behavioral signature of psychedelic drugs upon stimulation of t... more Head-twitch behavior (HTR) is the behavioral signature of psychedelic drugs upon stimulation of the serotonin 5-HT 2A receptor (5-HT 2A R) in rodents. Following the previous report of a semi-automated detection of HTR based on the dynamics of mouse's head movement, here we present a system for the identification of individual HTR events in a fully automated fashion. The validity of this fully automated HTR detection system was tested with the psychedelic drug DOI in 5-HT 2A R-Ko mice, and via evaluation of potential sources of false-positive and false-negative HTR events. The increased throughput in data processing achieved via automation afforded the possibility of conducting otherwise time consuming HTR time-course studies. To further assess the versatility of our system, we also explored the pharmacological interactions between 5-HT 2A R and the metabotropic glutamate receptor 2 (mGluR2). Our data demonstrate the potentiation effect of the mGluR2/3 antagonist LY341495 on DOI-induced HTR, as well as the HTR-blocking effect of the mGluR2/3 agonist and antipsychotic drug in development LY404039. This fully automated system can contribute to speed up our understanding of 5-HT 2A R's pharmacology and its characteristic behavioral outputs in rodents. The study of rodent behavior has experienced in recent years a significant degree of automation, which is consonant with the demand of reproducibility in biomedical research 1. The outcomes of rodent behavior studies are sensitive to a number of biases emerging from laboratory idiosyncrasies and analyst's expectations that can affect the output of behavior assessment in traditional scoring by direct observation. As a consequence, elimination of the observer via automation offers both a greater degree of homogeneity in the execution of behavioral techniques and significant increases of data throughput by enabling the processing of larger datasets that would otherwise be unfeasible or extremely time consuming 1,2. Classic hallucinogens, also known as psychedelics, such as lysergic acid diethylamide (LSD), psilocybin (and its active dephosphorylated metabolite psilocin), mescaline and (±)-2,5-dimethoxy-4-iodoamphetamine (DOI), induce profound alterations in human perception, cognition, emotion and sense of self 3,4. In rodents, psychedelics produce a characteristic side-to-side movement of the head commonly known as head-twitch response (HTR). This characteristic behavior is not induced by other psychoactive drugs, such as cocaine, phencyclidine (PCP), scopolamine, or amphetamine, and is thus widely employed to study the behavioral pharmacology of psychedelics in rodent models 5-7. Previous findings based on both pharmacological blockade with relatively selective serotonin 5-HT 2A receptor (5-HT 2A R) antagonists, such as volinanserin (M100907) and ketanserin, and genetic deletion of certain G protein-coupled receptors (GPCRs) in knockout (KO) mice have provided convincing evidence that the HTR induced by psychedelics is at least in part mediated via serotonin 5-HT 2A R-dependent signaling 5,8-13. Regarding the subjective effects of psychedelics, analogous findings have been observed in healthy volunteers. Thus, administration of the 5-HT 2A R antagonist ketanserin prevented the psychedelic effects of psilocybin and LSD in humans 14-16. Our previous work focused on the fundamental paradox that all known hallucinogens, such as LSD, mescaline and
NeuroImage. Clinical, 2018
The DSM-5 separates the diagnostic criteria for mood and behavioral disorders. Both types of diso... more The DSM-5 separates the diagnostic criteria for mood and behavioral disorders. Both types of disorders share neurocognitive deficits of executive function and reading difficulties in childhood. Children with dyslexia also have executive function deficits, revealing a role of executive function circuitry in reading. The aim of the current study is to determine whether there is a significant relationship of functional connectivity within the fronto-parietal and cingulo-opercular cognitive control networks to reading measures for children with mood disorders, behavioral disorders, dyslexia, and healthy controls (HC). Behavioral reading measures of phonological awareness, decoding, and orthography were collected. Resting state fMRI data were collected, preprocessed, and then analyzed for functional connectivity. Differences in the reading measures were tested for significance among the groups. Global efficiency (GE) measures were also tested for correlation with reading measures in 40 c...
NeuroImage. Clinical, 2017
Mood disorders and behavioral are broad psychiatric diagnostic categories that have different sym... more Mood disorders and behavioral are broad psychiatric diagnostic categories that have different symptoms and neurobiological mechanisms, but share some neurocognitive similarities, one of which is an elevated risk for reading deficit. Our aim was to determine the influence of mood versus behavioral dysregulation on reading ability and neural correlates supporting these skills in youth, using diffusion tensor imaging in 11- to 17-year-old children and youths with mood disorders or behavioral disorders and age-matched healthy controls. The three groups differed only in phonological processing and passage comprehension. Youth with mood disorders scored higher on the phonological test but had lower comprehension scores than children with behavioral disorders and controls; control participants scored the highest. Correlations between fractional anisotropy and phonological processing in the left Arcuate Fasciculus showed a significant difference between groups and were strongest in behavior...
JAMA Psychiatry, 2017
As psychiatrists, we are asked to treat patients with extremely complex illnesses. There are many... more As psychiatrists, we are asked to treat patients with extremely complex illnesses. There are many possible ways to think about and formulate cases, including a range of psychological and social perspectives, each with their own strengths and limitations. To varying degrees, these perspectives have rightfully guided the development of our field and continue to shape the standards of our practice. During the past 20 years, revolutionary new tools and approaches in neuroscience have led to unprecedented progress in our ability to understand the biological underpinnings of psychiatric illnesses. 1 This work very much complements rather than competes with our other rich traditions. In fact, distinctions between "psychological" and "biological" are rapidly fading as evidence demonstrates that all effective treatments (whether psychotherapy or pharmacologic agents) alter core brain networks and thus are all biological in nature. 2 Cognitive neuroscience is providing contemporary neural system models for understanding psychodynamic concepts such as our sense of self, defenses and drives, and unconscious thoughts and motivations. 1 In addition, an understanding of epigenetics offers novel insights into how social context and environmental factors translate into biological changes at the level of gene expression. 3 Collectively, these advances offer a new framework for drawing together the seemingly diverse perspectives of a traditional biopsychosocial formulation. 4 They present an opportunity to create a new dialogue with our patients, their families, and other health care professionals about the cause and meaning of psychiatric symptoms. They ground psychiatric disorders and associated maladaptive behaviors in the context of a brain disease and away from issues of character and moral fiber that often drive the shame, blame, and stigma many patients face. While many of these findings have not yet translated into novel therapeutic approaches, they can still guide and inform our treatment choices. For example, understanding the role that fear conditioning and learning plays in posttraumatic stress disorder helps to clarify why trauma-focused psychotherapies are currently our most effective treatments. 5,6 Despite the relevance of neuroscience to the practice of psychiatry, figuring out how to best integrate this perspective into our field remains a challenge. 7 Psychiatry has been a well-established clinical discipline since long before we had the power to study the brain in a nuanced manner, let alone to develop sophisticated biological explanations of psychiatric illness. Accordingly, it is no surprise that such a large practice gap should exist: although mental illness is increasingly understood in terms of genetics, developmental neurobiology, and underlying neural circuitry, these essential perspectives are
Biological Psychiatry, 2017
Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, Jun 18, 2016
Over the past 25 years, the roles of physicians as clinicians, educators, and administrators in a... more Over the past 25 years, the roles of physicians as clinicians, educators, and administrators in academic medicine have received increasing attention [1, 2]. Awareness of the complex nature of this career path has also been heightened [3]. A review of the literature revealed several types of programs intended to help Clinician Educator (CE) faculty with career development and advancement. The first type of program, available through universities or professional organizations, is open to applicants from a variety of disciplines [4]. The second type of program, developed at several academic medical centers, focuses on comprehensive development of physician faculty members across medical school departments [5]. These types of programs typically provide a certificate or advanced degree in medical education. They also require significant financial and time commitments from departments and participants, including protected time from clinical work. A third type of program emphasizes peer mentorship and skill building. These programs, which require less financial and time commitment than the first two types, have generally been grass roots programs developed by faculty members within a department [6]. More recently, departments are developing systematic programs for their early career faculty members with a focus on skill development and mentorship and guided by the expertise of more senior faculty [7]. In developing the Clinician Educator Faculty Development Program (CEFDP), we evaluated these program models and designed a program that was focused within our Department, required relatively few resources and required limited time investment. The program was encouraged and supported by the Department Chair and hospital leadership and expanded on our Department’s CE development track for residents [8, 9]. This paper describes the development of a CEFDP pilot in our Department of Psychiatry from 2012 to 2013. We provide an overview of the program’s conceptualization, implementation, and evaluation, as well as reflections on lessons learned in the process that may be instructive to other departments seeking to pursue similar initiatives.
Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 2016
Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, Jan 3, 2016
Thank you Dr. Nasca for the opportunity to participate in the Accreditation Council for Graduate ... more Thank you Dr. Nasca for the opportunity to participate in the Accreditation Council for Graduate Medical Education (ACGME) plan to review the accreditation requirements for resident duty hours and key dimensions of the learning and working environment. Needless to say, the American Association of Directors of Psychiatric Residency Training (AADPRT) has a very compelling interest in this area as we share with you a dedication to quality in residency education. We are pleased to take this opportunity to share our thoughts with you. Of the points you requested we address, I would like to begin with the last and say that we are very much willing to participate in a Resident Duty Hours in the Learning and Working Environment Congress, to be held in March 2016 in Chicago, Illinois. To prepare a response to your questions, we surveyed our members to assure that the opinions we present adequately represent the views of a majority of our members. The survey was completed in January 2016, with 225 responses. Of those responding, 203 are program directors; 70 % of these direct general psychiatry programs, and most of the rest direct child and adolescent fellowship programs. Thus, we believe this to be a representative sample of our members. We asked our members questions in several domains. Although we understand the ACGME has asked about both duty hours and other key dimensions of the learning and working environment, we focused on duty hours as being the most controversial issue in residency training. What follows is a summary of the questions and responses, with an accompanying discussion and comparison with the literature.
Academic Psychiatry, 2016
This study reports the academic outcomes, including scholarly productivity, of the graduates of o... more This study reports the academic outcomes, including scholarly productivity, of the graduates of one residency training track for future clinician educators and academic administrators. Since its implementation in 2008, the Academic Administrator, Clinician Educator (AACE) track at Western Psychiatric Institute and Clinic - UPMC has grown in popularity with reports of participants achieving post-graduate academic success; however, there has been no prior assessment of outcomes. In 2015 all graduates of the track were surveyed using an anonymous, web-based survey. Twenty-nine total graduates were surveyed RESULTS: Twenty-four graduates responded to the survey (83% response rate). The graduates are very active in academic psychiatry with 23 (96%) holding an academic appointment with different administrative roles, medical director (50%) and training director (17%) being the most frequent. Participants have also been active in pursuing scholarship with 80% presenting their scholarly projects at local and national conferences and producing post-graduate, peer-reviewed articles (50%). This study underscores the benefits of a clinician educator track and suggests areas for future growth.
PloS one, 2016
High comorbidity among pediatric disorders characterized by behavioral and emotional dysregulatio... more High comorbidity among pediatric disorders characterized by behavioral and emotional dysregulation poses problems for diagnosis and treatment, and suggests that these disorders may be better conceptualized as dimensions of abnormal behaviors. Furthermore, identifying neuroimaging biomarkers related to dimensional measures of behavior may provide targets to guide individualized treatment. We aimed to use functional neuroimaging and pattern regression techniques to determine whether patterns of brain activity could accurately decode individual-level severity on a dimensional scale measuring behavioural and emotional dysregulation at two different time points. A sample of fifty-seven youth (mean age: 14.5 years; 32 males) was selected from a multi-site study of youth with parent-reported behavioral and emotional dysregulation. Participants performed a block-design reward paradigm during functional Magnetic Resonance Imaging (fMRI). Pattern regression analyses consisted of Relevance Vec...
Journal of Labelled Compounds and Radiopharmaceuticals Q24, 1999
In Journal of Psychopharmacology, 1998
Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, Jan 30, 2015
The authors sought to demonstrate the feasibility of integrating small private online course (SPO... more The authors sought to demonstrate the feasibility of integrating small private online course (SPOC) technology with flipped classroom techniques in order to improve neuroscience education across diverse training sites. Post-graduate medical educators used SPOC web conferencing software and video technology to implement an integrated case conference and in-depth neuroscience discussion. Ten psychiatry training programs from across the USA and from two international sites took part in the conference. Feedback from participants was largely positive. This pilot demonstrated the feasibility of such a program and provided a diverse audience with the opportunity to engage in an interactive learning experience with expert faculty discussants. This may be a useful model for programs with limited local expertise to expand their teaching efforts in a wide range of topics.
Asian Journal of Psychiatry, 2015
This is an extraordinary time for psychiatry, as new research in neuroscience is re-defining the ... more This is an extraordinary time for psychiatry, as new research in neuroscience is re-defining the essence of how we conceptualize psychiatric illness. In this issue, Torous et al. (2015) have written a significant paper that captures at once the excitement of new work in the field and the importance of meaningfully incorporating this perspective into both clinical and educational settings. The authors also review some of the many challenges to doing so effectively. The authors’ work comes at a time when many academics are wrestling with this same question and the authors refer to various ongoing efforts seeking to address this practice gap. One such program is the National Neuroscience Curriculum Initiative (Ross et al., 2015; www.NNCIonline.org). The NNCI was formally launched in March of 2014 with the overarching goal of creating a set of open resources that will help improve the teaching of neuroscience in psychiatry. Similar to Torous et al.’s goal of helping trainees ‘‘bridge, in real-time, brain-symptom relationships in psychiatry’’, the NNCI sets as a central objective that ‘‘residents will incorporate a modern neuroscience perspective as a core component of every formulation and treatment plan.’’ Additional learning objectives relate to relevant knowledge, attitudes towards neuroscience, and specific behavioral skills – including that residents will be able to serve as Ambassadors of Neuroscience who can thoughtfully communicate findings from the field to different audiences. The core work of the NNCI has been the creation of educational resources that can be used as in-class teaching and learning activities for residency programs. The guiding principles for these resources are: to maintain an integrative, patient centered approach; to teach well, by applying adult learning theory; and
Schizophrenia Research, 2003
Psychopharmacology, 2001
Head-twitch behavior (HTR) is the behavioral signature of psychedelic drugs upon stimulation of t... more Head-twitch behavior (HTR) is the behavioral signature of psychedelic drugs upon stimulation of the serotonin 5-HT 2A receptor (5-HT 2A R) in rodents. Following the previous report of a semi-automated detection of HTR based on the dynamics of mouse's head movement, here we present a system for the identification of individual HTR events in a fully automated fashion. The validity of this fully automated HTR detection system was tested with the psychedelic drug DOI in 5-HT 2A R-Ko mice, and via evaluation of potential sources of false-positive and false-negative HTR events. The increased throughput in data processing achieved via automation afforded the possibility of conducting otherwise time consuming HTR time-course studies. To further assess the versatility of our system, we also explored the pharmacological interactions between 5-HT 2A R and the metabotropic glutamate receptor 2 (mGluR2). Our data demonstrate the potentiation effect of the mGluR2/3 antagonist LY341495 on DOI-induced HTR, as well as the HTR-blocking effect of the mGluR2/3 agonist and antipsychotic drug in development LY404039. This fully automated system can contribute to speed up our understanding of 5-HT 2A R's pharmacology and its characteristic behavioral outputs in rodents. The study of rodent behavior has experienced in recent years a significant degree of automation, which is consonant with the demand of reproducibility in biomedical research 1. The outcomes of rodent behavior studies are sensitive to a number of biases emerging from laboratory idiosyncrasies and analyst's expectations that can affect the output of behavior assessment in traditional scoring by direct observation. As a consequence, elimination of the observer via automation offers both a greater degree of homogeneity in the execution of behavioral techniques and significant increases of data throughput by enabling the processing of larger datasets that would otherwise be unfeasible or extremely time consuming 1,2. Classic hallucinogens, also known as psychedelics, such as lysergic acid diethylamide (LSD), psilocybin (and its active dephosphorylated metabolite psilocin), mescaline and (±)-2,5-dimethoxy-4-iodoamphetamine (DOI), induce profound alterations in human perception, cognition, emotion and sense of self 3,4. In rodents, psychedelics produce a characteristic side-to-side movement of the head commonly known as head-twitch response (HTR). This characteristic behavior is not induced by other psychoactive drugs, such as cocaine, phencyclidine (PCP), scopolamine, or amphetamine, and is thus widely employed to study the behavioral pharmacology of psychedelics in rodent models 5-7. Previous findings based on both pharmacological blockade with relatively selective serotonin 5-HT 2A receptor (5-HT 2A R) antagonists, such as volinanserin (M100907) and ketanserin, and genetic deletion of certain G protein-coupled receptors (GPCRs) in knockout (KO) mice have provided convincing evidence that the HTR induced by psychedelics is at least in part mediated via serotonin 5-HT 2A R-dependent signaling 5,8-13. Regarding the subjective effects of psychedelics, analogous findings have been observed in healthy volunteers. Thus, administration of the 5-HT 2A R antagonist ketanserin prevented the psychedelic effects of psilocybin and LSD in humans 14-16. Our previous work focused on the fundamental paradox that all known hallucinogens, such as LSD, mescaline and
Psychopharmacology, 2001
Head-twitch behavior (HTR) is the behavioral signature of psychedelic drugs upon stimulation of t... more Head-twitch behavior (HTR) is the behavioral signature of psychedelic drugs upon stimulation of the serotonin 5-HT 2A receptor (5-HT 2A R) in rodents. Following the previous report of a semi-automated detection of HTR based on the dynamics of mouse's head movement, here we present a system for the identification of individual HTR events in a fully automated fashion. The validity of this fully automated HTR detection system was tested with the psychedelic drug DOI in 5-HT 2A R-Ko mice, and via evaluation of potential sources of false-positive and false-negative HTR events. The increased throughput in data processing achieved via automation afforded the possibility of conducting otherwise time consuming HTR time-course studies. To further assess the versatility of our system, we also explored the pharmacological interactions between 5-HT 2A R and the metabotropic glutamate receptor 2 (mGluR2). Our data demonstrate the potentiation effect of the mGluR2/3 antagonist LY341495 on DOI-induced HTR, as well as the HTR-blocking effect of the mGluR2/3 agonist and antipsychotic drug in development LY404039. This fully automated system can contribute to speed up our understanding of 5-HT 2A R's pharmacology and its characteristic behavioral outputs in rodents. The study of rodent behavior has experienced in recent years a significant degree of automation, which is consonant with the demand of reproducibility in biomedical research 1. The outcomes of rodent behavior studies are sensitive to a number of biases emerging from laboratory idiosyncrasies and analyst's expectations that can affect the output of behavior assessment in traditional scoring by direct observation. As a consequence, elimination of the observer via automation offers both a greater degree of homogeneity in the execution of behavioral techniques and significant increases of data throughput by enabling the processing of larger datasets that would otherwise be unfeasible or extremely time consuming 1,2. Classic hallucinogens, also known as psychedelics, such as lysergic acid diethylamide (LSD), psilocybin (and its active dephosphorylated metabolite psilocin), mescaline and (±)-2,5-dimethoxy-4-iodoamphetamine (DOI), induce profound alterations in human perception, cognition, emotion and sense of self 3,4. In rodents, psychedelics produce a characteristic side-to-side movement of the head commonly known as head-twitch response (HTR). This characteristic behavior is not induced by other psychoactive drugs, such as cocaine, phencyclidine (PCP), scopolamine, or amphetamine, and is thus widely employed to study the behavioral pharmacology of psychedelics in rodent models 5-7. Previous findings based on both pharmacological blockade with relatively selective serotonin 5-HT 2A receptor (5-HT 2A R) antagonists, such as volinanserin (M100907) and ketanserin, and genetic deletion of certain G protein-coupled receptors (GPCRs) in knockout (KO) mice have provided convincing evidence that the HTR induced by psychedelics is at least in part mediated via serotonin 5-HT 2A R-dependent signaling 5,8-13. Regarding the subjective effects of psychedelics, analogous findings have been observed in healthy volunteers. Thus, administration of the 5-HT 2A R antagonist ketanserin prevented the psychedelic effects of psilocybin and LSD in humans 14-16. Our previous work focused on the fundamental paradox that all known hallucinogens, such as LSD, mescaline and
NeuroImage. Clinical, 2018
The DSM-5 separates the diagnostic criteria for mood and behavioral disorders. Both types of diso... more The DSM-5 separates the diagnostic criteria for mood and behavioral disorders. Both types of disorders share neurocognitive deficits of executive function and reading difficulties in childhood. Children with dyslexia also have executive function deficits, revealing a role of executive function circuitry in reading. The aim of the current study is to determine whether there is a significant relationship of functional connectivity within the fronto-parietal and cingulo-opercular cognitive control networks to reading measures for children with mood disorders, behavioral disorders, dyslexia, and healthy controls (HC). Behavioral reading measures of phonological awareness, decoding, and orthography were collected. Resting state fMRI data were collected, preprocessed, and then analyzed for functional connectivity. Differences in the reading measures were tested for significance among the groups. Global efficiency (GE) measures were also tested for correlation with reading measures in 40 c...
NeuroImage. Clinical, 2017
Mood disorders and behavioral are broad psychiatric diagnostic categories that have different sym... more Mood disorders and behavioral are broad psychiatric diagnostic categories that have different symptoms and neurobiological mechanisms, but share some neurocognitive similarities, one of which is an elevated risk for reading deficit. Our aim was to determine the influence of mood versus behavioral dysregulation on reading ability and neural correlates supporting these skills in youth, using diffusion tensor imaging in 11- to 17-year-old children and youths with mood disorders or behavioral disorders and age-matched healthy controls. The three groups differed only in phonological processing and passage comprehension. Youth with mood disorders scored higher on the phonological test but had lower comprehension scores than children with behavioral disorders and controls; control participants scored the highest. Correlations between fractional anisotropy and phonological processing in the left Arcuate Fasciculus showed a significant difference between groups and were strongest in behavior...
JAMA Psychiatry, 2017
As psychiatrists, we are asked to treat patients with extremely complex illnesses. There are many... more As psychiatrists, we are asked to treat patients with extremely complex illnesses. There are many possible ways to think about and formulate cases, including a range of psychological and social perspectives, each with their own strengths and limitations. To varying degrees, these perspectives have rightfully guided the development of our field and continue to shape the standards of our practice. During the past 20 years, revolutionary new tools and approaches in neuroscience have led to unprecedented progress in our ability to understand the biological underpinnings of psychiatric illnesses. 1 This work very much complements rather than competes with our other rich traditions. In fact, distinctions between "psychological" and "biological" are rapidly fading as evidence demonstrates that all effective treatments (whether psychotherapy or pharmacologic agents) alter core brain networks and thus are all biological in nature. 2 Cognitive neuroscience is providing contemporary neural system models for understanding psychodynamic concepts such as our sense of self, defenses and drives, and unconscious thoughts and motivations. 1 In addition, an understanding of epigenetics offers novel insights into how social context and environmental factors translate into biological changes at the level of gene expression. 3 Collectively, these advances offer a new framework for drawing together the seemingly diverse perspectives of a traditional biopsychosocial formulation. 4 They present an opportunity to create a new dialogue with our patients, their families, and other health care professionals about the cause and meaning of psychiatric symptoms. They ground psychiatric disorders and associated maladaptive behaviors in the context of a brain disease and away from issues of character and moral fiber that often drive the shame, blame, and stigma many patients face. While many of these findings have not yet translated into novel therapeutic approaches, they can still guide and inform our treatment choices. For example, understanding the role that fear conditioning and learning plays in posttraumatic stress disorder helps to clarify why trauma-focused psychotherapies are currently our most effective treatments. 5,6 Despite the relevance of neuroscience to the practice of psychiatry, figuring out how to best integrate this perspective into our field remains a challenge. 7 Psychiatry has been a well-established clinical discipline since long before we had the power to study the brain in a nuanced manner, let alone to develop sophisticated biological explanations of psychiatric illness. Accordingly, it is no surprise that such a large practice gap should exist: although mental illness is increasingly understood in terms of genetics, developmental neurobiology, and underlying neural circuitry, these essential perspectives are
Biological Psychiatry, 2017
Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, Jun 18, 2016
Over the past 25 years, the roles of physicians as clinicians, educators, and administrators in a... more Over the past 25 years, the roles of physicians as clinicians, educators, and administrators in academic medicine have received increasing attention [1, 2]. Awareness of the complex nature of this career path has also been heightened [3]. A review of the literature revealed several types of programs intended to help Clinician Educator (CE) faculty with career development and advancement. The first type of program, available through universities or professional organizations, is open to applicants from a variety of disciplines [4]. The second type of program, developed at several academic medical centers, focuses on comprehensive development of physician faculty members across medical school departments [5]. These types of programs typically provide a certificate or advanced degree in medical education. They also require significant financial and time commitments from departments and participants, including protected time from clinical work. A third type of program emphasizes peer mentorship and skill building. These programs, which require less financial and time commitment than the first two types, have generally been grass roots programs developed by faculty members within a department [6]. More recently, departments are developing systematic programs for their early career faculty members with a focus on skill development and mentorship and guided by the expertise of more senior faculty [7]. In developing the Clinician Educator Faculty Development Program (CEFDP), we evaluated these program models and designed a program that was focused within our Department, required relatively few resources and required limited time investment. The program was encouraged and supported by the Department Chair and hospital leadership and expanded on our Department’s CE development track for residents [8, 9]. This paper describes the development of a CEFDP pilot in our Department of Psychiatry from 2012 to 2013. We provide an overview of the program’s conceptualization, implementation, and evaluation, as well as reflections on lessons learned in the process that may be instructive to other departments seeking to pursue similar initiatives.
Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 2016
Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, Jan 3, 2016
Thank you Dr. Nasca for the opportunity to participate in the Accreditation Council for Graduate ... more Thank you Dr. Nasca for the opportunity to participate in the Accreditation Council for Graduate Medical Education (ACGME) plan to review the accreditation requirements for resident duty hours and key dimensions of the learning and working environment. Needless to say, the American Association of Directors of Psychiatric Residency Training (AADPRT) has a very compelling interest in this area as we share with you a dedication to quality in residency education. We are pleased to take this opportunity to share our thoughts with you. Of the points you requested we address, I would like to begin with the last and say that we are very much willing to participate in a Resident Duty Hours in the Learning and Working Environment Congress, to be held in March 2016 in Chicago, Illinois. To prepare a response to your questions, we surveyed our members to assure that the opinions we present adequately represent the views of a majority of our members. The survey was completed in January 2016, with 225 responses. Of those responding, 203 are program directors; 70 % of these direct general psychiatry programs, and most of the rest direct child and adolescent fellowship programs. Thus, we believe this to be a representative sample of our members. We asked our members questions in several domains. Although we understand the ACGME has asked about both duty hours and other key dimensions of the learning and working environment, we focused on duty hours as being the most controversial issue in residency training. What follows is a summary of the questions and responses, with an accompanying discussion and comparison with the literature.
Academic Psychiatry, 2016
This study reports the academic outcomes, including scholarly productivity, of the graduates of o... more This study reports the academic outcomes, including scholarly productivity, of the graduates of one residency training track for future clinician educators and academic administrators. Since its implementation in 2008, the Academic Administrator, Clinician Educator (AACE) track at Western Psychiatric Institute and Clinic - UPMC has grown in popularity with reports of participants achieving post-graduate academic success; however, there has been no prior assessment of outcomes. In 2015 all graduates of the track were surveyed using an anonymous, web-based survey. Twenty-nine total graduates were surveyed RESULTS: Twenty-four graduates responded to the survey (83% response rate). The graduates are very active in academic psychiatry with 23 (96%) holding an academic appointment with different administrative roles, medical director (50%) and training director (17%) being the most frequent. Participants have also been active in pursuing scholarship with 80% presenting their scholarly projects at local and national conferences and producing post-graduate, peer-reviewed articles (50%). This study underscores the benefits of a clinician educator track and suggests areas for future growth.
PloS one, 2016
High comorbidity among pediatric disorders characterized by behavioral and emotional dysregulatio... more High comorbidity among pediatric disorders characterized by behavioral and emotional dysregulation poses problems for diagnosis and treatment, and suggests that these disorders may be better conceptualized as dimensions of abnormal behaviors. Furthermore, identifying neuroimaging biomarkers related to dimensional measures of behavior may provide targets to guide individualized treatment. We aimed to use functional neuroimaging and pattern regression techniques to determine whether patterns of brain activity could accurately decode individual-level severity on a dimensional scale measuring behavioural and emotional dysregulation at two different time points. A sample of fifty-seven youth (mean age: 14.5 years; 32 males) was selected from a multi-site study of youth with parent-reported behavioral and emotional dysregulation. Participants performed a block-design reward paradigm during functional Magnetic Resonance Imaging (fMRI). Pattern regression analyses consisted of Relevance Vec...
Journal of Labelled Compounds and Radiopharmaceuticals Q24, 1999
In Journal of Psychopharmacology, 1998
Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, Jan 30, 2015
The authors sought to demonstrate the feasibility of integrating small private online course (SPO... more The authors sought to demonstrate the feasibility of integrating small private online course (SPOC) technology with flipped classroom techniques in order to improve neuroscience education across diverse training sites. Post-graduate medical educators used SPOC web conferencing software and video technology to implement an integrated case conference and in-depth neuroscience discussion. Ten psychiatry training programs from across the USA and from two international sites took part in the conference. Feedback from participants was largely positive. This pilot demonstrated the feasibility of such a program and provided a diverse audience with the opportunity to engage in an interactive learning experience with expert faculty discussants. This may be a useful model for programs with limited local expertise to expand their teaching efforts in a wide range of topics.
Asian Journal of Psychiatry, 2015
This is an extraordinary time for psychiatry, as new research in neuroscience is re-defining the ... more This is an extraordinary time for psychiatry, as new research in neuroscience is re-defining the essence of how we conceptualize psychiatric illness. In this issue, Torous et al. (2015) have written a significant paper that captures at once the excitement of new work in the field and the importance of meaningfully incorporating this perspective into both clinical and educational settings. The authors also review some of the many challenges to doing so effectively. The authors’ work comes at a time when many academics are wrestling with this same question and the authors refer to various ongoing efforts seeking to address this practice gap. One such program is the National Neuroscience Curriculum Initiative (Ross et al., 2015; www.NNCIonline.org). The NNCI was formally launched in March of 2014 with the overarching goal of creating a set of open resources that will help improve the teaching of neuroscience in psychiatry. Similar to Torous et al.’s goal of helping trainees ‘‘bridge, in real-time, brain-symptom relationships in psychiatry’’, the NNCI sets as a central objective that ‘‘residents will incorporate a modern neuroscience perspective as a core component of every formulation and treatment plan.’’ Additional learning objectives relate to relevant knowledge, attitudes towards neuroscience, and specific behavioral skills – including that residents will be able to serve as Ambassadors of Neuroscience who can thoughtfully communicate findings from the field to different audiences. The core work of the NNCI has been the creation of educational resources that can be used as in-class teaching and learning activities for residency programs. The guiding principles for these resources are: to maintain an integrative, patient centered approach; to teach well, by applying adult learning theory; and
Schizophrenia Research, 2003